410 Statement of Organization Recipient Committee - Termination Stamped by SOSStatement of Organization
Date Stamp
,
Recipient Committee
5ForOfficial
Statement Type
❑ Initial
❑ Amendment
❑x
Termination —See P
Use Only
Q Not yet qualified
sit
EIVED AND FILED
or
in theoffice
of the Secretary of State
A U G 2020
O Date qualification threshold met
Date qualification threshold met
Date of termination
of the State of California
/
10 11
/ 2D18
06 / 30 2020
' I
�` L 29
CUPERTIlVl1 CITY I CLLRK
1. Committee Information
I.D. Number 1412139
2. Treasurer and Other Principal Officers77
(if applicable)
NAME OF COMMITTEE
NAME OF TREASURER
Cupertino Residents for Local Ethical Government
Michael Malik
.
STREET ADDRESS (NO P.O. BOX)
19847 Beekman Place
STREET ADDRESS (NO P.O. BOX)
CITY STATE
ZIP CODE AREA CODE/PHONE
20660 Stevens Creek Blvd #196
Cupertino CA
95014 (408)464-1039
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Cupertino CA 95014 (415)884-5500
Nancy L Warren
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
20 Galli Drive STE A Novato, CA 94949
20 Galli Drive STE A
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
CITY STATE
ZIP CODE AREA CODE/PHONE
nwarren@wepacca.com
Novato CA
94949-5731 (415)884-5500
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Santa Clara County Cupertino
NAME OF PRINCIPAL OFFICER(S)
Oscar Hur
STREET ADDRESS (NO P.O. BOX)
7565 Erin Way
Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 95014 (408)656-2478
3. Verification
I have used all reasonable diligence in preparind_tD1Vt-aTyent 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 of i rn=that�i**srue an correct.
Executed on 7/24/2020 By
DATE N REOFTREASURERORASSISTANTTREASURER
Executed on By
DATE
Executed on By
DATE
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
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
COMMITTEE NAME
I.D. NUMBER
Cupertino Residents for Local Ethical Government
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Bank of San Francisco
ADDRESS
AREA CODE/PHONE
(415)744-6700
CITY
BANK ACCOUNT NUMBER
704019232
STATE ZIP CODE
575 Market Street #900 San Francisco CA 94105
4.`Type of Committee Complete the applicable sections.
1 Controlled Committee
Page 2 of 3
1412139
• 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)
Nonpartisan I Partisan (list political party below)
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.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
T r OPPOSE
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
COMMITTEE NAME
Cupertino Residents for Local Ethical Government
4. Type of Committee (continued)
Genemi Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
E 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
STREET ADDRESS NO, AND STREET
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE ARIA CUUt(PHUNt
Date qua{ified
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