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410 Statement of Organization Recipient Committee – TerminationStatement of Organization Recipient Committee Statement Type ❑ Initial Not yetquaiified ❑ or Date qualified as committee NAME OF COMMITTEE ❑ Amendment List I.D. number: Date qualified as committee (If applicable) ® Termination - See Part 5 List I.D. number: REC # 1376003 in the ` 12 ®,SY' /2017 Date of Termination Cupertino Residents for Sensible Zoning Action Committee STREET ADDRESS (NO P.O. BOX) 18691 Newsom Avenue CITY STATE ZIP CODE AREA CODE/PHONE CA DIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Dec/2012) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc-ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Cupertino Residents for Sensible Zoning Action Committee • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE SAN K ACCOUNT NUM BER Pending ID # ADDRESS CIZY STATE ZIPCODE Page 2 LD.NUMBER +' _.i' t i }„ T f'COI1f1(1111tt@e:,Coi11 lE!te tlle'a IICa�?IE' SQGtlOhS + + YI?F., r R Pp„ >....,.+.v,.. _ ,: ... ,.x. ..� -. .,.�.. e 10111111111111 • 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 parry 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 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) CANDIDATE(S) OFFICE SOUG HT OR HELD OR M EASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITYOR COUNTY, ASAPPLICABLE) PARTY CHECK ONE SUPPORT OPPOSE SUn OPPOSE FPPC Form 410 (Dec/MZ) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER Cupertino Residents for Sensible Zoning Action Committee r r • Not formed to support or appose specific candidates or measures in a single election. Check only one box: ® CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY We are focused on engaging residents and our city government to balance growth and quality of life for residents of Cupertino. • List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREETADDRESS NO. AND 57REET CITY STATE ZIP CODE Small• r •r Committee❑ Date qualified .. .,. .,... -.e ,� L:r S:+Term natiloW a uirements a ,51 rnn the:.Verlfica,,on .the reasurer .assls#ant:treascrer. antl/or.;candldaYe officeholder; or roponent celtlf}+ahat all of, the following condinons:have been met ' �p ....::n.,. ::......> ,,.:.e,c.. _•;...,:., . ....:::.. i-y.g �,. ..:.<.,,a,._. �.4.. ,., i.�....h. .,, .... ,.... ,w_ ,.n.... ,�ii..... ,., ... p:N.,....,, • 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 (Dec/2012) FPPC Advice: advice@fppc ca-gov (866/275-3772) www.fppc.ca.gov