460 Recipient Committee Campaign Statement – Preelection Statement 09-22-16-10-25-16 Reci ient Committee ,._ COVER PAGE
p Type or print in ink. D ^ at�ar� � � '
Campaign Statement ' ' ' � � •
Cover Page
(Government Code Sections 84200-84216.5) OCT 2 � 2016 + �9 1 °f 11
Statement covers period Date of election if appli�l .
9/25/2016 (Month, Day,Year) ( br Official Use on�y
from �
SEE INSTRUCTIONS ON REVERSE through 10/22/2016 � 1 � �j� � Z-�' � { Cl. PERTiNO CITY CL�RK
1. Type of ReCiplellt Commlttee: ,4��committees-comp�ete Parts�,z,a,a�a a. 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
� Recall Q Controlled. � Termination Statement � Supplemental Preelection
(AlsoCompletePartS) � Sponsored Also file a Form 410 Termination
(AlsoComplelePart6) � � Statement-Attach Form 495
❑ General Purpose Committee ❑ Amendment(Explain below)
Q Sponsored � Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
�Political Party/Central Committee (AlsoComplefePart7)
3. Committee Information I D. NUMBER Treasurer(s)
1381645
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
Yes on C for Citizens. No on D for Developer. - Committee supporting Xiaowen Wang
Cupertino Citizens' Sensible Growth Initiative - nnn���r,c nooRess
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
CITY STATE ZIP CODE AREA CODElPHONE NAME OF ASSISTANT TREASURER, IF ANY
Cupertino CA 95014
MAILING ADDRESS(IF DIFFERENT) N0.AND STREET OR P.O. BOX MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 95015
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 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 is true and correct.
/^7 / / ��� �����
Executed on �� ! `�` � `� By
�,..-=;� �.,�
' Date Signature`of ConVolling Officeholder,Candidate,Slate Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent
Executed on By
Date Signature of ConUolling Officeholder,Candidate,State Measure Proponent
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
State of California
Type or print in ink. COVER PAGE-PART 2
Recipient Committee
Campaign Statement � �� � � • 1
Cover Page—Part 2
Page 2 of 11
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
Measure C (Cupertino Citizens'Sensible Growth Initiative)
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION � SUPPORT
C City of Cupertino ❑ oPPose
RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT
Related Committees Not Included in this Statement: �ist any comminees
nof included in this statement that are confro/led by you or are primarily formed to receive OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY
contributions or make expenditures on 6eha/f of your candidacy.
COMMITTEENAME I.D. NUMBER
NAMEOFTREASURER CONTROLLEDCOMMITTEE7 7• Primarily Formed Candidate/OfficeholderCommittee Lisfnamesof
officeholder(s)or candidate(s)for which this committee is primarily formed.
� YES ❑ NO
COMMITTEEADDRESS STREETADDRESS (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
COMMITTEE NAME I.D. NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD I � SUPPORT
❑ OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
� YES ❑ NO I ❑ SUPPORT
❑ OPPOSE
COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX)
CITY STATE 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
Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE
Amounts may be rounded Statement covers period � -
Summary Page to whole doilars. I
from
9/25/2016 •- • �
SEE INSTRUCTIONS ON REVERSE through 10/22/2016 page 3 of 11
NAME OF FILER I.D. NUMBER
Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
To olumn oD cCoNomn B Calendar Year Summary for Candidates
Contributions Received Runnin in Both the State Prima and
(FROMATTACHEDSCHEDULES) TOTALTODATE 9 rY
General Elections
1. Monetary Contributions ........................................... scnedu�e a,�r�e s g �0,051.55 $ 72,091.17
2. Loans Received ...................................................... scnedu�e a.�r�e s
0 10,000.00 1/1 through 6/30 �i� to Date
3. SUBTOTALCASH CONTRIBUTIONS ......................... Add�ines�+2 $ 10,051.55 $ 82,091.17 Z0. Contributions
Received $ $
4. Nonmonetary Contributions.................................... scheduie c,�r�e s 8,887.05 17,156.38
21. Expenditures
5. TOTALCONTRIBUTIONSRECEIVED ...........................Add�iness+q $ 18,938.60 $ 89,247.55 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made....................................................... scneduie E,�r�e a g 13,786.23 g 69,486.86 Candidates
7. LOaf1S Mad@............................................................. Schedule H,Line 3 0 0
13,786.23 13,786.23 22• Cumulative Expenditures Made'
8. SUBTOTAL CASH PAYMENTS .................................... Add�ines s+7 $ $ (If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ...............................scneduie F�rne s � � Date of Election Total to Date
10. Nonmonetary Adjustment ..........................................scneduie c,Line 3 8,887.05 17,156.38 (mm/ddlyy)
11. TOTAL EXPENDITURES MADE................................Add�ines s+s+�o $ 22,673.28 g 86,643.24 �� $
Current Cash Statement �� $
12. B2ginning C2Sh Ba18nCe....................... PreviousSummaryPage,Line 16 $ 16,339.02
To calculate Column B,add
13.Cash ReCeiptS ................................................... Column A,Line 3 above 10,051.55 amounts in Column A to the
0.01 corresponding amounts *Amounts in this section may be different from amounts
14.Miscellaneous Increases to Cash........................... scnedu�e�,Line 4 from Column B of your last reported in Column B.
