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HomeMy WebLinkAboutForm 410 - Teng, Chia Yu - 2022.09.14 (Amendment)x x x m � � o ■ ra ❑ e� �p n a r.- CD V c O a y > ON N o ca"tN Q e_ x N Q W< d m � N a '- a' a o Q W ® L ❑m R? v a O� Aa u a H 3 a z� nj z I 2 = CQ o o a C c Q c 4 ° 3 z ❑ o m d HE �o � Q U ❑ � o ❑ N 13 o�y�-w C Q `❑ _ N .a f� W C5 a .a 14E N � y c M w N 7 at 7 fp L i� o [tii o 0 b O a c c c c 0 o a 0 u u u aui LU LU LU LU Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER DR. TE.NG FOR ❑B CITY COUNCIL 2022 1451670 All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION EAST WEST BANK ADDRESS 19756 E. COLIMA ROAD AREA CODE/PHONE CITY ROWLAND HEIGHTS BANK ACCOUNT NUMBER STATE ZIP CODE CA 91748 • 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. NAME OF CAN DIDATEIOFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HEL❑ YEAR OF PARTY (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE CHIA YU TENG ❑IAMOND BAR CITY COUNCIL 2022 Nonpartisan Partisan (list political party betow) Nonpartisan Partisan (list political party below) Primarily formed to support Or appose specific candidates or measures in a single election. List below: CANDIDATE(5) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) IF A RECALL, STATE "RECALL' IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATEIS) OFFICE SOUGHT OR HELD OR MEASURE(5) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 420 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fpp5�.ca• ov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSL I Page 3 NAME I.D. NUMRE F7 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 DESCRPTION OF ACTIVITY RAISE FUND FOR DIAMOND BAR CITY COUNCIL ELECTION CAMPAIGN List additional sponsors on an attachment. NAME OF SPONSOR I N DUSTRY GRO UP Oft AFFILIATION OF 5PON50R STREET ADDRESS NO, AND STREET CITY STATE ZIP CODE ARFACODEIPNONE Datc qu aH tied 5. Termination Requirements By Si gn i ng the verification, th e t rea s urer, a ssi stant treas u re r an d/ o r C a n d idate, offi ce h ol d ee, o r po ne nt cerfifV that .111 of the fo I Iowi ng conditi an s have been rnet • 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: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov