410 Statement of Organization Recipient Committee - Initial not yet qualified Statement of Organization D 1._ �at�'Smq' U L4L.IFORNIA 41 0
Recipient Committee F FORM
Statement Type ❑Initial 0 Amendment ❑ Termination—See Part 5 MFor Official Use Only
Not yet qualified ® Or List I.D.number. List I.D.number:
# #
DategL,iifiedas committee Datequalfied committee Date of Termination
CUPERTINO CITY CLERK
It applicable)
1;_'Committee Information 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
Don Sun For Cupertino City Council 2014 Helen Fu
STREET ADDRESS NO P.O.BOXI STREET ADDRESS NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS(IF 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 C.7+ STATE Zip COUP AREA CODE/PHONE
Santa Clara
NAME OF PRINCIPA'.OFFICERIS?
STREET ADDRESS(NO PO.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 foregoing is true and Corr t.
Executed on 03/14/2014 By
DATE SIGNATURE CE TREASURER OR,A5S TANT TREASURER
Executed on 03/14/2014 By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDI .UR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OP 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 41 0
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
Don Sun For Cupertino 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
East West Bank (
ADDRESS CITY STATE ZIP CODE
4.=Type^ f 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.
'J_ _ff li _,J _heck
■ List the poiiiicai party viii!wind!Cd!f!UI!IICIIUIUC! V(ltliiU!V aIC is affiliated ui check
• 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
Don Xiao Sun Cupertino City Council 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 OUNTY,AS APP)ICABLDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPP■
FPPC Form 410(Dec/2012)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA 41 0
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME
1.0,NUMBER
Don Sun For Cupertino 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
Date q,alined
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