460 Recipient Committee Campaign Statement 7-1-15 to 12-31-15 Recipient Committee Type or print in ink. _ COVER PAGE
' p t ..,,- '. ., .1 V I CALIFORNIA
Campaign Statement 2091./0z 460
Cover Page I
FOENA
23
(Government Code Sections 84200-84216.5) Statement covers period Date of election if applicable: r[o '� 2016�L of
(Month,Day,Year) FEBor Oficial Use Only
from 7/1/2015
SEE INSTRUCTIONS ON REVERSE
through 12/31/2015 —CUPERTINO CITY C ERK
1. Type of Recipient Committee: An committees-Complete Parts 1.2,3,and 4. 2. Type of Statement:
❑ Officeholder,Candidate Controlled Committee 0 Primarily Formed Ballot Measure ❑ Preelection Statement 0 Quarterly Statement
O State Candidate Election Committee Committee • Semi-annual Statement 0 Special Odd-Year Report
O Recall 0 Controlled ❑ Termination Statement ❑ Supplemental Preelection
(Also Complete Pert 5) 0 Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495
(Also Complete Part 6) ❑ Amendment(Explain below)
MI General Purpose Committee
O Sponsored ❑ Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee
O Political Party/Central Committee (Also Complete Par:n
1,0.NUMBER
3. Committee Information 1390395 Treasurer(s)
NAME OF TREASURER
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) Andrae Macapinlac
ASIAN PACIFIC—ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC)
MAILING ADDRESS
956 Lanier Way
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL:FAX/E-MAIL ADDRESS OPTIONAL:FAX/E-MAIL ADDRESS
Treasurer: senatormac9@aol.com
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the complete. I certify
under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on 2/1/2015 By
Dale Signature of Treasurer or Assistant Treasurer
Executed on _ _ By
Dale Signature at Controlling Officeholder,Condidale,Slate Measure Proponent or Responsible Officer el Sponsor
Executed on By
Date Signature of eonuolfng Officeholder.Candidate,Slate Measure Proponent
Executed on By FPPC Form 460(January/85)
Date Signature of Conlroting Officeholder,Candidate,Stale Measure Prepanurl FPPC Toll-Free Helpliine:666/ASH-FPPC 18661275.31721
Slate of California
2n17447-n
• Recipient Committee Type or print in ink. COVER PAGE-PART2
CALIFORNIA 460
Campaign Statement FORM
Cover Page - Part 2
Page 2 of 23
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑SUPPORT
❑OPPOSE
RESIDENTIAL/BUSINESS 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:List any committees
not Included In this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO.IF ANY
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D.NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate/Officeholder Committee List names of
❑YES ❑NO officeholder(s)or candidate(s)for which this committee is primarilyformed.
COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 SUPPORT
0 OPPOSE
CITY STATE ZIP CODE AREA CODEIPHONE —
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 SUPPORT •
COMMITTEE NAME I.D.NUMBER 0 OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 SUPPORT
0 OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE?
❑YES NO NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT
❑OPPOSE
COMMTi7EE ADDRESS STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPS 116e/271-3772)
State of California
7(119447-D
Type or print in ink. SUMMARY PAGE
• Campaign Disclosure Statement Amounts may be rounded Statement covers period CALIFORNIA 460
Summary Page to whole dollars. 7/1/2015 FORM
from
12/31/2015
SEE INSTRUCTIONS ON REVERSE through - Page 3 of 23
NAME OF FILER I.O.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
Column A Column B
Contributions Received
TOTAL-181S nFJUGD cap FNDAREAR Calendar Year Summary for Candidates
(FROMATTACHEO SCHEDULES) TOTAL TO DATE Running in Both the State Primary and
1. Monetary Contributions Schedule A,Line 3 $12,230.00 $12,230.00 General Elections
2. Loans Received Schedule B.the 3 $0.00 $0.00 1/1 through 6/30 7,1 to Date
20. Contributions
3. SUBTOTALCASH CONTRIBUTIONS Add Lines l+2 $12,230.00 $12,230.00 Received
4. Nonmonetary Contributions Schedule C.Line 3 $0.00 $0.00 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $12,230.00 $12,230.00 Made
Expenditures Made Expenditure Limit Summary for State
6. Payments Made Schedule E.Line $10,899.91 $10,899.41 Candidates
7. Loans Made Schedule H,Line 3 $0.00 $0.00
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $10,844.41 $10,844.41 (If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses(Unpaid Bills) Schedule F.Line 3 $0.00 $0.00 Date of Election Total to Date
10. Nonmonetary Adjustment Schedule C,Line 3 $0.00 $0.00 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $10,844.41 $10,844.41
Current Cash Statement _
12. Beginning Cash Balance Previous Summary Page.Line 16 $2.573.00
To calculate Column B,add Amounts in this section may be different from amounts
13. Cash Receipts Column A,Line 3 above $12,230.00 amounts In Column A to the reported in Column B.
corresponding amount
14. Miscellaneous Increases to Cash schedule 1,Line 4 $0.00 from Column B of your last
$1089993 report. Some amounts in
, .
15. Cash Payments Column A,line a above Column A may be negative
16. ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $3,958.59 tigurestuld be
subtracted figures ffromrom previous
If this is a termination statement,Line 16 must be zero. period amounts. If this Is
the first report being filed
for this calendar year,only
17. LOAN GUARANTEES RECEIVED Schedule B,Pert 2 $0.00 carry over the amounts
from Lines 2,7,and 9(if
any).
Cash Equivalents and Outstanding Debts
18. Cash Equivalents See/nslrucaons on reverse $0.00
19. Outstanding Debts Add Line 2+Line 9 in Column B above $0.00
FPPC Form 460(January/05)
MPG Toll-Free Hotpitne;666IAS WFPPC(6661275.1772)
2012447-0
• • Schedule A Type or print in ink. SCHEDULER
Amounts may be rounded Statement covers period CALIFORNIA 460
Monetary Contributions Received to whole dollars. 7/1/2015 FORM
from
12/31/2015
SEE INSTRUCTIONS ON REVERSE through Page 9 of 93
NAME OF FILER I.D.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1390395
IF AN INDIVIDUAL.ENTER
DATE FULL NAME,STREET ADDRESS AND ZIPAMOUNT CUMULATIVE TO DATE PER ELECTION
CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDARULATITOYETO DATE
RECEIVED OF COMMITTEE,ALSO ENTER LD.NUMBER) CODE' OF SELF-EMPLOYED.ENTER NAME
OP BUSINESS) PERIOD (JAN.1-DEC.31) (IF REQUIRED)
10/15/2015 Alexander Lin MIND OCCUPATION: Policy Aide $100.00 $100.00
❑ OTH County
❑ PTY
❑ SCC .
10/17/2015 Vicki Vincker • IND OCCUPATION: Attorney $300.00 $300.00
❑ OTH BUSINESS: Self
❑ PTY
❑ SCC
10/16/2015 Clarence Madrilejos U ND OCCUPATION: Realtor $100.00 $100.00
❑ OTH
❑ pry
O SCC
10/17/2015 MArtin Martin-MMus MIND OCCUPATION: Vice Mayor $200.00 $200.00
❑ OTH Sunnyvale
❑ PTY
❑ SCC
10/16/2015 Rich Constantine MI ND OCCUPATION: Fire $100.00 $100.00
❑ OTH EMPLOYER: City of San
Jose
❑ PTY
❑ SCC
SUBTOTAL$ laStnekaallartaataid
Schedule A Summary
`Contributor Codes
1. Amount received this period-itemized monetary contributions. IND-Individual
$12,230.00
(Include all Schedule A subtotals.) COM-Recipient Committee
S0.DO (other than PTY or SCC)
2. Amount received this period-unitemized monetary contributions of less than$100 OTH-Other(e.g.,business entity)
3. Total monetary contributions received this period. PlY-Political Party
(Add Lines 1 and 2. Enter here and on the Summary Page,Column A,Line 1.) TOTAL S12,230.00 SCC-Small Contributor Committee
FPPC Form 460(January/05)
FPPC TED-Free&Dam:86N0.5K{PPC(888R7S3772)
2012447-n
Type or print in ink. SCHEDULE A(CONT.)
