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460 Recipient Committee Campaign Statement - Semi Annual 7-1-21 to 12-31-21Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink. COVER PAGE dD1J����%% Sp CALIFORNIA 2001/02 FORM 460 Statement covers period Date of election if P i ble: Page 1 of 13 (Month, Day, a J', �'�22 For Official Use Only from 7/1/2021 (through 12/31/2021 SEE INSTRUCTIONS ON REVERSE 1. Type of Recipient Comm ittee: All Committees - Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure OState Candidate Election Committee Committee O Recall O Controlled (Also Complete Part 5) O Sponsored ® General Purpose Committee (Also Complete Part 6) O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part 7) I.D. NUMBER 3. Committee Information 1 1340395 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) STREET ADDRESS (NO P.O- BOX) CITY SATE ZIP CODE AREA CODE/('HONE SUNNYVALE CA 94085 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET 09 P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE 6/7/2022 2. Type of Statement: ❑ Preelection Statement ® Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 NAME OF TREASURER Andrae Macapinlac MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE Milpitas CA 95035 NAME OF ASS!STAN T TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL FAX / E-MAIL ADDRESS 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 knowled d 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. Execatedon 1/28/2022 By Dale Signature of Treasurer or Assistant Treasurer Executed or By Dale Signature of Controlling Officeholder. Candidate, Stale Measure "roponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, Slate Measure Proponent Executed on By FPPC Form 460 (January/05) Dale Signature of Controlling Officeholder. Candidate, Stale Measure Proponent FPPC ToII Pre. Helpline. 8661ASK-FPPC (a66/2%5-37I2) Stale al Califor a 0V%., F Wnt �:OmmlttType or print in ink. ee Campaign Statement Cover Page - Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ;INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAUSUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: Listany 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 NAME OF TREASURER COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page Z Ot 13 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 I.D. NUMBER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate/Officeholder Committee List names of n vac n in officeholder(s) or candidate(s) for which this committee is primarily formed. CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED CCMMTTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) C.TY STATE ZIP CODE AREA CODE/PHONE NAME OF OFr CFHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPCSE NAME OF OFFICEHOLDER CR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPCRT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPCRT ❑ CPPOSE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free HelPline. 666!ASK-FPPC (666/275-3772) Stale of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period CALIFORNIA Summary Page to whole dollars. 7/1/2021 - I FORM 460 from 11 12/31/2021 SEE INSTRUCTIONS ON REVERSE through Page 3 of 13 NAME OF FILER I.D. NUMBER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1.340395 Column A Column B Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Calendar Year Summary for Candidates (PROM ATTACHI-D SCHEDULES) TOTAL TO DA rE Running in Both the State Primary and 1. Monetary Contributions ................................ Schedule A, Line 81, 925.00 $5, 790.00 General Elections 2. Loans Received Schedule B, Line 3 $0 . 00 $0 . 00 1/1 through 6130 7/. to Date ............. ..................... ................ . "' 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ................................ Add tines 1 +2 $1, 925.00 85, 790. 00 Received 4. Nonmonetary Contributions ........................................... Schedule C, Line 3 $0.00 $0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............................... Add Lines 3 + 4 $1 925.00 ' $5, 790 .00 Made Expenditures Made 6. Payments Made ........................................ 7. Loans Made ............................................. 8. SUBTOTAL CASH PAYMENTS ................... 9. Accrued Expenses (Unpaid Bills) .................. 10. Nonmonetary Adjustment _....................... 11. TOTAL EXPENDITURES MADE ................ ................ ScheduleE, Line4 $2, 307.68 $ 0 . 00 . I ............... Schedule H, Line 3 $2,307.68 ........ Add Lines 6+7 ................. Schedule F. Line 3 $ 0 . 00 ................ Schedule C, Line 3 $2,301 611 .............. Add Lines 8+9+10 Current Cash Statement 12. Beginning Cash Balance ........................... Previous summary Page, Line 16 $ 3 , 8B4.68 13. Cash Receipts ................ Column A, Line 3 above $1, 925.00 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 80 . 00 15. Cash Payments ......... Column A, Line a above $ 2, 30 7 . 6 B 16. ENDING CASH BALANCE ............... Add Lines 12+ 13+ 14, then subtract Line 15 $3, 502 .00 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule Part $0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ...... _........ See instructions on reverse 19. Outstanding Debts .. Add Line 2 + Line 9 in Column B above $o . 00 54,047.45 $0.00 $4,047.45 $0.00 $0.00 $4,047.45 To calculate Column B, add amounts in Column A to the corresponding amount 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (It Subject tc Voiuntary 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 (January/05) FPPC Toil -Free Helpiine. 866/ASK-FPPC (866/275-3772) SCHFDUL F A zlicneouie H Z :'"' Amounts may be rounded Statement covers period - Monetary Contributions Received to whole dollars. , • 7/l/2021 .- from 12/31/2021 through Page 4 of 13 SEE !NS-RUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER ASIAN PACIFIC -ISLANDER 2MPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 IF AN INDIVIDUAL EATER DATE FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE PER ELECTION PECEIVED (IF COMMITTEE, ALSO ENTER I.D NUMBER) CODE` (IF SELF EMPLOYED, ENTER NAME RECEIVED THIS CALENDAR YEAR TO DATE OF BUSINESS) PERIOD (JAN.1-DEC. 31) (IF REOUIRED) 12/1/2021 Andrae Macapinlac ■ IND OCCUPATION: District $800.00 5800.00 ❑ COM Representative ❑ OTH EMPLOYER: California Campbell, CA 95008 State Senate ❑ PTY ❑ SCC 9/17/2021 Edwin Tar. IND OCCUPATION: Government $500.00 $500.00 ❑ COM Relations San Jose, CA 95131 ❑ OTH EMPLOYER: San Jose State University ❑ PTY ❑ SCC 9/17/2021 Clarence Madrilejos IND OCCUPATION: Realtor $150.00 $150.00 ❑ COM EMPLOYER: Compass San Jose, CA 95133 ❑ OTH ❑ PTY ❑ SCC 8/19/2021 Re -Elect Margaret Abe Koga ❑ IND $260.00 $260.00 COM Mountain View, CA 9,1014 ❑ OTH COMMITTEE ID: 1386424 ❑ PTY ❑ SCC 12/29/2021 Tamara Fagin 0 IND OCCUPATION: Not Emplyed $100.00 $100.00 ElCOM EMPLOYER: Not Employed Los Altos, CA 94022 ❑ OTH ❑ PTY ❑ SCC Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.) ....... ..................................................... ............... 2. Amount received this period - unitemized monetary contributions of less than S100 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) . SUBTOTAL$ $1,925.00 $0.00 TOTAL $1,925.00 '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 FPPC Form 460 (January/05; FPPC Tall -Free Helph- B66IASK-FPPC (P66/275 3772; SCHEDULE A (CONT.) s, r,,,.• •,, ,, bcneauie A► L:ontinuation bneet o Amoustunts may be rounded Statement covers period CALIFORNIA Monetary Contributions Received to whole dollars. ' 7/1/2021 from FORM 12/31/2021 through Page 5 of 13 NAME OF FILER LD. NUMBER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (Ir COMMITTEE ALSO ENTER !.D. NUMBER) CODE' (IF SELF-EMP_OYED, ENTER NAME RECEIVEDTHIS ` RIOD CALENDAR YEAR (-'AN. 1 - DEC. 31) TO DATE (IF REQUIRED) OF BUSINESS) 12/29/2021 Tara Sreekrishnan ® IND OCCUPATION: Policy and $25.00 $25.00 ❑ COM Outreach Director Cupertino, CA 95014 ❑ OTH EMPLOYER: County of ❑ PTY Santa Clara ❑ SCC 12/29/2021 Carmen Montano ® IND OCCUPATION: $25.00 $25.00 ❑ COM Councilmember Milpitas, CA 95035 ❑ OTH EMPLOYER: C-ty of ❑ PTY Milpitas ❑ SCC 12/30/2021 Sudhanshu Jain ® IND OCCUPATION: Not $25.00 $25.00 ❑ COM Employed Santa Clara, CA 95050 ❑ OTH EMPLOYER: n/a ❑ PTY ❑ SCC 12/30/2021 Alan Gouig IND OCCUPATION: Nonprofit $20.00 $20.00 ❑ COM Fellowship San Jose, CA 95112 ❑ OTH EMPLOYER: Silicon Valley Council of ❑ PTY Nonprofits ❑ SCC 12/31/2021 Sylvia Leong IND OCCUPATION: Consultant $20.00 $20.00 ❑ COM EMPLOYER: Self Cupertino, CA 95014 ❑ OTH ❑ PTY ❑ SCC 'Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Tof.