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410 Statement of Organization Recipient Committee – Amendment Reassign for 2020 Stamped by SOSStatement of Organization Recipient Committee Statement Type 0 Initial 0 Amendment Q Not yet qualified or O Date qualification threshold met Date qualification threshold met �Jf / ----. 31 1 2018 Termination — See Part Date of termination -/ / Date Stamp CEIVED AND FILE e office of the Secretary of Sta of the State of California MAR 28 2019 1. Committee Information I LE). Number 1404247 I 2. Treasurer and Other Principal Officers (if applicable) NAME OF COMMITTEE Hung Wei for Cupertino City Council 2020 STREET ADDRESS (NO P.O. BOX) 10969 Maria Rosa Way CITY STATE ZIP CODE AREA CODE/PHONE 95014 408-605-6959 FULL MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) hungweichien@gmaii.com COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Santa Clara City of Cupertino Attach additional information on appropriately labeled continuation sheets. Hung Wei For Official Use APR 3 0 2019 STREET ADDRESS (NO P.O, BOX) 10969 Marla Rosa Way CITY STATE ZIP CODE AREA CODE/PHONE CA 95014 408-605-6959 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 3. VeriRcation I have used all reasonable diligence in DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 420 (August/2018) 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 LD. NUMBER Hung Wei for Cupertino City Council 2020 • All committees must list the financial institution where the campaign bank account Is located. NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BANK ACCOUNT NUMBER Wells Fargo Bank -6100 12176669386 ADDRESS CITY STATE ZIP CODE CA 95014 4. Type of Committee Complete the applicable sections. 1404247 • 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." Stating "No party preference" is acceptable. • 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 YEAR OF PARTY NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE Nonpartisan Partisan (list political party below) Hung Wei City Council Member, Cupertino 2020 EI✓ Nonpartisan Partisan (list political party below) El 1:1 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) IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATEIS) OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE I 1 OPPOSE FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE =OMMITTEE NAME Hung Wei for Cupertino City Council 2020 Committee (Continued) 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 GRIEF DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS NO, AND STREET ilill[�lOi1i71:1Ii (i]i[SUiiliilliT:7:� ❑ Date qualified CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR Page 3 I.D. NUMBER 1404247 STATE ZIP CODE AREA CODE/PHONE 5. 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 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov