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460 Recipient Committee Campaign Statement – Preelection Statement COVER PAGE Recipient Committee u�,�J�:�,,,� , . . , . � ' Campaign Statement D L_� C� �� � ��/ �� . - • Cover Page ` I P $ 1 ot 12 Statement covers period Date of election if applic SEP 2 j 20�6 4 I-�/ � 07/01/2016 (Month,Day,Year) : � � �..J For Otticial Use Only from d tm. SEEINSTRUCTIONSONREVERSE 09/24/2016 11/08/2016 t,'E '��r'T�^„n �`�TY CLE�3K through � � s_; o : .. . _. ..s t � 1. Type of Recipient Committee: All Committees—Complete Parts 1,z,s,and 4. 2. Type of Statement: [�✓ Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure � Preelection Statement ❑ Quarterly Statement � 5tate Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report � Recall � Controlled ❑ Termination Statement (AlsoCompktePert�) � Sponsored (Also file a Form 410 Termination) (Also Complete Part 6J ❑ General Purpose Committee ❑ Amendment(Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ � Small Contributor Committee Officeholder Committee � Political Party/Central Committee (A�soCompletePertn 3. Committee Information I i.D."uMeER Treasurer(s) 1383579 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER David Fung for City Council 2016 Kathy Jacques MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE 7539 Barnhart Place Cupertino CA 95015 ( CIIY STATE ZIPCODE NAMEOFASSISTANTTREASURER,IFANY Cupertino CA 95014 (408)821-6359 IF DIFFEREN�NO.AND STREETOR P.O.BOX MAILINGADDRESS P.O. Box 281 . CITY STATE ZIPCODE CIIY STATE ZIPCODE AREACODElPHONE Cupertino CA 95015 (408) 821-6359 . 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best Spon>or Executed on BY ' Date SignaWre of CoNrolling Officeholder,Candida�e,State Measure Proponent Executed on BY Date Signature of CoMrolling Officeholder,Candidate,State Measure Proponent FPPC Form 460(Jan/2016) FPPC Advice:aclvice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov COVER PAGE-PART 2 Recipient Committee , � . . - , Campaign Statement • - ' Cover Page — Part 2 Page 2 of �2 5. �fficeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE David Fung OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION � SUPPORT Member Cu ertino Ci Council I ❑ OPPOSE , P iY (N0.AND STREET) CITY STATE ZIP Identify the controlling officeholder,candidate,or state measure proponent,if any. 7539 Barnhart Place Cupertino, CA 95014 NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Inctuded in this Statement: Lisf any commitiees not included in this siatement that are controlled by you or are primarily formed fo receive OFFICE SOUGHT OR HELD I DISTRICT NO.IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7• Primarily Formed Candidate/Officeholder Committee List names of officeholder(s)or candidate(s)lor which fhis commitfee is primarily formed. ❑ YES ❑ NO _ • COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE C�Ty 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 ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDP,TE OFFICE SOUGHT OR HELD ❑ YES ❑ NO ❑ SUPPORT ❑ OPPOSE COMMITTEEA6DRESS STREETADDRESS (NO P.O.BOX) . CITY STATE ZIP CODE AREA CODEIPHONE qttach continuation sheefs if necessary FPPC Form 460(1an/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may b�e rounded SUMMARY PAGE to whole dollars. Statement covers period , � . � Summary Page 07/01/2016 -. - � • � from through 09/24/2016 Page 3 op �2 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER 1 David Fung for City Council 2016 1383579 I Column A Column B Calendar Year Summary for Candidates � Contributions Received TOTALTHISPERIOD CALENDARYEAR (FROMATTACHEDSCHL=DULES) TOTA�TODATE Running in Both the State Primary and 7,8g8 12,147 General Elections 1. Monetary Contributions................................................... s�nedUieA,Line 3 $ 5,000 $ 5,000 1�1 through 6l30 7i� co Date 2. Loans Received................................................................ s�ned�ie e,�;ne s 20. Contributions 12,898 17,147 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add�ines�+2 $ $ Received $ $ 4. Nonmonetary Contributions............................................ scheduie c,une s � � 21. Expenditures 5. TOTALCONTRIBUTIONSRECEIVED....................................Add�ines3+4 $ 12�898 g 17,147 Made $ $ Expendita�res Made Expenditure Limit Summary for State 6. PaymentsMade................................................................ scneauieE,unea $ 3,974.30 $ 4,124.30 Candidates 7. Loans Made....................................................................... s�naduie N,une s 0 0 3,974.30 4.124.30 2Z� C s b e�acoVvoiEn are etlPe�deur Mad'e* 8. SUBTOTALCASH PAYMENTS.......................................... Add�ines6+7 $ $ ( � v 9. Accrued Expenses(Unpaid Bills)..........................................s�ned�ie F��ne s � � Date of Election Total to Date 10. Nonmonetary Adjustment.........................................................s�neduie c,Line 3 0 0 (mm/ddlyy) 11. TOTAL EXPENDITURES MADE.........................................4dd�ines8+g+�o $ 3,974.30 g 4,124.30 _�� $ Current Cash Statement —�� $ . . 4,099 12. Begmning Cash Balance............................ P.evro�5 summa.y Paye,Line 16 $ To calculate Column B, 13. C2Sh ReCelpts........................................................... Column A,Line 3 above �2�898 add amounts in Column 300 A to the corresponding �Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash.................................. scnedu�e i,Line 4 amounts from Column B reported in Column B. 15. Cash Payments......................................................... column A,�ine e above 3,974.30 ofyour last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add�ines 12+13+i4,then subtract Cine 15 $ 13,322.70 be negative ftgures that should be subtracted from Ifthis is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED................................ schedu�e e,Pan 2 $ 0 filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts f�om��neS 2, �,and 9(if 18. C2Sh EqulV8leftts................................................ See instructions on reverse $ O any). 'I 9. OUtStB�dlllg D@btS.............................. Add Line 2+Line 9 in Column 6 above $ � FPPC Fo1'm 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A to whole dollars. Statement covers period Monetary Contributions Received � • ' � • � � from 07/01/2016 � - through 09�24/2016 page 4 of �2 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER David Fung for City Council 2016 1383579 DATE FULL NAME,STREETADDRESS AND ZIP CODE OF CONTRIBUTUR CONTRIBUTOR IF AN INDIVIDUAL,ENTER RECEIVED THIS c CALENDAR YEARTE PE TO DATEON RECEIVED pF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER (IFSELF-EMPLOYED,ENTER NAME PCRIOD (JAN.1 -DEC.31) (IF REQUIRED) OF BUSINESS� �IND 9/18/2016 ❑OTH Machine Topanga, CA 90290 ❑PN ❑scc m IND 9/19/2016 ❑OTH 100 100 Los Altos, CA 94024 ❑Pn' ❑scc �IND 9/9/2016 ❑OTH Cupertino, CA 95014 �Pn' ❑scc ❑OTH Development Cupertino, CA 95014 ❑PrY ❑scc ❑OTH Consultant, Self 200 200 Los Gatos, CA 95032 ❑Pnr Employed ❑scc SUBTOTAL$ 4,600 I , Schedule A Summary �Contributor Codes 1. Amount received this period-itemized monetary contributions. �N�-�ndividua� Include all Schedule A subtotals. $ 7,550 COM—Recipient Committee ( �......................................................................................................... (other than Pl"Y or SCC) 2. Amount received this eriod-unitemized monetar contribu�ions of less than $100 ...........................$ 348 OTH—Other(e.g.,business entity) p Y PTY—Political Party 3. Total monetary contributions received this period. scc-sma��contributor committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ �'898 FPPC Form 460(Jan/2016) FPPC Advice:advir_e@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary Contributions Receiv�ed towholedollars. Statementcoversperiod . � - � � , from 07/01/2016 • ' � through 09/24/2016 page 5 of �2 NAME OF 1=1LER I.D.NUMBER � David Fung for City Council 2016 1383579 CONTRIBUTOR IFAN INDIVIDUAL,ENTER AMOUNT CUMULATIVETO DATE PER ELECTION DATE FULL NAME,STREETADDRESS AND ZIP CODE OF CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE (IF SELF-EMPLOYED,ENTER NAME oFeuslNEss) PERIOD (JAN.1-DEC.31) (IF RECtUIRED) ❑OTH 500 500 Cupertino, CA 95014 ❑P�' ❑scc ❑coM Cu ertino 100 100 ❑OTH P Cupertino, CA 95014 ❑pn ❑scc ❑OTH 100 100 Cupertino, CA 95014 ❑Pn ❑scc ❑OTH Metropolitan Symphony MinneapoEis, MN 55408 ❑pn Orchestra ❑scc ❑OTH Bo Katzakian ❑PTY ❑SCC SUBTOTAL$ 1,000 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(1an/2016) SCC—Small Contributor Committee FPPC Advice:advice@fppc.ca.gov�866/275-3772) www.�ppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDUL�A (CONT.) Monetary Contributions Received townolec�o�lars. statementcoversperiod . . - , � ` from 07/01l2016 � ' � through �9�24/2016 page 6 of �2 NAME OF�ILER I.D.NUMBER David Fung for City Council 2016 1383579 DATE FULL NAME,STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IFCOMMITTEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IFSE�F-EMPLOYED,ENTERNAME PERIOD (JAN.1-DEC.31) (IF REQUIRED) OF HUSINESS) ❑OTH 250 250 Cupertino, CA 95014 ❑P�' ❑scc ❑coM 200 200 ❑OTH Cupertino, CA 95014 ❑Pn ❑scc . ❑coM Strate ies 200 200 ❑OTH g Cupertino, CA 95014 ❑PTv ❑scc ❑OTH Company 100 100 Cupertino, CA 95014 ❑P�rv ❑scc �oTH 500 500 San Jose, CA 95110 ❑PN ❑scc SUBTOTAL$ 1,250 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{Jan/2016) SCC—Small Contributor Committee FPPC Advice:advice@fppc.ca.gov�866,/275-3772) � www.fippc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULCA (CONT.) Monetary Contributions Received towholedollars. Statementcoversperiod . . - , � , from 07/01/2016 � ' � through 09/24/2016 Page � of �2 NAME OF FILER I.D.NUMBER David Fung for City Council 2016 1383579 DATE FULL NAME,STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IFAN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IFCOMMITTEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN.1-DEC.31) (IFREQUIRED) OF BUSINESS) ❑OTH Saratoga, CA 95070 ❑P�' ❑scc ❑OTH 300 300 Cupertino, CA 95014 ❑pTv ❑scc ❑OTH 100 199 Cupertino, CA 95014 ❑PTv ❑scc ❑OTH San Jose, CA 95125 ❑P1v ❑scc . ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 700 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(Jan/2016) SCC—5mall Contributor Committee FPPC Advice:advice@fppc.ca.gov(866/275-3772j www.fppc.ca.gov Amounts may be rounded SCHEDUL�B-PART 1 Schedule B — Part 1 to whole dollars. Statement covers period , � _ 1 Loans Received � � from 07l01/2016 • - SEE INSTRUCTIONS ON REVERSE through 09/24/2016 page 8 of �2 NAME OF FILER I.D.NUMBER David Fung for City Council Z016 1383579 � IF AN INDIVIDUAL,ENTER �a� �b) (c) Idl ' lel lTi ' l91 FULL NAME,STREETADDRESSAND ZIP CODE OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING �NTEREST ORIGINAL GUMULATIVE OFL�NDER OCCFSELFOMA UD�MPTOYER gALANCE RECEIVEDTHIS pRFORGIVEN BALANCEAT PAIDTHIS AMOUNTOF CONTRIBUTIONS (IFGOMMITTEE,ALSOENTERI.D.NUMBERj NnMEOFBUSINESs) BEGINNINGTHIS pERIOD THISPERIOD* CLOSEOFTHIS pERIOD LOAN TODATE PERIOD PERIOD David Fung Principal, Symian �PA�� ca�LENDAR VEAR 7539 Barnhart Place Cupertino CA Development � 0 � 5.000 0 � § 5.000 g 10,000 95014 ❑FORGIVEN RA7E PER ELEC710N"" � 0 � 5,000 � 0 None 5 0 9/24/16 g t� IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDAR YEAR q� S % 5 S ftATE PER ELECTION'* ❑ FORGIVEN S 3 g S � t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ S % 5 5 ❑FORGIVEN RATE PER ELECTION�'' $ 5 $ S $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ $ � $ l ; (Enter(e)on Schedule B Summary ScheduleE,Line3) 1. Loans received this period....................................................................................................................$ �nnn (Total Column (b) plus unitemized loans of less than $100.) tContributor Codes 2. Loans aid or for iven this eriod.........................................................................................................$ IND—Individual p g p � COM—Recipient Committee (Total Column (c) plus loans under$100 paid or forgiven.) (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-Political Party 3. Net chan e this eriod. Subtract Line 2 from Line '1. NET $ F n�n 5CC—Small Contributor Committee 9 P � ).............................................................. Enter the net here and on the Summary Page, Column A, Llll@ 2. (May be a negative numher) � Amounts forgiven or paid by another party also must be reported on Schedule A. � FPPC Form 4E0(Jan/2016) ;t � FPPC Advice:advice@fppc.ca.gov(866/275-3772) �* If required. www.fppc.ca.gov SCHEDULE E Schedule E Amounts may be rounded Statementcovers period � � - . to whole dollars. � � , Payment� Made f�om 07/01/2016 � " through 09/24/2016 page 9 of �Z SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER David Fung for City Council 2016 1383579 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 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 LIT campaign literature and mailings PRT print ads WEB information technology costs(internet, e-mail) NAMEANDADDRESS OF PAYEE (IFCOMIAITTEE,AISOENTERI.D.NUNIBER) CODE OR DESCRIPTIONOFPAYMENT AMOUNTPAID PO Box Rental, FPPC Registration FEE, Domain 7539 Barnhart Place Cupertino CA 95014 OFC Name Registration �29•68 City of Cupertino Quinlan Center Room Rental & $300 refundable 10300 Torre Avenue FN� deposit for campaign kick-off event 660,00 Cupertino, CA 95014 318.38 Cupertino, CA 95014 'Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,108.06 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 3,558.50 2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 418.97 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.) 3,977.47 ........................... TOTAL $ FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E(CONT.) Amounts may be rounded Statement covers period (Continuation Sheet) to whole dollars. ,� ' � � � Payments Made from 07/01/2016 through 09/24/2016 SEE INSTRUCTIONS ON REVERSE Page �� of �2 NAME OF FILER I.D.NUMBER David Fung for City Council 2016 1383579 CODES: If one of the follov�ning codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalialmisc. MBR member communications 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)* P05 postage,delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG Iegal defense PRO professional services(legal,accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs(internet,e-mail) NANIE AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID QF COPAMITTEE,ALSO ENTER I.D.NUMBER) LIT 131.83 866-614-8002 CMP 1,133.01 Neenah,Wl 54956 CMP 102.00 San Jose, CA 95112 LIT 523.08 866-614-8002 LIT 358.87 866-614-8002 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2�24g,�g FPPC form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov{866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded SCHEDULE E(CONT.) (Continuation Sheet) to whole doliars. Statement covers period , • � . / • ' Payments Made from 07/01/2016 through 09/24/2016 Page �� of �2 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER David Fung for City Council 2016 1383579 � CODES: If one of the follow�ing 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 costs CNS campaign consultants MTG meetings and appearances RFD retucned 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 candidatelsponsor LEG legal defense PRO professional services(legal,accounting) VOT voter registration LIT campaign literature and mailinc�s PRT print ads WEB infonnation technology costs(internet,e-mail) NANIE AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COfAMITTEE,AL50 ENTER I.D.NUMBER) LIT 201.65 Campbell, CA 95008 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 201.65 FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule I Amounts may be rounded SCHEDULE I Miscellaraeous Increases to Cash towholedollars. Statementcoversperiod , � _ , , � � from 07/01/2016 • � through 09/24l2016 page �Z of �2 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER David Fung for City Council 2016 1383579 DATE FULL NAMEANDADDRESS OF SOURCE AMOUNT OF RECEIVED (IF COMMITTEE,AL50 ENTER I.D.NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH City of Cupertino Refund for Quinlan Center room rental 9/5/2016 10300 Torre Avenue deposit $300 Cupertino, CA 95014 Aftach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 300 Schedule I Summary 1. Itemized increases to cash this period. ...........................................................................................................................$ 300 2. Unitemized increases to cash of under$100 this period. ................................................................................................$ � 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) .......................................$ � 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ......... TOTAL $ 300 .................................................................................................................... FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov