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HomeMy WebLinkAboutGupta Form 410 08-02-2016_RedactedStatement of Organization Recipient Committee Statement Type D Initial ® Amendment Notyetqualifled D or List I.D. number: #1357076 0 --/0_ —/2013 Date qualified as committee Date qualified as committee (if applicable) NAME OF COMMITTEE Abe Gupta for Dublin City Council 2014 P.O. ® Termination — see Part 5 List I.D. number: # CITY STATE ZIP CODE AREACODE/PHONE MAILING ADDRESS (IFDIFFERI FAX / E-MAIL ADDRESS COUNTY OF DOMICILE Alameda County WHERE COMMITTEE IS Attach additional information on appropriately labeled continuation sheets. Date of Termination I have used all reasonable diligence in preparing this statement and to the best of my penalty of perjury under the laws of the S Executed on 3 \ --t- 0 , 6 By DATE Executed on' By DATE NAME OF TREASURER Date Stamp g For Official Use AUG 2 816 x'ry OF DUBLIly CITYMANAGER'S ®FFZC Matthew Morrison STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE /PHONE lowledge the information contained herein is true and complete. I certify under 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 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Abe Gupta for Dublin City Council 2014 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION ADDRESS AREA CODE /PHONE CITY BANK ACCOUNT NUMBER STATE ZIP CODE 4520 Dublin Blvd. Dublin CA 94568 i'Controlled f Committee Page 2 I.D. NUMBER 1357076 • 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. NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Abe Gupta City of Dublin City Council 2014 ® Nonpartisan SO ❑ Nonpartisan 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 FPPC Form 410 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov SUPPORT OPPOSE SO O[n FPPC Form 410 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 Abe Gupta for Dublin City Council 2014 U11357076 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 Sponsored List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS NO, AND STREET CITY GROUP OR AFFILIATION OF SPONSOR STATE ZIP CODE • 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 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov