410 Statement of Organization Recipient Committee_Termination 12.31.24_Sheila Mohan for Cupertino City Council 2022Statement of Organization
Recipient Committee
Date Stamp
. • _ .
-
Statement Type
For Official Use Only
❑ Initial ❑ Amendment
] Termination —see Part 5
Filed Date:
O Not yet qualified
12/30/2024 07:57
or
O Date qualification threshold met Date qualification threshold met
Date of Termination
PM
12/31/2024
1. Committee Information2.
Treasurer and Other Principal Officers
Bf aPPlicable)
NAME OF COMMITTEE
NAME OF TREASURER
Sheila Mohan For Cupertino City Council 2022
Ram Mohan
STREET ADDRESS (NO P.O. BOX) CITY
STATE ZIP CODE
Cupertino
CA 95014
STREET ADDRESS (NO P.O. BOX)
EMAIL ADDRESS OF TREASURER ( REQUIRED)
AREA CODE/PHONE
(
CITY STATE ZIP CODE AREACODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Cupertino CA 95014 (
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX) CITY
STATE ZIP CODE
E-MAIL ADDRESS OF COMMITTEE (REQUIRED) / FAX (OPTIONAL)
EMAIL ADDRESS OF ASSISTANT TREASURER (REQUIRED)
AREA CODE/PHONE
COUNTY OF DOMICILE
IURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
Santa Clara
STREET ADDRESS (NO P.O. BOX) CITY
STATE ZIP CODE
Attach additional information on appropriately labeled continuation sheets.
EMAIL ADDRESS OF PRINCIPAL OFFICER(S)(REQUIRED)
AREA CODE/PHONE
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 foregoing is true and correct.
Executed on 12/29/2024 By Ram
Executed on
Executed on
By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410(October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA '
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D. NUMBER
Sheila Mohan For Cupertino City Council 2022 1448574
• All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records.
NAME OFFINANCIAL INSTITUTION AND PERSON(S) AUTHORIZED TO OBTAIN BANK RECORDS AREA CODE/PHONE BANK ACCOUNT NUMBER
Wells Fargo Bank (
ADDRESS CITY STATE ZIP CODE
Cupertino CA 95014-4768
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 actsjointly 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 CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IFAPPLICABLE) ELECTION CHEK ONE
Ms Sheila Mohan
City Council Member City Cupertino
Nonpartisan
Partisan
(list political party below)
2022
0
❑
Nonpartisan
Partisan
(list political party below)
O
D
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULLTITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPPORT
OPPOSE
D
D
SUPPORT
OPPOSE
D
D
FPPC Form 410(October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee im,
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.D. NUMBER
Sheila Mohan For Cupertino City Council 2022 1448574
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRYGROUP OR AFFILIATION OF SPONSOR
STREETADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
Smafl Contributor Committee El
Date qualified
• 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 maybe 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