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410 Statement of Organization Recipient Committee - Amendment add email address Statement of Organization Date Stamp Recipient Committee RECEIVED Statement Type ElInitial 0 Amendment ❑ .MOfffificial Termination—See Part 5 For Use Only Not yet qualified ❑ or List I.D.number: List I.D.number: K-144 I # 1376003 # MAR 9-�,-' 201 a I—! 03 /31 /2017 / / UPERTI O CITY CLE RK Date qualified as committee Date qualified as COMM ittee Date of Termination (If applicable) 1. Committee Information 2 Treasurer and Other Principal officers NAME OF COMMITTEE NAME OF TREASURER Cupertino Residents for Sensible Zoning Action Committee STREET ADDRESS(NO P.O.BOX) STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY STREET ADDRESS(NO P.O.BOX) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE Santa Clara County Cupertino, CA NAME OF PRINCIPAL OFFICER(S) Attach additional information on a STREET ADDRESS(NO P.O.BOX) f appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE 3. Verification 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. / Executed on / I �tJ) By / /DATE } OR ASSISTANT TREASURER Executed on ( t �/'>'Dt D f f DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on BY DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE 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