Schedule A (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA 460
Monetary Contributions Received to whole dollars. 7/1/2015 FORM
from
12/31/2015 Page 5 of 2�
through
LD.NUMBER
NAME OF FILER -
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
IF AN INDIVIDUAL.ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
DATE FULL NAME,STREET ADDRESS ANO LP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECENEDTHIS CALENDARYEAR TODATE
RECEIVED IIF COMMITTEE ALSO ENTER ID.NUMBERI CODE' IF SE6£MPLOYEO.ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED)
OF BUSINESS)
10/17/2015 Rosemary KAmei MI ND OCCUPATION: Executive $100.00 $100.00
EMPLOYER: Building
❑ OTH Futures Now
❑ pry
❑ SCC
10/15/2015 Andrew Knaack • IND OCCUPATION: Nonprofit $100.00 $100.00
❑ OTH EMPLOYER: AACI
❑ PTY
❑ SCC
10/15/2015 Gustav Larson MI IND OCCUPATION: Software $100.00 $100.00
9 OTH EMPLOYER: Cienga Corp
❑ PTY
❑ SCC
10/15/2015 DAvid Lee MIND OCCUPATION: Business $100.00 $100.00
❑ 0TH EMPLOYER: Self
❑ PTV
❑ SCC
10/13/2015 Jimmy Nguyen MIND OCCUPATION: Attorney $100.00 $100.00
BUSINESS: LAw Office of
❑ OTH Jimmy Nguyen
• ❑ PTY
❑ SCC
SUBTOTAL$ Illingelenallatiel
'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)
FPPCTOILFree HOIDIino:85E/ASK-FPPC(666/275-3772)
2(717447-n
SCHEDULE A(CONT.)
•• Schedule A (Continuation Sheet) Type or print in ink.
Amounts may be rounded Statement covers period CALIFORNIA 460
Monetary Contributions Received to whole dollars. 7/1/2015 FORM
from
throw h 12/31/2015 Page 6 of 23
9
NAME OF FILER I.D.NUMBER '
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
IF AN INDIVIDUAL.ENTER
VE TO DATE PER ELECTION
RECEIVED THIS CALENDAR TO
DATE FULL NAME.STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE
TO DATE
RECEIVED OF COMMIT1EE,ALSO ENTER I.D.NUMBER) CODE' OF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DRC.31) OF REQUIRED)
OF BUSINESS)
10/13/2015 Emily Thurber • ND OCCUPATION: none $200.00 $200.00
❑ OTH
❑ PTY
❑ SCC
10/13/2015 MAson Fong • ND OCCUPATION: Staff $25.00 $25.00
0 OTH EMPLOYER: US House of
Representatives
❑ PTY
O SCC
10/13/2015 Helen Chapman U IND OCCUPATION: None $100.00 $100.00
❑ OTH
❑ PTY
❑ SCC
10/13/2015 Kristen Lyn MI IND OCCUPATION: none $100.00 $100.00
❑ OTH
❑ PTY
O SCC
10/3/2015 Darcy Paul U IND OCCUPATION: Attorney $200.00 $200.00
❑ OTH Group
❑ PTY
O SCC
SUBTOTAL$ laliallalliallia
`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 Td1{roe Holpf e:136WASWFPPC(866276J772)
2012447-0
Type or print in ink. SCHEDULE A(CONT.)
Schedule A (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA 460
Monetary Contributions Received towholedollars. 7/1/2015 FORM
from
12/31/2015
through Page 7 of 23
NAME OF FILER
I.D.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
IFUPITNIMPLOR AMOUNT CUMULATIVE TO DATE PER ELECTION
DATE FALL NAME,aTREET ADpRESS ANp ZIP CODE OF CONn21BUTOR CONTRIBUTOR OCCUPATION AND EAND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED (IF COMMITTEE.ALSO ENTER I.D.NUMBER) CODE' (IF SELF-EMPLOYED,ENTER NAME
OF BUSINESS) PERIOD (JAN.1-DEC.31) (IF REQUIRED)
10/3/2015 Peter Allen IN IND OCCUPATION: Manager $100.00 $100.00
❑ OTH
❑ PTY
❑ scc
10/3/2015 Rishi Kumar IIIIND OCCUPATION: Executive $250.00 $250.00
EMPLOYER: Smart Utility
❑ 0TH Systems
❑ PTY
❑ SCC
10/1/2015 Margaret Okuzumi MIND OCCUPATION: none $100.00 $100.00
❑ OTH
❑ PTY
❑ SCC
10/1/2015 John Liu II IND OCCUPATION: Chinese $100.00 $100.00
0 OTH EMPLOYER: Sand Hill
Property
❑ PTY
❑ SCC
9/28/2015 Erik Fong NI IND OCCUPATION: Manager $100.00 $100.00
0 OTH
❑ PTY
❑ SCC
SUBTOTALStaisgminisamissa
`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 To-Ree Helprnu 886!ASKFPPC(B66/276-3772)
2012447-n
Type or pont in ink.
SCHEDULE A(CONT.)
• Schedule A (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA 460
Monetary Contributions Received to whole dollars. 7/1/2D15 FORM
from
12/31/2015 Page a of —
through
NAME OF FILER LD.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
DATE FULL NAME,STREET ADDRESS ANO ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED IIF COMMITTEE.ALSO ENTER I.D.NUMBER) CODE' (IF SELF-EMPLOYED.ENTER NAME
PERIOD (JAN,1-BEC.31) (IF REQUIRED)
OF BUSINESS)
9/28/2015 Evan Low U IND OCCUPATION: $1,000.00 $1,000.00
❑ OTH EMPLOYER: California
State Assembly
❑ PTY
❑ SCC
9/16/2015 Marsha Grilli • IND OCCUPATION: $100.00 $100.00
0 OTH Milpitas
City of
❑ pTY
❑ SCC
9/9/2015 James Davis i IND OCCUPATION: $100.00 $100.00
EMPLOYER:❑ OTH Sunnyvale City of
❑ PTY
❑ SCC
10/17/2015 Emily Ramos • IND OCCUPATION: Events $185.00 $185.00
❑ OTH EMPLOYER: The Tech
Museum
❑ pry
❑ SCC
9/14/2015 Rich Gordon for State Assembly 2014 ❑ IND $500.00 $500.00
0 OTH
❑ PTY
❑ SCC
SUBTOTAL S . - . • _ , - R9
*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 To LFree Holpline:866/AS W FPPC(666R1S.3712)
mH 2447-n
Type or print in ink. •
SCHEDULE A(CONT.)
•
• Schedule A (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA
•
Monetary Contributions Received towholedollars. 7/1/2015 FORM 460
from
12/31/2015 q _
through Page of
NAME OF FILER I.D.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1390395
IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED IIF COMMITTEE.ALSO ENTER I.D.NUMBER) CODE' OF SELF-EMPLOYED,ENTER NN,IE PERIOD (JAN.1-DEC.31) (IF REQUIRED)
OF BUSINESS)
9/20/2015 Marc Berman for Assembly ❑ IND $500.00 $500.00
❑ PTY
O SCC
10/6/2015 Lofgren for Congress ❑ IND $450.00 $450.00
0 PTY
❑ SCC
9/20/2015 Josephine Lucey MIND OCCUPATION: Board $250.00 $250.00
EMPLOYER: Cupertino
❑ OTH Unified School District
❑ pry
❑ SCC
9/29/2015 Wendy Ho MIND OCCUPATION: Policy Aide $150.00 $150.00
❑ OTH
❑ PTY
❑ SCC
10/3/2015 Gary Kreman RIND OCCUPATION: Director $100.00 $100.00
Li OTH VAlley Water District
❑ PTY
O SCC
SUBTOTAL$ lineli
`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:868/ASIC-FPPC(86612754772)
ont24f7-n
Type or print in ink. SCHEDULE A(CONT.)
•
• Schedule A (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA 460
Monetary Contributions Received to whole dollars. 7/1/2015 FORM
from
12/31/2015
through Page 10 of 23
NAME OF FILER I.D.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
IFUPITNID ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION ANE
AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED (WCOMMITTEE ALSO ENTER ID.NUMBER) CODE' OIFSELF-EMPLOYED,ENTER NAME
OF BUSINESS) PERIOD (JAN,1-DEC.31) (IF REQUIRED)
10/17/2015 Jill Chesler I. IND OCCUPATION: none $550.00 $550.00
❑ OTH
❑ PTY
❑ SCC
10/9/2015 Democratic Democratic Activists for Women ❑ IND $250.00 $250.00
Now • COM
0 PTY
O SCC
10/16/2015 Thelma Boac • IND OCCUPATION: retired $200.00 $200.00
0 OTH
❑ PTY
❑ SCC
10/13/2015 Gilbert Wong I. IND OCCUPATION: $350.00 $350.00
0 OTH EMPLOYER: City of
Cupertino
0 PTY
O SCC
10/11/2015 Jerry Liu MI IND OCCUPATION: retired $100.00 $100.00
❑ OTH
❑ PTY
O SCC
SUBTOTAL S MillanninERIMESth
'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 Farm 460(January/05)
FPPC Tc-Free Helpfre:860/ASH-FPPC(866/2754772)
onWdd7-n
• SCHEDULE A(CONT.)
