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Fitzsimmons - 410-initial Secretary of Stateq 3 //-12 1 i C'� Pram: ft I, Statement of Organization i `J i J ol;, °,,L, y7F., -Recipient fir Secreta 1Statement Committee ,yaiJ `' J /Cdi'iDrniatOfficalUseOnly Type ❑ ❑ Termination—SeePartS ®Initial Amendment Not yet qualified , d 2020 or O Date qualification threshold met Date qualification threshold met Date of termination I.D. Number 2. Treasurer and;Other Principal Officers (if , NAME OF TREASURER Katbleen Fitzsimmons NAME OF COMMITTEE Fitzsimmons for Saratoga Council 2020 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 13735 CA 95070 408- STATE ZIP CODE AREA OF DOMICILE JURISDICTION WHER E COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFf ICER(5) Santa Clara City of Saratoga STREET ADDRESS (NO P.O. BOXI CITY STATE ZIP CODE AREA CODE/PHONE Attach additional information on appropriately labeled continuation sheets. I IIdVe U>eU dl1 Iedsvndule U1116t1IL.0 111 iJl CP01 ill IIU >latClllP It auU w UIc ' �. .��}' n„v.^a...6.. �••` •, ••`�••••"`•"•• _.............. ..... _... ._ -. __ _.._ --...�.---. -- --• —_- penalty of per'u �, under the laws of the Sta SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT executed an DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/1018) FPPC Advice: advicePfPPc.ca.faov ($66/275-3772) www.fppc.Ca.?,OV Statement of OrganizationCALIFORNIA, Recipient Committee • - 4 INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME Fitzsimmons for Saratoga Council 2020 I.D. NUMBER • 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 CITY STATE ZIP CODE 333 North Santa Cruz Los Gatos CA 95030 - 4. . of Committee Complete thp 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." 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 CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE Nonpartisan Partisan (lis[political party below)Colleen "Koo)de" Fitzsimmons City of Saratoga, Member City Council 2020 Nonpartisan Partisan (list political parry below) ( Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATES) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASUREIS) JURISDICTION IF A RECALL, STATE -RECALL IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (August/2018) FPPC Advice: advice@fw0aca.eov (866/275-3772) www.fo0csa.e0v Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Fitzsimmons for Saratoga City Cound12020 Pate 3 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 OESCPoPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS Small Contributor Committee GROUP OR AFFILIATION OF SPONSOR I'll STATE ZIP CODE AREA CODE/PNDNE S. Termination Requirements By signing the veribcahon, the treasurer, assistant treasurer and/or candidate, officeholder, orponentCertify that all ofthe followmgconditionshave beenmet 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: advice0fooc.ca.¢ov (866/275-3772) vvW WJnnc.ca.eov