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Huang 460Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE COVER PAGE I D M((�NHW Statement covers period Date of election if applica _ 1 of from 07/01 /2016 (Month, Day, Year) JA N 2 ? 2017 For Official Use Only through 12/31 /2016 1. Type of Recipient Committee: All committees — complete Parts 1, 2, 3, and a. © Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored ❑ General Purpose Committee (Also Complete Part 6) 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D. NUMBER 1368800 0 COMMITTEE) Dr. Huang for City Council 2018 STREET ADDRESS (NO P.O. BOX) 10502 Peralta Ct. CITY STATE ZIP CODE AREACODE/PHONE Cupertino CA 95014 408-489-8989 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 267-501-1818 / DrAndyHuang@gmail.com tPERTINJ CITY CLgRK 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Isabel Rodriguez MAILING ADDRESS 10502 Peralta Ct. CITY STATE ZIP CODE AREA CODE/PHONE Cupertino CA 95014 408-482-8282 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS YGI 111%.QIIVII - I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete certify under penalty of perjury under the %laws of the State of California that the foregoing is true and correct. Executed on Jl'z l / 7 By / Date a i 3 e I Ign re of Tr s rAssistant Treasurer Executed on DateBy m........ .... ..o r,.....,.ii..,.. r,.:_ .. _ _ Executed on Date Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Andy Huang OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 10502 Peralta Ct. Cupertino CA 95014 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page 2 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE of 3 BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. Statement covers period from 07/01 /2016 SUMMARY PAGE SEE IN ON REVERSE through 12/31 /2016 Page 3 of 3 NAME OF FILER DY. 11 UriNf j D('� L/T 10(1,N611 2Gn1�/ I.D. NUMBER 1368800 Contributions Received Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) Column B CALENDAR YEAR TOTAL TO DATE Calendar Year Summary for Candidates Running in Both the State Primary and 1. Monetary Contributions................................................... Schedule A, Line 3 $ 0 $ General Elections 2. Loans Received................................................................ schedule a, Line 3 0 6773 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS .............................. 4. Nonmonetary Contributions ............................................ 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Add Lines 1 +2 Schedule C, Line 3 Lines 3 + 4 $ 0 $ 0 $ 0 $ 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditures Made 6. Payments Made................................................................ Schedule e, Line 4 $ 7. Loans Made....................................................................... schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 10. Nonmonetary Adjustment, ........................................................ Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9+ 10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 13. Cash Receipts........................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash .................................. schedule I, Line 4 15. Cash Payments......................................................... Column A, Line 8 above 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule 5, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 $ 0 0 0 0 0 0 0 0 0 0 6773 0 $ 0 $ To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) /-/ $ $ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460(Jan/2016) FPPC Advice: advice@fppc.ca.gov (966/275-3772) www.fppc.ca.gov