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497 Contribution Report 4 - Contributions Received on 9-18-22497 Contribution Report Amounts may be rounded to whole dollars. NAME OF FILER Date of Date Stamp _ Sheila Mohan For Cupertino City Council 2022 This Filing 09/18/2022 _ AREA CODE/PHONE NUMBER I.D. NUMBER (if applicable) Report No. 4 For Official Use Only ( 1448574 ❑Amendment Filed Date: STREET ADDRESS to Report No. 09/18/2022 05:20 (explain below) PM CITY STATE ZIP CODE Cupertino CA 95014 No. of Page 1 1. Contribution(s) Received DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ** IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) ❑ IND 2,000.00 IFPTE Local 21, TJ anthony PAC Fund (FPPC #881248) ❑ COM 9/18/2022 ❑� OTH ❑ Check if Loan ❑ PTY San Francisco CA 94103 ❑ SCC Provide interest rate ❑/ IND 2,000.00 Prabhu Goel ❑ COM 9/18/2022 ❑ OTH Retired ❑ Check if Loan ❑ PTY Atherton CA 94027 ❑ SCC Provide interest rate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide interest rate Reason for Amendment: —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 497 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov