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460 Recipient Committee Campaign Statement - Semi Annual 01-01-16 to 06-30-16 COVER PAGE Recipient Committee Date Stamp Campaign Statement t i: I�, � , J s, •! ' � � � � Cover Page � �� i� �� J \� '�_, i Statement covers period Date of election if applicati 1 of 4 Jan 1, 2016 (Month, Day,Year) {� A 1�� 1 �O'�C For O�cial Use Only from �� f-�t� � u SEE INSTRUCTIONS ON REVERSE Jun 30, 2016 through - ( ( 8;��;� r��Y CL�RK 1. Type of ReCipierlt Committee: A��committees-comp�ete Parts�,2,s,a�d a. 2. Type of Statemen�: � �� ❑ 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 (AlsoCompletePartS) � Sponsored � Termination Statement (AlsoCompletePaR6) (Also file a Form 410 Termination) � General Purpose Committee ❑ Amendment(Explain below) � Sponsored ❑ Primarily Formed Candidate/ � Small Contributor Committee Officeholder Committee � Political Party/Central Committee (AlsoCompletePart7) 3. Committee Information I �1299673 Treasurer(s) COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Cupertino Chamber PAC Andrew Walters MAILING ADDRESS STREETADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY 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-MAILADDRESS 4. Verification ' I have used all reasonable dili ence m re arin and reviewin this statement and to the best o��kn ledge�the info a� n co -- 9 P P � 9 9 ntained'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 is t�r.�,�'an or ect. �/ /�� /� �� __-__ Executed on / � � / ate / �Signature of Treasurer or Assistant Treasurer � t Executed on gy Date Signature of Controlling Offceholder,Candidate,State Measure Proponent or Responsible Offcer of Sponsor � Executed on gy Date Signature of Controlling Offceholder,Candidate,State Measure Proponent � Executed on gy Date Signature of Controlling Officeholder,Candidate,State Measure Proponent � FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summary Page to whole dollars. Statement covers period � - , Jan1, 2016 � _ � � from Jun 30, 2016 2 4 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D.NUMBER Cupertino Chamber PAC 1299673 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR (FROMATTACHEDSCHEDULES) TOTALTODATE Running in Both the State Primary and 300 300 General Elections 1. Monetary Contributions................................................... scneduiea,�i�e s $ � $ � 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ scneduie a,Line 3 300 300 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add�ines�+2 $ 0 $ 0 Received $ $ 4. Nonmonetary Contributions............................................ scneduie c,une s 300 300 21. Expenditures Made $ $ 5. TOTALCONTRIBUTIONSRECEIVED....................................Add�ines3+4 $ $ Expenditures Made 250 250 Expenditure Limit Summary for State 6. Payments Made................................................................ scnedu�e E,�ine a $ $ Candidates 7. Loans Made....................................................................... Schedule H,Line 3 0 0 250 250 22• Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS.......................................... Add�ines s+� $ $ (If Subject to Voluntary Expenditure Limit) 9. Accrued Ex enses Un aid Bills Schedule F,Line 3 � 0 P � P ) �� Date of Election Total to Date 10. Nonmonetary Adjustment.........................................................scnedu�e c,�ine 3 � � (mm/dd/yy) 11. TOTAL EXPENDITURES MADE........................................Add�ines s+g+�o $ 250 $ 250 �� Current Cash Statement �� $ 0 12. 609111C11f1g CaSh BalaflC@............................ Previous Summary Page,Line 16 $ To calculate Co�umn B, . 300 add amounts in Column 13. Cash Receipts........................................................... coiumn a,Line 3 above Q A to the corresponding *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash.................................. Scnedu�e�,�ine a amounts from Column B reported in Column B. 250 of your last report. Some 15. CaSh PaymentS......................................................... Column A,Line 8 above amounts in Column A may 16. ENDING CASH BALANCE ..................Add�ines�2+13+14,then subtract Line 15 $ 50 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If O this is the first report being 17. LOAN GUARANTEES RECEIVED................................ scnedu�e e,Part z $ filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2,�,and 9(if 0 a�y�� 18. Cash EqulvalentS................................................ See instructions on reverse $ 0 19. OUtStBfldlllg D@btS.............................. Add Line 2+Line 9 in Column 8 above $ FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/2753772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A to whole dollars. Statement covers eriod Monetary Contributions Received P � _ Jan1, 2016 � _ � • � from Jun 30, 2016 3 4 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D.NUMBER Cupertino Chamber PAC 1299673 DATE FULL NAME,STREETADDRESSAND 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-EMP�OYED,ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED) OF BUSINESS) Richard Abdalah �IND Attorney,Abdalah Law ❑OTH ❑PTY 4/28/16 ❑SCC Andrew Walters �IND 5/17/16 ❑OTH Officer, San Jose Water $100 $100 �P�, Company ❑scc Kevin McClelland �IND President, Leeward 5/17/16 ❑OTH Services ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ $300 i 1 Schedule A Summary � �ContributorCodes � 1. Amount received this period — itemized monetary contributions. 300 IND—Individual (Include all Schedule A subtotals.).........................................................................................................$ COM—Recipient Committee O (other than PTY or SCC) 2. Amount received this period— unitemized monetary contributions of less than $100 ...........................$ OTH—Other(e.g.,business entity) PTY—Political Party 3. Total monetary contributions received this period. 300 SCC—Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ ' FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Amounts may be rounded Statement covers period to whole dollars. • I � , Payments Made Jan 1, 2016 . - from Jun 30, 2016 4 4 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D.NUMBER Cupertino Chamber PAC 1299673 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 Secretary of State Annual Fee to the state Political Reform Division $250 1500 11 th Street, Room 495 Sacramento, CA 95814 '"Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 250 Schedule E Summary 250 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 0 2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)............................................................................. $ 250 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ FPPC Form 460(1an/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov