497 Contribution Report - Contributions Received on 09-24-2016 497 Contribution Report Amounts may be rounded to whole dollars.
NAME OF FILER Date of Date Stamp , � - .
9/26/20 i- � -- , �
David Fung for City Council 2016 rh'S F'i'"g [� � [� � �/ `� � • -
UAREA I.D.NUMBER(i�epplicableJ ! or icia se n y
408-821-6359 1383579 Report No. � � J
S E P 2 7 2016 I
❑Amendment
P.O. Box 281 to Report No.
(explain below)
No.of Pages � CUF'ERTINO CITY CLERK
Cupertino CA 95015 ,
1. Contribution(s) Received
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, AMOUNT
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * �ENTER OCCUPATION AND EMPLOYER RECEIVED
IF SELF-EMPLOYED,ENTER NAME OF BUSINESS)
❑ coM Development $4000
9/24/2016 CUpe1�l110, CA 95014 ❑ OTH ❑ Check if Loan
❑ PTY
❑ SCC ��
Provide interest rete
❑ coM Development $5000
9/24/2016 Cupertino, CA 95014 ❑ OTH 0 Check if Loan
❑ PTY
❑ SCC �
Provide interest rate
❑ IND
❑ COM
❑ OTH p Check if Loan
❑ PTY
❑ SCC ��
Provide interest rate
`"Contributor Codes
IND — Individual
COM— Recipient Committee(other than PTY or SCC)
OTH — Other(e.g.,business entity)
PTY — Political Party
Reason for Amendment: SCC — Small Contributor Committee
FPPC Form 497(lul/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov