1st 460 Semi-Annual
Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
Type or print in ink.
Statomont covors poriod
from January 1, 2004
. -- -- -ôEE lNSfF([JCTiTIt'fSON REVERSE
.Jttne-~2004
through
1. Type of Recipient Committee: All Committees - Complo" Parts " 2, 3, and 4.
IXI Officeholder, Candidate Controlled Committee Ballot Measure Committee
State Candidate Election Committee 0 Pomarily Fonmed
0 Recall 0 Controlled
(A/w Compæœ PM" 0 Sponsored
(AI",Comp"'P'.6J
0 General Purpose Committee
0 Sponsored
0 Small Contributor Committee
0 Political PartylCentral Committee
0 Primarily Formed Candidatel
Officeholder Committee
IAI",Compl."p,.,)
3. Committee Information
1.0 NUMBER
1237120
COMMITTEE NAME COR CANDCDATES NAME CF NO COMMCTTEE)
Elect Patrick Kwok for City Council
STREET ADDRESS (NO PO BOX)
10222 Carmen Road
CCTY STATE lCP CODE
Cupertino CA 95014
MACUNG ADDRESS ICF OCFFERENT) NO AND STREET OR PO BOX
AREA CODE/PHONE
(408)777-3191
C'TV
STATE
lCP CODE
AREA CODE/PHONE
OPTCONAI. FAX i E-MAIL ADDRESS
CUpERTINO CITY ClE
For Official Use OoCy
2. Type of Statement:
0 Preelection Statement
IXI Semi-annual Statement
0 Termination Statement
0 Amendment (Explain below)
0 Special Odd-Year Report
0 Supplemental Preelection
Statement - Attach Fonm 495
Treasurerjs)
NAME OF TREASURER
Claudia Chang
MACUNG ADDRESS
7437 Fallenleaf Lane
CCTY
Cupertino
NAME OF ASSISTANT TREASURER. CF ANY
STATE
CA
lCP CODE
95014
AREA CODE/PHONE
(408) 277-5186
Patti Nakamura
MACUNG ADDRESS
3447 Cadillac Drive
CCTY
STATE
CA
San Jose
OPTIONAL FAX I E-MAIL ADDRESS
lCP CODE
95117
AREA CODE/PH-ó"NE
4. Verification
I have used all reasonable diligence in preparing and revlewmg 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 ~ twe and correct
¡i'dIIL C/1A
Exec"led on
July 27, 2004
By
Dare
Exewled 00
July 27, 2004
¡¡;¡;
By
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By
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FPPC Fo,m 460 IJ"no/01J
FPPC TolI-F,.. Helpline, 8661ASK-FPPC
State of Califomi.
Daie
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FIlER
Contributions Received
1. Monetary Contributions
2. Loans Received
3 SUBTOTAL CASH CONTRIBUTIONS
4 Nonmonetary Contributions.
Schedule A. Line 3
Schedule B. Line 3
Add Lines 1 +2
Sch.dule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED
Add Lines 3 +4
Expenditures Made
6. Payments
7. Loans
Schedule E, Line 4
Schedule H, Lin. 3
Add Lines 6+7 $
8. SUBTOTAL CASH PAYMENTS
9. Accrued Expenses (Unpaid Bilis)
10. Nonmonetary Adjustment
11. TOTAL EXPENDITURES MADE
.. Schedule é lone 3
Sched"'e C. Un. 3
.AddLines8+9+10
Current Cash Statement
12. Beginning Cash Balance
13. Cash Receipts
Prr"ious S"mmar¡ Page. lone 16
Co/"mn A. Line 3 abo,e
14. Miscelianeous Increases to Cash
15 Cash
Schedule I Line 4
Col"mn A, lone 8 abo"
16. ENDING CASH BALANCE
Add Lines 12+ 13 + 14 thensubl",ctUne 15
If fhis is a termination stafement. Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED
Schedule B. Pan 2
Cash Equivalents and Outstanding Debts
18 Cash Equivalents See Instrucdons on 'e",se
19. Outstanding Debts Add lone 2 +Lme 9mColum"Babo"
Type or print in ink.
