425 Semi-Annual Statement of No Activity 01-01-2017 to 6-30-17Semi -Annual Statement of No ActlVlty Type or print in ink � f �9at MENT OF NO ACTIVITY
For use by recipient committees that have not received any contributions and have not made any expenditures
during the six-month period covered by a semi-annual statement. Candidate controlled committees formed for
an elective office may not use this form.
Seethe Information Manual on Campaign Disclosure Provisions of the political Reform Act for additional information
information required to be provided to you pursuant to the Information PracticesAct of 1977.
1. Committee Information
CONCERNED CITIZENS OF CUPERTINO
1287471
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIPCODE AREACODElPHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
Treasurer(s)
NAME OFTREASURER
Marolyn 0. Chow
AN 2 6 2017
RTINC CITY
Official Use Only
WWLINGADDRESS
CITY STATE ZSP CODE AREACODErPHONE
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIPCODE AREACODEIPHONE CITY STATE ZIP GODE AREACODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
2. Period of No Activity
OPTIONAL: FAX IE -MAIL ADDRESS
No contributions have been received and no expenditures have been made during the period covering the dates below:
Check one of the follovAng boxes and complete the year. ® January 1, through June 30, 20 17 ❑ July 1, through December 31, 20
3. Verification
I have used all reasonable diligence in preparing this statement. I have reviewed the statement
FPPC Form 425 (Jan/01)
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