425 Semi-annual Statement of No Activity Semi-Annual Statement of No Activity Type or print in ink D E C E 0 V Ir TEMENTOF NO ACTIVITY
CALIFORNIA 425
FORM
For use by recipient committees that have not received any contributions and have not made any expenditures JAN 2 6 2016 la For Official Use Only
during the six-month period covered by a semi-annual statement. Candidate controlled committees formed for
an elective office may not use this form.
See the Information Manual on Campaign Disclosure Provisions of the Political Reform Act for additional information anc CUPERTINO CITY CLERK
information required to be provided to you pursuant to the Information Practices Act of 1977.
I.D.NUMBER
1. Committee Information 1287471 Treasurer(s)
COMMITTEE NAME NAME OF TREASURER
CONCERNED CITIZENS OF CUPERTINO Marolyn O. Chow
MAILING ADDRESS
21941 Columbus Aveue
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
20850 Pepper Tree Lane Cupertino CA 95014 408.257.7883
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Cupertino CA 95014 408.255.5175
MAILING ADDRESS(IF DIFFERENT)NO.AND STREET MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL:FAX/E-MAIL ADDRESS
2. Period of No Activity
No contributions have been received and no expenditures have been made during the period covering the dates below:
Check one of the following boxes and complete the year. 0 January 1,through June 30, 20 15 ®July 1,through December 31, 20 15
3. Verification
I have used all reasonable diligence in preparing this statement. I have reviewed the state
TREASURER
FPPC Form425(Janf01)
FPPC Toll-Free Helpline: B66/ASK-FPPC
866/275-3772