Amounts may be roundod
to whole dollars,
ColumnA
TOTA' T"'S"RIOD
f'ROMATTACHEDSŒEDUIESI
585
585
3894.25
0
7,45
0
3901.07
Cotumn B
CAlENDAR "'-R
TOTAL TO DATE
from
through
To calculate Column B. add
amounts in Column A to the
corresponding amounts
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 fiffit report being filed
for this calendar year. only
carry over the amounts
from LInes 2. 7. and 9 (if
anyJ
SUMMARY PAGE
January 1, 2004
CALIFORNIA 460
FORM
Statement covers period
June 30, 2004
I Page
i 10 NUMBER
¡ 1237120
3
of
5
Calendar Year Summary for Candidates
Running in Both the State Primary and
Il1lh1O"9h 6/30
20 Contributions
Received
21 Expenditures
Made
7/1 co D"e
Expenditure Limit Summary for State
Candidates
22- Cumulative Expendlturos Mad.'
("""bjo<lloVo'onta""'p."""",,Llm'l
Date of Election
(mm/ddlyy)
TotalloOate
$
$
$
$
$
$
'SInce January ,. 2001. Amounts in this section may be
different from amounts reported in Column B
FPPC Form 460 (June/O1)
FPPC Toil-Free Helpline: 866/ASK-FPPC
Schedule C
Nonmonetary Contributions Received
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULE C
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
from
through
June 30, 2004
CALIFORNIA 460
FORM
Statoment covers period
January 1, 2004
I Page~ of~
I I
I ID.NUMBER (
¡. -- t
I n^,O I ! CUMULATIVE TO
FUll NAME. STREET ADDRESS AND CONTRIBUTOR IF AN CNDIVIDUAl. ENTER I DESCRIPTION OF FA~~~~~~~T DATE PE':~~^~~ON
, RECEIVED i C" COMMIT'" ALSO ENTER' D. NUMBERI wuo C" SELF-EM"O"D ENTER i VALUE v~'ONU~n IIF REOUIRED)
NAME OF BUSINESSI (JAN 1 - DEC 31)
I OIND two tickets for the, ~~~..
2/14/041 OCOM $75 each $150
~OTH Annual Banquet I /3 2.f ¡.,~ytir
OPTY of Hong Kong It~L, 8:;;~
I OSCC Students
6/13/041 OIND 2 tickets to a fvilwJ) ~ cJ.;),
OCOM perform. by China $75 each $150 ~~ N,J.£6
iilOTH
OPTY Disabled People 43 4-75 ž¡lj
DSCC Perf. Arts Grp Fr.LWlIKt.
OIND '
OCOM
OOTH
OPTY
OSCC
i OIND
I OCOM I
I DOTH i
OPTY I
OSCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 300 I
'(JAI~i
-etal'
~
'If-ð/l)
~~
,.;tft5r--
37
'Contributor Codes
IND -Individual
COM-RecipientCommitlee
(other than PTY or SCC)
OTH-Other
PTY - Political Party
SCC - Small Contributor Committee
Schedule C Summary
1. Amount received this period - nonmonetary contributions of $1 00 or more.
(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.)
$
$
300
285
TOTAL $
585
FPPC Form 460 (JuneIO1)
FPPC Toll-Free Helpline: 866IASK.FPPC
Schedule I
Miscellaneous Increases to Cash
Type or print in Ink.
Amounts may be roundod
towholo dolla""
SEE INSTRUCTIONS ON REVERSE
NAME OF FIlER
Claudia Chang/Elect Patrick Kwok for City Council
DATE
FUll NAME AND ADDRESS OF SOURCE
mE ALSO EN"R I D NUMBER
Attach additional information on appropriately labeled continuation sheets
Schedule I Summary
1 Increases to cash of $100 or more this period.
2. Unitemized increases to cash 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
Summary Page, Line 14.)
Statemont cove", period
from January 1, 2004
through June 30. 2004
DESCRIPTION OF RECEIPT
$
$
$
TOTAL $
5
of
5
pago
1.0 NUMBER
1237120
AMOUNT OF
INCREASE TO CASH
SUBTOTAL $
7.45
7.45
FPPC Form 460 (June/O1)
FPPC TolI.Free Helpline: 866IASK.FPPC