• Schedule A (Continuation Sheet) Type or print in ink.
Amounts may be rounded Statement covers period CALIFORNIA 460
Monetary Contributions Received towhMledollars. 7/1/2015 FORM
from
12/31/2015
through Page 11 of 23
NAME OF FILER LMNUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
IF AN INDIVIDUAL,ENTER DATE PER ELECTION
RECEIVED THIS
VE TO
DATE FULL NAME.STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER CAMOUNT CUMULATIVE
OTO DATE
RECEIVED OF COMMITTEE.ALSO ENTER W.NUMBER) CODE' OF SELF-EMPLOYER ENTER NAME PERIOD (JAN.1-DRC.31) (IF REQUIRED)
OF BUSINESS)
10/16/2015 MOUNTAIN VIEW PROFESSIONAL FIREFIGHTERS 0 IND $1,000.00 $1,000.00
POLITICAL ACTION COMMITTEE COM
❑ PTY
❑ sec
10/16/2015 Michelle Lew II NO OCCUPATION: Executive $250.00 $250.00
❑ OTH EMPLOYER: AACI
LI PTY
❑ SCC
10/16/2015 Michael Chang MIND OCCUPATION: Executive $200.00 $200.00
❑ OTH EMPLOYER: APALI •
❑ PTY
❑ scc
10/16/2015 Elias Portales II IND OCCUPATION: Attorney $100.00 $100.00
❑ OTH Group
❑ PTY
❑ SCC
10/16/2015 Daniel Hoffman MI IND OCCUPATION: none $125.00 $125.00
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ NiartigninildiSSM
*ContributorCodes
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 Helpbro:666/ASRFPPC(B6N]7S3712)
9017247-0
Type or print in ink. SCHEDULE A(CONT.)
• Schedule A (Continuation Sheet) Amounts may be rounded Statement coverseriod
P CALIFORNIA
Monetary Contributions Received to whole dollars. 7/1/2015 FORM 460
from
through 12/31/2015 Page 12 of 23
NAME OF FILER I.D.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
IF AN INDIVIDUAL,ENTER
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE PER ELECTIONRECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED (IF COMMITTEE,ALSO ENTER 1.0.NUMBER) CODE' (IF SELFFNPLOYED,ENTER NMIE
OF BUSINESS) PERIOD (JAW.1-DEC.31) (IF REQUIRED)
10/16/2015 Richard Nguyen II ND OCCUPATION: policy aide $100.00 $100.00
❑ OTH Jose
❑ PTY
❑ SCC
10/16/2015 Grace Sonia Melanio MIND OCCUPATION: Policy Aide $100.00 $100.00
❑ OTH
❑ PTY
❑ SCC
10/16/2015 Andrae South Bay Labor Council COPE ❑ IND $100.00 $100.00
❑ 0TH
❑ PTY
❑ SCC
10/6/2015 Peter Chiu MIND OCCUPATION: Physician $100.00 $100.00
Permanente
❑ OTH
❑ PTY
❑ SCC
10/16/2015 Arcaidi Kolchak RIND OCCUPATION: none $50.00 $50.00
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ rillaIMMINEMPlar
'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 Ta0.Fme Helpf¢866/ASWFPPC(9W075-3772)
2012447-n
SCHEDULE A(CONT.)
Type or print In ink.
Schedule A (Continuation Sheet) Amounts may be rounded Statement covers period
• Monetary Contributions Received to whole dollars.
7/1/2015 CALIFORNIA 460
FORM
from
12/31/2015
through Page •13 of 23
NAME OF FILER
LD.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
ICUP TNIENTER
DATE FULL NAME,STREET ADDRESS ANp ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND AND EMPLOYER AMOUNT CUMULATIVETODATE PER ELECTIONRECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED IIFCOMNITTEE,ALSO ENTERI.0.NUMBER) CODE' (IF SELF-EMPLOYED,ENIER NAME
OF BUSINESS) PERIOD MAN.1-DEC.31) (IFREOOIRED)
10/16/2015 Noveed Sofipur U IND OCCUPATION: student $25.00 $25.00
❑ OTH
❑ PTY
❑ SCC
10/9/2015 San Jose Firefighters Political Action ❑ ND $500.00 $500.00
Committee COM
❑ PTY
❑ SCC
10/16/2015 Russel Melton MIND OCCUPATION: none $220.00 $220.00
❑ OTH
❑ PTY
❑ SCC
10/16/2015 PLUMBERS, STEAMFITTERS & REFRIGERATION 0 IND $1,000.00 $1,000.00
FITTERS LOCAL 393 POLITICAL ACTION FUND • COM
❑ PTY
❑ SCC
10/16/2015 Pacific GAs and Electric ❑ IND $1,000.00 $4,000.00
MOTH
❑ PTY
❑ SCC
SUBTOTAL$ re . 3". {P .." ;14 '✓ ..^ 7e1
•
'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)
FPPCTaI-Free Helpline:866/0.5WFPPC 1868/215-3772)
201244741
Schedule B - Part 1 Type or print in ink. SCHEDULE B-PART1
•
Amounts may be rounded Statement covers period CALIFORNIA 460
Loans Received to whole dollars. 7/1/2015 FORM
from
SEE INSTRUCTIONS ON REVERSE 12/31/2015 Page e
through1a of 2
NAME OF FILER I.D.NUMBER
ASIAN PACIFIC—ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
FULL NAME,STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL,ENTER (a) (b) (c) (d) (e) (Q (g)
OF LENDER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE
9F SELF-EMPLOYED,ENTER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS
OF COMMITTEE.ALSO ENTERIA.NUMBER) NAME OF BUSINESS) BEGIMINCTHIS PERIOD TEERR1IOO HIS PERIOD' CLOAF.OFDTHIS PERIOD LOAN TO DATE
ER OD ❑ PAID CALENDAR YEAR
RATE
❑ FORGIVEN PER ELECTION"
TO IND ❑ COM 0 OTH ❑ PTY ❑ SCC
DATE DUE DATE INCURRED
0 PAID CALENDAR YEAR
RATE
El FORGIVEN PER ELECTION"
TO IND ❑ COM 0 OTH 0 PTY ❑ SCC
DATE DUE DATE INCURRED
❑ PAID CALENDAR YEAR
RATE
❑ FORGIVEN PER ELECTION"
tEl IND 0 COM 0 OTH 0 PTY ❑ SCC
DATE DUE DATE INCURRED
SUBTOTAL$ $ $ $ INIMIEMEERS
(Enter(e)on
Schedule B Summary Schedule E.Line 3)
1. Loans received this period 50.00
(Total Column(b)plus unitemized loans of less than$100.) *Contributor Codes
IND-Individual
2. Loans paid or forgiven this period $0.00 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 change this period. (Subtract Line 2 from Line 1.) NET $0.00 SCC-Small Contributor Committee
Enter the net here and on the Summary Page,Column A,Line 2. (Mar be a nega6.eaurnbe,)
*Amounts forgiven or paid by another party also must be reported on Schedule A.
•'If required. FPPC Form 460(January/05)
FPPC TelIFlee Helplire:666/ASK.FPPC(8BW2753772)
70124.17_n
• Schedule C Type or print in Ink. SCHEDULE C
Amounts may be rounded Statement covers period CALIFORNIA 460
Nonmonetary Contributions Received to whole dollars. 7/1/2015 FORM
from
12/31/2015
SEE INSTRUCTIONS ON REVERSE through Page 35--Of 23
NAME OF FILER I.D.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1390395
FULL NAME,STREET ADDRESS AND IF AN INDIVIDUAL,ENTER AMOUNT/ CUMULATIVE TO PER ELECTION
DATE ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF DATE
RECEIVED OF COMMITTEE,ALSO ENTER LD.NUMBER) CODE' BF SELF-EMPLOYED.ENTER NAME GOODS OR SERVICES FAIR MARKET CALENDAR YEAR TO DATE
OF BUSINESS) VALUE (JAN.1-DEC.31) (IF REQUIRED)
❑ IND
O COM
❑ OTH
O PTY
❑ SCC
O IND
O COM
❑ OTH
O PTY
O SCC
❑ IND
❑ COM
O OTH
❑ PTY
O SCC
O IND
O COM
O OTH
❑ PTY
❑ SCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ „ , '• ,'t$ :sem --- 41,4
Schedule C Summary
`Contributor Codes
1. Amount received this period-itemized nonmonetary contributions.
(Include all Schedule C subtotals.) 50.00 IND-Individual
COM-Recipient Committee
2. Amount received this period-unitemized nonmonetary contributions of less than$100 $0.00 (other than PTY or SCC)
OTH-Other(e.g.,business entity)
PTY-Political Party
3. Total nonmonetary contributions received this period. SCC-Small Contributor Committee
(Add Lines 1 and 2. Enter here and on the Summary Page,Column A,Lines 4 and 10.) TOTAL $0.00
FPPC Form 460(January/05)
FPPC Toll-Foe Helpline:96610.5WFPPC(86e276.3,72)
2n124.17-n
Schedule D Type or print in ink. SCHEDULE D
•
Amounts may be rounded Statement covers period CALIFORNIA 460
Summary of Expenditures to whole dollars. 7/1/2015 FORM
Supporting/Opposing Other from
Candidates, Measures and Committees 2/31/2015 ,6— 23
through Page of
SFF INCTRI Ir`TI/ING ON RFVFRCF
NAME OF FILER I.D.NUMBER
ASIAN PACIFIC—ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1390395
NAME OF CANDIDATE,AND DISTRICT,OR DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION
DATE MEASURE NUMBER OR LETTER ANDJURISDICTION, TYPE OF PAYMENT (IF REQUIRED) PERIOD CALENDAR YEAR TO DATE
OR COMMITTEE
(JAN.t-DEC.31) (IF REQUIRED)
12/31/2015 Ash Kalra
• Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
Expenditure
Support ❑ Oppose
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
Expenditure
❑ Support ❑ Oppose
•
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
Expenditure
❑ Support ❑ Oppose ,Fy
SUBTOTAL$ ,
Schedule D Summary
1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) $4,200.00
2. Unitemized contributions and Independent expenditures made this period of under$100 $0.00
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) $4,200.00
FPPC Form 460(January/05)
FPPC Tot-Free Heyl :1366/ASIC-FPPC(666.27S37]3)
2012447-0
' . • Schedule E
Type or print in ink. SCHEDULE E
Pa ments Made Amounts may be rounded Statement covers period CALIFORNIA 460
Y to whole dollars. 7/1/2015 FORM
from
12/31/2015 17 23
SEE INSTRUCTIONS ON REVERSE through - Page Of
NAME OF FILER ID.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1390395
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
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
Ash Kalra for California- Assembly 2016 CTB $9,200.00
FedEx P05 '$9.63
San Jose Garden Airport Hotel FND $1,000.00
Memo Reference: 1
*Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
1. Itemized payment made this period. (Include all Schedule E subtotals.) S10,894.91
2. Unitemized payments made this period of under$100 $0.00
3. Total interest paid this period on loans. (Enter amount from Schedule B,Part 1,Column(e).) $0.00
4. Total payments made this period. (Add Lines 1,2,and 3. Enter here and on the Summary Page,Column A,Line 6.) S10,844.41
FPPC Form 460(January/05)
FPPC TWFree Helpons:866/ASK-FPPC l880ar53772)
2n17447-n
Schedule E Type or print in ink.
•
SCHEDULE E(CONT.)
(Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA 460
to whole dollars. 7/1/2015 FORM
Payments Made from
12/31/2015
through Page 18 of 23
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER LD.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
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
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 Lv.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
(IFCOMMITRE,ALSOENTERLD.NUMBER) CODE OR DESCRIPTMNOFPAYMENT AMOUNTPMD
Olympic Recognition Products Trophies for awards 5297.34
Flower Cottage 12-15-15 FND $200.00
Memo Reference: 2
San Jose Garden Airport Hotel FND $2,000.00
Madhuban Ashwini Kumar FND Cateruing $1,957.50
Pacific Printing FND Programs for event $1,005.94
Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
FPPC Form 460(January/05)
FPPC Toll-Free Helpri:666/0.5WFPPC(666/275.3772)
2019447-0
• Schedule E Type or print in ink. SCHEDULE E(CONT.)
(Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA
[o whole dollars.
Payments Made from 7/1/2015 FORM 46.0
12/31/2015 Pa .n__of 23—
through 9e
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D.NUMBER
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1390395
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
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 fling/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(intemet,e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Democracy.com Website maintenance 5179.00
'Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL S
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/AsWFPPC(0661275-772)
2017447-n .
SCHEDULEF
• Schedule FType or print In ink.
