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460 Recipient Committee Campaign Statement - Semi Annual 1-1-21 to 6-30-21Recipient Committee COVER PAGE Campaign Statement Date Stamp CALIFORNIA I Cover Page ' RM SEE INSTRUCTIONS ON REVERSE Statement covers period from 01 /01 /2021 through 06/30/2021 1. Type of Recipient Committee: All Committees— Complete Parts 1, 29 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 3 State Candidate Election Committee Committee 3 Recall 0 Controlled (Also Complete Part 5) O Sponsored ❑ General Purpose Committee (Also Complete Part 6) 3 Sponsored ❑ Primarily Formed Candidate/ 3 Small Contributor Committee Officeholder Committee 3 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I I.D. NUMBER 1428230 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) J. R. Fruen for Cupertino City Council 2020 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE Cupertino CA 95014 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY OPTIONAL: FAX / E-MAIL ADDRESS STATE ZIP CODE AREACODE/PHONE Date of election if applicable: (Month, Day, Year) 11 /03/2020 Filed Date- 08/02/2021 10:02 PM Page 1 of 13 For 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 Joseph "J.R." Fruen MAILING ADDRESS CITY STATE Cupertino CA ZIP CODE AREACODE/PHONE 95014 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE 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 08/02/2021 By Date Signature of Treasurer or Assistant Treasurer Executed on 08/02/2021 Date Executed on Date Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor By Signature of Controlling Officeholder, Candidate, State Measure Proponent By oignacure or uoncrouing urncenoiaer, uanamace, ocace measure rroponenc 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 Joseph "J.R." Fruen OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Cupertino CA 95014 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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑YES ONO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑YES ONO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 13 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 Summary Page Amounts may be rounded to whole dollars. Statement covers period from 01 /01 /2021 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE through 06/30/2021 Page 3 of 13 NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 1428230 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Prima and g Primary (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 1. Monetary Contributions Schedule A, Line 3 $ 515.00 $ 515.00 1/1 through 6/30 7/1 to Date 2. Loans Received............................................................ Schedule a, Line 3 0.00 10,000.00 3. SUBTOTAL CASH CONTRIBUTIONS ............................. Add Lines 1 +2 $ 515.00 $ 10,515.00 20. ContributionsReceived $ $ 4. Nonmonetary Contributions ......................................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............................ Add Lines 3+4 $ 515.00 $ 10,515.00 Made $ $ Expenditures Made 6. Payments Made.............................................................. Schedule e, Line 4 $ 7. Loans Made...................................................................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ........................................ Add Lines 6+7 $ 9. Accrued Expenses (Unpaid Bills) ................................ Schedule F, Line 3 10. Nonmonetary Adjustment ............................................. Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ............................... Add Lines 8 + 9 + 10 $ current casn 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 B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................. See instructions on reverse $ 19. Outstanding Debts ............................... Add Line 2 +Line 9 in Column B above $ 907.06 $ 907.06 0.00 0.00 907.06 $ 907.06 0.00 0.00 0.00 0.00 907.06 $ 907.06 92.51 To calculate Column B, 515.00 add amounts in Column A to the corresponding 299.67 amounts from Column B of your last report. Some amounts in Column A may 907.06 0.12 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 0.00 any). 0.00 10.000.00 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) *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 to whole dollars. Monetary Contributions Received Statement covers period . - from 01 /01 /2021 • - .1 through 06/30/2021 Page 4 of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 14 88230 DATE FULL NAME, STREET ADDRESS 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 (IF SELF-EMPLOYED, ENTER NAME RECEIVED CALENDAR YEAR TO DATE OF BUSINESS) THIS PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ./❑ IND Attorney Joseph Fruen ❑ COM self 1/5/2021 ❑ OTH 100.00 465.00 ❑ PTY Cupertino CA 95014 ❑ SCC ❑./ IND Attorney Jose h Fruen ❑ COM self 2/17/2021 ❑ OTH 50.00 465.00 ❑ PTY Cupertino CA 95014 ❑ SCC ❑./ IND Attorney Joseph Fruen ❑ COM self 3/16/2021 ❑ OTH 150.00 465.00 ❑ PTY Cupertino CA 95014 ❑ SCC ❑./ IND Attorney Jose h Fruen ❑ COM self 5/24/2021 ❑ OTH 30.00 465.00 ❑ PTY Cupertino CA 95014 ❑ SCC ❑./ IND Attorney Jose h Fruen ❑ COM self 6/17/2021 ❑ OTH 135.00 465.00 ❑ PTY Cupertino CA 95014 ❑ SCC SUBTOTAL $ 465.00 Schedule A Summary 1. Amount received this period — itemized monetary contribution (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 $ 465.00 50.00 *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 515.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Notes NOTES CALIFORNIA ._ i • Page 5 of 13 NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 �1428230 1/5/2021 - Fruen Joseph - 100.00 - No 1135 A mi. +� m y hn r AA SCHEDULE B - PART 1 Schedule B —Part 1"'��"`� "'�' to whole dollars. Statement covers period • - Loans Received - I • , from 01 /01 /2021 • SEE INSTRUCTIONS ON REVERSE through 06/30/2021 9 6 of 13 pa e NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 1428230 IF AN INDIVIDUAL, ENTER (a)ANDING OUTST (b) (c) (d)ANDI OUTSTNG (a) M (g) FULL NAME, STREET ADDRESS AND ZIP CODE OCCUPATION AND EMPLOYER BALANCE AMOUNT AMOUNT PAID BALANCE AT INTEREST ORIGINAL CUMULATIVE OF LENDER (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE Licensed Psychologist 0 PAID CALENDAR YEAR Clifton Der Bing Self $ 0.00 $ 10,000.00 0.00 10,000.00 $ 0.00 $ 0 FORGIVEN PER ELECTION** RATE Cupertino CA 95014 $ 10,000.00 $ 0.00 $ 0.00 08/20/2021 $ 0.00 09/19/2020 $ t O IND ❑ COM ❑ OTH ❑PTY ❑SCC DATE DUE DATE INCURRED PAID CALENDAR YEAR $ $ 0.00 / $ $ FORGIVEN PER ELECTION** RATE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ $ DATE DUE DATE INCURRED PAID CALENDAR YEAR $ $ 0.00 / $ $ FORGIVEN PER ELECTION** RATE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ $ DATE DUE DATE INCURRED SUBTOTALS $ 0.00 $ 0.00 $ 10,000.00 $ 0.00 Schedule B Summary 1. Loans received this period ..................................................... (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period................................................................ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 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 party also must be reported on Schedule A. ** If required. e E LI NET $ 0.00 (May be a negative number) (Enter (a) on Schedule E, Line 3) *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 Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period from 01/01/2021 SEE INSTRUCTIONS ON REVERSE I through 06/30/2021 I Page 7 of 13 NAME OF FILER J. R. Fruen for Cupertino City Council 2020 I.D. NUMBER 1428230 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 RAID 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 FIND 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Business to Business ACH ActBlue WEB Merchant service 1.50 Somerville MA 02144 Business to Business ACH ActBlue WEB Merchant service 4.56 Somerville MA 02144 MailChimp WEB Mailchimp email service 135.00 Atlanta GA 30308 Business to Business ACH ActBlue WEB Merchant service 5.00 Somerville MA 02144 Payments that are contributions or independent expenditures must also be summarized on Schedule D. 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.). SUBTOTAL $ 146.06 ........... $ 847.06 ............ $ 60.00 ........... $ 0.00 TOTAL $ 907.06 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Yyaam�� K.�rrr Schedule E Amounts may be rounded Statement covers periodFPage - to whole dollars. (Continuation Sheet) •from 01/01/2021 Payments Made SEE INSTRUCTIONS ON REVERSE through 06/30/2021 of 13 NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 1428230 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 RAID 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 FIND 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Business to Business ACH ActBlue WEB Merchant service 1.00 Somerville MA 02144 MailChimp WEB Mailchimp email service 135.00 Atlanta GA 30308 Business to Business ACH ActBlue WEB Merchant service 5.00 Somerville MA 02144 MailChimp WEB Mailchimp email service 135.00 Atlanta GA 30308 Business to Business ACH ActBlue WEB Merchant service 5.00 Somerville MA 02144 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 281.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Yyaam�� K.�rrr Schedule E Amounts may be rounded Statement covers periodFPage - to whole dollars. (Continuation Sheet) •from 01/01/2021 Payments Made SEE INSTRUCTIONS ON REVERSE through 06/30/2021 of 13 NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 1428230 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 RAID 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 FIND 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID MailChimp WEB Mailchimp email service 135.00 Atlanta GA 30308 Business to Business ACH ActBlue WEB Merchant service 5.00 Somerville MA 02144 Business to Business ACH ActBlue WEB Merchant service 135.00 Somerville MA 02144 Business to Business ACH ActBlue WEB Merchant service 5.00 Somerville MA 02144 MailChim WEB Mailchimp email service 135.00 Atlanta GA 30308 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 415.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Yyaam�� K.�rrr Schedule E Amounts may be rounded Statement covers period - to whole dollars. (Continuation Sheet) FPage •from 01/01/2021 Payments Made SEE INSTRUCTIONS ON REVERSE through 06/30/2021 0 of 13 NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 1428230 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 RAID 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 FIND 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Business to Business ACH ActBlue WEB Merchant service 5.00 Somerville MA 02144 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 5.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Cnhnrl��In C Chnn+% NOTES Notes CALIFORNIA FORM .1 Page 11 of 13 NAME OF FILER J. R. Fruen for Cupertino City Council 2020 I.D. NUMBER 1428230 1/6/2021 - Business to Business ACH ActBlue - 1.50 - Merchant service 1/11/2021 - Business to Business ACH ActBlue - 4.56 - Merchant service 1/19/2021 - MailChimp - 135.00 - Mailchimp email service 1/25/2021 - Business to Business ACH ActBlue - 5.00 - Merchant service 2/9/2021 - Business to Business ACH ActBlue - 1.00 - Merchant service 2/18/2021 - MailChimp - 135.00 - Mailchimp email service 2/25/2021 - Business to Business ACH ActBlue - 5.00 - Merchant service 3/18/2021 - MailChimp - 135.00 - Mailchimp email service 3/25/2021 - Business to Business ACH ActBlue - 5.00 - Merchant service 4/19/2021 - MailChimp - 135.00 - Mailchimp email service 4/26/2021 - Business to Business ACH ActBlue - 5.00 - Merchant service 5/18/2021 - Business to Business ACH ActBlue - 135.00 - Merchant service 6/21/2021 - MailChimp - 135.00 - Mailchimp email service 6/25/2021 - Business to Business ACH ActBlue - 5.00 - Merchant service 5/25/2021 - Business to Business ACH ActBlue - 5.00 - Merchant service Schedule I Ami -+� ro v K. ri. -I.A SCHEDULEI Miscellaneous Increases to Cash to whole dollars. Statement covers period from 01 /01 /2021 _ .1 3EE INSTRUCTIONS ON REVERSE through 06/30/2021 page 12 of 13 NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 1428230 DATE RECEIVED FULL NAME, STREET ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH City of Cupertino 04/14/2021 Partial refund of ballot statement fees 284.00 Cupertino CA 95014 Attach additional information on appropriately labeled continuation sheets. Schedule I Summary 1. Itemized increases to cash this period...................................................................................... 2. Unitemized increases to cash of under $100 this period.......................................................... 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.).................................................................................................................. SUBTOTAL$ 284.00 $ 284.00 $ 15.67 $ 0.00 TOTAL $ 299.67 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule I (Continuation Sheet) Notes NOTES CALIFORNIA ._ i • Page 13 of 13 NAME OF FILER I.D. NUMBER J. R. Fruen for Cupertino City Council 2020 �1428230 4/14/2021 - City of Cupertino - 284.00 - Partial refund of ballot statement fees - Check No 727733