HomeMy WebLinkAbout2014_08_26 Form 410 - John Chen Statement of Organization Date Stamp ,
Recipient Committee of
Statement Type Inittal Amendment
i ❑ ❑ Termination—See Part s D For Official Use Only
Not yet qualified or list I.D.number: List I.D.number:
a #
AUG 2 6 2014
--/--/ -�-/ -/--/ By
Date qualified as committee Date qualified as committee Date of Termination
(If applicable)
NAME OF COMMITTEE NAME OF TREASURER
FRIENDS GF CHEN FdR SARl!t?LCA CITY COUNCIL, Z014 C�iaC.�i a LO
STREET ADDRESS(NO P.O.BOX) STREET ADDRESS(NO P.O.BOX)
(
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
3ARA-i 0CA 75C7o SAPA:lz>6 `� '��
MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY
FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX)
-
COUNTY OF DOMICILEJURISDICTIONWHERE COMMITTEE ISACTIVE CITY STATE ZIPCODE AREA CODE/PHONE
SANTA CLARN SAFA-TaG-A
NAME OF PRINCIPAL OFFICER(S)
Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
I 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
penalty of perjury under the laws of the State o Cplifornia that the foregoing is true and correct.
Executed on
rDATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on f ZBy --""►— �--- N
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(Dec/2012)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
41
Recipient Committee
FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
14AllrCziG�Ds
OF OJC- ' Fort SPrRPrT0C:-At C1T (-OUNc-T—L 2,01A-
All
committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Well IS12.
STATE ZIP CODE
Controlied
Committee
• 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."
• 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
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF EL`CTION PARTY
S C)t-4 N SI'r2,kTJGA- CITY COUNCIL N6kt !�.
E1445-npartisan
❑ Nonpartisan
Primarily Foi
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER)
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOS
FPPC Form 410(Dec/2012)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME
J.D.NUMBER
F9tCNPs of CCAC-.N Fog sNRPfTOGh C!Ty C.00NczL 201t
CommitteeGeneral Purpose 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
Sponso �� List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREETADDRESS NO.AND STREET CITY STATE ZIP CODE
Small Contributor Committee
Date qualified
• 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(Dec/2012)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov