410 Statement of Organization Recipient Committee - Initial not yet qualified stamped by SOS Statement of Organization i pIND F11, CALIFORNIA
Recipient Committee
e ffic" ecretary oil FORM � 410
Statement Type 0 Cal mia
12 Initial Amendment Termination SP rt 5 F ForlOfficial Use Only Use DD
List I.D.number: List I.D.number: . .1
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I [ILHRTINO CITY CI-E K APR O'S Z017
Date qualified as committee Date qualified as committee Date of Termination
(if applicable) T,-1 11 aFV0TE 8 S
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NAME OF COMMITTEE NAME OF TREASURER
Xiaowen Wang
Better Cupertino Political Action Committee STREET ADDRESS(NO P.O.BOX)
MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX)
FAX/E-MAILADDRESS CITY STATE ZIP CODE AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
Xiangchen Xu
STREET ADDRESS(NO P.O.BOX)
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e used "ll"est 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 correct.
Executed on J 17-Z-1 By
DATE
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(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization .CALIFORNIA
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
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List
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• 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 CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
❑ Nonpartisan
❑ Nonpartisan
1 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 N0.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPP05E
F-1 El
SUPPORT OPPOSE
El EL
FPPC Form 410(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA '
Recipient Committee -
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME - I.D.NUMBER
Better Cupertino Political Action Committee
. y
I General
Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
R✓ CITY Committee ❑ COUNTY Committee® STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Promote sensible growth, educate the public, empower our community, advocate transparency and accountability in local government.
•• 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 • ❑
Date qualified
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a _ , .,�� . n a re,ass a t reasure[a d,bhta.nddate.officeholder or, co o]ent.ce,rtlf,.thatal:l.bfthe,fo oWm .c n itlonsha.. n. 1
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�. S'�ki.�t.vraw,..,�s. kr,..ys1,Pom.,ar.,,�r.��fs'�K4�i,.nndir+>�,w19dL�f�>�}s�. �.mr.,..�wv:�Fa.,Tsv.ti w7�:Na,Jwc�ta\.,a,'m,.«,��,aF�c�s aa�AP�a,._�t:,Aaoax4.u.�Fxl�rwhZT`I,c.�w,-dx uuv..x�l r�1,.,_.<�..�4a'n. wr,>,1�.�,�.>,A�yr,J,,u,a��wR.,t 4�'b,� a„aeLa„:,ut�A�4zu�lsHo g,,.a.,,a$Yx,.:...:6us�„rw�:'LE3,�s,t'.:�a7.rtmtrA.s
• 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 maybe 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(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov