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460 Recipient Committee Campaign Statement – Preelection Statement COVER PAGE :�_ecipient Committee 1 � �at�a�� / , �� ,;;� � ' Campaign Statement �'1 �,�c ��s -> Cover Page � - � �� I 'i ...� ��:..,�,_ ^ � Page � of 4 Statement covers period Date of election if applicak�� SEP 2 9 2016 :_ from 1/01/2016 (Month, Day,Year) , For Official Use Only 9/24/2016 11/08/2016 c`sPERTINO CITY CLE?� SEE INSTRUCTIONS ON REVERSE thfOugh - 1. Type of Recipient Committee: a,u comm�nees-compiece Parts�,2,s,a�a a. 2, Type of Statement: 0 Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure � Preelection Statement ❑ Quarterly Statement � State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report � Recall 0 Controlled ❑ Termination Statement (AlsoCompletePartSJ � Sponsored (Also file a Form 410 Termination) (Also Complefe Part 6) ❑ General Purpose Committee ❑ Amendment(Explain below) � Sponsored ❑ Primarily Formed Candidate/ � Small Contributor Committee Officeholder Committee � Political Party/Central Committee (A�so Complefe Part 7J 3. Committee Information I i.o."u"'BER Treasurer(s) 1390787 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Kris Wang for City Council 2016 Angela Tsai CITY STATE ZIP CODE AREACODE/PHONE 20660 Stevens Creek Blvd. Suite#136 CITY STATE ZIP CODE NAME OF ASSISTANT TREASURER,IF ANY Cupertino CA 95014 408-931-6186 MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS ��7y STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAILADDRESS OPTIONAL: FAX/E-MAILADDRESS 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�aws of the State of California that the Proponent or Responsible Officer of Sponsor � Executed on BY Date Signature of Controlling Officeholder,Candidate,Stale Measure Proponent Executed on BY ' Date Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) Cam 81 n Disclosure Statement Amounts may be rounded SUMMARY PAGE p 9 to whole dollars. `�.- Summary Page Statementcovers period � �� ;e e��(,r '� ��, �'� 1/01/2016 �` �s�� ' �:� � � � ,. from ` • ,�..�..�.y.,., *�_.;.i�;,;�::,;, throu n 9�24/2016 Page 2 of 4 9 SEE INSTRUCTIONS ON REVERSE { NAME OF FILER I.D.NUMBER I Kris Wang for City Council 2016 1390787 � Cotumn A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CAL[NDARYEAR (FROMATTACHEDSCHEDULES) TOTALTODATF Running in Both the State Primary and 3016 3016 General Elections 1. Monetary Contributions................................................... scned�iea,�ir,e s $ O � O 1/1 through 6/30 �i� co Date 2. Loans Received................................................................ scneduie e,une s 3016 3016 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add�ines�+2 $ $ Received $ $ 4. Nonmonetary Contributions............................................ scneduie c,�ine s � � 2�. Expenditures 3016 3016 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add�ines3+4 $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ scneduie E,Line 4 $ 0 $ � Candidates 7. LoBns Made....................................................................... Schedule H,Line 3 � 0 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS.......................................... Add�ines s+� $ � $ 0 (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills)..........................................soneduie F u�e s � � Date of Election Total to Date 10. Nonmonetary Adjustment.........................................................scneduie c,une a � 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE........................................Add�ines 8+g+�o $ � $ 0 _�_� $ Current Cash Statement —�—� $ 12. B2gltlllltlg C8SI1 BBIaIlC2............................ Previous Summary Page,Line 16 $ O To calculate Column B, 13. Cash Receipts........................................................... Column a,�ine 3 above 3016 add amounts in Column A to the corresponding 'Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash.................................. scneau�e i,�ine a � amounts from Column B reported in Column B. 15. Cash Payments......................................................... coi�m�a,Line 8 above O of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add�ines 12+ 13+14,then subtract Line 15 $ 3016 be negative figures that should be subtracted from !f this is a termination statement,Line 16 must be zero, previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED................................ scnedu�e e,Part 2 $ 0 filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts aroy) Lines 2,�,and 9(if 18. CBSh EqUlvalents................................................ See instructions on reverse $ � 'I J. OUtSt2f1C11f1g D2btS.............................. Add Line 2+Line 9 in Column 8 above $ � FPPC Form 460(Jdn�2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov SC�iE.'G`�U�e /4 Amounts may be rounded SCHEDULE A to whole dollars. Statement covers Monetary Contributions Received period • - • 1 1/01/2016 • from � ' throu h g�24/2016 3 4 SEE INSTRUCTIONS ON REVERSE 9 Pdge of NAME OF FILER I.D.NUMBER Kris Wang for City Council 2016 1390787 DATE FULL NAME,STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE,AlSO ENTER I.D.NUMBER) CONTRIBU*OR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE CODE (IF SELF-EMPLOYED,ENTER NAME PERIOD oF euswess) (JAN. 1 -DEC.31) (IF REQUIRED) SSGI Asia ❑IND ' 9/02/2016 ❑OTH ❑PTY ❑SCC Ning Chang 01ND 9/08/2016 ❑OTH ❑PTY ❑SCC Mission Peak Lodge ❑IND 9/18/2016 ❑OTH ❑PTY ❑SCC W&H P.B. LLC ❑IND 9/18/2016 ❑PTY ❑scc Phyllis Dickstein �IND retired 100 9/18/2016 � �PTY ❑scc SUBTOTAL$ 1610 f Schedule A Summary "Contributor Codes 1. Amount received this period - itemized monetary contributions. irv�-ind��duai (Include all Schedule A subtotals.) � 2670 COM-Recipient Committee ......................................................................................................... (other than PTY or SCC) 2. Amount received this period—unitemized monetary contributions of less than $100 ...........................$ 346 OTH-Other(e.g., business entity) PTY—Political Party 3. Total monetary contributions received this period. scc-smaii contributor committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 3016 - 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 SCHEDULEA (CONT.) Monetary Contributions Received to whole dollars. Statement covers period • - � • 1 from 1/01/2016 � - through 9�24/2016 page 4 of 4 NAME OF FILER I.D.NUMBER Kris Wang for City Council 2016 1390787 DATE FULL NAME,STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE QF SELF-EMPLOYED,ENTER NAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED OF BUSINESS) � Lei Wu ��N� retired 9/18/2016 ❑OTH ❑PTY ❑SCC James Chang �IND retired 9/18/2016 ❑OTH ❑PTY ❑SCC Wan Sun �IND house wife 9/26/2016 ❑OTH ❑PTY ❑SCC Albert Chang Q IND retired 9/26/2016 ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 1060 i 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(Jan/2016) ' FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov