The URL can be used to link to this page

460 Recipient Committee Campaign Statement - Termination 10-23-2016 to 12-31-2016 Recipient Committee COVER PAGE Campaign Statement [� te � • - , • Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 10/23/2016 through 12/31/2016 1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 91 Officeholder,Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information :UMMITTEE NAME(OR CANDIDATE'S NAME IF NO Jerry Liu for City Council 2016 ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D.NUMBER 1386578 STREETADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX CITY STATE ZIP CODE AREACODE/PHONE Date of election if appli (Month,Day,Year) JAN 2 6 2017 Novembers, 20161 _�PERTINO CITY CFERK 1 of 8 Official Use Only 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd-Year Report ® Termination Statement (Also file a Form 410 Termination) ❑ Amendment(Explain below) Treasurer(s) NAME OF TREASURER Jennifer Fang MAILINGADDRESS 21837 Lomita Avenue CITY STATE ZIP CODE AREA CODE/PHONE CA 95014 408 996 1177 NAME OF ASSISTANT TREASURER,IF ANY Nan Yu MAILING ADDRESS 1935 Cappelletti Court CITY STATE ZIP CODE AREACODE/PHONE 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information coained 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 Executed on January 22, 2017 Date Executed on January 22,2017 Date Executed on Date Executed on By By ,,,y vu ,iuiuw{c.m iu i uate,oiare Ivreasure Proponent or Kesponsib le Officer of Sponsor By Signature of Controlling Officeholder,Candidate,State Measure Proponent By Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Jerry Liu OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE) Cupertino City Councilmember RESIDENTIAUBUSI NESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP 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. 1 I I CC NAM I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D.NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE-PART 2 Page 2 of 8 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE 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 SOUGHT OR HELD DISTRICT NO.IF ANY 7. Primarily Formed Candidate/Officeholder Committee Listnames of officeholder(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(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jerry Liu for City Council 2016 Contributions Received 1. Monetary Contributions................................................... Schedule A,Line 3 $ 2. Loans Received................................................................ Schedule B,Line 3 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lines 1+2 $ 4. Nonmonetary Contributions............................................ Schedule C,Line 3 5. TOTAL CONTRIBUTIONS RECEIVED...................................Add Lines 3+4 $ Statement covers period from 10/23/2016 through Column A Column B TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE 14721.78 29119.78 $ 29119.78 (15000.00) 0.00 (278.22) 29119.78 $ Add Lines 6+7 $ 0.00 424.99 (278.22) $ 29544.77 Current Cash Statement 12. Beginning Cash Balance............................ Previous Summary Page,Line 16 $ 13.Cash Receipts........................................................... Column A,Line 3 above 14.Miscellaneous Increases to Cash.................................. Schedule 1,Line 4 15.Cash Payments......................................................... Column A,Line 8 above 16.ENDING CASH BALANCE ..................Add Lines 12+13+14,then subtract Line 15 $ If this is a termination statement,Line 16 must be zero_ 17. LOAN GUARANTEES RECEIVED................................ Schedule e,Part $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents................................................ See instructions on reverse $ 19. Outstanding Debts.............................. Add Line 2+Line 9 in Column B above $ 8839.94 (278.22) 0.00 8561.72 0.00 0.00 0.00 0.00 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). SUMMARY PAGE 12/31/2016 page 3 of 8 I.D.NUMBER 1386578 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6130 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) / J $ I-� $ `Amounts in this section may be different from amounts reported in Column B. FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov 6. Payments Made................................................................ Schedule E,Line 4 $ 8561.72 $ 29119.78 7. Loans Made....................................................................... Schedule H,Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS.......................................... Add Lines 6+7 $ 8561.72 $ 29119.78 9. Accrued Expenses(Unpaid Bills).......................................... Schedule F Line 3 0.00 0.00 10. Nonmonetary Adjustment......................................................... Schedule C,Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE........................................ Add Lines 8+9+10 $ 8561.72 $ 29119.78 Current Cash Statement 12. Beginning Cash Balance............................ Previous Summary Page,Line 16 $ 13.Cash Receipts........................................................... Column A,Line 3 above 14.Miscellaneous Increases to Cash.................................. Schedule 1,Line 4 15.Cash Payments......................................................... Column A,Line 8 above 16.ENDING CASH BALANCE ..................Add Lines 12+13+14,then subtract Line 15 $ If this is a termination statement,Line 16 must be zero_ 17. LOAN GUARANTEES RECEIVED................................ Schedule e,Part $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents................................................ See instructions on reverse $ 19. Outstanding Debts.............................. Add Line 2+Line 9 in Column B above $ 8839.94 (278.22) 0.00 8561.72 0.00 0.00 0.00 0.00 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). SUMMARY PAGE 12/31/2016 page 3 of 8 I.D.NUMBER 1386578 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6130 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) / J $ I-� $ `Amounts in this section may be different from amounts reported in Column B. FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A ivwnetary %.,onirIDuvonS Keceived Statement covers period 10/23/2016 CALIFORNIA from FORM SEE INSTRUCTIONS ON REVERSE through 12/31/2016 Page 4 of 8 NAME OF FILER Jerry Liu for City Council 2016 I.D.NUMBER .NUM 1386578 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IFAN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CAN.1- RYEAR TO DATE (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) PERIOD (.IAN.1-DEC.31) (IF REQUIRED) 10/30/2016 DRIVE Committee, FEC ID#C00032979 ❑IND ®COM 25 Louisana Avenue NW ❑OTH 250.00 250.00 250.00 Washington DC 20001-2198 ❑PTY ❑SCC 11/1/2016 IBEW 332 Education Fund, FPPC#1298069 [1 IND El 2125 Canoas Garden Ave, Ste 100 El OTH OTH 500.00 500.00 500.00 San Jose, CA 95125 ❑PTY ❑SCC IFPTE Local 21, FPPC#881248 ❑IND ® 11/4/2016 1167 Mission St,2nd floor El OTH OTH 500.00 500.00 500.00 San Francisco, CA 94103 ❑PTY ❑SCC Jerry Zheng 0 IND 111712016 21880 Lomita Avenue ❑COM El Businessman Self-employed 500.00 500.00 500.00 C Cupertino, CA 95014 ❑PTY El ❑SCC Friends of Barry Chang Against the Recall ❑IND 11/11/2016 FPPC#1385778 W]COM ❑OTH 4000.00 4000.00 4000.00 Madison Avenue, Sacramento, CA 95841 ❑PTY ❑SCC SUBTOTAL$ 5750.00 Scneauie A summary 1. Amount received this period—itemized monetary contributions. (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period—unitemized monetary contributions of less than$100...........................$ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 14721.78 e 14721.78 'Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH—Other(e.g.,business entity) PTY—Political Parry SCC—Small Contributor Committee FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded Mnno+7rci ('nn+r:h..+ C.,....:....A 6-...w i_ SCHEDULEA (CONT.) _ -------- ----••�•.....�......� .\6V�i.Y G\A •�°...,.� ., a�• Statement covers period from 10/23/2016 CALIFORNIA • FORM through 12/31/2016 page 5 of 8 NAME OF FILER I.D.NUMBER Jerry Liu for City Council 2016 1386578 DATE RECEIVED FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL,ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) PERIOD JAN.1-DEC.31 TO DATE IF REQUIRED) Friends of Barry Chang Against the Recall El IND 12/7/2016 FPPC#1385778 ®❑OTH 4400.00 8400..00 8400.00 Madison Avenue, Sacramento, CA 95841 ❑PTY ❑SCC 12/27/2016 Jerry Liu ®IND El COM Research Manager 21837 Lomita Avenue [_j OTH HP Inc 4571.78 4571.78 4571.78 Cupertino, CA 95014 ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 8971 78 '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(Jan/2016). FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov C..L...d..l.. M M—L A Amounts may be rounded SCHEDULE B-PART 1 _ ' p&` ' to whole dollars. Statement covers period Loans Received CALIFORNIA from 10/23/2016 FORM SEE INSTRUCTIONS ON REVERSE through 12/31/2016 Page 6 of 8 NAME OF FILER I.D.NUMBER Jerry Liu for City Council 2016 1386578 FULL NAME,STREETADDRESS AND ZIP CODE OF LENDER IF AN INDIVIDUAL,ENTER OCCUPATION AND EMPLOYER a OUTSTANDING (b) AMOUNT (c) AMOUNT PAID S (d) OUT TANDING (e) INTEREST ORIGINAL (9) CUMULATIVE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) (IF SELF-EMPLOYED,ENTER NAME OF BUSINESS) BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN ` BALANCE AT CLOSE HIS PAID THIS AMOUNT OF CONTRIBUTIONS PERIOD THIS PERIOD ERIOD PERIOD LOAN TO DATE Jerry Liu Research Manager m PAID CALENDARYEAR 21837 Lomita Avenue HP Inc $ 15000 $ 0.00 15000 $ 15000 Cupertino, CA 95014 % $ El FORGIVEN FORGIVEN PER ELECTION' t $15000.00 $ 0.00 $ 1 1DUEo $ 15000 V IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DATE INCUR DATE INCURRED $ ❑PAID CALENDARYEAR $ $ $ $ ❑FORGIVEN PER ELECTION'" RATE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ DATE DUE DATE INCURRED $ ❑PAID CALENDARYEAR ❑FORGIVEN PER ELECTION`"" RATE t❑ IND El ❑ SCC ❑ COM ❑ OTH $ $ $ $ DATE DUE DATE INCURRED $ SUBTOTALS $ 0 $ 0 $ 0 $ aurleuule D summary 1. Loans received this period....................................................................................................................$ 000 (Total Column (b) plus unitemized loans of less than$100.) 2. Loans paid or forgiven this period.........................................................................................................$ (15000 nrn (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. NET $ I I(1-,0()J 0_ (May be a negative number) Schedule E,Line 3) tContributor 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(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Jerry Liu for City Council 2016 Amounts may be rounded to whole dollars. Statement covers period from 10/23/2016 through 12/31/2016 SCHEDULE E Page 7 of 8 I.D.NUMBER 1386578 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP CNS campaign paraphernalia/misc. MBR member communications RAID radio airtime and production costs CTB campaign consultants contribution(explain nonmonetary)* MTG OFC meetings and appearances RFD returned contributions CVC civic donations PET office expenses petition circulating SAL TEL campaign workers'salaries FIL candidate filing/ballot fees PHO phone banks TRC t.v.or cable airtime and production costs candidate travel,lodging,and meals FND IND fundraising events independent expenditure supporting/opposing others(explain)* POL POS polling and survey research delivery TRS staff/spouse travel,lodging,and meals LEG legal defense 4805 Woodview Avenue postage, 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) NAME AND ADDRESS OF PAYEE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Pacific Printing 1445 Monterey Highway LIT San Jose, CA 95110 8149.05 Santa Clara County Registrar of Voters 1555 Berger Drive POL 225.00 San Jose, CA 95112 Premiere Political Communications 4805 Woodview Avenue PHO 105.60 Austin, TX 78756 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 8479.65 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................$ 2. Unitemized payments made this period of under$100..........................................................................................................................................$ 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.)..............:............TOTAL $ 8561.72 0.00 0.00 8561.72 FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Amounts may be rounded to whole dollars. Statement covers period SCHEDULE E(CONT.) ' CALIFORNIA Payments Made 378.07 City of Cupertino Cupertino, CA 95014 10/23/2016 FORM (296.00) from SEE INSTRUCTIONS ON REVERSE through 12/31/2016 page 8 of 8 NAME OF FILER Jerry Liu for City Council 2016 ID NUMBER 1386578 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. CNS campaign consultants MBR member communications RAD radio airtime and production costs CTB contribution(explain nonmonetary)* MTG OFC meetings and appearances office expenses RFD returned contributions CVC civic donations FIL candidate filing/ballot fees PET petition circulating SAL campaign workers'salaries TEL t.v.or cable airtime and production costs FND fundraising events PHO POL phone banks polling and survey research TRC candidate travel,lodging,and meals TRS staff/spouse travel,lodging,and meals IND independent expenditure supporting/opposing others(explain)* LEG 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) ads VOT voter registration print WEB information technology costs(internet,e-mail) NAME AND A E OF PAYEE (IF COMMITTEE,ALSO L50 ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Dynasty Chinese Seafood Restaurant Cupertino, CA 95014 Lunch for volunteers 378.07 City of Cupertino Cupertino, CA 95014 FIL Refund from City Clerk's Office (296.00) Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ AO 07 FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov