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410 Statement of Organization Recipient Committee - Initial not yet qualified Statement of Organization Date Stamp CALIFORNIA Recipient Committee D 1g © L? Ii U FORM 41 0 Statement Type ❑ Amendment El Termination—See Part 5 .1 For Official Use Only Initial Not yet qualified ® or List I.D.number: List I.D.number: JUN 302014 # # --/-/ /-/ -i-/ C PERTINO CITY CLERK Date qualified as committee Date qualified as committee Date of Termination (If applicable) 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER Hunsweck for City Council 2014 Michael Hunsweck STREET ADDRESS(NO P.O.BOX) STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE ( MAILING ADDRESS OF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE Santa Clara City of Cupertino NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS(NO P.O.BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE 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 foree oing is true and correct. Executed on 06/28/2014 By I„/��rE'N/J DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on 06/28/2014 9frierrist ii'4f+f4t.k - By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT FPPC Form 410(Dec/2012) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization CALIFORNIA 410 Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I .NUMBER Hunsweck for City Council 2014 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Bank of America ( ADDRESS CITY STATE ZIP CODE 4.Type of Committee Complete the applicable sections. 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.LC political party WILL WLItL COLL officeholder U.candidate is affiliated or check"nonpartisan." • 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 NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY ® Nonpartisan Michael Hunsweck Cupertino City Councilmember 2014 ❑ 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) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE SUPPORT OPPOSE 0 SUPPORT OPPOSE FPPC Form 410(Dec/2012) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization CALIFORNIA 410 Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D.NUMBER Hunsweck for City Council 2014 4.Type of Committee (Continued) General Purpose Committee 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 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 Small Contributor Committee El Date qualified 5.Termination Requirements By signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that all of the following conditions 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(Dec/2012) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov