410 Statement of Organization Recipient Committee - Termination Statement of Organization oatestamP , � _ ,
Recipient Committee � I� � �/ f� � �
Statement Type
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❑ Initial � Amendment � Termination—See For Official Use Only
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� Date qualification threshold met Date qualification threshold met Date of termination
� � 10 � 11 � 2018 06 � 30 � 2020� � . ���o ��� ���py�
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1. Committee Information I.D. Number 2, Treasurer and Other Principal Officers
(if applicableJ 1412139
NAME OF COMMITTEE NAME OF TREASURER
Cupertino Residents for Local Ethical Government Michael Malik
STREETA�DRE55(NO P.O.BOX)
STATE ZIP CODE AREA COOE/PHONE
STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANTTftEASURER,IP ANY
Cupertino CP. 95014 ( Nancy L Warren
FUIL MAILING ADDRESS(IF DIFFERENT) STREET ADDRE55(NO P.O.BOX)
STATE ZIP CODE AREA CODE/PHONE
Novato CA 94949-5731 (
COLINTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
Santa Clara County Cupertino Oscar Hur
STREET ADDRE55(NO P.O.BOX)
STATE ZIP CODE AREA CODE/PHONE
Attach additional informadon on appropriate/y labeled continuation sheets.
Cupertino CA 95014 (
3. Verification
I have used all reasonable diligence in preparing thi ta
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Executed on gy
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SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on gy
DATE � SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on gv
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
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
Page 2 of 3
COMMITTEE NAME
I.D.NUMBER
Cupertino Residents for Local Ethical Government
1412139
� All committees must list the financial institution where the campaign bank account is located.
NAME Of FINANCIA�INSTITUTION AREACODE/PHONE BANKACCOUNTNUMBER
Bank of San Francisco ( 704019232
ADDRESS CITY STATE ZIP CODE
San Francisco CA 94105
4. Type of Committee Complete the app�icable sections.
• Lis±the name of each controlling ofFiceholder,candidate, or state measure proponent. If candidate or officeha!der 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 APPLICABIE) EIECTION
CHECK ONE
Nonpartisan Partisan (list political party below}
Nonpartisan Partisan (list political party below)
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(5)NAME OR MEASURE(5)FULL TITLE(INCIUDE BALLOT N0.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(5)JURISDICTION
IF A RECALL,STATE"FECALL"IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT Opp05E
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
Page 3 of 3
COMMITTEE NAME
I.D.NUMBER
Cupertino Residents for Local Ethical Government
4. Type of Committee �co�ti��ed� '
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
To support and oppose candidates and measures of interest to residents of Cupertino who are comitted to Ethical government
List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP Oq AFFILIATION OF SPONSOR
STREETADDRESS NO.ANDSTREET CITY STATE ZIPCODE AREACODE/PHONE
� � �
�ate qualified
5.Termi nation Req u i rements 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