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460 Termination Amended from ---period 10/21/2003 co oa [E ~stpW [E Recipient Committee Campaign Statement (Govemment Code Sections 84200 - 84216.5) APR 1 4 2004 DaID of EJoctIon If through 12/31/2003 1. Type of Recipient Committee: 00 Officeholder, Candidate Conlrolled Committee 0 Ballot Measure Commlttaa 0 State Candidate Election Commlttaa 0 Primarily Formed 0 Recall 0 Controlled 0 Sponsored 0 General Purpose Committee 0 Sponsored 0 Small Contributor Committaa 0 Political Party/Central Committee 0 Primarily Formed Candidate Officeholder Committaa 2. Type of Statement: 0 Pre-election Statement 0 Quarterty Statement @ Semi-annual Statement 0 Special Odd-Year Report ~ Tennlnatlon Statement 0 Supplemental Pre-election ~ Amendment (Explain below) Statement - Attach Fonn 495 é/7C':!.f...J ../c../e. ",....-7/" -- rh",r... ..-"'<-5 / /1/,., .;r'n-£.ø..."" ,,0-- ß")""r;-",. c.h"'::ye- 3. Committee Information 1.0. NUMBEA 1256061 Treasurer(s) caMMITTEE NAME RE-ELECT RICHARD LOWENTHAL NAME aFTAEASUAEA TOM HALL STAEET AOOAESS STATE ZIP COOE AREACOOE/PHaNE (408) 973 -8494 CITY CUPERTINO 21040 HOMESTEAD RD STAEET .oDRESS (NO P.o.. BOX) 21602 VILLA MARIA COURT CITY STATE ZIP COOE AREA COOE/PHONE (408)773-1400 CUPERTINO CA 95014 NAME Of ASSISTANTTAEASUAEA, IF ANY CA 95014 STAEET .oORESS (IF "'FFEAENT] No. ANO STAEET OR P.o. eo.x STAEET .oDRESS CITY STATE ZIP COOE AREA COOEJPHONE CITY STATE ZIP CODE AREA COOEJPHONE ( aFTlON^" FAX¡E-MAL.oDRESS (408) 255-8033/ aFTlaNAL FAXiE-MAJLAOOAESS 4. Verification I have used all reasonable diligence In preparing and reviewing this statement and to the best of my knowledge the information co.ntalned herein and In the attached schedules Is true and complete. I certify under penal. ty of MEASUAE PROPONENT OR AESPONSIBLE aFACEA OF SPONSOA DATE By SIGNATUAE aFCONTROLLING aFFICEHOI.OEA, CANDIDATE,STATE MEASUAE PROPONENT Executed on DATE By SIGNATUAE Of CONTROLLING OFFICEHOI.OEA, CAN"'DATE, STATE MEASURE PROPONENT S- of California Fair PoJlUcaI Practices Commission. S/CCW - PCAPOB 01504 (Rev. 9/99) Recipient Committee Campaign Statement Cover Page - Part 2 5. Officeholder or Candidate Controlled Committee 6. Banet Measure Committee NAME aF BALLOT MEASUAE NAME OF QFFICEMOLDEA OF CANDiDATE RICHARD LOWENTHAL OFFICE SOUGIfT OR HELC ØNCLUDE LOCATION AND DISTRICT NUMBER IP APf'UCASLE) City Council Member, RESlDENl1A1JBUSlNESS ADORESS (NO. AND STREET] CrTY STATE ZIP COOE 21602 VILLA MARIA CT CUPERTINO CA 95014 Related Committees Not Included In this Statement: List snycammlttees not Úlc/uded Úllhis ccnsoUdsled statement that BI8 conI1D/Jed by you or which BI8 primarily farmed to receive ccntribut/ons or to maIaJ explDinu",s on behalf of your csndidacy. COMMITTEE NAME 1.0. NUMBER NAME OP TREASURER CONTROLLEO COMMITTEE? COMMlTTEEAODAESS STREET AODAESS (NO P.o. BO>Q CrTY STATE AREA COOE¡PHONE ZIP COOE ~,- I~- NAME OP TREASURER CONTROLLEO COMMITTEE? COMMITTEE AODAESS STREET AODRESS (NO P.o. BO>Q CrTY STATE AREA COOEJPHONE ZIP CODE BALLOT NO. OR LETTER I JUA~N I ~ = --- Identify the controlling officeholder, candidate, or 51818 measure proponent, If any. NAME OF OFFICEHOlDER. CANDIDATE Œ!. PROPONENT aFFICE SOUGHT aR HEW "'STRICT No. IF ANY 7. Primarily Formed Committee NAME Of OFFICEHOLCER OR CANOIDATE OFFICE SOUGHT OR HEW 0 SUPPORT 0 aPPOSE NAME OF OFFICEHOlDEA Œ! CAN"'DATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER Œ! CAN"'DATE OFFICI! SOUGHT OR HELD 0 SUPPORT 0 OPPOSE NAME ap OFFICEHOlDER Œ! CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 aPPOSE Campaign Disclosure Statement Summary Page NAMEOFALER RICHARD LOWENTHAL, RE-ELECT RICHARD LOWENTHAL Contributions Received 1. Monetary Conb1but1ons ..................................... SchedulB A, Une 3 $ 2. Loans ReceiVed ....................."......................... Schedule B, Une 7 3. SUBTOTALCASHCONTRIBlJTlONS .................. AddUnes 1 +2 $ 4. Nan-monetary Cantrtbutlans """""""""""""'" Schedule C, Une 3 6. TOTALCONTRIBUTlONSRECEIVED.................AddUnes3+4 $ Expenditures Made 6. Cash Payments ..............................................., Schedule E, Une 4 $ 7. Loans Made ..........."......................................... Schedu/øH, Une 7 8. SUBTOTAL CASH PAYMENTS ........".................. Add Lines 6 + 7 , 9. AccruecI Expenses (Unpaid BIlls) """"""""""" Schedule F, Unø3 10. Nonmonetary Adjustment ............".................. SchedulB C, Une 3 11. TOTAL EXPENDITURES MADE ..................AddUnes8+9+ 10 $ Current Cash Statement 12. Beginning Cash Balance .......... Prev/ausSummaryPaga, Une 18 $ 13. Cash Receipts ......................,.................. ColumnA, Una 3 abovø 14. MIscellaneous Increases to Cash ................"... Schedule I, Une 4 16. Cash Payments """""",,"""""""""""'" Column A, Une 8 above 16. ENJING CASH BAlßllfGfbes 12 + 13 + 14, then subtract Une 15 , If this Is a TemJlnatJon Stalsment Una 18 must be zero. 17. LOAN GUARANTEES RECEIVEDSchedulB B, Part 1, Column (b) , Cash Equivalentsalld Outstanding Debts 18. Cash Equivalents ......:...............................;.........................................$. 19. Outstanding Debts .......... Add Une 2 + Une 91n Column C above $ S/CCW - PCAPOB 01504 (Rev. 9/99) Column A TOTAL TH1S PERIOD (FAaM ATTACHED SCHEDULES) 12,975,64 (12.000.00) ~ 0.00 .!US.. 64 2 100.00 0.00 2.100.00 JL.JU! _0.00 2.100.00 , I 1.124.36 975.64 0.00 2.100.00 0.00 - 0.00 - 0.00 0.00 _covenoperiod SUMM"'{~P;G,E from 10/21 /2003 ' .t,! .." - "/H/',"' - ' ". LD. NUMBER 1256061 CaIendIr V".. SUmnI8y for Candi~ Running In Botih the Slate Pri"""1f .,mJ GeœraI EIediœs , Column B CALENDAR YEAR TOTAL TO DATE 15 929 L6.4 0.00 1.5...9.2.9...64 398.00 16 . 3 2.2..Ji4. 15.929.64 0.00 15,929,64 0.00 398.00 1.6.. 32.L 64 111 throu9h 6/30 7/1 to Data 20.=~, 0 21. Expondllu... 0 Made .......... , . .Q .Q ExpenIiIure Unlit SI8nIIwy for - CandIdates 22. Cumulative Expenditure Made" (I Su~ to VoIurUry Expendiure Urnft) Dol. 01 - (mm/ddlyy) Total to Date Schedule A Monetary Contributions Received SIa- covers period from 10/21/2003 ' through 12/31/2003 "-~ of I.D. NUMBER NAMEOFALER RICHARD LOWENTHAL, RE-ELECT RICHARD LOWENTHAL 1256061 IF AN INOMOUAL. ENTER OCCUPATION AND EMPl.OYER ~F seLJ'-EMPLOYED ENTER NAME OFSUSNESS) AMOUNT RECEIVED THIS PERIOO CUMULATIVE TO DA1E CAl.ENDAR YEAR (,IAH1-DEC31) PER ElECTlO" TO OATE OF REQUIRED) 975.64«~(jJ) 12,OOO.00(l°(jj) OA1E RECENED FULL NAME. SlREET ADDRESS AND ZIP COOE OF CONTRIBUTOA I CONTRIBUTOR ~F COMMITTEE, ALSO EN"" 1.0. "-'MaER) CODE' iii IND 0 COM 0 OTH Om 0 see 0 INO 0 COM 0 OTH Om 0 see 0 IND 0 COM 0 OTH Om Osee 0 IND 0 COM 0 OTH OPTY Osee 0 IND 0 COM 0 OTH Om 0 see , ' . SUBTOTAL $ 12,975.64- 12/16/20031 RICHARD LOWENTHAL 21602 VILLA MARIA CT 12/16/2003 CUPERTINO, CA .95014 12/16/2003 RICHARD LOWENTHAL (c,pntinued) 12/16/2003 Candidate 12,975.64 nc1udes DanIs) 2,000,00 '*FORGlVEN LOP 7,000.00 *FORGlVEN LOP 3,000.00 " 975.64 *FORGlVEN La. Monetary Conbibutions Summary 1. Amount received this period - contributions of$100 armors. (Include all Schedule A subtotals.) .."""""""""""""""""""""""""""""""""""""""""""""""" $ 2. Amount received this ¡ieriod - contributions ofless than $100. (Do not itemize.) .............................................................................................................................. $ 3. Total monetary contributions received this period. (Add Unes 1 and 2. Enter here and on the Summary Page, C01wnn A, Une 1.) .............. TOTAL $ 12.91.5....H 0.00 12. 91.5....6i Schedule B - Part I Loans Received NAMEOFALER RICHARD LOWENTHAL, RE-ELECT RICHARD LOWENTHAL FULL NAME, STREETAODRESS AND ~p CODE OF LENDER QF COMMITTEE, ALSO EHTER 1.0. NU""') IF AN INDMDUAI.., ENTER OCCUPAT1Of4 AND EMPLOI'ER (1F~"'e'i\s,"",\'¡,~TER Candidate ~ . ~ 'OOING BALANCE BEGINNING THIS (b) AMOUNT RECENEDTHIS PE"OO RICHARD LOWENTHAL 21602 VILLA MARIA CT CUPERTINO, CA 95014 (0) AMOUNTPAJD OR FORGIVEN THlSPE"OO OpAJD $ -----2.. iii FtRGlVEN o~ 10-----2.. lo~ IiIIND 0 COM 0 OTH 0 PTY Osee RICHARD LOWENTHAL (Continued) OpAJD 0 -----2.. iii FORGIVEN $ ---L..Q.Q!!. 1 $ -----2.. 1 $---L..Q.Q!!. 0 IND 0 COM 0 OTH 0 PTY Osee RICHARD LOWENTHAL (Continued) (Continued) - covers period from 10/21 /2003 ' Ihrough 12/31/2003 -- ._.'ÁNDING BALANCE AT CLOSE OF THIS (.¡ lN1ëAeST PAJDTHIS PE"OD 1256061 (I) (9) tRIGlNAL CUMULATiVe AMOUNT OF CONTAIBUTIC,'IS LD.AN To. DATe CALENDAA YE.'" $ --9.. I ~ $ --k..!2Q.Q.. $ ~ RATE PEA ELECTION 07/01/2004 .-----2.. D7/D1/2C03 0 12.000 "OJ GATE DUE DATE INCURRED CALENDAR YEAA . --9.. 1 ~ I' -2.....!2!!.!L I' 12 9 7 5 RATE PER ELECTION ~ 1'-----2.. 09/03/2003 $- .12,.QQQ. P03 DATE DUE GATE INCURRED OpAJD $ -----2.. I. --9.. CALENDAR YEAA . --2....QQ.!L I $ 12, \>,7 5 iii FORGIVEN ~ RATE PER ELECTION 0 IND 0 COM OOTH 0 PTY 0 see .~ 1.-----2.. I $~ 1 ~ 1.--9.. DATE DUE 12 000 P03 SUBTOTAL $ O.CO $ 12,000.00 $ Schedule B Summary 1. Loans received this period ..................................................,.........................................................$ (Total Column (b) plus ¡nitemized I.oans less than $100.) 2. Loans paid or forgiven this period ................".............................................................................. $ (Total Golumn (c) plus loans uncler$1oo paid or forgiven.) (Include loans paid by a third party that 81'9 also itemized on Schedule A.) 3. Net change this perod. (Subtract Line 2 from Line 1.) """"""""""""""""""""""""'" Enter the net here ~ on the SummBl)' Page, Column A, Line 2 NET $ C.OO $ 975.64 12.975.64 (12,COO.CO¡ D. DO .SCHEDULEB.