410 Statement of Organization Recipient Committee – Amendment Stamped by SOSQECE[)VE
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1. Committee Information 2. Treas.urer and O'ther Pr!nc!pal OfflCerS oftheStateofCalifomia
STREET ADDRESS (NO P. 0. BOX)
CITY STATE- ZIPCODE
CUI"HRTTNO CA 95014
MAILING ADDRESS (IF DIFFERENT)
CUPERTTNO, Un 95014
OPTIONAL- FAX/E-MAILADDRESS
COUNTY OF DOMl51LEi
Sacramento I?:lSACflValr
AllaCh additionai inIormalion on appropnataly label(d coriiii'iualioh sheets.
CITY
CUPERTINO
S7AYE ZIP CODE
CA 95014
NAME OF ASSIST ANT TREASURER, [F ANY
Don Sun
STREET ADDRESS
CITY
CUI)ERTINO
STATE
CA
ZIP C!ODE
95014
NAME AND PO8i jlON OF OTHERPRINCIPAL OFFICER(S), IF APPLICABLE
c.c. Yin, Co Chair/Trcasurcr
MAILING ADDRESS
CITY
Vacaville
STAT'e ZIP CODE
CA gs<,87
Verification
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DATE
DATE
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SIGNATIIRE OF OR STATE MEASURE F'ROPONENT
!ilt-NAT LlFtE C)F CON I HOLllNG OFFleEHOLL)bH. GANDIDA1'H, OR 8'{'AJ'E MEASl)HE PRC)PCINENi
FPPC Form 410 (Jan/[11)
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