HomeMy WebLinkAbout2014-12-17 Form 410 John Chen termination Statement of Organization Date Stamp
Recipient Committee
Statement Type E]Initial (— Amendment
® Termination—See Part 5 EEE�-"
, LI, For Official Use Only
Not yet qualified [] or List I.D.number: List I.D.number:
# # 1370979 i4
12 14 Date qualified as committee Date qualified as committee Date of Termination
(It applicable)
1: Committee inforrr+ration �.. v
.. �..,f.v .n .,..; .. 'tt aWt6r andOtfwerPrinci al Officers,
NAME OF COMMITTEE � -
NAME OF TREASURER `
CHEN FOR SARATOGA CITY COUNCIL 2014; FRIENDS OF Chiachia Lo
STREET ADDRESS(NO R&BOX)-- STREET ADDRESS(NO P.O.BOX)
STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
Saratoga CA 95070 ( Saratoga CA 95070 (
MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY
FAX/E-MAIL ADDRESS
STREET ADDRESS(NO P.O.BOX)
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE
Santa Clara County City of Saratoga
NAME OF PRINCIPAL OFFICER(S)
Attach additional information on appropriately ppropriately labeled continuation sheets.
STREET ADDRESS(NO P.O.BOX)
�// py yy1nn�� CITY STATE ZIPCODE AREACODE/PHONE
06
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
rr[the laws/of the State of C lifornia that the foregoing is true and correct.
Executed on ' Y ( r t�J By
DATE S OF TREASURER OR ASSISTANT TREASURER
Executed on (Z 14 By
DATE
SIGNATURE O ONTROLLING 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 Date StampLA
E37 Recipient Committee Statement Type ❑Initial ( Amendment For Official Use O® Termination—See Part 5
Not yet qualified ❑ or List I.D.number: List I.D.number:
# # 1370979
12 31 14
Date qualified as committee Date qualified as committee Date of Termination
(If applicable)
1. Committee Information 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
CHEN FOR SARATOGA CITY COUNCIL 2014; FRIENDS OF Chiachia 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
Saratoga CA 95070 ( Saratoga CA 95070 (
MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY
FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX)
JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE
Santa Clara County City of Saratoga
NAME OF PRINCIPAL OFFICER(S)
Attach additional information on appropriately labeled continuation sheets. STRE ET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
3. Verification
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 of California that the foregoing is true and correct.
Executed on By
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
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
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
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
CHEN FOR SARATOGA CITY COUNCIL 2014; FRIENDS OF 1370979
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Wells Fargo 1( 16064054742
ADDRESS CIN ZIP CODE
Cupertino CA 95014
4.Type of Committee Complete the applicable sections.
• 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 ELECTION PARTY
m Nonpartisan
JOHN CHEN CITY OF SARATOGA COUNCIL MEMBEfi 2014
❑ Nonpartisan
Primarily Formed Committee 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) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
1:1 El
sum OMP
FPPC Form 410(Dec/2012)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA '
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.D.NUMBER
CHEN FOR SARATOGA CITY COUNCIL 2014; FRIENDS OF 1370979
4.Type of Committee (Continued)
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 DESCRIPTION OF ACTIVITY
SponsoredList additional sponsors on an attachment.
NAME OF SPONSOR I INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE
Small Contributor Committee
❑
Date qualified
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(Dec/2012)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov