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460 Recipient Committee Campaign Statement 1-1-15 to 6-30-15Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 1/1/2015 through 6/30/2015 Date of election if applit (Month, Day, Year) E C E 0 V J 11 cl Ia`2015 UPERTINO CITY COVER PAGE 1 of 13 Official Use Only 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 ❑ O State Candidate Election Committee Committee Semi Statement Quarterly Statement ❑ O Recall O Controlled - annual Special Odd -Year Report (Also Complete Part 5) O Sponsored ❑ Termination Statement El Supplemental Preelection (Also Complete Part 6) (Also file a Form 410 Termination) El Statement - Attach Form 495 � General Purpose Committee Amendment (Explain below) O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party /Central Committee (Also Complete Part 7) I.D. NUMBER 3. Committee Information 1340395 Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Andrae Macapinlac ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) MAILING ADDRESS 456 Lomer Way STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 465 N. WOLFE ROAD Milpitas CA 95035 (707) 334 -3489 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY SUNNYVALE CA 94085 (408) 746 -2020 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE CITY STATE ZIP CODE AREA CODE /PHONE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS Treasurer: senatormac9 @aol.com 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the informatied here' nd 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 is true and correct. Executed on 7/31/2015 gy Date Signature of Treasurer or Assistant Treasurer Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Data Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed On By FPPC Form 460 (January/05) Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Toll -Free Helpline: 886 /ASK -FPPC (866/275 -3772) State of California 1982109 -0 RPrinipnt C:nmmittnn Type or print in ink. COVER PAGE - PART 2 NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE RESIDENTIAL /BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP OFFICE SOUGHT OR HELD ❑ SUPPORT Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees Not Included in this Statement: List any committees OFFICE SOUGHT OR HELD not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMMITTEE NAME I.D. NUMBER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate /Officeholder Committee List names of NAME OF TREASURER ❑SUPPORT ❑ YES ❑ NO officeholder(s) or candidate(s) for which this committee is primarily formed. 1982109 -0 COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT [:]OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT []OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑ OPPOSE S IAI E ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Type or print in ink. SUMMARY PAGE Campaign Disclosure Statement Amounts may be rounded Statement covers period ID. - Summary Page to whole dollars. 1/1/2015 •- from 6/30/2015 SEE INSTRUCTIONS ON REVERSE through ge 3 of 13 NAME OF FILER MBER ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 0395 Contributions Received Column A TOTAL THIS PERIOD Column B CALENDAR YEAR Calendar Year Summary for Candidates Schedule E, Line 4 $1,367.00 (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and 1. Monetary Contributions Schedule A, Line $3,775.00 $3, 775.00 General Elections 2. Loans Received ........................... ............................... Schedule B, Line $0.00 $0.00 1/1 through 6/30 7/1 to Date Nonmonetary Adjustment ............. ............................... Schedule C, Line 3 $0.00 11. 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS . ............................... Add Lines 1 +2 $3, 775.00 $3, 775.00 Received 4. Nonmonetary Contributions ............ ............................... Schedule C, Line 3 $0.00 $0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............................... Add Lines 3 +q $3,775.00 $3,775.00 Made Expenditures Made 6. Payments Made .......................... ............................... Schedule E, Line 4 $1,367.00 7. Loans Made ................................ ............................... Schedule H, Line $0.00 8. SUBTOTAL CASH PAYMENTS Add Lines 6 +7 $1,367.00 9. Accrued Expenses (Unpaid Bills) ..... ............................... Schedule F, Line 3 $0.00 10. Nonmonetary Adjustment ............. ............................... Schedule C, Line 3 $0.00 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 +9 +10 $1,367.00 Current Cash Statement 12. Beginning Cash Balance .............................. Previous Summary Page, Line 16 $2,573 .00 13. Cash Receipts Column A, Line 3 above $3, 7 7 5 . 0 0 14. Miscellaneous Increases to Cash Schedule 1, Line 4 $0.00 15. Cash Payments Column A, Line 8above $1,367.00 16. ENDING CASH BALANCE ............... Add Lines 12 +13 +14, then subtract Line 15 $4, 981.00 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED Schedule 8, Part 2 $0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $0.00 19. Outstanding Debts .. ............................... Add Line 2 + Line 9 in Column 8 above $0.00 1982109 -0 $1,367.00 $0.00 $1,367.00 $0.00 $0.00 $1,367.00 To calculate Column B, add amounts in Column A to the corresponding amount 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 first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any) Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK.FPPC (866/275 -3772) n -'- - -11- -1 _ w -r....,. ,....- :...:.. ;_" R(l."Pr11 II F A Amounts may be rounded Monetary Contributions Received to dollars. Statement covers period - whole 1/1/2015 - LUGO from 0 6/30/2015 through Page 4 of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE* (IF SELF - EMPLOYED, ENTER NAME RECEIVED THIS CALENDAR YEAR TO DATE OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 5/27/2015 Flower Cottage ❑ IND IND $75.00 $75.00 465 N Wolfe Rd ❑ Sunnyvale, CA 94085 OTH ❑ PTY ❑ SCC 1/12/2015 Jerrold Hiura IND OCCUPATION: Dentist $200.00 $200.00 90 E Taylor St ❑ EMPLOYER: Self San Jose, CA 95112 COM ❑ OTH ❑ PTY ❑ SCC 2/9/2015 Balbir Dhillon IND OCCUPATION: retired $500.00 $500.00 127 Sierravista Place F-1 COM EMPLOYER: n/a San Jose, CA 95116 ❑ OTH ❑ PTY ❑ SCC 6/15/2015 PG &E Corporation ❑ IND $3,000.00 $3,000.00 77 Beale St E] COM San Francisco, CA 94105 E] OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.) ......................................... ............................... 2. Amount received this period - unitemized monetary contributions of less than $100 ........ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ............. 1982109 -0 $3,775.00 $0.00 TOTAL $3,775.00 *Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275.3772) n_ __ -1 -- _ r% r%_ -i w T.. -- .;- 4; -;..t, SCHFr)I11FR -PART1 Amounts may be rounded Statement covers period ICALIFORNIA Loans Received to whole dollars. 1 /1 /2015 FORM • from through 6/30/2015 Page 5 of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER ASIAN PACIFIC- ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING (b) AMOUNT (c) AMOUNT PAID (d) OUTSTANDING (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) BALANCE BEGPERIOD THIS rt VD RECEIVED THIS PERIOD OR FORGIVEN THIS PERIOD" BALANCE AT CLODS &?F JTHIS tt'' IOO PAID THIS PERIOD AMOUNT OF LOAN CONTRIBUTIONS TO DATE ❑ PAID CALENDAR YEAR % RATE ❑ FORGIVEN PER ELECTION — t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTION - t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR % RATE ❑ FORGIVEN PER ELECTION - t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTAL$ $ $ $ Schedule B Summary 1. Loans received this period ................................ ............................... (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ............................... ............................... (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. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. 1982109 -0 $0.00 $0.00 NET $0.00 (May be a negative number) (Enter (e)on Schedule E, Line 3) *Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC T°II -Free Helpline: 866 1ASK -FPPC (866/275 -3772) c�_t -- -1 _ i+ T., o— ., +, i., SCHFDLIIFC Amounts may be rounded Nonmonetary Contributions Received to dollars. Statement covers period I CALIFORNIA whole 1/1/2015 460 from FORM 6/30/2015 through Page 6 Of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 DATE FULL NAME STREET ADDRESS AND , ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE` IF ( SELF - EMPLOYED, ENTER NAME OF BUSINESS) GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR (JAN. 1 - DEC. 31) TO DATE ( IF REQUIRED) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this period - itemized nonmonetary contributions. (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.) 1982109 -0 $0.00 $0.00 ..................TOTAL $0.00 *Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) r% Tv S(.HPr)tll F r) VV111i MM 114-1 Y - -. Amounts may be rounded Summary of Expenditures to dollars. Statement covers period ICALIFORNIA whole 1/1/201s 460 Supporting /Opposing Other from FORM Candidates, Measures and Committees 6/30/2015 , 13 through Page of NAME OF FILER I.D. NUMBER ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 DATE NAME OF CANDIDATE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE OR COMMITTEE (JAN.1 -DEC. 31) (IF REQUIRED) 2/20/2015 Tim Orozco $500.00 $500.00 Office Description: CouncilmemberJurisdiction: City Monetary District 4 Contribution ❑ Nonmonetary Contribution ❑ Independent Expenditure 0 Support El Oppose ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent El Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent Expenditure ❑ Support ❑ Oppose SUBTOTAL$ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ........................................................... ............................... $500.00 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.) ................................ ............................... $500.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) 1982109 -0 Schedule E Payments Made Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 1/1/2015 SCHEDULE E SEE INSTRUCTIONS ON REVERSE through 6/30/2015 Page 8 of 13 NAME OF FILER I.D. NUMBER ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia /mist. MBR member communications RAD radio airtime and production 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 fling /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 PAYEE (IF COMMITTEE, ALSO ENTER R I .D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Liquid Restaurant and Lounge Mixer food and beverages $1,000.00 32 S 3rd St San Jose, CA 95113 Olympic 5 -28 -15 Awards for Mixer $67.00 1358 E. San Fernando St San Jose, CA 95116 Nation Builder 3 -11 -15 Website maintenance $29.00 520 S. Grand Ave., 2nd Floor Los Angeles, CA 90071 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payment made this period. (Include all Schedule E subtotals.) ............................................. ............................... 2. Unitemized payments made this period of under $100 ..................................................................... ............................... 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ................. ............................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ................ 1982109 -0 $1,367.00 ................. $0.00 $0.00 $1,367.00 FPPC Form 460 (January/05) FPPC Toll -Free Hdplin 866 /ASK -FPPC (8661275 -3772) Schedule E Type or print in ink. SCHEDULE E (Continuation Sheet) Amounts may be rounded Statement covers period - Payments Made to whole dollars. 1/1/2015 FOR from ON REVERSE NAME OF FILER ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) through 6/30/2015 Page 9 of 13 I.D. NUMBER 1340395 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia /misc. MBR member communications RAD radio airtime and production 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 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 technoloov costs (internet. e-mail) NAME AND ADDRESS PAYEE (IF COMMITTEE, ALSO ENTER R I .D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Nation Builder 3 -11 -15 Website maintenance $29.00 520 S. Grand Ave., 2nd Floor Los Angeles, CA 90071 Nation Builder 3 -11 -15 Website maintenance $29.00 520 S. Grand Ave., 2nd Floor Los Angeles, CA 90071 Nation Builder 4 -20 -15 Website maintenance $29.00 520 S. Grand Ave., 2nd Floor Los Angeles, CA 90071 Nation Builder 5 -18 -15 Website maintenance $29.00 520 S. Grand Ave., 2nd Floor Los Angeles, CA 90071 Nation Builder 6 -18 -15 Website maintenance $29.00 520 S. Grand Ave., 2nd Floor Los Angeles, CA 90071 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/2753772) 1982109 -0 Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 1/1/2015 through 6/30/2015 SCHEDULE E Page 10 of 13 I.D. NUMBER 1340395 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia /mist. MBR member communications RAD radio airtime and production 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 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 Drint ads wFR infnrmntinn fachnnlnn \/ a fe /inf —mf c nih NAME AND ADDRESS PAYEE (IF COMMITTEE, ALSO ENTER R I .D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Sean Manalo 4575 Piper St Fremont, CA 94538 Reimbursement for Meeting dinner $126.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) 1982109 -0 Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FILER ASIAN PACIFIC — ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 1/1/2015 through 6/30/2015 SCHEDULE Page 11 of 13 I.D. NUMBER 1340395 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia /misc. MBR member communications RAD radio airtime and production 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 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 CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSING OF THIS PERIOD • P. .9'.".d oe1S°in' tr o ions or imtepenaem ex�neiwres muse also ee summer ed on seneawa D. SUBTOTAL $ $ $ 5 Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $ 100.) ......................................... ............................... 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $ 100.) ....................... ............................... 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.) ....................................................................................................... ............................... 1982109 -0 ......INCURRED TOTALS $0.00 .PAID TOTALS $0.00 NET $0.00 (May be a negative number) FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule H Loans Made to Others* Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 1/1/2015 6/30/2015 SCHEDULE H SEE INSTRUCTIONS ON REVERSE through Page 12 of 13 NAME OF FILER ASIAN PACIFIC- ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) I.D. NUMBER 1340395 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING (b) AMOUNT (c) REPAYMENT OR (d) OUTSTANDING (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF RECIPIENT (IF SELF - EMPLOYED, ENTER BALANCE LOANED THIS FORGIVENESS BALANCE AT RECEIVED AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) BEGINNING THIS PERIOD THIS PERIOD` CLOSE OF THIS LOAN TO DATE PERIOD PERIOD ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTION— 'Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. Schedule H Summary 1. Loans made this period ....................................... ............................... (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans ................................. ............................... (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) .............................. Enter the net here and on the Summary Page, Column A, Line 7. 1982109 -0 DATE DUE ❑ PAID ❑ FORGIVEN DATE DUE SUBTOTALI$ I$ I$ $0.00 $0.00 .................. ............................NET $0.00 (May be a negative number) DATE INCURRED CALENDAR YEAR o� RATE PER ELECTION" DATE INCURRED (Enter (a)on Schedule I, Line 3) *" If required. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) 0— L.. -..1- -1.- 1 T „no — fiCHP:ni ii F I VVI I%.” 14 1 Amounts may be rounded - Statement covers period 1 Miscellaneous Increases to Cash to whole dollars. CALIFORNIA 1/1/2015 FORM 460 from 6/30/2015 SEE INSTRUCTIONS ON REVERSE through Page 13 of 13 NAME OF FILER I.D. NUMBER ASIAN PACIFIC - ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH SUBTOTAL$ Schedule I Summary 1. Itemized increases to cash this period . ............................................................................................................ ............................... $0.00 2. Unitemized increases to cash of under $100 this period . ..................................................................................... ............................... $0.00 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ...................................... ............................... $0.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ................................................................................................................... ............................... TOTAL $0.00 FPPC Form 460 (January/05) FPPC Toll -Frce Wpki 866 /ASK -FPPC (866/275 -3772) 1982109 -0