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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) COVER PAGE Type or print in ink, 11D Statement covers period - Date of election if app h : JUL 3 0 2015 of from 01101/201 (Month, Day, Year 1 for Official Use Only SEE INSTRUCTIONS ON REVERSE I through 06/30/2015 1. Type of Recipient Committee: All Committees— Complete Parts 1, 2, 3, and 4. [] Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee 0 Recall (Also Complete Pert 5) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee 0 Political Party /Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF Dr, Huang for Ciy Council 2016 Committee Q Controlled Q Sponsored (Alm Complete Part 5) ❑ Primarily Formed Candidate) Officeholder Committee (Also complete Part 7) I.D. NUMBER 1368800 STREET ADDRESS (NO P.O, BOX) 10502 Peralta Ct. CITY STATE ZIP CODE AREA CODE /PHONE Cupertino CA 95014 408489 -8989 MAILING ADDRESS (IF DIFFERENT) NO, AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE CUPERTINO CITY CLIRK 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi- annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination ❑ Supplemental - A Preelection Statement -Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Isabel Rodriguez MAILING ADDRESS 10502 Peralta Ct. CITY STATE ZIP CODE AREA CODE /PHONE Cupertino CA 95014 408-482 -8282 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS 267 -501 -1818 / DrAndyHuang @gmail.com 4. Verification I have used all reasonable diligence In preparing and reviewing 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 pedury under the laws of the State of California that the foregoing is true and correct. 07/30/2015 Executed on By Date OfllcerorSponsor Executed on By Date Signature of Control ing Officeholder, Candidate, State Measure Proponent Executed on By Date'. Signature of Conedling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll-Free Helplinet: 8661ASK -FPPC (8661275-3772) State of California Type or print in ink. COVER PAGE - PART 2 Recipient Committee CALIFORNIA Campaign Statement FORM 460 Cover Page --Part 2 Page L of S. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Andy Huang OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 10502 Peralta Ct. Cupertino CA 95014 Related Committees Not Included In this Statement: List any committees 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. I.D. NUMBER NAME OF TREASURER ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEENAME II.D. NUMBER NAME OF ADDRESS (NO P.O. BOX) ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE /PHONE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE DISTRICT NO. IF ANY 7. Primarily Formed Candidate /Officeholder Committee List names of officehoider(s) or candidate(s) for which this committee is primarily formed, 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 Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free HelpBne: 8661ASK -FPPC (86612753772) State of Califomia Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. Statement covers period from 01101/2015 SUMMARYPAGE SEE INSTRUCTIONS ON REVERSE through 06/30/2015 Page NAME OF FILER Dr. Huang for City Council 2016 NUM I.D. .D. NUM NUMBER 1368800 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTO DATE Running In Both the State Primary and 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ 0 $ General Elections 2. Loans Received ....................... ............................... Schedule B, Line 3 -776 6773 111 through 6130 711 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ -776 $ 20. Contributions 4. Nonmanetary Contributions ..... ............................... schedule c, Line 3 0 Received $ $ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ -776 $ Made $ $ Expenditures Made 6. Payments Made ........................ ............................... Schedule E Line 4 $ 7. Loans Made .............................. ............................... schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment ........... ............................... schedule C, Line 3 11. TOTAL EXPENDITURES MADE .... ............................ Add Lines 8 + g + 10 $ 110 $ 0 110 $ 0 0 110 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 301 13. Cash Receipts .................... ............................... Column A, Line 3 above -776 14. Miscellaneous Increases to Cash ........................... Schedule 1, Linea 496 15. Cash Payments ........... Column A, Line 8 above 110 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1 If this is a termination statement, Line 16 must be zero. Should be 0, roundup error of 1 17. LOAN GUARANTEES RECEIVED ........................... Schedule 6, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding) Debts ......................... add LMe 2 + Line Sin Column a above $ u Z 6773 I 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 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' (M 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 (Januery105) FPPC Toll-Free Helpline: 866 /ASK -FPPC (8661275-3772) T..r.e w nrw in in', SCHEDULE B -PART 1 Schedule B — Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. 01/01/2015 CALIFORNIA 460 from FORM 06130/2015 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D, NUMBER Dr. Huang for City Council 2016 1368800 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE AMOUNT (� AMOUNT PAID OUTSTANDING BALANCEAT INTEREST ORIGINAL Y CUMULATIVE OFLENDER (IF SELF-EMPLOYED. ENTER BEGINNING THIS RECEIVED THIS FORGIVEN* CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD THIS THIS PERIOD PERIOD PERIOD LOAN TO DATE Andy Huang River Oaks Travel Q PAID CALENDAR YEAR 10502 Peralta Ct., $ 776 $ 4804 none 1100 $ 5582 Cupertino, CA. 95014 % s ❑ FORGIVEN PERELECrION- $ 5580 $ 0 $ 0 12130/2016 s 10/31/14 s DATE DUE DATE INCURRED tQ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION'* RATE b S S S S DATE DUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED (� PAID CALENDAR YEAR $ $ % $ s ❑ FORGIVEN PER ELECTION'" RATE b S S S S DATE DUE DATE INCURRED tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC 4 SUBTOTALS $ 0$ 776$ 804 $ 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 parry also must be reported on Schedule A. If required. 776 ....... NET $ -776 ......................... (May be a negafi enumber) (Enter (e) an Sdiedula E, Une 3) tContdbutor 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 (January105) FPPC Toll -Free Helpline. 866 /ASK -FPPC (866/2754772) Schedule E Type or print in ink. SCHEDULE Statement covers period Payments Made Amounts may 4e rounded CALIFORNIA to whole dollars. 01/01/2015 • - from SEE INSTRUCTIONS ON REVERSE through 06/30/20115 Page S of 6 NAME OF FILER I.D. NUMBER Dr. Huang for City Council 20116 1368800 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Clue CNS campaign paraphernalia/misc. campaign consultants MBR member communications RAID radio airtime and production costs CTB contribution (explain nonmonetary)` MTG OFC meetings and appearances office expenses RFD SAL returned contributions CVC FIL civic donations candidate filing /ballot fees PEr petition circulating TEL campaign workers' salaries Lv. or cable airtime and production costs FIND fundraising events PHO POL phone banks polling and survey research TRC TRS candidate travel, lodging, and meals staff /spouse travel, lodging, and meals IND LEG independent expenditure supporting /opposing others (explain)` legal defense POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor LIT campaign literature and mailings PRO PRT professional services (legal, accounting) print ads VOT voter registration WEB information technology costs (Internet, e-mail) " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 0 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................... ............................... $ 0 2. Unitemized payments made this period of under $100 110 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ..... ................................................................... $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. ) ............................. TOTAL $ 110 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK -FPPC (866/2753772) Ce- Iherluln 1 Cr_Wr_n) u F i --- - - - - -- - Miscellaneous Increases to Cash Amounts may be rounded to whole dollars. Statement covers period 01/01/2015 from I • ' CALIFORNIA • ' SEE INSTRUCTIONS ON REVERSE through 06130/2015 Page G of 6 NAME OF FILER I.D. NUMBER Dr. Huang for City Council 2016 1368800 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH City of Cupertino City Council Candidate Statement 01/28/2015 10300 Torre Ave. Cupertino, CA. 95014 Reimbursement 407 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 407 Schedule I Summary 1. Itemized increases to cash this period ......................................................................................... ............................... $ 407 2. Unitemized increases to cash of under $100 this period ........................... .......... $ 89 3. Total of all interest received this period on loans made to others. Schedule H, Column (e).) ...... $ 0 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ............................................................................................ ............................... TOTAL $ FPPC Forrn 460 (January105) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275.3772) 496