Amounts may be rounded Statement covers period CALIFORNIA 460
Accrued Expenses (Unpaid Bills) to whole dollars. 7/1/2015 FORM
from
12/31/2015
through Page _at_of 23
SEE INSTRUCTIONS ON REVERSE NUMBER
NAME OF FILER I.O.D.NUMB 5
ASIAN PACIFIC—ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC)
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
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)
(b) (C)
NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT) CURRED AMOUNT PAID OUTSTANDING
(IF COMMITTEE.ALSO ENTER LO NUMBER) DESCRIPTION OF PAYMENT BALANCEOF THIS PERIOIDG THIS PERIOD (ALSOIS PERIOD R PORT ONE) BALANCE
OF THIS PERIOD
=vivre`°3 ron wuw.wm.me,p.,awa.muu+wa smman..a m sums,.. SUBTOTALS S S S
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F,Column(b)subtotals for INCURRED TOTALS $0.00
accrued expenses of$100 or more,plus total unitemized accrued expenses under$100.)
2. Total accrued expenses paid this period. (Include all Schedule F,Column(c)subtotals for payments on PAID TOTALS 90.00
accrued expenses of$100 or more,plus total unitemized payments on accrued expenses under$100.)
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and NET $0.00
on the Summary Page,Column A,Line 9.) (May be a negative number)
FPPC Form 460(January/05)
FPPC Toll-Free Holpino:866A51(-FPPC(86612154772)
2n12447-n
SCHEDULE H
Type or print in ink.
•
Schedule H Amounts may be rounded Statement covers period CALIFORNIA 460
Loans Made to Others* to whole dollars. from 7/1/2015 FORM
throw h 12/31/2015 21 23
9 Page -of
SEE INSTRUCTIONS ON REVERSE
I.D.NUMBER.,
NAME OF FILER 1390395
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC)
WAN INDIVIDUAL,ENTER (a) (b) (c) (d) (a) (f) (g)
FULL NAME,STREET ADDRESS AND ZIP CODE OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT REPAYMENT OR OUTSTANDING INTEREST ORIGINAL CUMULATIVE
OF RECIPIENT (IF SELF-EMPLOYED,ENTER BALANCE LOANED THIS FORGIVENESS BALANCE AT RECEIVED AMOUNT OF LOANS
(IF COMMITTEE,ALSO ENTER W.NUMBER) NAME OF BUSINESS) BEGINNING THIS PERIOD THIS PERIOD' CLOSE OF THIS LOAN TO DATE
PERIOD . . PERIOD
0 PAID CALENDAR YEAR
RATE
0 FORGIVEN PER ELECTION"
DATE DUE DATE INCURRED
❑ PAID CALENDAR YEAR
RATE
❑ FORGIVEN PER ELECTION"
DATE DUE DATE INCURRED
'Loans that are contributions to another candidate or committee
must also be summarized on Schedule D. Loans forgiven must SUBTOTAL $ $ $ $ A
also be reported on Schedule E.
(Enter(a)on
•
Schedule I,'Line 3)
Schedule H Summary
$0.00
1. Loans made this period
(Total Column(b)plus unitemized loans of less than$100.)
$0.00
2. Payments received on loans
(Total Column(c)plus unitemized payments of less than$100.) '*If required.
3. Net change this period. (Subtract Line 2 from Line 1.) NET $0.00
Enter the net here and on the Summary Page,Column A,Line 7. (May be a negative number)
•
FPPC Form 460(January/05)
FPPC Tell-Free Helpline:6613/ASK-FPPC(066/2]53)12)
2m7447-fl
SCHEDULE I
Type or print in ink.
Schedule I Amounts may be rounded Statement covers period CALIFORNIA 460
Miscellaneous Increases to Cash to whole dollars. 7/1/2015 FORM
from
12/31/2015
through Page 22 of 23
SEE INSTRUCTIONS ON REVERSE NUMBER
NAME OF FILER I.D.D. 5
ASIAN PACIFIC-ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC)
AMOUNT OF
DATE FULL NAME AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT INCREASE TO CASH
RECEIVED (IF COMMITTEE.ALSO ENTER I.D.NUMBER)
SUBTOTAL$
Schedule I Summary
50.00
1. Itemized increases to cash this period.
S0.00
2. Unitemized increases to cash of under$100 this period.
50.00
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 TOTAL 50.00
Summary Page,Line 14.)
FPPC Form 460(January/05)
FPPC Toll-Free Holpllnot B66/A5KFPPC(6661275-3772)
2n12447-n
Memo Reference: 1
Deposit for fundraiser
Memo Reference: 2
Flowers for fundraiser
90t2447_n