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460 Semi-annual 2nd ecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from __ July 1~, 200~3 Ithrough December 31, 2003 1. Type of Recipient Committee: All Committees - Complete Parts t, 2, 3, and 4. Date of election if applical (Month, Day, Year) 2. Type of Statement: LJPERTINO CITY Cl COVER PAGE [] Officeholder, Candidate Controlled Committee O State Candidate Election Committee (~ Recall [] GeneraI Purpose Committee 0 Sponsored 0 Small Contributor Committee O Political Party/Central Committee [] Ballot Measure Committee 0 Pdmadly Formed O Controlled O Sponsored [] Primarily Formed Candidate/ Officeholder Committee [] Preelecfion Statement [] Semi-annual Statament [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Repor~ [] Supplemental Preelection Statement - Attach Form 495 3. Committee Information 1237120 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Elect Patrick Kwok for City Council STREET ADDRESS (NO PO SOX) 10222 Carmen Road CITY STATE ZIP CODE AREA CODE/PHONE Cupertino CA 95014 408 777-3191 MAILING ADDRESS (~F DIFFERENT) NO. AND STREET OR PO BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAiL ADDRESS Treasurer(s) NAME OF TREASURER Claudia Chang MAILING ADDRESS 7437 Fallenleaf Lane CITY STATE ZIP CODE AREA CODE/PHONE Cupertino CA 95014 408 277-5186 NAME OF ASSISTANT TREASURER. IF ANY Patti Nakamura MAILING ADDRESS 3447 Cadillac Ddve CITY STATE ZIP CODE AREA CODE/PHONE San Jose Ca 95117 OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best Executed o~ By FPPC Toll-Free Helpline: 866/ASK-FPPC State o! California ecipient Committee Campaign Statement Cover Page-- Part 2 Type or print in ink. 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Patrick Kwok OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City of Cupertino Council Member RESIDENTIAL/BUSINESS ADDRESS (NO AND STREET) CITY STAT ZIP 10222 Carmen Road, Cupertino, CA., 95014 Related Committees Not Included in this Statement: Llstanycommi~ees not Included in this statement that are controlled by you or are p~fmarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMI~CFEE NAME I.D. NUMBER CONTROLLED COMMFFTEE? [] YES [] NO NAMEOFTREASURER COMMIttEE ADDRESS STREET ADDRESS (NO RO, BOX) CITY STAT ZIP CODE AREA CODE/PHONE [] YES [] NO COMMITTEE ADDRESS STREET ADDRESS (NO PO. BOX) CITY STAI~ ZIP CODE AREA CODE/PHONE COVE R PAGE - PART 2 6. Ballot Measure Committee 2 Page __ of 4 NAMEOFBALLOTMEASURE BALLOT NO. OR LE~i-E R URISDICTION []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 Committee List names of olficehoider(s) or candldate(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 (June/Of) FPPC Toll*Free Helpline: 866/ASK-FPPC State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars, Statement covers period from July 1,2003 SUMMARY PAGE through December 31, 2003 Page 3 of 4 NAME OF FILER Claudia Chang/Elect Patrick Kwok for City Council Contributions Received 1. Monetary Contributions ........................................... Schedu/eA, Line3 2. Loans Received ...................................................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... AddLinesl+2 4. Nonmonetary Contributions .................................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 7. Loans Made ............................................................. Schedu~ H, Lme 3 8. SUBTOTAL CASH PAYMENTS ....................................AddUnesS+7 9. Accrued Expenses (Unpaid Bills) ........ .' ...................... ScheduteF, Line3 10. Nonmonetary Adjustment .......................................... Schedu~ C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 Current Cash Statement 12. Beginning Cash Balance ....................... Previous SummaryPage, Line 16 13. Cash Receipts ................................................... ColumnA, Line 3above 14. Miscellaneous Increases to Cash ........................... Schedu/e I, Line 4 15. Cash Payments .................................................. ColumnA, LineSabove 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 B. Part 2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse 19, Outstanding Debts ......................... AddLine2+LineginColurnneabove Column A 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ $ 0 $ 3887.52 0 6.73 0 $ 3894.25 $ 0 $ 0 $ 0 Column B 0 0 0 20. Contdbubens Received 0 21. Expenditures 0 Made LD. NUMBER 1237120 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 0 $ $ 0 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounls in Column A may be negative figures that should be subtracted from previous pedod 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* Date of Election Total to Date (mm/dd/yy) £__ $ L__ $ £__ $ __ /___ $ __£__ $ /-__ $ *Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B FPPC Form 460 (Junel01) FPPC Toll-Free Helpline: 8661ASK-FPPC 0 0 $ $ Schedule I Miscellaneous Increases to Cash Type or print in ink. Amounts may be rounded to whole dollars, SEEINSTRUCTIONS ON REVERSE NAME OF FILER Claudia Ohang/Eloct Patrick Kwok [or City Council DATE FULL NAME AND ADDRESS OF SOURCE RECEIVED (iF COMMITTEE ALSO ENTER f D NUMBER) SCHEDULEI from July 1, 2003 through~)ecember 31,200..:- 4 4 I Page of .__ LD. NUMBER 1237120 AMOUNT OF DESCRiPTiON OF RECEIPT INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule I Summary 1. Increases to cash of $100 or more this period ........................................................................................................... $ 2. Unitemized increases to cash under $100 this period ............................................................................................... $ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14~) ........................................................................................................................... TOTAL $ 6.73 6.73 FPPC Form 460 (Junel01) FPPC Toll-Free Helpline: 8661ASK-FPPC