410 Statement of Organization Recipient Committee – Amendment Stamped by SOSStatement of Organizati1.s OPY D' ~ ~ ~ ~ ~ Date Stamp -~ ;·-,, Recipient Committee Q&iVED AND fl Statement Type D Initial 0 Amendment ollllll iftlft'Whrft"IIY Ir If tne ltltt ~, O!!Wamln D Not yet qualified ITV CLERK D Date q::lification threshold met Date qualification thresh CLJ ERTi NO C · · SEP 09 2022 ___ , ___ / __ _ 09 ,/ 06 / 2022 1.0. Number 1451685 (if applicable) NAME OF COMMITTEE Steven Scharf for Cupertino City Council STREET ADDRESS (NO P.O. BOX) 20183 Somerset Dr CITY STATE Cupertino CA FULL MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL) scharfcupertino2022@gmail.com ZIP CODE 95014 COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Santa Clara Cupertino AREA CODE/PHONE 408 202 7910 Attach additional information on appropriately labeled continuation sheets. 2. Treasurer and Other Prjncipal Officers NAME OF TREASURER Nicole Woon STREET ADDRESS (NO P.O. BOX) 20380 Stevens Creek BLVD Apf 312 CITY STATE Cupertino CA NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE NAME OF PRINCIPAL OFFICER(S) Steven Scharf STREET ADDRESS (NO P.O. BOX) 20183 Somerset Dr CITY STATE Cupertino CA SEP 19 2022 ZIP CODE 95014 . ZIP tODE ZIP CODE 95014 PA'l Of V'OTE:R;S ""'O:S,,i.'ii"Ac.1 '" [mi, AREA CODE/PHONE 408 784 0053 AREA CODE/PHONE AREA CODE/PHONE 408 202 7910 penalty of perjury under the laws of the St .. a~t~e ~o~f :C:a l~if~o~rn~i~a ~th~a~t~t~h:e~fo~r~e:g:o ·~in:g~is~t~r:u~e~n:.d~c:o~r §ctt~S.~~!!~====~J~,~Q~------Executed on Sep 06, 2022 By -DATE Executed on Sep 06, 2022 DATE Executed on DATE Executed on DATE By By By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT 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 CALIFORNIA 410 FORM . INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME 1.0. NUMBER Steven Scharf for Cupertino City Council 1451685 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Wells Fargo Bank 408 863 6100 8623229492 ADDRESS CITY STATE ZIP CODE 10260 S De Anza BL VD Cupertino CA 95014 Controlled Committee • 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/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY CHECK ONE Nonpartisan Steven Scharf Cupertino City Council Member 2022 v Nonpartisan Primarily Formed Committee 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) 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) Partisan Partisan (list political party below) (list political party below) CHECK ONE SUPPORT OPPOSE SUPPORT SUPPORT 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 CALIFORNIA 41 Q 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 SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Small Contributor Committee □ --.1--.1--Date qualified 5. Termination Requirements By signing th~ verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent certify that all ofthe following conditio~s have been met: • This committee has ceased to receive contributions and make expenditures; • 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 (August/2018) FPPC Advice: advice@fppc.ca.gov {866/275-3772) www.fppc.ca.gov