¡:'","I(co~::J Schedule B - Part I (Continuation Sheet) Loans Received - .,.",.,.. pM'iod from 10/21.L2003 1hn>ugh.12/31/2003 "-~ 01 I.D. NUMBER NAMEOFALER RICHARD LOWENTHAL, RE-ELECT RICHARD LOWENTHAL FULL NAME, STREET AOORESS AND ZIP COOE OF LENDER ØF COMMITTEE. ALSO ENTER LD. NU"'ER) IF AN INOMDUAL, ENTER accUPATIOII AND EMPl.CJYER (IF S~E~~~TER ~INQ BAlANCE BEGINNING THIS (b) AMOUNT RECEIVED THIS PERIOD (0) AMOUNTPAJD OR PQAGNEN THIS PERIOD - - IQ BALANCE AT ClOSE Of THIS (.) INTEREST PAJDTHIS PERICO 1256061 ro (g) ORIGINAL CUMULATIVE AMOUNT OF CONTRIBlJTlONS LOAN ToOATE CALENDAR yEAR 0 INO 0 COM 0 OTK 0 PTY 0 see DpAJD I ---'1.. iii FORaVEN 1---'1.. II~ II~ I ---'1.. I ~ I"~'~ RATE PER ELECTION 11/05/2004 I ---'1.. ~ 3 ,~PUJ OATEDUE OATE INCURRED OpAJO CALENDAR YEAR 1- 1- ~ 1_'- 0 FORGIVEN RATE FER ElECTION "-1"-1"- -¡;¡:¡e¡;¡jE ,-- OATE INCURRED 0 PAlO CALENDAR YEAA 1- 1- ~ "_"- 0 FORGIVEN RATE PER ELECTION '-1'-1"- -¡;¡:¡e¡;¡jE ,--- OATE INCURRED 0 PAID CALENDARYEAA ,- 1- ~ 1-'- 0 FORGIVEN RATE PER ELECTION '-1"-1"- ,-- OATE DUE DATE INCURRED OpAJO I CALENDAR YEAR 1_1- ~ "_"- 0 FORGIVEN RATE PER ELEcTION RICHARD LOWENTHAL (Continued) (Continued) (Continued) 0 INO 0 COM DOTK OPTY Osee 0 IND Ocou OOTK 0 PTY Osee 0 INO Ocou 0 OTK 0 PTY 0 see O'NO 0 COM 0 OTK 0 PTY Osee I 1'-1"-1"-1 -¡;¡:¡e¡;¡jE 1'- I ÕÃTËiÑëUAAEo ~ SUBTOTAL $ 975.64 $ 975.64 $ 0.00 $ O.CD- from 10/11 12003 ' 7 of Schedule E Payments Made SIa- """"'" I8IIod through 12/31/2003 NAME OF FILER RICHARD LOWENTHAL, RE-ELECT RICHARD LOWENTHAL 1256061 CODES: If one of the following codes accurately descrIbes the payment, you may enter the code. Otherwise, descrtbe the payment. C MP campaign paraphernaIa/mI M BR member communlœtlons RAD radio airtime and produotion coots CNS campaign - MTG moetlogo and appearances RFD reIumod comI>ution8 CTB -- (explain non.....-ry)" OFC oftice 0- SAL campaign workora- cvc oMc donaliona PET "011100 cln:uJotIng TEL l Y. or cable airtlrn..nd production cosIo FlL candldatefllnglbololf... PHO phonobanka TAC candldatetrall8l,iodgingandmoola(oxpiain) FND fundrafsingOVtnlS. POL poIlingandlUNOY- TRS atan¡.pou.etravel, lodging ondm..ls(oxplain) INO independente>q>ondlturuupportlng/oppoaing - (explain)" ?OS paoIago, doiveryand messengoroorvlces lSF _...bot-. commliteeaal thesom. candidals/spence, LEG legal del..... PRO prdeoalonal services (legal, accounting) VOT - regiatratlon LIT campaign Iit- and maiDnge PRT print ods WEB . information technology costa On_et, .-mail) NAME AND ADDRESS OF PAYEE OR CREDITOR ØFCCUUITTE!!,~ ENTERO.D. NU...." CODE OR DESCAIPt1ON OF PAYMENT AMOUNT PAJD TINA FERGUSON TRS ELECTION VICTORY PARTY 2,100.00 5278 RAFTON DRIVE SAN JOSE, CA 95124 . SUBTOTAL $ 2,100.00 Schedule E Summary 1. Payments made this period of $100 or more, (Include all Schedule E subtotals.) .............................,...............,...,......................... 2. Unitemized payments made this period of under $100. ...............................................................................,................................... 3. Total interest paid. this period on outstanding loans. (Enter amount from Schedule B, Part 2, Column(d).) .................................... 4. Total payments made this period. (Add Unes 1. 2, and 3. Enter here and on the Summary Page, Column A, Une 6.).... TOTAL $ $ $ $ 2.100.00 0.00 0.00 2,lQQ.QO