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Home My WebLink About410 Statement of Organization Recipient Committee - Tracy Kosolcharoen for Cupertino City Council 2026 _Amendment Stamped by SOS 06.09.2026Statement of Organization Recipient Committee Statement Type ❑ Initial COMMITTEE ® Amendment I❑ Termination — See Part 5 i] Not yet qualified ar ❑ Date qualification threshold met Date qualification threshold met 26 I D. Number #1490745 Tracy Kosolcharoen for Cupertino City Council 2026 STREET ADDRESS INO P.D. BOX] CITY STATE ZIP CODE AREA CODE/PHONE Cupertino CA 95014 FULL MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS OF COMMITTEE {REQUIREDI J FAX (OPTIONAL) COUNTY OFDOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Santa Clara County City of Cupertino Date of termination NAME DR TREASURER Tracy Kosolcharoen Date Stamp DIGITALLY RECEIVED AND FILED in the office of the California Secretary of State JUN 09 2026 STREET ADDRESS (ND P.O. BOX] EMAIL ADDRESS OF TR EASURER {REQUIRED] NAME OF ASSISTANT TREASURER, If ANY STREET ADDRESS INO P.O. BOX) EMAIL ADDRESS OF ASSISTANTTREASORER IR€QUIRED) CITY Cupertino c TTY JUN 252026 CUPERTLNO CITECLERK STATE ZIP CODE CA 95014 AREA CODE/PITON 408- ZIP CODE AR EA COOS/PHONE NAME OF PRINCIPAL OFFICEA]SI Tracy Kosolcharoen STREET ADDRESS I NO P.O. BOX) CITY STATE ZIP CODE 1169 CA 95014 EMAIL ADDRESS OF PRINCLPALOFFICER{S] (REQUIRED) AREA CODE/PHONE Attach additional information on appropriately labeled continuation sheets. tracy4cupertino@gmail. 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. Digitally on BY DATE 5EGNATORf OFCDNTROLEING OFFICEHOLDER, CAN DIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATOREOF CONTROLLINGOFFICEHOLDER,C4NDIGATE, OR STATE PAUSUREPI00 NEAT Executed on DATE By SIGNATURE OFEONTROLLING OFFICEHOLDER. CANDIOATE,OR STATE MEASURE PROPONENT FPPC Form 410 (October/202) FPPC Advice: aduicef5fp c.r_a,gov ( 6f 275.3772) www.fopc.ca.Eoy Statement of Organization Recipient Committee I NSTR UCTlON5 ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Tracy Kosolcharoen for Cupertino City Council 2026 #1490745 All committees must Iist the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records. NAME OF FINANCIAL INSTITUTION AND PERSONL51 AUTHORIZED TO OBTAIN BANK RECORDS AREA CODE/PHONE BANK ACCOUNT NUMBER West Coast Community Bank 1(408) 777-0233 ADDRESS OF FINANCIAL INSTITUTION CITY STATE 21P CODE Cupertino CA 95014 • 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." Stating "No party preference" is acceptable. If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT IINCLUDE DISTRICT NUMBER IF APPLICABLE i ELECTION CHECK ONE Tracy Kosolcharoen Cupertino City Councilmember 242E Nonpartisan Partisan (list politicaI party below) VI Nonpartisan Partisan (list political party below) Primarily formed to supportor oppose specific candidates or measures in a single election. List below: CANDIDATES) NAME OR MEASUREIS) FULL TITLE{INCLUDE BALL0TNO. OR LETTER) CARD IDATES}OFFICE SOUGHT OR HELD OR MEAS{J RE[5}JURISDICTJON IF A RECALL, STATE "RECALL" IN FRONT OF THE 0 FFICEHOLDER'S NAME. IINCLUDE DISTRICT NO.. CITY OR COUNTY AS APPLICARLF I FPPC Form 410 (October/2023) FPPC Advice: advice@fnoc.ca.gov (866/275-37721 www.fDoc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE :OMMITTEE NAME Tracy Kosolcharoen for Cupertino City Council 2026 Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee O COUNTY Committee ❑ STATE Committee PeoV IDE BRIEF DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR STREETAOORESS NO. AND STREET CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR Page 3 I.D. NUM8ER #1490745 STATE ZIP CODE AREA CODE/PHONE 5. Termination Requirements By signing the verifacationr the treasurer, assistant treasurer and}or candidate, officeholder, or panent certify that all of the foI lowing cc nditions have been met.- a , •- • 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 tOctoberf2023) FPPC Advice: advice@fopc.ca.eov {866/275-3772} www.flspc.ca.gov Tracy Kosolcharoen for Cupertino City Council 2026, FPPC #1490745 Note to Form 410 Amendment- Reason for new qualification dale was a bounced check, which took weeks to process. The campaign is now qualified above the threshold as of June 9th, 2026. Signed — Tracy Kosolcharoen