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410 Statement of Organization Recipient Committee – AmendmentStatement -of Organization Recipient Committee Statement Type ❑ Initial Amendment Not yet qualified ❑ or List I.D. number: # 1397633 �J1 07 1 28 1 2017 Date qualified as committee Date qualified as committee (If applicable) ® Termination — See Part 5 List B.D. number: _ . 1_ Date of Termination 1. Committee Information NAME OF COMMITTEE Barry Chang for Board of Equalization 2018 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) FAX / E-MAIL ADDRESS ( COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Sacramento H W N IPERTINO CITY CLE For Official Use Only 2. Treasurer and Other Principal Officers NAME OF TREASURER Rita Copeland STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) Attach additional infonTTatton on appropriately labeled continuation sheets. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/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 CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT www.netfile.com FPPC Form 410 (.Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee, INSTRUCTIONS ON REVERSE WMMI I I EE NAME I.D. NUMBER Barry Chang for Board of Equalization 2018 1397633 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Community 1st Bank ( ADDRESS CITY STATE ZIP CODE 4e 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. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CAN DIDXE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PAP. TY 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 SOUGHTOR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE J OPPOSE FPPC Form 410 (Jan/2016) wwryv.ne8file.con, FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Board of Equalization Member: Board of ❑ Nonpartisan Barry Chang Equalization District 2 2018 Democratic Party ❑ Nonpartisan 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 SOUGHTOR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE J OPPOSE FPPC Form 410 (Jan/2016) wwryv.ne8file.con, FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME LD. NUMBER Barry Chang for Board of Equalization 2018 1397633 4. Type of Committee (Continued) Not formed to support or oppose specific candidates or measures in a single election. Check only one box: CITY Committee 0 COUNTYCommittee ❑ STATECommittee PROVIDE BRIEF DESCRIPTION OF ACTIVITY • • • List additional sponsors on an attachment. NAME OF SPONSOP. INDUSTRY GROUP OR AFFILIATION OF SPONSOR :7 STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE • s • • ❑ �J Date qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certily 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. www.neifile.com FPPC Form 410 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov