410 Statement of Organization Recipient Committee - AmendmentStatement of Organization
Recipient Committee
Statement Type [3 Initial
Not yet qualified ❑ or
Date qualified as committee
m Amendment
List I.D, number;
#1376003
03 /17 /2015
Date qualified as committee
(If applicable)
Date Stamp
❑ Termination — See Part 5
List I.D. number;
#
1. Committee Information
NAME OF COMMITTEE
Cupertino Residents for Sensible Zoning Action Committee
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CO DE AREACODE /PHONE
MAILING ADDRESS (IF DIFFERENT)
FAX / E -MAIL ADDRESS
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Santa Clara County Cupertino, CA
Attach additional information on appropriately labeled continuation sheets.
Date of Termination
2. Treasurer all
NAME OF TREASURER
rs
MAR 2 0 2015
PERTINO CITY C
STREET ADDRESS INO P.O. BOX)
CITY
STATE ZIP CODE AREA CODE /PHONE
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.U. BOX)
CITY
STATE ZIPCODE AREA CODE /PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
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
OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
By
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
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME
I.D. NUMBER
Cupertino Residents for Sensible Zoning Action Committee 11376003
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Technology Credit Union
ADDRESS
AREA CODE /PHONE
(
STATE ZIP CODE
4. Type of Committee Complete the applicable sections.
• 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."
• 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
Primarily Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
1-11 —P
FPPC Form 410 (Dec /2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
SUPPORT
OPPOSE
SUPPORT
0�
FPPC Form 410 (Dec /2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization
CALIFORNIA
Recipient Committee _ 411
INSTRUCTIONS ON REVERSE
COMMITTEE NAME Page 3
I.D. NUMBER
Cupertino Residents for Sensible Zoning Action Committee 11376003
4. Type of Committee (Continued)
Ilia" 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 • ❑
l /
Date qualified
S. 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