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1st 460 Semi-Annual Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink. Statomont covors poriod from January 1, 2004 . -- -- -ôEE lNSfF([JCTiTIt'fSON REVERSE .Jttne-~2004 through 1. Type of Recipient Committee: All Committees - Complo" Parts " 2, 3, and 4. IXI Officeholder, Candidate Controlled Committee Ballot Measure Committee State Candidate Election Committee 0 Pomarily Fonmed 0 Recall 0 Controlled (A/w Compæœ PM" 0 Sponsored (AI",Comp"'P'.6J 0 General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political PartylCentral Committee 0 Primarily Formed Candidatel Officeholder Committee IAI",Compl."p,.,) 3. Committee Information 1.0 NUMBER 1237120 COMMITTEE NAME COR CANDCDATES NAME CF NO COMMCTTEE) Elect Patrick Kwok for City Council STREET ADDRESS (NO PO BOX) 10222 Carmen Road CCTY STATE lCP CODE Cupertino CA 95014 MACUNG ADDRESS ICF OCFFERENT) NO AND STREET OR PO BOX AREA CODE/PHONE (408)777-3191 C'TV STATE lCP CODE AREA CODE/PHONE OPTCONAI. FAX i E-MAIL ADDRESS CUpERTINO CITY ClE For Official Use OoCy 2. Type of Statement: 0 Preelection Statement IXI Semi-annual Statement 0 Termination Statement 0 Amendment (Explain below) 0 Special Odd-Year Report 0 Supplemental Preelection Statement - Attach Fonm 495 Treasurerjs) NAME OF TREASURER Claudia Chang MACUNG ADDRESS 7437 Fallenleaf Lane CCTY Cupertino NAME OF ASSISTANT TREASURER. CF ANY STATE CA lCP CODE 95014 AREA CODE/PHONE (408) 277-5186 Patti Nakamura MACUNG ADDRESS 3447 Cadillac Drive CCTY STATE CA San Jose OPTIONAL FAX I E-MAIL ADDRESS lCP CODE 95117 AREA CODE/PH-ó"NE 4. Verification I have used all reasonable diligence in preparing and revlewmg this statement and to the best of my knowledge the information contained herein and in the attached schedules IS true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing ~ da'¡¡ E"wted 00 By S',OO'C,""Coclro""gOffiœhc!do; c'c."" SI",M"'cœPmpoo," FPPC Fo,m 460 IJ"no/01J FPPC TolI-F,.. Helpline, 8661ASK-FPPC State of Califomi. Daie Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FIlER Contributions Received 1. Monetary Contributions 2. Loans Received 3 SUBTOTAL CASH CONTRIBUTIONS 4 Nonmonetary Contributions. Schedule A. Line 3 Schedule B. Line 3 Add Lines 1 +2 Sch.dule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 +4 Expenditures Made 6. Payments 7. Loans Schedule E, Line 4 Schedule H, Lin. 3 Add Lines 6+7 $ 8. SUBTOTAL CASH PAYMENTS 9. Accrued Expenses (Unpaid Bilis) 10. Nonmonetary Adjustment 11. TOTAL EXPENDITURES MADE .. Schedule é lone 3 Sched"'e C. Un. 3 .AddLines8+9+10 Current Cash Statement 12. Beginning Cash Balance 13. Cash Receipts Prr"ious S"mmar¡ Page. lone 16 Co/"mn A. Line 3 abo,e 14. Miscelianeous Increases to Cash 15 Cash Schedule I Line 4 Col"mn A, lone 8 abo" 16. ENDING CASH BALANCE Add Lines 12+ 13 + 14 thensubl",ctUne 15 If fhis is a termination stafement. Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED Schedule B. Pan 2 Cash Equivalents and Outstanding Debts 18 Cash Equivalents See Instrucdons on 'e",se 19. Outstanding Debts Add lone 2 +Lme 9mColum"Babo" Type or print in ink. Amounts may be roundod to whole dollars, ColumnA TOTA' T"'S"RIOD f'ROMATTACHEDSŒEDUIESI 585 585 3894.25 0 7,45 0 3901.07 Cotumn B CAlENDAR "'-R TOTAL TO DATE from through 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 fiffit report being filed for this calendar year. only carry over the amounts from LInes 2. 7. and 9 (if anyJ SUMMARY PAGE January 1, 2004 CALIFORNIA 460 FORM Statement covers period June 30, 2004 I Page i 10 NUMBER ¡ 1237120 3 of 5 Calendar Year Summary for Candidates Running in Both the State Primary and Il1lh1O"9h 6/30 20 Contributions Received 21 Expenditures Made 7/1 co D"e Expenditure Limit Summary for State Candidates 22- Cumulative Expendlturos Mad.' ("""bjo<lloVo'onta""'p."""",,Llm'l Date of Election (mm/ddlyy) TotalloOate $ $ $ $ $ $ 'SInce January ,. 2001. Amounts in this section may be different from amounts reported in Column B FPPC Form 460 (June/O1) FPPC Toil-Free Helpline: 866/ASK-FPPC Schedule C Nonmonetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE C SEE INSTRUCTIONS ON REVERSE NAME OF FILER from through June 30, 2004 CALIFORNIA 460 FORM Statoment covers period January 1, 2004 I Page~ of~ I I I ID.NUMBER ( ¡. -- t I n^,O I ! CUMULATIVE TO FUll NAME. STREET ADDRESS AND CONTRIBUTOR IF AN CNDIVIDUAl. ENTER I DESCRIPTION OF FA~~~~~~~T DATE PE':~~^~~ON , RECEIVED i C" COMMIT'" ALSO ENTER' D. NUMBERI wuo C" SELF-EM"O"D ENTER i VALUE v~'ONU~n IIF REOUIRED) NAME OF BUSINESSI (JAN 1 - DEC 31) I OIND two tickets for the, ~~~.. 2/14/041 OCOM $75 each $150 ~OTH Annual Banquet I /3 2.f ¡.,~ytir OPTY of Hong Kong It~L, 8:;;~ I OSCC Students 6/13/041 OIND 2 tickets to a fvilwJ) ~ cJ.;), OCOM perform. by China $75 each $150 ~~ N,J.£6 iilOTH OPTY Disabled People 43 4-75 ž¡lj DSCC Perf. Arts Grp Fr.LWlIKt. OIND ' OCOM OOTH OPTY OSCC i OIND I OCOM I I DOTH i OPTY I OSCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 300 I '(JAI~i -etal' ~ 'If-ð/l) ~~ ,.;tft5r-- 37 'Contributor Codes IND -Individual COM-RecipientCommitlee (other than PTY or SCC) OTH-Other PTY - Political Party SCC - Small Contributor Committee Schedule C Summary 1. Amount received this period - nonmonetary contributions of $1 00 or more. (Include all Schedule C subtotals.) . 2. Amount received this period - unitemized nonmonetary contributions of less than $100 3. Total nonmonetary contributions received this period (Add Lines 1 and 2. Enter here and on the Summary Page, Column A. Lines 4 and 10.) $ $ 300 285 TOTAL $ 585 FPPC Form 460 (JuneIO1) FPPC Toll-Free Helpline: 866IASK.FPPC Schedule I Miscellaneous Increases to Cash Type or print in Ink. Amounts may be roundod towholo dolla"" SEE INSTRUCTIONS ON REVERSE NAME OF FIlER Claudia Chang/Elect Patrick Kwok for City Council DATE FUll NAME AND ADDRESS OF SOURCE mE ALSO EN"R I D NUMBER Attach additional information on appropriately labeled continuation sheets 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.) Statemont cove", period from January 1, 2004 through June 30. 2004 DESCRIPTION OF RECEIPT $ $ $ TOTAL $ 5 of 5 pago 1.0 NUMBER 1237120 AMOUNT OF INCREASE TO CASH SUBTOTAL $ 7.45 7.45 FPPC Form 460 (June/O1) FPPC TolI.Free Helpline: 866IASK.FPPC