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460 Recipient Committee Campaign Statement - Semi Annual 01-01-2016 to 06-30-2016 COVER PAGE Recipient Committee D �- at Campaign Statement � � �� . � � � Cover Page � Statement covers period Date of election if applic� I.��. � 9 � of � from 1��2016 (Month,Day,Year) J U L 2 9 2016 �r Official Use Only SEE INSTRUCTIONS ON REVERSE thrOUgh 6/30/2016 November 8, 201 E �E IpERT1N0 CITY CL-RK 1. Type of Recipient Committee: au comm�ccees-compiete Parts�,z,a,a�a a. 2. Type of Statement: � 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 � Controlled ❑ Termination Statement �AlsoCompletePartS) � Sponsored (Also file a Form 410 Termination) /Also Complefe Par16J ❑ General Purpose Committee ❑ Amendment(Explain below) � Sponsored ❑ Primarily Formed Candidate/ � Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee IaisocomPiereP�n» 3. Committee Information I i.o."uMBER Treasurer(s) 1386578 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Jerry Liu for City Council 2016 Jennifer Fang MAILING ADDRESS 21837 Lomita Avenue CITY STATE ZIP CODE AREA CODE/PHONE 21837 Lomita Avenue Cupertino CA 95014 408 996 1177 NAMEOFASSISTANTTREASURER,IFANY Cupertino CA 95014 865-377-9548 Nan Yu MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAILADDRESS 2016@jerryliu.com , 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge t e information contained herein and in the attached schedules is true and complete. I certiry under penalty of perjury under the laws of the State of California that the foregoing Officer of Sponsor Executed on B" Date Signature ot Controlling Officeholder,Candldate,State 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(866/2753772) www.fppc.ca.gov COVER PAGE-PART 2 Recipient Committee Campaign Statement ' �' ' ' • � � Cover Page — Part 2 � � Page " of 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE ' Jerry Liu OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION � SUPPORT Cupertino City Councilmember I I ❑ oPPose RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP Identify the controlling officeholder,candidate,or state measure proponent,if any. Cupertino CA 95014 • NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Included in this Statement: �istanycommirtees not included in this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO.IF ANY confributions or make expenditures on behalf of your candidacy. I COMMITTEE NAME I.D.NUMBER . NAME OF TREASURER CONTROLLED COMMITTEE? 7. PI'117111'II)/ FOI'ITl@CI Ca11CI1CIat@/OffIC@IIOICI@t'COfTlfllltt@@ List names of officeholder(s)or candidate(s)for which fhis committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD I ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODElPHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD I ❑ SUPPORT ❑ OPPOSE COMMITTEE NAME I.D.NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD I ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES ❑ NO I ❑ SUPPORT COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX) � ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE 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 Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers period � - Summary Page 1/1/2016 . - � • � from throu h 6/30/2016 page � of �1 9 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Jerry Liu for City Council 2016 1386578 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CAIENDARYEAR (FROMATTACHEDSCHEDULES) TOTALTODATE Running in Both the State Primary and 7574.00 7574.00 General Elections 1. Monetary Contributions................................................... scneduiea,�r�e s $ $ 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ scneduie e,Line 3 15000.00 15000.00 22574.00 22574.00 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add�ines i+2 $ $ Received $ $ 4. Nonmonetary Contributions............................................ scneduie c,Line 3 0.00 0.00 z1. Expenditures 5. TOTALCONTRIBUTIONSRECEIVED....................................Add�ines3+q $ 22574.00 $ 22574.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ scneduie e,�rne a $ 221.75 g 221.75 Candidates 7. L08f1S M8d@....................................................................... Schedule H,Line 3 0.00 0.00 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS.......................................... Add Lines 6+7 $ 221.75 $ 221.75 (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses(Unpaid Bills)..........................................scneduie F�ine s 0.00 0.00 Date of Election Total to Date 10. Nonmonetary Adjustment.........................................................scneduie c,�rne s 0.00 0.00 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE......................................../+dd�ines s+s+�o $ 221.75 g 221.75 _�_� $ Current Cash Statement �-� � 12. Beglflfllflg CBSh B21a11C2............................ Previous Summary Page,Line 16 $ 0.00 To calculate Column B, 13. Cash Receipts........................................................... co�umn A,�ine s above 22574.00 add amounts in Column 0.00 A to the corresponding *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash.................................. scneduie i,�ine a amounts from Column B reported in Column B. 15.Cash Payments......................................................... Coiumn A,line s above 221.75 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add�ines�2+�s+1q,then subtract�ine�5 $ 22352.25 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED................................ Scnedule e,Part 2 $ 0.00 filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts aroy)Lines 2,�,and 9(if 18. Cash Equivalents................................................ See instructions on reverse $ 0.00 15000.00 FPPC Form 460 Jan 2016 19. Outstanding Debts.............................. Add Line 2+Line s in Column e above $ ( � � FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A to whole dollars. Statement covers period Monetary Contributions Received 1/1/2016 .� � • � from 6/30/2016 � through Page _ of , SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Jerry Liu for City Council 2016 1386578 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * IF REQUIRED RECEIVED (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DEC.31) ( � OF BUSINESS) �IND ❑OTH 1500.00 1500.00 1500.00 Cupertino, CA 95014 ❑PTY ❑scc �IND ❑OTH Paul Law Group Cupertino, CA 95014 ❑PTY ❑scc �IND ❑OTH Akamai Mountain View, CA 94043 ❑PTY ❑scc ❑conn Research Scientist 100.00 100.00 100.00 ❑OTH Quest Diagnostics WAYNE, PA 19087-1216 ❑PTY ❑scc ❑OTH Eno Schmidt 500.00 500.00 500.00 Cupertino, CA 95014 ❑PTY ❑scc SUBTOTAL$ 2400.00 ; Schedule A Summary �Contributor Codes � 1. Amount received this period-itemized monetary contributions. iN�-individuai (Include all Schedule A subtotals.) 7488.00 COM-Recipient Committee .........................................................................................................$ (other than PTY or SCC) 2. Amount received this eriod-unitemized monetar contributions of less than$100...........................$ 86.00 oTH-other(e.9.,business entity) p y PTY—Political Party 3. Total monetary contributions received this period. scc-smau Contributor committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 7574.00 ' 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 wno�e ao�lars. Statement covers period � _ from 1/1/2016 • ' � • 1 through 6/30/2016 pa9e � of� NAME OF FILER I.D.NUMBER Jerry Liu for City Council 2016 1386578 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 RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED,ENTER NAME pERIOD (JAN.1-DEC.31) (IF REQUIRED) OF BUSINESS) �IND ❑OTH Target 3888.00 3888.00 3888.00 Houston,TX 77059 ❑PTY ❑scc ❑OTH Samsung Mountain View, CA 94043 ❑PTY ❑scc ❑coM Myong Shin Woo 1000.00 1000.00 1000.00 ❑OTH Los Altos, CA 94024 ❑PTY ❑scC ❑OTH City of Cupertino Cupertino, CA 95014 ❑PTY ❑scc ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 5088.00 I 1 'Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH—Other(e.g.,business entity) PTY—Political Party FPPC Form 460(Jan/2016) SCC—Small Contributor Committee FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov SCHEDULE B-PART 1 Amounts may be rounded Schedule B — Part 1 to whole dollars. Statement covers period � . 1 Loans Received � � from 1/1/2016 • - SEE INSTRUCTIONS ON REVERSE thrOUgh 6/30/2016 page �C1 Of� NAME OF FILER I.D.NUMBER Jerry Liu for City Council 2016 1386578 IFAN INDIVIDUAL,ENTER �a� (b) lc) (dl (e) �t) (g� , FULL NAME,STREETADDRESS AND ZIP CODE OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS BALANCE AT pAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE.ALSO ENTER I.�.NUMBER) (IF SEIF-EMPLOYED,ENTER gEGINNING THIS OR FORGIVEN CLOSE OF THIS NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD� PERIOD PERIOD LOAN TO DATE ❑PAID CALENDAR YEAR HP Inc � 5 15000 , S 15000 S 15000 Cupertino, CA 95014 ❑FORGIVEN RATE PER ELECTION"' � 0 � 15000 � 12/31/20 § 6/29/16 5 t� IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDAR YEAR § 5 % 5 5 RATE pER ELECTION«" ❑FORGIVEN S 5 � 5 5 t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDAR YEAR � S % S S RATE pER ELECTIONi"` ❑FORGIVEN 5 5 g S 5 t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED . SUBTOTALS $ 15000 $ 0 $ 15000 $ ] (Enter(e)on Schedule B Summary SchetluleE,Line3) 1. Loans received this period....................................................................................................................$ 1 FIIDB_ (Total Column (b) plus unitemized loans of less than $100.) tcontributor codes 2. Loans aidorfor iventhis eriod.........................................................................................................$ IND—Individual p 9 p n COM—Recipient Committee (Total Column (c) plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g.,business entity) PTY—Political Party 3. Net chan e this eriod. Subtract Line 2 from Line 1. NET $ 1 F�p� scc-Smau Contributor Committee 9 p � ).............................................................. Enter the net here and on the Summary Page, Column A, Lllle 2. (Maybeanegativenumber) fAmounts forgiven or paid by another party also must be reported on Schedule A. � FPPC Form 460(Jan/2016) *'If required. FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Amounts may be rounded Statement covers period � _ P1�/111@IItS MaCI@ towho�edouars. 1/1/2016 , � ' • - from jT through 6/30/2016 page of � SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Jerry Liu for City Council 2016 1386578 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 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 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 LIT 131.10 San Jose, CA 95110 `Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 131.10 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 131.10 90.65 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).) � v�� ................................................................... . 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)...........................TOTAL $ 221.75 FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov