HomeMy WebLinkAbout410 Statement of Organization Recipient Committee - Barry Chang For CIty Council 2024 - Termination filed 07.22.2026Statement of Organization
Recipient Committee
Date Stamp
RECEIVED
JUL 2 2 2026
CALIFORNIA 41 0
FORM
Statement Type .... l □-,n-i-tia-l-------~l----------.l-------------11 0 Amendment Iii Termination -See Part 5 For Official Use Onl y
0 Not yet qualified
or
0 Date qualification threshold met I Date qualification threshold met Date of termination
CUPERTINO CITY CLER}(
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(if applicable) _ -
NAME OF COMMITTEE NAME OF TREASURER
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STREET ADDRESS (NO P.O. BOX)
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STREET ADDRESS (NO P.O . BOX) EMAIL ADDRESS OF TREASURER (REQU IRED)
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NAME OF ASSISTANT TREASURER, IF ANY
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AREA CODE/PHONE STATE ZIP CODE
- hREETADDRESS(NOP.0.BOX)
FULL MAILING ADDRESS (IF DIFFERENT )
CITY STATE ZIP CODE
1----------------------------------------1 EMAIL ADDRESS OF ASSISTANT TREASURER (REQUIRED) AREA CODE/PHONE
E-MAIL ADDRESS OF COMMITTEE (REQUIRED)/ FA X (OPTIONAL)
I > NAME oF PRINCIPAL oFFICER(s)
COUNTY OF DOMICILE / JURISDICTION WHERE COMMITTEE IS ACTIVE
I _ 4:tJY,4 C-lk/Lk I O :e -r; Y o'{:--C1.A..,f l}-1< r ~tJ O I STREET ADDRESS (NO P.O. BOX)
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CITY -
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STATE
ZIP CODE
EMAIL ADDRESS OF PRINCIPAL OFFICER(S) (REQUIRED) AREA CODE /PHONE
Attach additional information on appropriately labeled continuation sheets.
I have used all reasonab le 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
:::::::,:::::... _______________ _
DATE
Execute d on
DATE
By ____________ .;_ ______________________________ _
SIGNATURE OF CONTROLLING OFF ICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE -------------=s'"1G"N.,.A"'T"'u-=R-=e""o"'F,...c"'o""'N"'T"'R""o"'L..,.L"1N'"G'"o=FF"1"'c""eH"o=LD""E"'R'",-=c"A""N-=D"'10"'A"'T"'E-, o"'R""'sT"'A"'T"'E"'M""E"'A"s"'u"'R"'E""P"'R"'o"'e"'o'"N"'E"'N"'T,------------
FPPC Form 410 (October/2023 )
FPPC Advice: advice@fppc .ca .gov (866/275-3772)
www.fppc.ca .gov
Statement of Organization
• Recip ient Committee
CALIFORNIA 410
FORM .
INSTRUCTIONS ON REVERSE
Page2
COMMITTEE NAME LD. NUMBER
CH 4Al01 Vot< e:i::-rv CloctfJ e,-i;L-2-o lt/-69tf3 ~
• All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records.
NAME OF FINANCIAL INSTITUTION AND PERSON (S) AUTHORIZED TO OBTAIN BANK RECORDS AREA CODE/PHONE BANK ACCOUNT NUMBER
I )-?---
ADDRESS OF FINANCIAL INSTITUTION CITY STATE ZIP CODE
i Controlled Committee
I
• 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 jointfy with another controlled committee, list the name and identification number of the other controlled committee .
N AME OF CANDIDATE/O FFICEHOLDER/STATE MEASURE PROPONENT
f>fr/J fl-j cw4,J~ pf2. C -Y <f u,"C,\./4] U [_,
~
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
~l,-12.. '( ~ /J 0 ~Tyu,u;JC-,;{___
I
YEAR OF
ELECTION
)---D --..,J./
PARTY
CHECK ONE
No~;5an Partisan
Nonpartisan Partisan
(list po litical pa rty be lo w )
(list political party be low)
Primarily Formed Committee , Primarily formed to support or oppose specific candidates or measures i n a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHEC K O N E
SU PPO RT OPPOSE
SUPPORT SUPPORT O PPOSE
FPPC Form 410 (October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3 772)
www.fppc .ca.go11
Statement of Organization
Re cipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
CALIFORNIA 410
FORM
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
0 CITY Committee O COUNTY Committee O STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SP ONSOR
STREET ADDRESS NO . AND STREET CITY STATE ZIP CODE AREA CODE /PHONE
Small Contributor Committee □--1--1--
Date qualified
:S. :Termination Require111ents ,> . By signing t~everitic_ation, the treasurer, assista _nt treasurer and/or candidate, officeholder, or ponent certify that all of the following _cC>n_ditions hav!? ~e~~,rri_e}_:_;.;.;;::~
• Th is committee has cease d to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in th e 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 re strictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to
Governme nt 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 (October/2023}
FPPC Advice: advice@fppc .ca.gov (866/275-3772)
www.fppc.ca.gov