15.Cash Payments.................................................. Column A,Line 8 above 13,786.23 report. Some amounts in
Column A may be negative
16. ENDING CASH BALANCE.......... Add�ines�2+�s+14,then subtract Line 15 $ 12,604.35 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 e,Part z $ 0 for this calendar year, only
carry over the amounts
from Lines 2,7,and 9(if
Cash Equivalents and Outstanding Debts any).
18. Cash EqUlvalentS........................................ See instructions on reverse $ �
19. Outstanding Debts......................... Add Line 2+Line 9 in Column e above $ 1�,���.�� FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule A Type or print in ink. SCHEDULE A
Moneta Contributions Received Amounts may be rounded Statement covers period
� to whole dollars. • ' � � '
from 9�25/2016 � -
SEE INSTRUCTIONS ON REVERSE
through 10/22/2016 Page 4 of 11
NAME OF FILER I.D. NUMBER
Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION
RECEIVED (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * OCCUPATIONAND EMPLOYER RECEIVED THIS CALENDAR YEAR TODATE
(IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN.1 -DEC.31) (IF REQUIRED)
OF BUSINESS)
Li uan Chen 01ND
10/2/16 Y ❑COM engineer $500.00 $500.00
❑Pn'
❑scc
�IND
10/2/16 Phyllis Dickstein ❑coM retired $200.00 $1050.00
❑PN
❑scc
01ND
10/5/16 Phyllis Dickstein ❑COM retired $100.00 $1050.00
❑PT�"
❑scc
Cupertino Against Re-zoning (ID#1287457) ❑IND
10/7/16 ���M $3000.00 $4000.00
❑Pn'
❑scc
Qin Pan �IND
10/7/16
❑Pn'
❑scc
SUBTOTAL$ 3900.00
Schedule A Summary `Contributor Codes
1. Amount received this period-itemized monetary contributions. iN�-individuai
(Include all Schedule A subtotals.) $ 8725.00 COrvl-RecipientCommittee
........................................................................................................ (other than PTY or SCC)
2. Amount received this period-unitemized monetary contributions of less than$100 ............................. $ 1326.55 OTH—Other(e.g., business entity)
PTY—Political Party
3. Total monetary contributions received this period. sCC-smau Contributorcommittee
Add Lines 1 and 2. Enter here and on the Summa Pa e, Column A, Line 1. TOTAL $ 10051.55 -
( ry g � FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule A (Continuation Sheet) Typeorprintinink. SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded Statementcovers period
to whole dollars. 9/25/2016 •• � � '
from
through 10/22/2016 page 5 of 1�
NAME OF FILER I.D.NUMBER
Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED (IFCOMMITfEE,ALSOENTERI.D.NUMBER) CODE * �CCUPATIONANDEMPLOYER RECEIVEDTHIS CALENDARYEAR TODATE
(IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1-DEC.31) (IF REQUIRED)
OF BUSINESS)
Mary Ellen Chell �coM retired
10/5/16
❑PN
❑scc
Dawna Wolfson �coM housewife
9/25/16�
❑PTv
❑scc
Vi-Nhuan Le OcoM Education Researcher
9/30/16
❑PrY of Chicago
❑scc
Muni Madhdhipatla ��N� Software Professional
10/11/16
❑Pn
❑scc
Young Feng 01ND en ineer
10/11/16
❑Pr�r
❑scc
SUBTOTAL$ 600.00 I I
*Contributor Codes
IND—Individual
COM—Recipient Committee
(other than PTY or SCC)
OTH—Other(e.g., business entity)
PTY—Political Party FPPC Form 460(January/05)
SCC—Small ContributorCommittee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule A (Continuation Sheet) Typeorprintinink. SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded statementcovers period � .
towho�edollars. 9/25/2016 • - � • �
from
through 10/22/2016 page 6 of 11
NAME OF FILER I.D.NUMBER
Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION
(IFCOMMITTEE,ALSOENTERI.D.NUMBER) OCCUPATIONAND EMPLOYER RECEIVED THIS CALENDAR YEAR TODATE
RECEIVED CODE *
(IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN.1 -DEC.31) (IF REQUIRED)
OF BUSINESS)
10/20/16 Ignatius Ding �coM retired $1500.00 $2500.00
❑Pn'
❑scc
Josephine Ding 01ND retired
10/20/16 ❑COM $1500.00 $2500.00
❑PrY
❑scc
Tony Xu 01ND Realtor
10/19/16 ❑COM $500.00 $700.00
❑Pn
❑scc
Deepak Balasubramaniam OcoM Senior Director
9/28/16
❑PrY
❑scc
Balaji Seshachalam 01ND Vice President
9/29/16
❑PrY
❑scc
SUBTOTAL$ 3825.00
*Contributor Codes
IND—Individual
COM—Recipient Committee
(other than PTY or SCC)
OTH—Other(e.g., business entity)
PTY—Political Party FPPC Form460(January/05)
SCC—Small Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule A (Continuation Sheet) Typeorprintinink. SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded Statementcovers period
to whole dollars. � � � '
from 9�25/2016 • -
through 10/22/2016 page � of 11
NAME OF FILER I.D.NUMBER
Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED (�FCOMMITfEE,ALSOENTERI.D.NUMBER) CODE * OCCUPATIONANDEMPLOYER RECEIVEDTHIS CALENDARYEAR TODATE
(IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1-DEC.31) (IF REQUIRED)
OF BUSINESS)
Michael Nishimoto �COM Engineer
10/11/16
❑Pn'
❑scc
Lin Tu BIND Manager
10/14/16 ❑coM $100.00 $199.00
❑PTv
❑scc
Suzanne a'Becket 01ND Retired
10/22/16
❑Pn
❑scc
Veronica Lam �IND Retired
10/20/16
❑Pn
❑scc
❑IND
❑COM
❑OTH
❑PTY
❑SCC
SUBTOTAL$ 400.00 �
*Contributor Codes
IND—Individual
COM—Recipient Committee
(other than PTY or SCC)
OTH—Other(e.g.,business entity)
PTY—Political Party FPPC Form 460(January/05)
SCC—Small Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule C Type or print in ink.
Amounts may be rounded SCHEDULE C
Nonmonetary Contributions Received towholedollars. Statementcoversperiod � .
from
9/25/2016 • - � • �
SEE INSTRUCTIONS ON REVERSE
through 10/22/2016 page 8 of 11
NAME OF FILER
I.D.NUMBER
Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
IFAN INDIVIDUAL,ENTER AMOUNT/ CUMULATIVE TO pER ELECTION
FULL NAME,STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF DATE
DATE OCCUPATION AND EMPLOYER FAIR MARKET
ZIP CODE OF CONTRIBUTOR CODE * GOODS OR SERVICES CALENDAR YEAR TO DATE
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) (IF SELF-EMPLOYED,ENTER VALUE (IF REQUIRED)
NAME OF BUSINESS) (JAN 1-DEC 31)
9/29/16 Cupertino Residents for Sensible �COM yard signs 228.38 3,842.12
Zoning Action Committee#1376003 �OTH
❑SCC
❑IND
10/4/16 Cupertino Residents for Sensible OCOM yard signs 1,447.84 3,842.12
Zoning Action Committee#1376003 �OTH
❑SCC
Cupertino Residents for Sensible ❑IND yard signs
10/11/16 Zoning Action Committee#1376003 �COM 1,067.70 3,842.12
❑OTH
❑SCC
10/7/16 R. Wang ❑COM high tech flyers for mailing
�p-ry self-employed
❑SCC
Attach additional information on appropriately/abe/ed continuation sheets. SUBTOTAL$ 8,287.00 I
Schedule C Summary 'Contributor Codes
1. Amount received this period-itemized nonmonetary contributions. iN�-individuai
(Include all Schedule C subtotals.) $ 8�887•05 COM-RecipientCommittee
.....................................................................................................................
(other than PTY or SCC)
2. Amount received this period-unitemized nonmonetary contributions of less than$100 ....................................$ � OTH—Other(e.g., business entiry)
PTY—Political Party
3. Total nonmonetary contributions received this period. sCC-smau ContributorComminee
Add Lines 1 and 2. Enter here and on the Summa Pa e, Column A, Lines 4 and 10. TOTAL $ $�887•05
( rY 9 ) ......................
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule C Type or print in ink.
Amounts may be rounded SCHEDULE C
Nonmonetary Contributions Received towhole dollars. Statementcovers period � .
from
9/25/2016 • - � • �
SEE INSTRUCTIONS ON REVERSE
through 10/22/2016 page 9 of 11
NAME OF FILER I.D.NUMBER
Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
IF AN INDIVIDUAL,ENTER AMOUNT/ CUMULATIVE TO pER ELECTION
FULL NAME,STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF DATE
DATE OCCUPATION AND EMPLOYER FAIR MARKET
ZIP CODE OF CONTRIBUTOR CODE * GOODS OR SERVICES CALENDAR YEAR TO DATE
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) QF SELF-EMPLOYED,ENTER VALUE (IF REQUIRED)
NAME OF BUSINESS) (JAN 1-DEC 31)
Liang-Fang Chao �COM engineer buttons
10/11/16
�pn Systems, Inc.
❑sCC
10/11/16 Caryl Gorska ❑COM art director buttons 137.10 137.10
�pTy I
❑SCC
Jon Willey 01ND engineer TOB banner
10/19/16
�pTy pp
❑
❑SCC
❑IND
❑COM
❑OTH
❑PTY
❑SCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 600.05
Schedule C Summary •Contributor Codes
1. Amount received this period-itemized nonmonetary contributions. iN�-individuai
(Include all Schedule C subtotals.) � 8�887•05 COM-RecipientCommittee
.....................................................................................................................
(other than PTY or SCC)
2. Amount received this period-unitemized nonmonetary contributions of less than$100 ....................................$ � OTH—Other(e.g., business entity)
PTY—Political Party
3. Total nonmonetary contributions received this period. scc-smau contributorcomminee
Add Lines 1 and 2. Enter here and on the Summa Pa e, Column A, Lines 4 and 10. TOTAL $ $,$$�•05
( rY 9 ) ......................
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule E Type or print in ink. SCHEDULEE
Amounts may be rounded Statement covers period � . I '
Payments Made to whole dollars. 9/25/2016 •' �
from
through 10/22/2016 pa e 1� of 11
SEEINSTRUCTIONS ON REVERSE 9
NAME OF FILER I.D. NUMBER
Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
ClvP campaign paraphernalia/misc. MBR membercommunications 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 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
Lff campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IFCOMMITfEE,ALSOEN7ERI.D.NUMBER) CODE OR DESCRIPTIONOFPAYMENT AMOUNTPAID
Bern Steves Professional Service Fee
Deepak Balasubramaniam returned contributions
Xiangchen Xu flyers and signs
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 13738.95
Schedule E Summary
1. Itemized a ments made this eriod. Include all Schedule E subtotals. 13738.95
PY P ( ).............................................................................................................. $
2. Unitemized payments made this period of under$100 .......................................................................................................................................... $ 47.28
3. Total interest aid this eriod on loans. Enter amount from Schedule B, Part 1, Column e . �
P P ( � ))............................................................................... $
4. Total a ments made this eriod. Add Lines 1,2,and 3. Enter here and on the Summa Pa e, Column A, Line 6. TOTAL $ 13786.23
P Y p ( rY 9 ) .............................
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule I Type or print in ink. SCHEDULE I
Miscellaneous Increases to Cash Amountsmayberounded Statementcoversperiod � .
to wnole aollars. � � '
from
9/25/2016 � '
SEE INSTRUCTIONS ON REVERSE
through 10/22/2016 page 11 of �1
NAME OF FILER
I.D.NUMBER
Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645
DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH
Attach additional information on appropnately labeled continuation sheets. SUBTOTAL$
Schedule I Summary
1. Itemized increases to cash this period. .......................................................................................................................$ �
2. Unitemized increases to cash of under$100 this period.............................................................................................$ 0.01
3. Total of all interest received this eriod on loans made to others. Schedule H, Column e . �
p � � ) ) .................................$
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
SummaryPage, Line 14.) ........................................................................................................................... TOTAL $ 0.01
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)