HomeMy WebLinkAboutForm 410 - Teng, Chia Yu - 2022.08.05 (Initial)Statement of Organization
Date Stamp A
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Recipient Committee
F�- C Et -Statement
Type ® Initial ❑ Amendment
❑ Termination — See Part 5
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Date of termination
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Committee1. •n
2. Treasurer and Other
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NAMEOFCOMMITTEE
NAME OF TREASURER
DR. TENG FOR DB CITY COUNCIL 2022
CHIA YU TENG
STREET ADDRESS NO PC, BOX]
STREET ADDRESS (NO RO. BOX)
CITY
STATE ZIP CODE
AREA CODEIPHONE
DIAMOND BAR
CA 91765
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
DIAMOND BAR CA 91765
FULL MAILING ADDRESS OF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
DIAMOND BAR, CA 91765
E•M AN. AD D RESS(REQUI R ED) t FAX ;OPTIONAL]
CITY
STATE ZIPCODE
AREACOOE/PHONE
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(5)
LOS ANGELES
STRE ET ADDRESS (NO P.D. BOX)
Attach additional information on appropriately labeled continuation sheets.
CITY STATE ZIPCODF
AREACOOE/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
MEASURE PROPONENT
Executed on
Executed on
DATE
BY
By
SIGNATU R E 0 F CONTRO LLING 0 F F1 CEHO LDER, CANDIDATE, 0 R STATE M EASU RE PROPO N ENT
DATE SIGNATURE OF CONTROLLING OFFI CEH OLDER, CAN DIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/Z018)
FPPC Advice: adyi_c_e@jppc.ca.eov{866/275-3772j
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Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Frge2
COMMITTEE NAME
DR. TENG FOR DB CITY COUNCIL 2022 I.P. NUMBER
All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
ADDRESS
AREA CODE/PHONE I BANY,A000UNT NUMBER
CITY STATE ZIPCODE
Controfled 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." Stating "Ho party preference" is acceptable
■ if this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NgME OF CAN OIDATE/QFFICEHOLD ER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
(INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECKONE
CHIA TENG DIAMOND BAR CITY COUNCIL 2022 Nonpartisan Partisan (list political party below)
Nonpartisan Partisan I (list political party below)
FormedPrimarily Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) NAME OR MEASURES] FULLT)TLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECKONE
SUPPORT f OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice f c.ca. ov (866/275-3772)
www.fppc.ca.f!
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
:OMMMEE NAME
DR. TENG FOR DB CITY COUNCIL 2022
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 ACTJVfIY
RAISE FUND FOR DIAMOND BAR CITY COUNCIL ELECTION CAMPAIGN
• • List additional sponsors on an attachment.
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CITY
INDUSTRY GROUP OR AFFILIA71 0 N OFSPONSOR
Page 3
STATE ZIP CODE AREACODWHONE
Small Cont ributor Committee e5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, ❑r ponent 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. Referto
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/2028)
FPPC Advice: ELdviceMp Dc.ca. gov t$66/275-3772)
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