2nd 460 Semi-annual
4
of
1
ble"J
Page
C PERTlNO CITY CLERK
or print in Ink.
Date of election if appli
(Month, Day, Year)
covers period
2004
Type
Statement
July
Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200~84216.5)
Official Use Only
or
from
2004
December 31
through
SEE INSTRUCTIONS ON REVERSE
Quarterly Statement
Special Odd-Year Report
Supplemental Preelection
Statement - Attach Form 495
o
o
o
2. Type of Statement:
D Preelection Statement
iii Semi-annual Statement
o Termination Statement
D Amendment (Explain below)
Committees - Complete Parts 1, 2, 3, and 4.
o Ballot Measure Committee
o Primarily Formed
o Controlled
o Sponsored
(Also CamplelePatt6)
Committee:
!XJ Officeholder, Candidate Controlled Committee
o State Candidate Election Committee
o Recall
(Also Complete Part 51
AI
Recipient
Type of
1
Primarily Formed Candidatel
Officeholder Committee
(Also o,mplete Part '1)
o
D General Purpose Committee
o Sponsored
o Small Contributor Committee
o Political Party/Central Committee
Treasurer(s)
NAME OF TREASURER
Claudia Chang
MAILING ADDRESS
.D. NUMBER
1237120
IF NO COMMITTEE)
Committee Information
COMMITTEE NAME (OR CANDIDATE·S NAME
Elect Patrick Kwok for City Counci
3.
AREA CODE/PHONE
ZIP CODE
95014
STATE
Ca
7437 Fallenleaf Lane
CITY
Cupertino
NAME OF ASSISTANT TREASURER, IF ANY
BOX)
STREET ADDRESS (NO P,O.
10222 Carmen Road
CITY
AREA CODE/PHONE
408777-3191
STATE ZIP CODE
Ca 95014
(IF DIFFERENT) NO. AND ST'RËËT OR P.O BOX
Cupertino
MAILING ADDRESS
MAILING ADDRESS
AREA CODE/PHONE
ZIP CODE
STATE
CITY
AREA CODE/PHONE
ZIP CODE
STATE
CITY
E-MAIL ADDRESS
FAX
OPTIONAL:
Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge
certify under penalty of perjury under the laws of the State of California that the foregoing is true an[\CDrrect
E-MAIL ADDRESS
FAX
OPT!ONAL
4.
schedules is true and complete.
contained herein and in the attached
the information
8y
January 30, 2005
Date
January 30, 2005
o¡¡;
Executed on
SignatureOfCoI1tr'ú!
8y
Executed on
FPPC Form 460 (June/01)
FPPC TolHree Helpline: 866/ASK-FPPC
State of California
Siglaturn ofControiling OIfiœhokler, Candidate-State Measure Proponent
§gnatureofControllingöfficeholder, Cancidate siaiëMeasureï5roponem
8y
8y
Date
Date
Executed on
Executed on
Type or print in ink. COVER PAGE - PART 2
Recipient Committee
Campaign Statement
Cover Page - Part 2
- -
5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE -
NAME OF BALLOT MEASURE
Patrick Kwok
- BALLOT NO. OR LETTER JURISDICTION
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) D SUPPORT
City of Cupertino Council Member o OPPOSE
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STAlE ZIP
10222 Carmen Road, Cupertino, Ca 95014 Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT
DISTRICT NO. IF ANY
OFFICE SOUGHT OR HELD
7. Primarily Formed Committee Ust names of officeholder(s) or candidate(s) for
which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT
D OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT
D OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT
D OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT
D OPPOSE
Attach continuation sheets if necessary
Related Committees Not Included in this Statement: Ustanycommittees
not included In this statement that are controlled by you or are primarily formed to receive
contributions or make expenditures on behaff of your candidacy_
COMMITTEE NAME 1.0. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
DYES D NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME 1.0. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
DYES D NO
COMMITTEE ADDRESS STREET ADDRESS (NO P_O. BOX)
CITY STATE lIP CODE AREA CODE/PHONE
FPPC Fonn 460 (Junel01)
FPPC Toll-Free Helpline: 8661A$K-FPPC
State of California
SUMMARY PAGE
covers period
2004
Statement
July
Type or print In ink.
