HomeMy WebLinkAbout410 Statement of Organization Recipient Committee - Amendment 02-25-19 - McCoy, RobertStatement of Organization a�P p� • - A '
Recipient Committee I CUEV • -
Statement Type ❑ Initial 0 Amendment ❑ Termination — See Par For Official Use Only
O Not yet qualified FEB 2 5 20�9
or
Q Date qualification threshold met Date qualification threshold met Date of termination
/ / 07 / 30 / 2014 / / CUPERTINO CITY CLERK
1. Committee Information I.D. Number 2. Treasurer and Other Principal Officers
(if applicable) 1369332
NAME OF COMMITTEE NAME OF TREASURER
ROBERT MCCOY FOR COUNCIL 2020 BLOSSOM MCCOY
STREET ADDRESS (NO P.O. BOX)
20488 STEVENS CREEK BLVD #1101
STREETADDRESS(NO P.O. BOX)
20488 STEVENS CREEK BLVD #1101
CITY STATE ZIP CODE AREA CODE/PHONE
CUPERTINO CA 95014 (408) 916-7558
FULL MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
COUNTY OF DOMICILE I JURISDICTION WHERE COMMITTEE IS ACTIVE
CITY STATE ZIP CODE AREA CODE/PHONE
CUPERTINO CA 95014 (408) 916-7558
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
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 foregoin is true and correct.
Executed on 02/22/2019 By �1�J Q c- �-,� C lam—^
DATE 111^41 SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on 02/22/2019 By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
ROBERT MCCOY FOR COUNCIL 2020
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION I AREA CODE/PHONE BANK ACCOUNT NUMBER
BANK OF AMERICA (408) 725-4228 325092739200
ADDRESS CITY STATE ZIP CODE
20563 STEVENS CREEK BLVD CUPERTINO CA 95014
4. Type of Committee Complete the applicable sections.
Page 2
I.D. NUMBER
1369332
• 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 (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION
CHECK ONE
Nonpartisan
Partisan
(list political party below)
ROBERT MCCOY
CITY COUNCIL
2020
❑✓
Nonpartisan
Partisan
(list political party below)
El
1:1
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IF A RFrA1 I cTATF "aFrAl I" IN FRnNT nF THE nFFICFHOI DFR'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHFf K ONE
SUPPORT
OPPOSE
SUPPORT
OPPOSE
FPPC Form 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov