460 Recipient Commitee Campaign Statement 12-31-2011 Recipient Committee COVER PAGE
Campaign Statement Type or print in ink. I (�teS� W im�
V t5 y [ (4i.1 =0RNIA 460
Cover Page I)RM
(Government Code Sections 84200 - 84216.5) 1 6
Statement covers period Date of election if applica +: JAN 3 1 2011 .Z; of
from
7/1/10 (Month, Day, Year) �" .r Official Use Only
SEE INSTRUCTIONS ON REVERSE through 12/31/10 CriPERTINO CITY CLERK
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement:
® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement
Q State Candidate Election Committee Committee ® Semi - annual Statement ❑ Special Odd -Year Report
Q Recall 0 Controlled
(Also complete Part 6) 0 Sponsored ❑Termination Statement ❑ Supplemental Preelection
(Also file a Form 410 Termination) Statement - Attach Form 495
(Also Complete Part 6)
❑ General Purpose Committee ❑ Amendment (Explain below)
Q Sponsored ❑ Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
O Political Party /Central Committee (Also Complete Part 7)
3. Committee Information I.D. NUMBE Treasurer(s)
1257379
COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) NAME OF TREASURER
Re -Elect Kris Wang for City Council Lucy Lu
MAILING ADDRESS
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
State of California
Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE
Amounts may be rounded Statement covers period
CALIFORNIA 460
Summary Page to whole dollars.
from 7/1/10 FORM
SEE INSTRUCTIONS ON REVERSE through 12/31/10 Page 2 of 6
NAME OF FILER I.D. NUMBER
1257379
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and
1. Monetary Contributions Schedule A, Line 3 $ 0 $ 0.00
General Elections
2. Loans Received Schedule B, Line 3 0.00 0.00 1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 $ 0.00 $ 0.00 20. Contributions
Received $ $
4. Nonmonetary Contributions Schedule C, Line 3 0.00 0
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 + 4 $ 0.00 $ 0.00 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made Schedule E, Line 4 $ 2124.00 $ 2754.00 Candidates
7. Loans Made Schedule H, Line 3 0.00 0.00
2124.00 2754.00 22 Cumulative Expenditures Made*
.
8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ $ llf Subject fn Voluntary FvnnnAiture urine)
9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 0.00 0.00 Date of Election Total to Date
10. Nonmonetary Adjustment Schedule C, Line 3 0.00 0.00 (mm /dd /yy)
11. TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10 $ 2124.00 $ 2754.00 ____/_/ $
Current Cash Statement /--- $
12. Beginning Cash Balance Previous Summary Page, Line 16 $ 17837
To calculate Column B, add
13. Cash Receipts Column A, Line 3 above
0.00 amounts in Column A to the
32.92 corresponding amounts *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B of your last reported in Column B.
2124.00 report. Some amounts in
15. Cash Payments Column A, Line 8 above Column A may be negative
16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 15746.80 figures that should be
subtracted from previous
If this is a termination statement, Line 16 must be zero. period amounts. If this is
the first report being filed
17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ for this calendar year, only
carry over the amounts
Cash Equivalents and Outstanding Debts anm ny).
Lines 2, 7, ands (if
18. Cash Equivalents See instructions on reverse $
0.00 a
19. Outstanding Debts Add Line 2 + Line 9 in Column 8 above $ 0 FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule D
Summary of Expenditures Type or print in ink. SCHEDULED
ry p Statement covers period
Amounts may be rounded CALIFORNIA 460
Supporting /Opposing Other to whole dollars. 7/1/10 FORM
Candidates, Measures and Committees from
SEE INSTRUCTIONS ON REVERSE through 12/31/10 Page 3 of 6
NAME OF FILER I.D. NUMBER
1257379
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION CUMULATIVE TO DATE PER ELECTION
DATE TYPE OF PAYMENT AMOUNT THIS CALENDAR YEAR TO DATE
MEASURE NUMBER OR LETTER AND JURISDICTION,
OR COMMITTEE (IF REQUIRED) PERIOD
(JAN. 1 - DEC. 31) (IF REQUIRED)
Cupertino Rotary Foundation Fil Monetary 77-0288042
7/15/10 Contribution
150.00
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose Expenditure
Relay for Life ❑ Monetary
7/17/10 Contribution
❑ Nonmonetary 100.00
Contribution
❑ Independent
❑ Support ❑ Oppose Expenditure
John Chiang for Controller ® Monetary
9/12/10 Contribution
100.00
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose Expenditure
SUBTOTAL $
Schedule D Summary
1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) $ 350.00
2. Unitemized contributions and independent expenditures made this period of under $100 $ 0.00
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $ 350.00
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule D
(Continuation Sheet) Type or print in ink. SCHEDULE D CONT.
Summary of Expenditures A mounts maybe rounded Statement covers period
to whole dollars. CALIFORNIA 460
Supporting /Opposing Other from 7/1/10 FORM
Candidates, Measures and Committees
through 12/31/10 Page 4 of 6
NAME OF FILER
I.D. NUMBER
1257379
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION CUMULATIVE TO DATE PER ELECTION
DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED) AMOUNT THIS CALENDAR YEAR TO DATE
OR COMMITTEE PERIOD (JAN .1 - DEC . 31) (IF REQUIRED)
Dr. Michael Chang for County Board ® Monetary 1330308
10/2/10 Contribution
❑ Nonmonetary 200.00
Contribution
❑ Independent
❑ Support ❑ Oppose Expenditure
Ted Lieu for State Senate ® Monetary 1333752
12/19/10 Contribution
❑ Nonmonetary 100.00
Coniribution
❑ Independent
❑ Support ❑ Oppose Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose Expenditure
SUBTOTAL $
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
SCHEDULE E
Schedule E Type or print in ink. Statement covers Payments period 460
Pa Made Amounts may be rounded CALIFORNIA
y to whole dollars. 7/1/10 FORM
from
SEE INSTRUCTIONS ON REVERSE through 12/31/10 Page 5 of 6
NAME OF FILER I.D. NUMBER
1257379
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CfvP campaign paraphernalia /misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD retumed contributions
CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries
CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs
FIL candidate filing /ballot fees PHO phone banks TRC candidate travel, lodging, and meals
FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals
IND independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTERI.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Cupertino Rotary
MTG 354.00
AAGG
MTG 200.00
Friends of Children with Special Needs
CVC 100.00
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) $ 654.00
2. Unitemized payments made this period of under $100 $ 0.00
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) $ 0.00
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ 654.00
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule E Type or print in Ink. SCHEDULE E (CONT.)
(Continuation Sheet) Amounts may be rounded statement covers period CALIFORNIA 460
Payments Made to whole dollars. from 7/1/10 FORM
SEE INSTRUCTIONS ON REVERSE
through 12/31/10 Page 6 6
NAME OF FILER
I.D. NUMBER
1257379
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries
CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs
FIL candidate filing/ballot fees PHO phone banks 1RC candidate travel, lodging, and meals
FND fundraising events POL polling and survey research IRS staff /spouse travel, lodging, and meals
IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
LIT campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
OF COMMITTEE, ALSO ENTER I.D. NUMBER)
Ricky Lee, Internship
OFC 820.00
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL S 820.00
FPPC Form 460 (January/05)
FPPC Toll -Free Hetpline: 866 /ASK -FPPC (866/275 -3772)