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410 Statement of Organization Recipient Committee – Termination Stamped by SOSStatement of Organization CEIVl:ff.(Nb FILI Recipient Committee ~ 1 office of the Secr!§ttry ofl 5tatement Type .-~-1-ni-ti_a_l ---------r-□-A-m-en_d_m-en_t ____ -r~-x-~-e-rm-in_a_ti -on---S-e_e_P_a_rt...;.5~ of th e Slate of Oallfomla ® Not yet qualified or JAN 27 2021 2 ~ 20 21 0 Date qualification threshold met Date qualification thres hold met Date of termination Cl., NAME OF COMM ITTEE NAME OF TREASURER CUPERTINO CHAMBER OF COMMERCE PAC RICHARD ABDALAH -ST-R-EE_T_A_D_D-RE-SS-(:-N-O-P.-0 -. B-□--,X):----------------------------- STREET ADDRESS (NO P.O. BOX) CUPERTINO FULL MAILI NG ADDRESS (IF DIFFERENT) E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL) SANTA CLARA STATE ZI P CODE AREA CODE/PHONE CA 95014 (408)252-7054 JUR ISDICTION WHERE COMMITTEE IS ACT IVE CITY OF CUPERTINO Attach additional information on appropriately labeled continuation sheets. ~.~gtifiriatibn 20455 SILVERADO AVENUE STATE ZIP CODE CUPERTINO CA 95014 NAME OF ASSISTANT TREASURER, IF ANY JAMES SUTTON ST REET ADDR ESS (ND P.O. BOX) STATE ZIP CODE SAN FRANCISCO CA 94108 NAME OF PRINCIPAL OFFICER(S) KEVIN MCCLELLAND STRE ET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE CUPERTINO CA 95014 I have used all reasona e i igence in preparing t is statement an tot e est o my now e get e in ormation containe erein 1s true an compete. penalty of pe rj ury under the laws of the State of TREASURER Executed on ______ 0 A_T_E _____ By----------------------------=-----------:-:-:--:-::----------- s 1GNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By-------------------------------------------SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Exec uted on DATE By------------------------------------------------------- AREA CODE/PHONE (408)252 -7054 AREA CODE/PHONE (415)732-7700 AREA CODE/PHONE s1GNArnRE 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 netfi/e .com Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAM E CUPERTINO CHAMBER OF COMMERCE PAC 2a. Additional Officers I Assistant Treasurers NAME RICHARD ABDALAH MAILING ADDRESS CITY CUPERTINO NAME MAILING ADDRESS CITY NAME MAILING ADDRESS CITY NAME MAILING ADDR ESS CITY STATE CA STATE STATE STATE ZIP CODE 95014 ZIP CODE ZIP CODE ZIP CODE AREA CODE/PHONE (408)252 -7054 AREA CODE/PHONE AREA CODE/PHONE AREA CODE/PHONE NAME MAILING ADDRESS CITY NAME MAILING AD DRESS CITY NAME MAILING ADDRESS CITY NAME MAILING AD DRESS CITY 1299673 STATE ZIP CODE AR EA CODE/PHONE STATE ZIP CODE AREA CODE/PHONE STATE ZIP CO DE AREA CODE/PHONE STATE ZIP CODE AREA CODE/PHONE Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE CO M MITTEE NAME CUP ERTINO CHAMBER OF COMME RCE PAC • All committees must list the financial institution where the campaign bank account is located. NAM E O F FIN A NCIAL INSTITUTION AREA CODE /PHONE BANK OF THE WEST ( ZIP CODE CA 9 5 129 CALIFORNIA 410 FORM Page 3 o f 4 l.D. NUMBER 1 29967 3 • 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. NAME OF CANDIDATE/O FFICEHOLDER/STATE M EASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEA R OF ELECTION PARTY CHECK ONE Nonpartisan Partisan Nonpartisan Pa rtisan Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDID ATE(S) NAM E 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) (list political party below) (list pol itical party below) CHECK ON E I '""'"' I """ T OPPOSE . 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 General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: @ CITY Committee O COUNTY Committee O STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY TO SUPPORT LOCAL AND STATEWIDE CANDIDATES AND BALLOT MEASURES Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR CUPERTINO CHAMBER OF COMMERCE STREET ADDR ESS NO. AND STREET Small Contributor Committee o __ ; __ ; __ Date qualified INDUSTRY GROUP OR AFFILIATION OF SPONSOR CITY CUPERTINO • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; STATE CA • 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. ZIP CODE 95014 AREA CODE/PHONE 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 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov