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460 Recipient Committee 7-1-12 to 12-31-12 Termination �Recipient Committee Type or print In ink. COVERPAGE Campaign Statement D � � � '' ' � • 1 Cover Page � (Govemment Code Sections 84200-84216.5) 8�_ of Statement covers period Date of election if appit � JAN 3 G 2ui3 ` '1� � (Month, Day,Year) For Official Use Only from � a� SEE INSTRUCTIONS ON REVERSE through�,1��.C- ��. �_� NOV. S, 2011 C ERTlNO C{TY CLER 1. Type of Recipient Committee: Ail Committess—Complets Parta 1,z,s,a�n 4. 2. Type of Statement: QJ Officeholder,Candidate Controlled Committee ❑ Primatiiy Formed Balbt Measure ❑ Pree►ecUon Statement � Quarterly Statement Q State Candidate ElecGon Committee Committee � Semi-annual Statement Q Recali Q Controlled ❑ Speaat Odd-Year Report �aso ca„aereaens� 0 Termination Statement � Supplemental Preelection w Q Sponsored Also file a Form 410 Termination �aso canp�e Pert s) � � Statement-Attach Form 495 ❑ General Purpose Committee ❑ Amendment(Explain below) Q g�� Primarily Formed Candidate/ �Smail Contributor Committee Officeholder Committee �Political Party/Central Committee (�com�Part�� 3. Committee Information �.D. NUMBER Treasurer(s) 1337603 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Chris Zhang For Council 2011 Daisy Lu Li MAILING ADDRE8S % MAILING ADDRESS(�F DIFFERENT)NO.AND STREET OR P.O. 80X MAILtNG ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPT�ONAL: FAX/E-MAIL AODRESS OPTIONAL: FAX/E-MA1L ADDf2ESS 4. Verification 1 have used all reasonable diligence in preparing and reviewing this statement and to the best of my odraer d Sponsor Executed on By Dete Signature of ControYing 08icehaWer,Candidate,State Measure Proponerd Executed on � By Slgr,acure a Concrolw,g ofAcendder,Candidace,scace Mees�,re Pnoponern FPAC Form 460(Janerary/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866l275-3772) 3tate of Catifornla Type or print In ink. COVER PAGE-PART 2 Recipient Committee Campaign Statement � .� � � • 1 Cover Page—Part 2 Page �- of� 5. Officehoider or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Chris Zhang OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT N0.OR LETTER JURISDICTION � SUPPORT Cupertino City Council ❑ oaPOSe RESIDENTIAUBUSINESS AODRESS (NO.AND STREET) CiTY STATE ZiP tdentify the controlling officehotder, candidate, or state measure proponent, if any. 10550 Stokes Ave. Cupertino CA 95014 NAME OF OFFlCEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Included in thls Statement: Listanycommittees not Included in this statement that are controlled by you or are primarily formed to receive OFFiCE SOUGHT OR HELD DISTRICT NO. IF ANY contribuBons o�make expendkures on bQhaK of your cand7dacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLEDCdMMITTEE9 7• Primarfly Formed Candidate/Officeholder Committee Lisf names of o�ceho/der{s)or candldate(sJ for whlch this commfttee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDiDATE OFFICE SOUGHT OR HELD � SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEENAME I.D. NUMSER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � SUPPORT ❑ OPPCISE NAME OF TREASURER CQNTROLLED COMMITTEEI NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � YES ❑ NO ❑ SUPPORT ❑OPPOSE COMMITTEEADDRESS STREETADDRESS (NOP.O.BOX) CITY STATE 2IP CODE AREA CODE/PHONE Attach Contlnuatlon sheets H necessary FPPC Form 480(January/05) FPPC Toll-Free Helpline:886/A5K-FPPC(866/275-37T2) State of California Campaign Disciosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period �- Summary Page to Who�e aoue�8. 1^` ' ' � • 1 from �v�? � SEE INSTRUCTIONS ON REVERSE through Page� of�� NAME OF F4lER I.D.NUMBER Chris Zhang 1337603 Contributions Received To��u�E oo �°N�"B Calendar Year Summary for Candidates (FROMATfACHEDSCHEDULE3) TOTALTODATE Running in Both the State Primary and 1. Monetary Contributions ........................................... scnedurea,line 3 $ 0 g 2,500.00 General Elections 0 20,000.00 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... scneaure e,Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Gines 1+2 $ 0 $ 22,500.00 Za. Contributions Received $ $ 4. Nonmonetary Contributions.................................... scneduie c,Line 3 0 185.00 2�. Expenditures 5. TOTALCONTRIBUTIONSRECEIVED ��•�..•�•�•�•�•••••�••••�•Addtines3+4 $ 0 $ 22,685.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... scnedu�e E,u�e a $ 2,419.53 g 22,5Q0.00 Candidates 7. Loans Made............................................................. scned��e H,Line 3 � 0 n ��n en nn r_nn nn ZZ. CumulaUve Expenditures Made* 8. SUBTOTAICASHPAYMENTS .................................... Add�ines6+7 $ c,•ria.�.� $ �c,vw.vv (KgubJsettoVoluntaryExpandltureLimlt) 9. Accrued Ex nses Un aid Bills Schedule F,Line 3 � � Date of Eleaion Total to Date Pe � P ) .............................. 10.Nonmonetary Adjustment ..........................................scnedu�e c,Line 3 0 0 (mm/ddtyy) 11. TOTAL EXPENDiTURES MADE................................add t;nes a+s+ro $ 2,419.53 g 22,500.00 �_J $ Current Cash Statement —�—� $ 12.Beginning Cash Balance....................... Prev�ouss�mmaryPaye,��ne�s $ 2,4�9.53 To ca�cu�ate Column B,add 13.Cash Receipts ................................................... Co/umn A,�ine 3 above 0 amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14.Miscellaneous Increases to Cash........................... scnedu�e i,Line 4 � from Column B of your last reported'm Column B. 15.Cash Payments........... 2,419.53 report. Some amounts in ....................................... Column A,�ine 8 above Column A may be negative 16.ENDING CASH BALANCE..........Add Lines 12+13+14,lhen subtract Line 15 $ � figures that should be subtrected from previous If fhis is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17.LOAN GUARANTEES RECEIVED ........................... scned��e s,Part 2 $ 0 for this calendar year,only carry over the amounts Cash E uivalents and Outstandin Debts from Lines 2,�,and 9(if q 9 p any). 18. Cash Equivalents........................................ See instructions on reverse $ 19. Outstanding DebtS......................... Add tine 2+line 9 in Colum�6 above $ � FPPC Fortn 460(January/05y FPPC Toll-Free HelpBne:866/ASK-FPPC(866/275-3772) '1)rpe or pHnt in ink. SCHEDULE B-PART 1 Scheduie B—Part 1 Amounts may be rounded Statement covers period Loans Received to whole do►tars. f � �� • � from �`L � � SEE INSTRUCTIONS ON REVERSE through \" � Page� Of� NAME OF F�L.ER I.D. NUMBER Chris Zhang 1337603 IF AN lNDIVIDUAI, ENtER OUTSTANDING � (�� OUTST DING � 9 FULL NAME,STREET ADDRESS AlJD ZtP CODE AMOUNT AMOUNT PA{D INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER BALANCE BALANCEAT OF LENDER (��_EMPLOVED,ENT£R BEGINNING 7HtS RECEiVEO TH}S OR FORGIVEN CLOSE OF THIS pAiD THIS AMOUNT OF CONTRIBUTIONS (IFCOMMI'FTEE,ALSOENTERI.D.NUMBER) NAMEOFBU31NES5) PERIDD THIS PERIOD; p PERIOD LOAN TODATE Damon Frach �W(�eC ❑PA�� CALENDARYEAR �FORGfVEN RATE pERELECTION"" s 0 = 0 a 7500.00 s 0 5/i/2011 s 7,500 t� IND ❑COM ❑ OTH � PTY ❑ SCC DATE DUE DATE INCURRED LIR Y@ Owner �PA�� CALENDAR YEAR 60 Dixon Road Ye Lin Acupuncture s 2419.53 a 0 % $ 7,500 $ 5080.47 Miipitas, CA 95035 Ci�llllC �FORGIVEN �TE PEREtECTION''t $ 0 s a 5 5080.47 $ 5/1/2011 $ 5080.47 tra �u� r-i n r-� �ru n nTV r'� �� DATEDUE DATEINCURRED au � u � u v u �pq�p CALENDAR YEAR s a % s s �FORGIVEN �TE PERELECTION'* E S $ S E t❑ IND ❑COM ❑OTH � PTY ❑ SCC DATE DUE OATE INCURRED SUBTOTALS S S 15000.00 $ S 0 �e�te��, Schedule � Summary �E,�3> 1. Loans received this periad................................................................................ (Total Column(b)plus unitemized foans of less than$100.) tContributor Codes 15 000.00 iND-Individuai 2. Loans paid or forgiven this period .........................................................................................................$ ' COM—Recipient Commitkee (Tota!Colum�(c)plus loans under$100 paid or forgiven.) (ott,er tnan PT'�r or scc) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g.,business entity) PTY—Political Party 3. Net chan e this eriod. Subtract Line 2 from Line 1. .. � � 15,000.00 SCC—SmaN ContributorCommittee 9 p � )............................................................. Enterthe net here and on the Summary Page,Column A,Llfle G. (Meybeanagativenumber) "Amounts forglven or paid by another party also must be reported on Schedute A. *'If required. FPPC Form 460(January/05) FPPC Toll-Free Helpllne:866/ASK-FPPC(866/275-3772)