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460 Recipient Committee Campaign Statement – Termination Statement RecipientCommittee r �� ' �� :�� '� covERPa�E ype or print in ink. II � �J �S�mpv � � _ I Campaign Statement i� I � . • 1 Cover Page (Government Code Sections 84200-84216.5) � �,�=^ � _ Pa9� 1 of 11 Statement covers period Date of election if appli.�: I . from 10/23/2016 (Montt,, Day,Year) For Official Use Only SEE INSTRUCTIONS ON REVERSE thfOUgh 12/21/2016 CL PERT(NO CI�Y CL Rs� 1. Type of Recipient Committee: au commmees-comPiete Pa��,z,s,and 4. 2. Type of Statement: ❑ Officeholder,Candidate Controlled Committee � Primarily Formed Ballot Measure ❑ Preelection Statement � Quarterly Statement Q State Candidate Election Committee Committee ❑ Semi-annual Statement � Special Odd-Year Report � Recall �Controlled Termination Statement � ❑ Supplemental Preelection (A/soComp/etePaRSJ � Sponsored Also file a Form 410 Termination (AlsoComp/ete Part 6J � � Statement-Attach Form 495 ❑ General Purpose Committee ❑ Amendment(Explain below) Q Sponsored � Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (A/soCompletePart7J 3. Committee Information I.D. NUMBER Treasurer(s) 1381645 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Yes on C for Citizens. No on D for Developer. -Committee supporting Xiaowen Wang Cupertino Citizens' Sensible Growth Initiative MAILING ADDRESS 20010 De Palma Ln CITY STATE ZIP CODE AREA CODE/PHONE 21701 Stevens Creek Blvd.,#1132 AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Cupertino CA 95014 DIFFERENT) N0.AND STREET OR P.O. BOX MAILING ADDRESS PO Box 1132 AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE Cupertino CA 95015 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 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 Califomia that the foregoing is true and Sponsor Executed on By Date Signature of Controlling Officeholder,Candidffie,Slffie Measure Proponent F�cecuted on By Date SignatureofControllingOlficeholder,Candidate,StateMeasureProponent FPPC Fortn 460(January/Ob) FPPC Toll-Free Helpline:8661ASK-FPPC(866/275-3772) State of California Type or print in ink. COVERPAGE-PART2 Recipient Committee . - . Campaign Statement . - � • � Cover Page—Part 2 Page 2 of 11 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Measure C (Cupertino Citizens' Sensible Growth Initiative) OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION � SUPPORT � I City of Cupertino I ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Included in this Statement: u5ta�y�ommrrrees nof included in this statement that are contro/led 6y you or are primarily formed to receive OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEENAME I.D. NUMBER CONTROLLEDCOMMITTEE? 7• Primarily Formed Candidate/Officeholder Committee Listnames of NAME OF TREASURER o�ceholder(s)or candidate(s)for which this committee is primarily formed. ❑ YES ❑ NO . COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX) � NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHO�DER OR CANDIDATE OFFICE SOUGHT OR HELD � SUPPORT ❑ OPPOSE COMMITTEENAME I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � YES ❑ NO ❑ SUPPORT ❑ OPPOSE COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE AtfBCh COIIf111U8t1011 Sh2@tS If/1@CBSSBfy FPPC Form 460(January/OS) FPPC Toll-Free Helpline:866/ASK-FPPC(866127&3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period � - Summary Page to whole dollars. I � � from 10/23/2016 • ' SEE INSTRUCTIONS ON REVERSE through 12/21/2016 page 3 of 11 NAME OF FILER I.D. NUMBER Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR (FROMATTACHEDSCHEDULES) TOTALTODATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... scneduie a,�ine s g 4,594.94 $ 76,686.11 2. Loans Received ...................................................... scneduie s,u�e s -10,000.00 p ii� cn�o�9n s�so �ii co Date 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add�ines y+2 $ -5,405.06 $ 76,686.11 20. Contributions Received $ $ 4. Nonmonetary Contributions.................................... scned�ie c,une s 21.00 17,177.38 2� Expenditures 5. TOTALCONTRIBUTIONSRECEIVED •••••••••••••••••••.••••..•Add�ines3+4 $ -5,384.06 $ 93,863.49 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... scneduie E,�ine a g 7,199.30 $ 76,686.16 Candidates 7. L02f1S M2d0............................................................. Schedule H,Line 3 � 0 7,199.30 76,686.16 22• Cumulative Expenditures Made� 8. SUBTOTALCASHPAYMENTS .................................... .4dd�iness+� $ $ (IfSubJedtoVoluntaryExpendltureLimtt) 9. Accrued Expenses (Unpaid Bills)...............................scned�ie F u�e s � � Date of Election Total to Date 10. Nonmonetary Adjustment ..........................................scneduie c,�ine s 21.00 17,177.38 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE.................................4dd�ines s+s+�o $ 7>220.30 g 93,863.54 _�� $ Current Cash Statement -�� 12. Beginning Cash Balance....................... Previous summaryPa9e,�ine is $ 12,604.35 To calculate Column B,add 13. CaSh ReCelptS ................................................... Column A,Line 3 above -5,405.06 amounts in Column A to the 0.01 corresponding amounts *Amounts in this section may be different from amounts 14. MisCellaneous InCreases to Cash........................... schedule 1,Line a from Column B of your last reported in Column B. 15.Cash Payments.................................................. Coiumn a,�ine a above 7,199.30 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE.......... Add�ines�z+�s+�4,then subtract line�5 $ � figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED........................... scnedu�e a,Part 2 $ 0 for this calendar year, only carry over the amounts from Lines 2,7,and 9(if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents........................................ See instructions on reverse $ � 19. OUtStBfldltl9 D@btS......................... Add Line 2+Line 9 in Column 8 above $ � FPPC Form 460(January/05) FPPC Toll-Free Helpline:8661ASK-FPPC(8661275-3772) Schedule A Type or print in ink. SCHEDULE A Moneta Contributions Received Amounts may be rounded Statement covers period �_ n/ to who�e do��ars. � � t from 10/23/2016 � - through 12/21/2016 Page 4 of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 pA� FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION RECEIVED (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CODE * �CCUPATIONAND EMPLOYER RECEIVED THIS CALENDAR YEAR TODATE (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1-DEC.31) (IF REQUIRED) OF BUSINESS) �IND 10/29/16 ❑OTH pyramid Consulting Inc Cupertino, CA 95014 ❑PT�' ❑scc �IND 11/1/16 ❑OTH Whittaker Insurance Cupertino, CA 95014 �PN Agency, Inc ❑scc �IND 10/29/16 ❑OTH CUSD Cupertino, CA 95014 ❑Pn' ❑scc ❑OTH $150.00 $150.00 Gigamon Systems Cupertino, CA 95015 O Pn' ❑scc ❑coM TME $100.00 $100.00 ❑orH aerohive networks Cupertino, CA 95014 ❑Pn' ❑scc SUBTOTAL$ 650.00 I Schedule A Summary 'Contributor Codes 1. Amount received this period-itemized monetary contributions. iN�-i�d�v�duai (Include all Schedule A subtotals.) .......................................$ 4,150.00 COM-RecipientCommittee ................................................................. (other than PTY or SCC) 2. Amount received this eriod-unitemized moneta contributions of less than$100 ............................. $ 444.94 OTH—Other(e.g.,business entiry) P ry PTY—Political Party 3. Total monetary contributions received this period. scc-smau contributorcomminee �Add Lines 1 and 2. Enter here and on the Summa Pa e, Column A, Line 1. TOTAL $ 4,594.94 ry 9 �� FPPCForm460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Typeorprintinink. SCHEDULEA (CONT) Monetary Contributions Received Amounts may be rounded , Statementcovers period to whole dollars. • ' from 10/23/2016 • - � • � through 12/21/2016 Pa e 5 of 11 9 NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensibie Growth Initiative 1381645 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION (IFCOMMITTEE,ALSOENTERI.D.NUMBER) CONTRIBUTOR OCCUPATIONAND EMPLOYER RECEIVED THIS RECEIVED CODE * CALENDAR YEAR TODATE (IFSELF-EMPLOYED,ENTERNAME PERIOD (JAN. 1-DEC.31) (IF REQUIRED) OF BUSINESS) Aravind Balakrishnan ��N� coM Student 11/18/16 ❑Pn ❑scc Yanping Zhao � ��N� en ineer 11/18/16 �pn ❑scc Gregory L, Schaffer ��N� Analo I.C. Desi ner 11/27/16 �P-� ❑scc Liana Crabtree m�N� technical writer 11/28/16 �Pn ❑scc ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 3500.00 � 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(January/05) - FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Type or print in ink. SCHEDULEB-PART1 Schedule B—Part 1 Amounts may be rounded Statement covers period � _ Loans Received to whole dol�ars. 10/23/2016 �- � • � from SEE INSTRUCTIONS ON REVERSE through 12/21/2016 page 6 of 11 NAME OF FILER I.D. NUMBER Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 IF AN INDIVIDUA�, ENTER OUTSTANDING (b) (�) OUTSTANDING (e) (r) (9) FULL NAME,STREET ADDRESS AND ZIP CODE AMOUNT AMOUNTPAID INTEREST ORIGINAL CUMULATIVE OCCUPATIONAND EMPLOYER gALANCE BALANCEAT OF LENDER (IFSELF-EMPIOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSEOFTHIS PAIDTHIS AMOUNTOF CONTRIBUTIONS (IFCOMMITTEE,ALSOENTERI.D.NUMBER) NAMEOFBUSINESS) PERIOD PERIOD THISPERIOD" PERIOD PERIOD LOAN TODATE Omnivision S 10,000 5 0 0 , S 10,000 S 11,398 Cupertino, CA 95014 �FORGIVEN RATE pERELECTION'" 5 10,000 � 0 5 0 12/31/17 S 7/20/16 � t� IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATEDUE DATEINCURRED �PAID CALENDARYEAR 5 S % S S �FORGIVEN RATE pERELECTION'* S 5 S 3 5 t❑ IND ❑ COM � OTH ❑ PTY ❑ SCC DATEDUE DATEINCURRED �PAID CALENDARYEAR $ S % S S _ �FORGIVEN RATE PERELECTION** 3 5 5 b 5 t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATEDUE DATEINCURRED SUBTOTALS $ 0$ 10,000 $ 0 $ 0 I (Enter(e)on Schedule B Summary ScheduleE,Line3) 1. Loans received this period.................................................................................................................... $ � (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes � 10,000 IND-Individual 2. Loans paid orforgiven this period ......................................................................................................... $ COM—RecipientCommittee (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are aiso itemized on Schedule A.) OTH—Other(e.g., business entity) PTY—Political Party 3. Net chan e this eriod. /1Subtract Line 2 from Line 1. ................................................ NET $ -10,000 SCC-Smail ContributorCommittee 9 p ` �� (Maybeanegativenumber) Enter the net here and on the Summary Page,Column A, Line 2. fAmounts forgiven or paid by another party also must be reported on Schedule A. "if required. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule C Type or print in ink. SCHEDULE C Amounts may be rounded Statement covers period Nonmonetary Contributions Received towholedollars. • " ' , � from 10/23/2016 • - • 12/21/2016 7 11 SEE INSTRUCTIONS ON REVERSE th�OUgh Peg@ Of NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer.-Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 CUMULATIVE TO IFAN INDIVIDUAL,ENTER AMOUNT/ PER ELECTfON FULL NAME,STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF DATE TO DATE DATE OCCUPATION AND EMPLOYER FAIR MARKET RECEIVED ZIP CODE OF CONTRIBUTOR CODE ''�' (IFSELF-EMPLOYED,ENTER GOODS OR SERVICES VALUE CALENDAR YEAR IF REQUIRED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) (JAN 1-DEC 31) � � ❑IND ❑COM ❑oTM ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC - - - — - — ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑�TM ❑PlY ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ I Schedule C Summary 'Contributor Codes 1. Amount received this period-itemized nonmonetary contributions. iN�-ind��iduai (Include all Schedule C subtotals.).....................................................................................................................$ � COM—RecipientCommittee (other than PTY or SCC) 2. Amount received this period-unitemized nonmonetary contributions of less than$100 ....................................$ 21.00 oTH-otner(e.g., business entity) PTY—Political Party 3. Total nonmonetary contributions received this period. scc-smau concr;burorcommittee Add Lines 1 and 2. Enter here and on the Summa Pa e,Column A, Lines 4 and 10. TOTAL $ 21.00 � ( rY 9 ) ...................... FPPC Form 460(Ja�uary/OS) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule D SCHEDULED Summary of Expenditures Type or print in ink. Statement covers period SU OI"tlll �� OSIII Other Amounts may be rounded •� � � , pp g pp 9 to Wno�e dollars. 10/23/2016 • - Candidates, Measures and Committees from through 12/21/2016 page $ of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Yes on C for Citizens. No on D for Developer.-Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 � CUMULATIVE TO DATE PER ELECTION DATE NAME OF CANDIDATE,OFFICE,AND DISTRICT,OR TypE OF PAYMENT OESCRIPTION AMOUNTTHIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN.t-DEC.31) (IF REQUIRED) OR COMMITTEE _ _ _ __ _ _ ___ Cupertino Residents for Sensible Zoning � Monetary 12/17/2017 ❑ Nonmonetary Cupertino, CA 95014 Contribution � Independent � SuppoR ❑ Oppose Expenditure � Monetary Contribution � Nonmonetary Contribution � Independent ❑ Support ❑ Oppose Expenditure � Monetary Contribution � Nonmonetary Contribution � Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 492J1 , I Schedule D Summary 1. Itemized contributions and inde endent ex enditures made this eriod. Include all Schedule D subtotals. $ 492.71 p P p � )......................................................... 2. Unitemized contributions and independent expenditures made this period of under$100..................................................................................... $ � 3. Total contributions and inde endent ex enditures made this eriod. Add Lines 1 and 2. Do not enter on the Summa Pa e. TOTAL $ 492.71 p p P � rY 9 ) ............ FPPC Form 460(January/OS) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule E Type or print in ink. SCHEDULEE Amounts may be rounded Statement covers period � _ I Payments Made to whole dollars. 10/23/2016 •' � ' from 12/21/2016 9 11 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Yes on C for Citizens. No on D for Developer. - Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/misc. MBR member communications RAD 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 PI-10 phone banks TRC candidate travel,lodging,and meals FND fundraising events POL poiling 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 (IFCOMMITfEE,ALSOENTERI.D.NUMBER) CODE OR DESCRIPTIONOFPAYMENT AMOUNTPAID PRO $4771.00 Cupertino, CA 95014 �� $700.00 San Francisco, CA 94018 LIT $400.00 Cupertino, CA 95014 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 5871.00 Schedule E Summary 1. Itemized a ments made this eriod. Inciude all Schedule E subtotals. 7,179.38 P Y P � ).............................................................................................................. $ 2. Unitemized payments made this period of under$100 .......................................................................................................................................... $ 19.92 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1,Column(e).)............................................................................... $ � 4. Total a ments made this eriod. Add Lines 1,2, and 3. Enter here and on the Summa Pa e, Column A, Line 6. TOTAL $ 7,199.30 P Y P � rY 9 ) ............................. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule E SCHEDULE E(CONT.) Type or print in ink. Statement covers period (Continuation Sheet) Amountsmayberounded • ' � � ' Payments Made towhoiedollars. 10/23/2016 • ' from through 12/21/2016 Pa9e �p of �� SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer. -Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 CODES: If one of the foilowing codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/misc. MBR member communications RAD 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 F�f petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PI-10 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 LfT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE,ALSO ENTER I.D.NUMBER) LIT $625.25 Cupertino, CA 95014 WEB $190.42 Cupertion, 95014 CTB $492.71 Cupertino, CA 95014 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ $1,308.38 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) i Schedule I Type or print in ink. SCHEDULE i Miscellaneous Increases to Cash Amountsmayberounded Statementcoversperiod to whole dollars. � � / � ' from 10/23/2016 • - 12/21/2016 11 11 SEE INSTRUCTIONS ON REVERSE thfOugh Page Of NAME OF FILER I.D.NUMBER Yes on C for Citizens. No on D for Developer.-Committee supporting Cupertino Citizens' Sensible Growth Initiative 1381645 � DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ Schedule I Summary 1. Itemized increases to cash this period. .......................................................................................................................$ � 2. Unitemized increases to cash of under$100 this period.............................................................................................$ 0.01 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.) ........................................................................................................................... TOTAL $ 0.01 FPPC Form 460(January/05) FPPC Toll-Free Helpiine:866/ASK-FPPC(866/275-3772) ------ - I