410 Statement of Organization Recipient Committee – Amendment Stamped by SOS Statement of Organization
Recipient Committee
Statement Type ❑Initial ® Amendment
Not yet qualified ❑ or List I.D.number:
#1376003
01 /09 /2017
Date qualified as committee Date qualified as committee
(If applicable)
NAME OF COMMITTEE
Cupertino Residents for Sensible Zoning Action Committee
❑ Termination—See Part 5
Ust I.D.number:
#
STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 95014
MAILING ADDRESS(IF DIFFERENT)
FAX/E-MAIL ADDRESS
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Santa Clara Cupertino, CA
Attach additional information on appropriately labeled continuation sheets.
Date Stamp
DIVED Pw.
in th office of the Secretary of State
of the StG Of California
r i
Date of Termination
NAME OF TREASURER
Xiaowen Wan
=3 ,10
STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER,IF ANY
STREET ADDRESS(NO
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
Xiangchen Xu
STREET ADDRESS(NO P.O.BOX)
CITY
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I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the foregoing is true and correct.
1/ 17 Executed on By
DATE —
STATE MEASURE PROPONENT
Executed on
DATE
Executed on
DATE
By
By
SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIk '
Recipient Committee -
INSTRUCTIONS ON REVERSE
Page 2
M
MITTEE ME I.D.NUMBER
�U' RWir I5 Residents for Sensible Zoning Action Committee 1376003
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
ADDRESS
CITY
BANK ACCOUNT NUMBER
STATE ZIP CODE
• List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholder controlled,also list the elective office sought or held,and
district number,if any,and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check"nonpartisan."
• If this committee acts jointly with another controlled committee,list the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION
PARTY
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)NAME OR MEASURE(S)FULLTITLE(INCLUDE BALLOT NO.OR LETTER)
CAN DIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE)
CHECK ONE
FPPC Form 410(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(8661275-3772)
www.fppc.ca.gov
SUPPORT
OPPOSE
SUPPORT
OPPOSE
FPPC Form 410(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(8661275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Q�7{vj, qfy� } } }} Page3
C� odi LII IO Residents for Sensible Zoning Action Committee I.D.NUMBER
11376003
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑CITY Committee ❑ COUNTY Committee❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored List additional sponsors on an attachment.
NAMEOFSPONSOR
STREET ADDRESS NO.AND STREET
Date qualified
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE
.nl.r,.,
}
5<Term na. OnRc' Ulrem ntS:4 , , .B =st nin ,th verlfica a ah tre ur r.
., . tr n as a ssistanttreasurerand_or a drdate-officeholder or ro on ❑t, a ,_th .all.ofthe Ii , v �.� rv..
.
G,.,�,�.�>�
.a 1. « . , w fiw .aNrn d;�
• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in the future;
• This committee has eliminated or has no intention or ability to discharge all debts,loans received,and other obligations;
• This committee has no surplus funds;and
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
-- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519.
-- Leftover funds of ballot measure committees may be used for political,legislative or governmental purposes under Government Code Sections 89511-89518,and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov