410 Statement of Organization Recipient Committee - Amendment 09-06-22atatemeni or urganization
Recipient Committee
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Date of Termlr
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09/02/2022
C
INO CITY CLERK
I.D. Number 1452894
(IlaPPlk.bk)
NAME OF COMMITTEE
NAME OF TREASURER
Govind Tatachari For Cupertino Council 2022
Balaji Seshachalam
STREET ADDRESS (NO 11.0, BOX)
SrREEI ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE
AREA CODE/PHONE
Cupertino
CA 95014
(
CITY STATE ZIP CODE
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
CITY
STATE ZIP CODE
AREA CODE/PIIONE
COUNTY OF DOMICILE
JURISDICTION WHERE COMMI REF. IS ACTNF.
NAME OF PRINCIPAL OFFICERIS)
Santa Clara
Cupertino
GOVIND TATACHARI
STREET ADDRESS (NO P.O. 00X)
Attach additional information on appropriately labeled continuation sheets.
CITY
STATE ZIP CODE
AREA CODE/PHONE
CUPERTINO
CA 95014
(
1 ,
i have used aii reasonable diligence in preparing this statement 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
Executed on By
Executed on
DATE
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
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
CALIFORNIA
FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME
I.U. NUMBER
Govind Tatachari For Cupertino Council 2022
1452894
a All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
AREA CODE/PHONE
BANK ACCOUNT NUMBER
Bank of America
ADDRESS Cll'y
STATE ZIP CODE
Cupertino
CA 95014
a 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.
a 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 CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHEK ONE
GOVIND TATACHARI
CUPERTINO CITY COUNCIL City CITY OF
Nonpartlsan
Partisan
(list political party below(
CUPERTINO
2022
O
Nonpartisan
Partisan
(IM political party below)
O
0
- Primarily Formed Cotritnittee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULLTITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL. STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATF.(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
I INrI nF nISTRIrT Nn rITV nR rni INTV AS ARCI IrARI cl
CHECK ONE
SUPPORT
OPPOSE
0
❑
SUPPORT
OPPOSE
0
0
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
COMMITTEE NAME
I.D. NUMBER
Govind Tatachari For Cupertino Council 2022 1452894
General Purpose Committee 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 DESCRIPI'ION OF ACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR
STREET ADDRESS NO. AND STREET
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE
AREA CODE/PHONE
Srncrll Contributor Committee
S. Termthatron Requirements ay"sl nlna Elie v_Oication, the treasurer, assistant treasurer and%or can dlelatP, officeholder, or proponent certify that all of fhe following conditions have Seen 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