-Free HeIph- 666/ASK FPPC (866/275.3772) SCHEDULE B - PART 1 cneoUIE ti - F'arit l I I _ - Y"""" 1.11 may be rounded to whole dollars. Loans Received to Statement covers periodCALIFORNIA 7/1/2021 from FORM I60, through 12/31/2021 Page 6 of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITEE ,ALSO ENTER1D.NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED, ENTER NAME OF BUSINESS) (a) OUTSTANDING BALANCE BEGdNIIN&THIS O (b) AMOUNT RECEIVED THIS PERIOD (c) AMOUNT PAID OR FORGIVEN THIS PERIOD' (d) OUTSTANDING BALANCE AT CLOIS�QLTHIS (e) INTEREST PAID THIS PERIOD If) ORIGINAL AMOUNT OF LOAN (g) CUMULATIVE CONTR(BUFiONS TO DATE ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTION" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTION — TO IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTION" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTAL$ $ $ $ Schedule B Summary 1. Loans received this period ........................................................... (Total Column I 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.) 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 party also must be reported on Schedule A. " If required. $c.00 $0.00 NET $0.00 (May be a negative nurnbeQ (Enter (e) 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 (January/GS) FPPC 1 oil -Free Helpllne 8661ASK-FPPC (866/275-3772) SCHEDULE C t)cneouoe u . Y" v r.,,...,..,.... Amounts may be rounded Statement covers period - Nonmonetary Contributions Received to whole dollars. O ' 7/1/2021 • • from 12/31/2021 through Page of 13 SCE INSTRUCTIONS ON REVERSE NAME OF FILER LD. NUMBER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1.340395 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED -LIP CODE OF CONTRIBUTOR (IF COMMITTEE. ALSO ENTERID.NUMBER) CODE' (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR (JAN.1- DEC .31) TO DATE (IF REQUIRED) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on approoriatefy labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1 . Amount received this period - itemized nonmonetary contributions. (Include all Schedule C subtotals.)..................................................................... 2. Amount received this period - unitemized nonmonetary contributions of less than $100 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) $0.00 $0.00 TOTAL $0.22 '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 (January/05) FPPC Toll -Free Flelplin B66/ASK-FPPC (B66/2753772) SCHEDULE D N , bcneauie u mrr.,. bI Aounts may be rounded Statement covers period CALIFORNIA Summary of Expenditures to whole dollars. ` • , Supporting/Opposing Other 7/1/2021 from FORM Candidates, Measures and Committees .,FP INSTRI ainNS ON RFVFRSF through 12/31/2021 Page 8 of 13 NAME OF FILER I.D. NUMBER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 NAME OF CANDIDATE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS CUMULATIVE TO CATE PER ELECTION DATE MEASURE NUMBER OR LETTER AND JUR;SCICTION, TYPE OF PAYMENT (IF REQUIRED) PERIOD CALENDAR YEAR TO DATE OR COMMITTEE (JAN, 1 - DEC. 31) (IF REQUIRED) 8/B/2021 Santa Clara County United Democratic Campaign Contribution $1,Soo .00 $1,500.00 Monetary Contrib0on ❑ Nor -monetary Contribution ❑ Independent Expenditure Support ❑ Oppose 8/8;2021 Young API Democrats of California Contribution $250.00 $250.00 ■ Monetary Contribution ❑ Nonmonetary Contrioution ❑ Independent Expenditure Support ❑ Oppose 10/19/2021 victoria Chon Contribution $250.00 $250.00 Off_ce Description: Board of Monetary EducationJurisdiction: County Santa Clara County Board of Education Contribution ❑ Nonmonetary Contrioution ❑ Independent Expenditure ■ Support ❑ Oppose SUBTOTAL$ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) . 2. Unitemized contributions and independent expenditures made this period of under $100 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) . $2,000.00 $0.00 $2,000.00 FPPC Form 460 (January/05) FPPC Tali.Free He.O.. 969/ASK-FPPC (8661275 3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 7/1/zozl from 1.2/31/2021 through SCHEDULE E Page 9 of 13 I.D. NUMBER 1340395 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 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 (intereet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Victoria Chon for Santa Clara County Board of Victoria Chon for CTB $250.00 Santa Clara County Board of Education 2020, Fremont, CA 94538 COMMITTEE ID: 1428490 Santa Clara County United Democratic Campaign. CTB $1,500.00 San Jose, CA 95128 COMMITTEE ID: 871053 Young API Democrats of California CTB S250.00 Sacramento, CA 95811 COMMITTEE ID: 1380716 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payment made this period. (lnc,lude all Schedule E subtotals.) .............. ................. ......................... .................................................... ............................ $2, 307. 68 2. Unitemized payments made this period ol` under $100.................................. $0. 00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ....... $0 . 00 4, Total payments made this period. (Add Unes 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ................ $2, 307.68 FPPC Form 460 (January/05) PPPC Toll -Free HelphPe: 866/A5K-FPPC (B66/275-3772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7/1/2021 through 12/31/2021 SCHEDULE E Page 10 of 13 I.D.NUMBER 1340395 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 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) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Go Daddy WEB $31.16 Scottsdale, AZ BS260 Harland Clarke Check Printing $129-50 San Antonio, TX 78256 MeetUp WEB $138-52 New York, NY 10012 ActBlue WEB $8.50 Cambeidge, MA 02138 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ FPPC Form 460(Jarnary/05) FPPC Toil Free Hmpltne 866/ASK-FPPC (8661275-3772) Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FIt-ER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7/1/2021 12/31/2021 through SCHEDULEF Page 11 of 13 I.D-NUMBER 1340395 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 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 firing/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) NAME AND ADDRESS OF CREDITOR (iF COMMITTEE, ALSO ENTER LD. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSING OF THIS PERIOD vxymAm d o�'sc%ed�ie ��o�s �. �„a�pe�ee„i a.ad„aw,e, m 1 a1. be -ma ,4— sn,.d.n. o. SUBTOTALS $ S $ Schedule F Summary 1 . Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.)................... 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of S100 or more, plus total unitemized payments on accrued expenses under $100.). 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.)................................................................................. INCURRED TOTALS $0 .00 .....PAID TOTALS $0 . 00 .....NET $0.00 (May oe a negative number) FPPC Form 460(January/05) FPPC To,I Free H6phi , 866/ASK-FPPC (8661275-3772) Schedule H Loans Made to Others* Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 7/1/2021 from 12/31/2021 SCHEDULE H through Page 12 of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER AS1AN PACIFIC -ISLANDER EMPOWERMENT PAC (APT EMPOWERMENT PAC) 1340395 IF AN ENTER FULL NAME, STREET ADDRESS AND ZIP CODE TION AND EMPLOYER OCCUPATION AND OUTSTANDING AMOUNT REPAYMENT OR OUTSTANDING INTEREST ORIGINAL CUMULATIVE(g) LATIVE OF RECIPIENT (tE SELF-EMPLOYED, ENTER BALANCE LOANED THIS FORGIVENESS BALANCE AT RECEIVED AMOUNT OF LOANS (1F COMMITTEE, ALSO ENTER I NUMBERI NAME OF BUSINESS) BEGINNING THIS PERIOD THIS PERIOD' CLOSE OF THIS LOAN TO DATE PERIOD PERIOD ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTiON" 'Loans that are contributions to another candidate or committee must also be summarized on Scheaule D, Loans iorgiven must also be reported on Schedule E. SUBTOTAL $ Schedule H Summary 1. Loans made this period................................................................................................. (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans.......................................................................................... (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) ........................................................ Enter the net here and on the Summary Page, Column A, Line 7. DATE DUE ❑ PAID ❑ FORGIVEN DATE DUE $ $ so.00 $0.00 NET $0.00 (May be a negative number) DATE INCURRED RATE DATEINCURRED $ (Enter (e) on Schedule I, Line 3) CALENDAR YEAR PER ELECTION" " If required. FPPC Form 460(Januaryi05) FF'FC rolbFTee Heipline: 666/A9K-FPPC (a66/275-3772) Y47PIi M1i41 bcneauie iAmounts may be rounded Increases t® Cash to whole dollars. Statement covers period 7/112021 CALIFORNIAMiscellane®us FORM 4601 from 12/31/2C21 through Page 13 Of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395 DATE DECEIVED FULL NAME AND ADDRESS OF SOURCE IMF COMMITTEE, ALSO ENTER ID. NUMBER! DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH 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.)....................................................................................................... $0 00 50.00 50.00 ..... TOTAL $0. 00 SUBTOTAL$ FPPC Form 460(January/OS) FPPC Toll -Free Heipline 666iASK-FPPC ;e66/275-3772)