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410 Statement of Organization Recipient Committee - Initial Not Yet Qualified Stamped by SOSI have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under Executed on BV DATE SIGNATURE OF CONTROLIING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.zov (866/275-3772) www.fppc.ca.Hov f:N!!K1W zL_a!I I 7.i ai I.ffl @ ;;g Jll I * *71* a v-*Ili iuiqi a I i Ia Fage 2 COMMITTEE NAME Cupertino Facts 1.D. NIIMBER a All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIALINSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIPCODE am ffl I I s.I I s 1 II I (-laPThil=ll:T-niffi!'llm4ai V! " .7 il 4 'l IIIN 'l II11I II l'l(:I rffi@tlNr 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. NAME OF CANDIDATE/OFFICEHOtDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCIUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF EIECTION PARTY CH ECK O N E Nonpartisan Partisan (list political parky below) Nonpartisan Partisan (list political party below) a * * II-i a 1( H I Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULLTITLE (INCIUDE BALLOT NO. OR tncti) IF A RECALL, STATE "RECAII" IN FRONT OF TH E OFFICEH OLDERaS N AM E. CANDIDATE(S) OFFICE soucsr OR HELD OR MEASURE(S) JURISDICTION (ixciuoc DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)CHECK )NE SUPPORT OPPOSE SllPPORT OPPOSE FPPC Form 410 (August/2018) FPPC Advice: advice(a)fppc.ca.zov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Pace 3 1.D. NUMBER Cupertino Facts ' -t - r ' aa - a n u < ' - Nnt formed to support or oppose specific candidates or measures in a single election. Check only one box: Z CITY Committee € COUNT/ Committee € STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY We work on collecting plain facts, sharing the Truth about Cupertino city to local residents. Hope to help informed voters and volunteer to benefit our local community. fiq Iist additional sponsors on an attachment. STREET ADDRESS NO. AND STREET CITY STATE Zll" CODE AREA CODE/PHONE ll4mrilT'tma[: r ] Date qualffled 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 he1d by elected officers who are leaving office ahd by defeated candidates. Refer to Government Code Sedion 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(a)fppc.ca.zov (866/275-3772) www.fppc.ca.gov