Amounts may be rounded
to whole dollars.
Campaign Disclosure Statement
Summary Page
4
3
2004
December 31
from
of
Page
.D. NUMBER
1237120
through
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
Column B
CALENDAR YEAR
TOTAl TO DATE
Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
Claudia Chang/Elect Patrick Kwok for City Counci
Contributions Received
to Date
71
through 6/30
1
$
$
Schedule A, Line 3
Schedule B, Une 3
Monetary Contributions
Loans Received
SUBTOTAL CASH CONTRIBUTIONS
Nonmonetary Contributions..
TOTAL CONTRIBUTIONS RECEIVED
2.
3
4.
5.
$
$
20. Contributions
Received
Expenditures
Made
21
$
$
+2
Schedule C, Une 3
Add Lines
$
Expenditure Limit Summary for State
Candidates
$
$
$
Add Lines 3 +4
Expenditures Made
Payments Made
6.
7.
$
$
Schedule E, Line 4
Schedule H, Line 3
Made
Loans
22. Cumulative Expenditures Made·
(rr SubjllCtto Voluntary Expenditure Umlt)
Total to Date
$
$
$
$
$
Date of Election
(mm/dd/yy)
---1---1_
---1---1_
---1---1_
---1---1_
---1---1_
---1---1_
$
$
Add Lines 6 + 7
Schedule F. Une 3
Schedule C, Line 3
SUBTOTAL CASH PAYMENTS
Accrued Expenses (Unpaid Bills)
Nonmonetary Adjustment.
TOTAL EXPENDITURES MADE
8
9.
10.
$
~Sinœ January 1, 2001. Amounts in this section may be
different from amounts reported in Column S,
To calculate Column S, 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 first report being filed
for this calendar year, only
carry over the amounts
from Lines 2. 7. and 9 (if
any).
$
3901.07
$
$
AddUnes8+9+ 10
Previous Summary Page, Line 16
Column A, Line 3 above
11
Current Cash Statement
12. Beginning Cash Balance
13. Cash Receipts
Miscellaneous
5.99
3907.06
$
Line 4
Column A, Line 8 above
then subtract Line 15
Schedule
14,
13 +
Cash
Add Unes 12 +
to
Increases
5. Cash Payments
16. ENDING CASH BALANCE
14.
$
Schedule B. Pari 2
Cash Equivalents and Outstanding Debts
8. Cash Equívalents See instructions on reverse
must be zero.
16
Line
17. LOAN GUARANTEES RECEIVED
If this is a terminatìon statement,
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866fASK-FPPC
$
$
Add Une 2 + Line 9 in Column B above
19. Outstanding Debts
Schedule Type or print In Ink.
Miscellaneous Increases to Cash Amounts may be rounded Statement covers period
to whole dollars.
from July 1 , 2004
through )ecember 31, 20q¡¡ 4 4
see INSTRUCTIONS ON REVERSE Pag8_ of_
NAME OF FILER .0. NUMBER
Claudia Chang/Elect Patrick Kwok for City Council 1237120
DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF
RECEIVED {IF COMMITIEE, ALSO ENTER 10. NUMBER} DESCRIPTION OF RECEIPT INCREASE TO CASH
i
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Schedule I Summary
1. Increases to cash of $100 or more this period. .... ....... ..... .......... ........ ....... ........... ......... $
2. Unitemized increases to cash under $100 this period. .......... ........... $ 5.99
.................................
3. Total of all interest received this period on loans made to others. (Schedule H, Coiumn (e).) ....... ....... $
4. Total miscellaneous increases to cash this period. (Add Lines 1. 2. and 3. Enter here and on the 5.99
Summary Page. Line 14.) . TOTAL $
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC