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460 Termination ecipient Committee Campaign Statement (Government Code Sections 84200 - 84216.5) Date of EIo~lo~ If ~ (Month, Day, Ye~)~~E:L ~. 10/31/~003 COVER PAGE - LONG JAN 2 ~ 2004 i 1°~ % For Official U~eOnly ~ERTINO CITY CLEI mm~h 12/31/2003 1. Type of Fle¢ipient Committee: [] Officeholder, Candidate Controlted Committee [] Ballot Measure Committee 0 State Candidate Election Committee C) nsc~ D General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Cent]al Committee 3. Committee Information O Primarily Formed O Controlled 0 Sponsored [] Primarily Formed Candidate Officeholder Committee RE ELECT RICHARD LOWENTHAL 21602 VILLJ% MARIA COURT CUPERTINO CA 95014 (408)973-8494 (408) 255- 8033/ 11/04/2003 2. Type of Statement: [] Pm-election Statement [] Semi-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarlerty Statement [] Special Odd-Year Report [] Supplemental Pm-election Statement - Attach Form 495 Treasurer(s) NAME O~ TREASURER TOM HALL 21040 HOMESTEAD RD CUPERTINO CA 95014 (408)773 -1400 ( ) 4. Verification I have used all reasonable diligence in preparing and DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE F~OPCN ENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT S/CCW - PCAP08 01504 (Rev. 9/99) State of Caltiomla Fair Political Practices Commission. ecipient Committee Campaign Statement Cover Page- Part 2 5. Officeholder or Candidate Controlled Committee COVER PAGE - PART 2 6. Ballot Measure Committee NAME OF BALLOT MEASURE RICHARD LOWENTHAL city Council Membei, 21602 VILLA MARIA CT CUPERTINO CA 95014 Related Committees Nat Included in this Statement: List any ~'nmli~s not included in this consolidated statement that are controlled by you or whio~ are pdmadly formed to receive cont~butions or to make expenditures on behalf of your candidacy. NAME OF TREASURER Identify the controlling officeholder, candidate, or state measure proponent, ff any. - NAME OF OFFICEHOLD;R, CANDIDATE ~1F%qOFONENT ,.O..UM'~. 7. Primarily Formed Committee CONTROU. ED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD NAME OF OFFICEHOLDER OF~ CANDIDATE OFFICE SOUGHT O~ HELD Campaign Disclosure Statement Summary Page NAMEOFFI~R RICHARD LOWENTHAL, RE-ELECT RICHARD LOWENTHAL Contributions Received 1. Monetary Contributions .....................................Schedule A, Line 3 2. Loans Received ................................................ Schedule B, One 7 3. SUBTOTAL CASH CONTRIBUTIONS .................. Add Ones I + 2 4. Non-monetary Contributions ............................. Schedule C, One 3 5. TOTAL CONTRIBUTIONS RECEIVED ................. Add Dunes 3 + 4 Expenditures Made 6. Cash Payments ................................................ Schedule E, Une 4 7. Loans Made ...................................................... Schedule H, Dune 7 8. SUBTOTAL CASH PAYMENTS ............................ Add Dunes 6 + 7 9. Accrued Expenses (Unpaid Bills) ...................... Schedule F, Line 3 10. Nonmonetary Adjustment ................................ Schedule C, One 3 11. TOTAL EXPENDITURES MADE .................. AddLines8+9+lO Current Cash Statement 12. Beginning Cash Balance .......... Previous Summa~/Page, Dune 16 13. Cash Receipts ......................................... Column A, One 3 above 14. Miscellaneous Increases to Cash ..................... Schedule I, One 4 15. Cash Payments ....................................... Column A, Dune 8 above 16. ENDING CASH BAl~//~es 12 + 13 + 14, then subtract Dune 15 ff this is a Termination Statement Line 16 must be zero. 17. LOAN GUARANTEES RECEtVEDSchedule B, Part I, Column (b) Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................................................ 19. Outstanding Debts .......... Add Dune 2 + Dune 9 in Column C above Column A TOTAL THIS PERI(DO (FROM AT~ACHED ~CHEDULES) $ 12,975.64 {12. 000.00) $ 975.64 0.00 975.64 $ 2,100.00 0.00 $ 2,100.00 0.00 0.00 2,100.00 1,124.36 975.64 0.00 2,100.00 0.00 0.00 0,00 0,00 SUMMARY PAGE C~umnB 15,929.64 0.00 15,929.64 398.00 16,327.64 15.929.64 0.00 15,929.64 0.00 398.00 16.327.64 Calendar Year Summa~ for Candidates Running in Both the State P~iman] and Gened Eleolic~s 1/1 through 6~30 7/1 to Date 20. Cont rib~ions Received,... $ Q 21. Expenditures Made .......... $ 0 E.xpenditure Umit Su.anmy for S;.~ Can~dates 22. Cumulative Expenditure Made* (if Subje~ to Volur~ar/Expenditure Limit) Date d E~ion Total to Date (mm/dd/yy) S/COW - PCAP08 01504 (Rev. 9/99) CHEDULE A Monetary Con~bufions Received through 12/31/__2003 PO 4 o~ 7 NAMEOF FILER RICHARD LOWENTHAL, RE-ELECT RICHARD LOWENTHAL LD. NUMBER 1256061 IF AN INDIVlDUAI~ ENTER DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT RECEIVED CUMULAtiVE TO DA'~ PER ELECTION OF BUSrNESS) (JAN 1 - DEC 31) (IF REQUIRED) 12/16/2003 RICHARD LOWENTHAL [] IND Candidate 2,000.00 12,975.64 975.64 21602 VILLA MARIA CT [] COM *FORGIVEN LOt ~ncludes 12,000.0( 12/16/2003 CUPERTINO, CA 95014 [] OTH 7,000.0Q Loan(s) [] PTY *FORGIVEN LO) 12/16/2003 [] SCC 3,000,0~ *FORGIVEN LOt RICHARD LOWENTHAL (c, ontinued) [] IND 12/16/2003 [] COM 975.64 [] OTH *FORGIVEN LOt [] P~Y [] SCC [] IND [] COM [] OTH [] PTY [] SCC [] IND [] COM [] OTN [] [] SCC [] lED [] COM [] OTH [] PTY [] SCC .64(GO3) fPO3) SUBTOTAL $ 12,975.64 Moneta~j Contributions Summary l. Amount received this period - contributions of $ lO0 or more. (Include all Schedule A subtotals.) .................................................................................................. $ 2. Amount received this period - contributions of less than $100. (Do not il~mize.) .............................................................................................................................. $ 3. Total monetary contributions received this period. (Add Lines I and 2. Enter here and on the Summary Page, Col. mn A, Line 1 .) .............. TOTAl $ 12,975.64 0.00 12,975.64 chedule B - Part I Loans Received ~ ~o/~i/2oo~ ~12/31/2003 SCHEDULE B - Part I Page 5 of 7 NAMEOFFI~R RICHARD LOWENTHAL, RE-ELECT RICHARD LOWENTHAL RICHARD LOWENTHAL 21602 VILLA MARIA CT CUPERTINO, CA 95014 ra,.o Doc~ I-Io~. O~rY Oscc RICHARD LOWENTHAL (Continued) E],~~ rlco~Do~ O.w Dscc RICHARD LOWENTHAL (Continued) (Continued) rl,.o Dco~ Oo~ D~r~ Osc~ IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER Candidate $ 71000 3,000 fo) AMOUNT RECEIVED THIS PERIOD $ $ 0 $ 0 fo} [] PND $ 0 [] FORGIVEN $ 2tO00 [] PAID $ 0 7r000 [] PAID $ 0 $ 0 o~/ol/~OO4 DATE O43E $ 0 o~/o3/~ooa $ 0 10/21/2004 (e) 0.000 PATE $ 0 $ 0 0.000 PATE I.D. NUMBER 1256061 (1) (g) ORIGINAL CUMULATIVE 07/01/2003 $ 12r000__ ~/O ~ 09/03/2003 12. 000 PO9 10/21/2003 $ 12 000 POh SUBTOTAL $ o.oo $ 1~,ooo.oo $ o.oo $ o.oo Schedule B Suaaery 1. Loans received this period ............................................................................................................ $ (Total Column (b) plus initemized loans less than $100.) 2. Loans paid or forgiven this pedod ................................................................................................ $ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1 .) ................................................... Enter the net here and on the Summary Page, Column A, Line 2 NET $ 975.64 12,975.64 (12,000.00) SCHEDULE B - Part I (cont.) Schedule B - Part I (Continuation Sheet) =---~...-.~,~,, ~a Loans Received ~ 10/31/2003 th~l 12/31/2003 I~ 6 ~ 7 NAMEOFF. LER RICHARD LOWENTHAL. RE-ELECT RICHARD LOWENTHAL 1D. NU.BER 1256061 FULL NAME, I~FREET AD•RE ~,~ AND Z}P CODE IF AN INDIVIDUAL, ENTER C~JT,~[)N GIN G (b) (c) ~(JTS'~DING (e) ~ (g) OF I~N~ER OCCUPATION AND EMPLOYER BALANCE AMOUNT AMOUNT PAID BALANCE AT INTE REI~T ORIGINAL CUMULATIVE (IF SELF-EMPLOYEO ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLO~E OF ~IIS PND THIS AMOUNT Of= CONTRIBUTIONS RICHARD LOWENTHAL [] PArD CAUSNDARYEAFI (Continued) (Continued) (Continued) $ 0 $ 0 % 0,000 $ 975 $ 12 975 [] FORGIVEN RATE PEn ELECTION I--lIND DCOMJ-'IoTH ~--]PTY []SCC $ 0 $ 975 $ 975 3.1/05/2004 $ 0 11/05/2003 $ 12~000 $ % $ D'"o D~o- Do~ D~" D= ' $ $ ' ' $ $ % $ [] F(~GIVEN RATE PER ELECTION DIND [~coMDoTH OPT~ Dscc s $ $ . $ __ S $ $ ~ $ [] FORGIVEN RATE ER ELECTION DIN• Elco- Do~, I-I~ E]scc $ $ $ $ $ $ % $ $ r-I,ND D~MOo~ Dm i-lscc ' s s ' PO3 SUBTOTAL $ 97~.e,~ $ 9~5.~ $ $ o.o, chedule E Payments Made h'om 10/31/2003 mroM~ 12/31/2003 SCHEDULE E Page 7 of 7 NAMEOFFI~R RICHARD LOWENTHAL, RE ELECT RICHARD LOWENTHAL CODES: If one of the following codes accurately describes the payment, you may enter the code. Othenvise, describe the payment. CMP campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations I.D. NUMBER 1256061 POL Ix~ling and suwey research POS postege, de{ivery and messenger services PRO prole~sional Se~k:es (legal, accounting) NAMEANDADDRESSOFPA~EORCREDITOR OF CO~MI~EE, AL~ E~ER I.D. NUM~fl CODE OR DESCRrPT~N OF PAYMENT AMOUNT MID TINA FERGUSON TRS ELECTION VICTORY PARTY 2,100.00 5278 RAFTON DRIVE SAN JOSE, CA 95124 SUBTOTAL $ 2,[00.00 Schedule E Summmy 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 Lines 1,2, and 3. Enter here and on the Summary Page, Column A, Line 6.) .... TOTAL $ 2,100.00 0.00 0.00 2,100.00