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460 Recipient Committee Campaign Statement – Preelection Statement COVER PAGE Campa g State ellt Type or print in ink. D (� (���st�n�/J � � � _ , � • , l� ly U V Cover Page � (Government Code Sections 84200-84216.5) "�s',�:,�e 1 of 22 Statement covers period Date of election if applic' I S E P 2 9 2016 from 7/1/2016 (Month, Day, Year) For officia� Use on�y i SEE INSTRUCTIONS ON REVERSE through 9/24/2016 ��V`r,;�. `�y;.�� �� CI�PERTINO CITY CLE�K Ji, 6�: � 1. Type of Recipient Committee: a,��comm��cees-compiece Pa��,2,s,and a. 2. Type of Statement: ❑ Officeholder,Candidate Controlled Committee � Primarily Formed Ballot Measure � Preelection Statement � QuaRerly Statement � State Candidate Election Committee Committee ❑ Semi-annual Statement � Special Odd-Year Report Q Recall Q Controlled � Termination Statement ❑ Supplemental Preelection (AlsoCompletePartS) Q Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 (Also Comp/ete Part 6) ❑ General Purpose Committee ❑ Amendment(Explain below) Q Sponsored � Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee � Political Party/Central Committee (AlsoCompletePaR7) 3. Committee Information I i.o. "uMeER 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 MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE 21701 Stevens Creek Blvd., #1132 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Cupertino CA 95014 . (IF DIFFERENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS PO Box 1132 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. Executed on ��`��� ," BY ate SignatureofCofSEroing fficeolder,Candidafe,Stat easure roponentorResponsibleOffcerofSponsor Executed on BY Date Signature of Controlling Officeholder,Candidate,State Measure Proponent Executed on BY Date SignatureofControllingOffceholder,Candidate,StateMeasureProponent FPPC FOfm 460(January105) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) State of California Type or print in ink. COVER PAGE-PART2 Recipient Committee Campaign Statement ' �• " ' � � � Cover Page— Part 2 Page 2 of 22 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAMEOF BALLOTMEASURE ' 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 I City of Cupertino I ❑ 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: ��sra�ycomm�ttees not included in this statemenf that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. I COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITfEE7 7• Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this commi#ee 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 COMMITfEE NAME ❑ OPPOSE I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � SUPPORT ❑ OPPOSE NAME OF TREASURER I CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES � NO ❑ SUPPORT ❑ OPPOSE COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(Januaryl05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) State of California Cam al n Disclosure Statement Type or print in ink. SUMMARYPAGE P 9 Amounts may be rounded Summary Page Statement covers period � - � to whole dollars. � ' from ��1/2016 • ' through 9�24/2016 pa9e 3 of 22 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth tnitiative 1381645 � ColumnA Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR Runnin in Both the State Prima and (FROMATTACHEDSCHEDULES) TOTALTODATE 9 rY General Elections 1. Monetary Contributions ........................................... scneauie a,�rne s $ 21,298.00 $ 62,039.62 2. Loans Received ...................................................... scneduie e.�ine s 10,000.00 10,000.00 ��1 through 6/30 7/1 to Date 31,298.00 72,039.62 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... add�ines�+2 $ $ Received $ $ 4. Nonmonetary Contributions.................................... scnedu�e c,�ine 3 8,141.28 8,269.33 21. Expenditures 5. TOTALCONTRIBUTIONSRECEIVED ••••••������••••••••���••••Add�ines3+4 $ 39,439.28 $ 80,308.95 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... scneduie E,une a $ 26,094.46 g 55,700.63 Candidates 7. LoanS Mad2............................................................. Schedule H,Line 3 � 0 26,094.46 55,700.63 ZZ• Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYM ENTS .................................... Add Lines 6+7 $ $ (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (UtlpBid BiIIS� ...............................Schedule F,Line 3 � � Date of Election Total to Date 10. Nonmonetary Adjustment ..........................................scneduie c,�ine s 8,141.28 8,269.33 (mm/dd�yy) 11. TOTAL EXPENDITURES MADE................................Add�ines 8+s+�o $ 34,235.74 $ 63,969.96 �� $ Current Cash Statement —�-� $ 12. Begl111l1t19 CBSh B81811C2....................... Previous Summary Page,Line 16 $ 11,135.47 To calculate Column B,add 13. Cash Receipts ................................................... Column A,Line 3 above 31,298.00 amounts in Column A to the 0.01 corresponding amounts *Amounts in this section may be different from amounts 14. MiSCellaneous InCreases to CBSII ........................... Schedule I,Line 4 from Column B of your last �eported in Column B. 26,094.46 report. Some amounts in 15.Cash PaymentS.................................................. Column A,Line 8 above Column A may be negative 16. ENDING CASH BALANCE.......... Add�ines�2+ �3+ 14,then subtract Line 15 $ 16,339.02 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 ........................... Schedu�e e, Part 2 $ 0 for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, �, and 9 (if 0 anY) 18. Cash Equlvalents........................................ See instructions on reverse $ 19. OUtSt811dlllg D2btS......................... Add Line 2+Line 9 in Column 8 above $ 10,000.00 FPPC Form 460(January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC(866/275-3772) Schedule A Type or print in ink. SCHEDULE A Amounts may be rounded Statement covers period Monetary Contributions Received to whole dollars. 7/1/2016 � � • � from � through 9�24/2016 Pa9e 4 of 22 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUA�, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC.31) (IFREQUIRED) OF BUSINESS) 01ND ❑OTH $200.00 $599.00 intel Cupertino, CA 95014 ❑PTY ❑scc �IND ❑�TH TE connectivity Cupertino, CA 95014 ❑PTY ❑scc 01ND ❑OTH na Cupertino, CA 95014 ❑PTY ❑scc 01ND ❑OTH na $300.00 $750.00 Cupertino, CA 95014 ❑PTY ❑scc 01ND ❑OTH na $500.00 $1000.00 San Jose, CA 95129 ❑PTY ❑scc SUBTOTAL$ 1400.00 I Schedule A Summary 'Contributor Codes 1. Amount received this period-itemized monetary contributions. irv�-inaividuai (Include all Schedule A subtotals.) .................................... $ 19706.00 COM—RecipientCommittee .................................................................... (other than PTY or SCC) 2. Amount received this period-unitemized monetary contributions of less than$100 ............................. $ 1592.00 OTH—Other(e.g., business entity) PTY—Political Party 3. Total monetary contributions received this period. scc-smau contr�butorcommittee (Add Lines 1 and 2. Enter here and on the Summa Pa e, Column A, Line 1. TOTAL $ 21298.00 � ry 9 �""'������"�"������� FPPCForm460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period � . , to whole dollars. 7/1/2016 • � � t from through 9�24/2016 Page 5 of 22 NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * IF REQUIRED RECEIVED (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC. 31) ( � OF BUSINESS) �IND ❑OTH Ericsson $1000.00 $1499.00 Cupertino, CA 95014 ❑PTY ❑scc ❑OTH Cupertino, CA 95014 ❑PTY ❑scc ❑OTH Design Systems, Inc. $500.00 $2000.00 Cupertino, CA 95014 ❑PTY 0 scc ❑OTH Pharmaceuticals Cupertino, CA 95014 ❑PTY ❑scc �IND Statistician Chiltern ❑OTH Cupertino, CA 95014 ❑PTY ❑scc SUBTOTAL$ 2700.00 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/OS) SCC—Small Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statementcovers period � . I to whole dollars. 7/1/2016 • - � ' from through 9�24/2016 Page 6 of NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * IF REQUIRED (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC.31) ( ) OF BUSINESS) 01ND ❑OTH employed $1000.00 $1200.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑OTH self $500.00 $500.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑OTH VMWare $100.00 $150.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑PTY ❑scc 01ND accountant ❑OTH Self-employed $100.00 $100.00 Cupertino, CA, 95014 ❑PTY ❑scc SUBTOTAL$ 1800.00 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 Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Moneta Contributions Received Amounts may be rounded � to whole dollars. Statement covers period � _ from ��1/2016 � - � • � through 9�24/2016 Pa e � of 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 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 * OCCUPATIONANDEMPLOYER RECEIVEDTHIS CALENDARYEAR TODATE (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED) OF BUSINESS) Jon Wille BIND 8/15/2016 y ❑conn engineer Applied $1000.00 ❑PTY ❑scc Govind Tatachari 01ND Software Consultant 8/11/2016 ❑PTY ❑scc Terry L Griffin 01ND 8/19/2016 ❑PTY na ❑scc Margaret S. Griffin �IND retired 8/19/2016 ❑PTY na $500.00 $1600.00 ❑scc Yanping Zhao �coM engineer 8/19/2016 ❑PTY ❑scc SUBTOTAL$ 2700.00 � l "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) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statementcovers period , � . � to whole dollars. 7/1/2016 • - � , from through 9�24/2016 Page 8 of NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) �IND _ ❑oTH VMWare Santa Clara, CA, 95051 ❑PTY ❑scc ❑OTH Apple $1000.00 $1125.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑OTH na Sunnyvale, CA, 94087 ❑PTY ❑scc �o�H HauZZ $500.00 $500.00 Sunnyvale, CA, 94087 ❑PTY ❑scc ❑OTH S.A.P. $200.00 $600.00 Cupertino, CA, 95014 ❑PTY ❑scc SUBTOTAL$ 2400.00 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 Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period � _ to whole dollars. 7/1/2016 • - � � , from through g�24/2016 page 9 of NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE QFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * IF REQUIRED RECEIVED (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC.31) ( � OF BUSINESS) 01ND ❑OTH na Cupertino, CA, 95014 ❑PTY ❑scc ❑coM LAM Research $200.00 $450.00 ❑OTH Cupertino, CA, 95014 ❑PTY ❑scc �o�H Pharmaceuticals $500.00 $1199.00 Cupertino, CA 95014 ❑PTY ❑scc ❑OTH Service $100.00 $200.00 Cupertino, CA 95014 ❑PTY ❑scc ❑OTH none Cupertino, CA, 95014 ❑PTY ❑scc SUBTOTAL$ 1899.00 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 Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period � _ to whole dollars. 7/1/2016 • - � � ' from through 9�24/2016 Page 1� of NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFCOMMITTEE,ALSOENTERI.D NUMBER) CODE * IF REQUIRED (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC. 31) ( � OF BUSINESS) ❑OTH Aviat Networks Cupertino, CA, 95014 ❑PTY ❑scc ❑PTY American Red Cross ❑scc ❑OTH none $100.00 $100.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑OTH Paypal $500.00 $550.00 Cupertino, CA, 95014 ❑PTY ❑scc 01ND ❑OTH Linkedln $200.00 $600.00 Cupertino, CA, 95014 ❑PTY ❑scc SUBTOTAL$ 1025.00 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 Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/2753772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statementcovers period � _ to whole dollars. 7/1/2016 • - � • , from through 9�24/2016 page �1 of 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 (IFCOMMITfEE,ALSOENTERI.D.NUMBER) CODE * OCCUPATIONANDEMPLOYER RECEIVEDTHIS CALENDAR YEAR TODATE RECEIVED (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED) OF BUSINESS) ❑OTH University and $120.00 $245.00 Cupertino, CA, 95014 ❑PTY Applied Materials ❑scc 01ND ❑OTH Apple $200.00 $200.00 San Jose, CA, 95138 ❑PTY ❑scc intermediary: �coM engineer ❑OTH Omnivision 18691 Newsom Ave Cupertino, CA, 95014 ❑PTY ❑scc ❑OTH Intel $200.00 $599.00 Cupertino, CA, 95014 ❑PTY ❑scc Do H VMware Inc. $100.00 $100.00 Cupertino, CA, 95014 ❑PTY ❑scc SUBTOTAL$ 620.00 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 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 7�1/2016 � - � • through 9�24/2016 Pa e �2 of 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 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CONTRIBUTOR OCCUPATIONANDEMPLOYER RECEIVEDTHIS RECEIVED CODE * CALENDAR YEAR TO DATE (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED) OF BUSINESS) B IND Veronica lam com retired 9/16/2016 ❑PTY ❑scc Yu Ying ' O�N� software en ineer 9/8/2016 ❑PTY ❑scc Hui u Fen B�N� 9/8/2016 ❑PTY ❑scc intermediary: �coM software engineer Yu Ying $200.00 ❑OTH ericsson ❑PTY ❑scc Yuling Zhao O�N� Anal st conn y 9/7/2016 � ❑PTY ❑scc SUBTOTAL$ 600.00 � "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) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounaed Statementcovers period � _ � to whole dollars. 7/1/2016 • - • ' from through 9�24/2016 Page 13 of I.D.NUMBER NAME OF FILER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER EIECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) - 01ND Housewife ❑OTH na Cupertino, CA, 95014 ❑PTY ❑scc ❑oTH Elixir Medical $100.00 $199.00 Santa Clara, CA, 95051 ❑PTY ❑scc ❑OTH Paypal $50.00 $550.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑OTH Visa $200.00 $200.00 Cupertino, CA, 95014 ❑PTY ❑scc �o H na $250.00 $250.00 Cupertino, CA, 95014 ❑PTY ❑scc SUBTOTAL$ 1100.00 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 Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statementcovers period � . to whole dollars. 7/1/2016 • - � � , from through 9/24/2016 Page 14 of NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED) OF BUSINESS) ❑OTH Infinera Corporation $100.00 $100.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑OTH na Cupertino, CA, 95014 ❑PTY ❑scc ❑oTH self $100.00 $210.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑oTH School District Cupertino, CA, 95014 ❑PTY ❑scc ❑OTH Amazon San Jose, CA, 95129 ❑PTY ❑scc SUBTOTAL$ 600.00 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 r FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. • ' from ��1/2016 � - � • � through 9�24/2016 Pa e 15 of 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 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 * �CCUPATIONANDEMPLOYER RECEIVEDTHIS CALENDARYEAR TODATE (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED) OF BUSINESS) in din �IND 8/8/2016 P g g ❑conn software engineer ❑PTY ❑scc John Ho BIND 8/8/2016 ❑coM engineer ❑PTY ❑scc Yuan Xu 01ND conn R&D director 8/9/2016 ❑PTY ❑scc Car I Gorska ��N� — y conn art director 8/11/2016 ❑PTY ❑scc ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 608.00 � "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) Schedule A (Continuation Sheet) Typeorprintinink. SCHEDULEA (CONT.) Moneta Contributions Received Amounts may be rounded � to whole dollars. Statement covers period , � . ' from ��1/2016 � - � • through 9�24/2016 Pa e 16 of 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 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION QFCOMMITTEE,ALSOENTERI.D.NUMBER) CONTRIBUTOR OCCUPATIONAND EMPLOYER RECEIVED THIS RECEIVED CODE * CALENDAR YEAR TO DATE QFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC. 31) QF REQUIRED) OF BUSINESS) 01ND weixun cao ❑coM engineer 8/18/2016 ❑PTY ❑scc dan pan 01ND 8/20/2016 ❑PTY na ❑scc Lil Li �IND 8/28/2016 �PTY na $128.00 $128.00 ❑SCC Shuyi Tang �coM unemployed 8/28/2016 ❑PTY ❑scc in din BIND p g g conn software engineer 8/29/2016 ❑PTY ❑scc � SUBTOTAL$ 1244.00 � 'Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH—Other(e.g., business entity) PTY—Political Party SCC—Small ContributorCommittee 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. • ' from 7/1/2016 � - � • � through 9�24/2016 Pa e 1� of 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 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CONTRIBUTOR OCCUPATIONANDEMPLOYER RECEIVEDTHIS RECEIVED CODE * (IFSELF-EMPLOYED,ENTERNAME PERIOD CALENDAR YEAR TODATE (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) �IND Sam Sun COM Scientist 8/30/2016 ❑PTY ❑scc surya josyula ' 01ND director 8/31/2016 ❑PTY ❑scc 8/31/2016 Thomas Posey OcoM Retired Electronic ❑PTY Retired ❑scc Aseem Vaid �coM Manager 8/31/2016 ❑PTY ❑scc Xinhua Wan B�N� 9/1/2016 ❑OTH Intel $100.00 $199.00 ❑PTY ❑SCC SUBTOTAL$ 700.00 � 1 �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) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statementcovers period , � . to whole dollars. 7/1/2016 • ' � � ' from through g�24/2016 page 18 of NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFCOMMITTEE,ALSOENTERID.NUMBER) CODE * IF REQUIRED (IFSEIF-EMPLOYED,ENTERNAME PERIOD (JAN. 1 -DEC. 31) ( � OF BUSINESS) �IND ❑OTH Reddisk capital $200.00 $200.00 San Jose, CA, 95129 ❑PTY ❑scc ❑OTH Cisco $110.00 $110.00 Cupertino, CA, 95014 ❑PTY ❑scc ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 310.00 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 Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) SCHEDULEB-PART1 Type or print in ink. Schedule B— Part 1 Amounts may be rounded Statement covers period � _ Loans Received to whole dollars. from ��1/2016 � - � • 1 through 9�24/2016 Pa9e 19 of 22 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 � IF AN INDIVIDUAL, ENTER �a� (b) (c) (d) �e) (f) �g) FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATIONAND EMPLOYER BALANCE OR FORGIVEN BA�'°'NCEAT RECEIVED THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IFCOMMITTEE,ALSOENTERI.D.NUMBER) (IFSELF-EMPLOYED,ENTER BEGINNINGTHIS pERIOD CLOSEOFTHIS pERIOD LOAN TODATE NAMEOFBUSINESS) PERIOD THIS PERIOD"' PERIOD - �PAID CALENDARYEAR Xiangchen Xu engineer 18691 Newsom Ave Omnivision $ 0 $ 10,000 0 , $ 10,000 $ 11,398 Cupertino, CA 95014 �FORGIVEN RATE pERELECTION"" 5 0 � 10,000 � 0 12/31/17 � 7/20/16 � t[� IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATEDUE DATEINCURRED �PAID CALENDAR YEAR S 5 � $ g � RATE PER ELECTION*"' �FORGIVEN S $ $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PlY ❑ SCC DATEDUE DATEINCURRED �PAID CALENDAR YEAR $ $ � $ � RATE pER ELECTION"" �FORGIVEN $ $ $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATEDUE DATEINCURRED SUBTOTALS $ 10,000 $ 0 $ 10,000 $ 0 � (Enter(e)on Schedule B Summary ScheduleE,Line3) 1. Loans received this period.................................................................................................................... $ 10,000 (Total Column(b)plus unitemized loans of less than$100.) � tcontributor codes , IND—Individual 2. Loans paid orforgiven this period ......................................................................................................... $ � COM—RecipientCommittee (Total Column(c)plus loans under$100 paid orforgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g., business entity) PTY—Politicat Party NET $ 10,000 SCC—SmallContributorCommittee 3. Net change this period. (Subtract Line 2 from Line 1.)............................................................... y (May be a negative number) 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. 1 � "' If required. J FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule C Type or print in ink. SCHEDULE C Amounts may be rounded Statement covers period Nonmonetary Contributions Received towholedollars. • - , � � from 7�1/2016 � - through 9�24/2016 Page 20 of 22 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 � CUMULATIVE TO IF AN INDIVIDUAL,ENTER AMOUNT/ PER ELECTION FULL NAME,STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF DATE DATE OCCUPATION AND EMPLOYER FAIR MARKET TO DATE ZIP CODE OF CONTRIBUTOR CODE * GOODS OR SERVICES CALENDAR YEAR (IF REQUIRED) RECEIVED (IF COMMITfEE,ALSO ENTER I.D.NUMBER) (�F SELF-EMPLOYED,ENTER VALUE NAMEOF BUSINESS) (JAN 1 -DEC 31) ❑IND Cupertino Residents for Sensible �COM yard signs �,098.20 1,098.20 9/20/16 �pN Cupertino, CA 95014 ❑SCC 9/23/16 �OTH Xcelsem, LLC. and distribution Cupertino, CA 95014 ❑pTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 8,141.28 � Schedule C Summary "Contributor Codes 1. Amount received this period-itemized nonmonetary contributions. irv�-inaividuai (Include all Schedule C subtotals.) 8,141.28 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 contributorcommittee (Add Lines 1 and 2. Enter here and on the Summa Pa e, Column A, Lines 4 and 10. TOTAL $ 8,141.28 � � ry g ) FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) SCHEDULEE Schedule E Type or print in ink. Statement covers period � _ Amounts may be rounded � � , Payments Made to whole dollars. 7/1/2016 • ' from through 9�24/2016 Page 21 of 22 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER + Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 I � CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/misc. MBR membercommunications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (exptain 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 (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE OR DESCRIPTIONOFPAYMENT AMOUNTPAID PRO $25785.56 Cupertino, CA 95014 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 25785.56 Schedule E Summary 1. Itemized a ments made this eriod. Include all Schedule E subtotals. $ 25785.56 pY P � ).............................................................................................................. 2. Unitemized payments made this period of under$100 .......................................................................................................................................... $ 308.90 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 $ 26094.46 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 Amounts may be rounded Statementcovers period � - to whole dollars. 7/1/2016 • � , � ' from through 9�24/2016 Page 22 of 22 SEE INSTRUCTIONS ON REVERSE 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 DESCRIPTION OF RECEIPT AMOUNT OF RECEIVED QF COMMITTEE,ALSO ENTER I.D NUMBER) INCREASE TO CASH Attach additional information on appropriately 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 Summar Pa e, Line 14. TOTAL $ 0.01 Y9 � ........................................................................................................................... FPPC Form 460(January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC(866/275-3772)