460 Recipient Committee Campaign Statement - Semi Annual 1-1-17 to 6-30-17Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84218.5)
from
Type or print in ink. D
Statement covers period Date of election if appli£
(Month, Day, Year)
1/1/2017
through
613p:,2017
JUL 3 1 2017
CU ERTINO CITY CLERK
SEE INSTRUCTIONS ON REVERSE
1. Type of Recipient Committee: All com7atees- complete Pans 9, 2.3; and 4.
2. Type of Statement:
❑ Officehoider, Candidate Controlled Committee
❑ Pnmaftly Formed, Ballot Measure'L
❑ Preelection Statement
O State Candidate Election Committee
Comrnittee
Semi-annual Statement
O Recall
O Controlled
❑ Termination Statement
(Also Complete Part 5)
O Sponsored
(Also file a Form 410 Termination)
(Also Compiete Pan 6J
El Amendment (Explain below)
General Purpose Committee,,: .
O Sponsored
❑ Primarily Formed Candidate!
O Small Contributor Comrrijttee
Officeholder Committee
O Political PartylCentral Committee
(Also Complete Pad 7)
-
tt ! f f n
LDrNUMBER
' 1340395
It';
Treasurer(S)
3. Commr ee norma to
• .1_ - . -'. - . NAME4FTREASORER
CASIANEPACIFIC- SLANDER EMPOWEP-MENTDIDATES NAME IF NO ITTEe) Andrae t4acap�nlac
PAC (API'EM7?04SERMENT FAC)
MAILING ADDRESS
STREET ADDRESS (NO P.O. BOX)
CIN STATE ZIP CODE AREA GODElPHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOY.
COVER PAGE
1 of 11
Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement -Attach Form 495
CITY STATE ZIP CODE AREACODEIPHONE
NAME;;OFASSISTANT TREASI9RFJ; SF ANY
MAILINGADDRESS
CITY STATE ZIP CODE AREA CODERHONB CITY. -.STATE ZIP CODE AREA CODE/PHONE
..
OPTIONAL' FAX I E-MAIL ADDRESS OPTIONAL:'. tttx r t-nrllatt�: wuxcaa
- r�`YedSi1T'er=
4. Verification
I have used all reasonable diligence in preparing and reviewing 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 penury under the laws of the State of Califomia that the foregoing is true and correct
Executed on 7/31/2017 BY- ---
Date
Exewted on By
Data stgnalure o£Controlfng ORceholtler, Candidate. Stale Measure Ptoponani or Responsible Ofr� -r of Sponsor
exLcuted on _ BY '
Dale 5lgnaiure ¢t ConV¢lling Officeholder, Candidate, State M�sure Proponent
By - FPPC Fours 480 (Janna yiOS)
EXOCUted on
Data vgnawm of Controlling Officeholder, Candidate, state Measure Proponent FPPC ToIFFrea Helpline: $MASK-FPPC (86612753772)
State of caftmia
777.r.'AI A -n
Recipient Committee
Campaign Statement
Cover Page - Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIALIBUSINESS ADDRESS (NO, AND STREET) CITY' STATE ZIP ,;
Related Committees Not Included in this Statemerit Cisi'anycommlttees
not included in this statement that are controlled by you orare primarily fdrmed to receive
contributions or make expenditures on behalf of your candidacy. -
COMMITTEE NAME LD. NUMBER
NAME OF TREASURER CONTROLL'EdCCMMITTE
„ ❑YES ," ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) -
CITY STATE ZIP CODE AREA CODEJPHO
COMMITTEE NAME
I.D. NUMBER
NAME OF TREASURER I CONTROLLED COMMITTEE?
❑ YES El NO
COMMn-TEE ADDRESS. STREET ADDRESS (NO P.O. BOX)
Type or print in ink.
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
COVER PAGE.- PART 2
Page 2 of 11
BALLOT NO. OR LETTER JURISDICTION [:]SUPPORT
— ❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if. any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE�S&GHT OR HELD- DISTRICT NO. IF ANY
7, Primarily Formed.Candidate/Officeholder Committee
offieeholder{s) or candidates) for which this committee is primarify farmed.
List names of
NAME OF OFFICEHOLDER ORCANDIDATE-�
-
OFFICE SOUGHT OR HELD
❑SUPPORT
❑ OPPOSE
;NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR,CAND@ATE
_ -
OFFICE SOUGHT OR HELD
El SUPPORT
❑ OPPOSE
NAME -OF OFFICEHOLDER OR,CANbIDATE
OFFICE SOUGHT OR HELD
❑ SllPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets ifnecessary
FPPC Form 460(January/05)
FPPCTcII-Free Helpline: a6WA5K-FPPC(8661275.9772)
State of Callfornla
2175,21-4-0
aE n Disclosure Statement Type or print in ink-
Campaign
nk-
Cam
P 9 Amounts may be rounded Statement covers period
Summary Page to whole dollars. from 1/1/2017
6/30/2017
through
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC}
Expenditures Made
6.
Payments Made ScneduleE,Lfne.4
Column A
Contributions Received
-
'TOTAL THIS PERIOD
.. Schedule N, line 3
'
(FROM ATTACHED SCHEDULES)
1- Monetary Contributions --------------
.... s`eiseddreA,Lire3
$550.00,,
2- Loans Received ................
e
..-..-...... Schedule B,Lin3
$0 -ea:
3. SUBTOTAL CASH CONTRIBUTIONS
..:....:::.:: ............_--.-. AddLUhes I t2
$556 00
4. NonmonetaryContributions..-_._
---..-Schedule C,Line3
$0.;40
5. TOTAL CONTRIBUTIONS RECEIVED
............. Add Lines 3+4
$550.00
Expenditures Made
6.
Payments Made ScneduleE,Lfne.4
$388.00
$550.00:.:'
7.
Loans Mads
.. Schedule N, line 3
$0.00
8-
SUBTOTAL CASH PAYMENTS .............
t.'. .............. Add Lin. es'b+7
$388-00
$0:00
9.
Accrued Expenses (Unpaid Bills) ....................................
-
scn-edale F, Linea
$000
(If Subject to Voluntary Expenditure Limit)
10.
Non monetary Adjustment .............. ..........................
schedule C, Line 3;
$0.00
11.
TOTAL EXPENDITURES MADE
............... Add Lines+9"+,yo
$386.00
Column B
CALENDARYEAR
TOTAL 70 DATE
$550.00
$0-00
$550.00
$0.00
SUMMARY PAGE
CALIFORNIA
FORM 461
Page 3 of 11
I.D. NUMBER
1340395
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
20. Contributions
Received
21. Expencsitures
ill through 6130 711 to Date
$0.00 Date of Election
$0 00 (mm1dd1yy)
.
$829.00
Current Cash Statement
Made
$550.00:.:'
To calculate Column B, add
$550-00
'amounts in Column'Atothe
:[amounts
Expenditure Limit Summary for State
oo
Candidates
$0:00
22- Cumulative Expenditures Made`
ColumnA'.Maybene4af d
(If Subject to Voluntary Expenditure Limit)
$0.00 Date of Election
$0 00 (mm1dd1yy)
.
$829.00
Current Cash Statement
12. Beginning Cash Balance .............................. Previous summary Page, Line 15 $'3;442.3'
To calculate Column B, add
$550-00
'amounts in Column'Atothe
:[amounts
13. Cash Receipts ..................................................... Column A, Line ,'
14- Miscellaneous Increases to Cash ......... ........ schedule r, Line $0.00
fromColumn`B,ofyourlast
report. Sotne'amountsm,: ,
15- Cash Payments ................................................... Column A, Line 6above $386.00
ColumnA'.Maybene4af d
$3,604.73
figurestlaatshould5e)
16- ENDING CASH BALANCE ............... Add Lines 12+13+14, then subtract Line 15
subtracted from previous
period amounts. Ifthi
If this is a termination statement line 16 must be zero.
the first report being filed
for this ualendaeyear, only
17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $0.00
carry over the amounts'' "
from Lines 2, 7, and 9 (if'':
any).
Cash Equivalents and Outstanding Debts
18. Cash Equivalents.............................................. see instructions on reverse $0.00
19. Outstanding Debts .. Add Line 2 +Lire 9 I Column B above $0.00
217S114_n
Total to Date
Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC7dr-Flee Helpline: 8661ASK FPPO (86611751772)
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS DN REVERSE
NAME OF FILER
A$IAN PACIFIC -ISLANDER EMPOW?RMENT PAC (API EMPOWERMENT ,PAC.)
Type or print in ink.
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTERI.D. NUMBER)
CONTRIBUTOR
CODE'.,
4/24/2017
Arthur Low
IND OC
❑ COM',
❑ OTH .
❑ PTY'.;LEI;
❑;SCC
-IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
„-
IND
Schedule A Summary
❑ COM
Statement covers period
1/1/2017
from
6/30/2017
through
IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE
OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR
(IF SELF-EMPLOYED. ENTER NAME
OF BUSINESS) PERIOD (JAN. 1 -DEC. 31)
CUPATION: Optometrist $100.00 $100.00
PLOYER: Self
1. Amount received this period - itemized monetary contributions, $100-00
(Include all Schedule A subtotals.)............................................................................................................ .
2- Amount received this period - unitemized monetary contributions of less than 5100 .....................................
3. Total monetary contributions received this period. $550.00
(Add Lines 1 and -2. Enter here and on the Summary Page, Column A, Line 1-) ........................................... TOTAL
7y 7r AIZ-n
Page 4 of 11
I.D. NUMBER
1340395
PER ELECTION
TO DATE
(IF REQUIRED)
*Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
0TH - Other (e.g., business entity)
PTY - Political Party
SCC - Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 8661A5K-FPPC (866f275.3M
Schedule B - Part 1
Loans Received
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
1/1/2017
from
6/30/2017
through
SEF INSTRUCTIONS ON REVERSE
ORIGINAL
CUMULATIVE
PAID THIS
AMOUNT OF
CONTRIBUTIONS
NAME OF FILER
ASIAN PACIFIC—ISLANDER EMPOWERMENT PAC
(API EMPOWERMENT.PAC)
TO DATE
CALENDAR YEAR
IF AN iNDIV1DLIAL.ENTER
(a)
OUT5TANOING
AMOUNT
O
N
AMOUNT PAID
(d)
OUTSTANDING
FULL NAME, STREET ADDRESS AND ZIP CODE
OCCUPATION AND EMPLOYER
BALANCE
RECEIVED THIS
OR FORGIVEN
BALANCE AT
OFLENDER
(IF SELF-EMPLOYED,ENTER
BEGd�IRINIS THIS
PERIOD
THIS PERIOD'
CLCD&?4 JHIS
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
NAMEOFBUSINESS}.
PE IOD
❑ PAID
❑ FORGIVEN
tEl IND ❑ CONI ❑ OTH ❑ PTY ❑ scc DATE DUE
. -
El FORGIVEN
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE.
- ❑ PAID
❑ FORGIVEd'.
tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC 7 DATEDUE
SUBTOTAL$ $ $ $
Schedule B Summary
1. Loans received this period .......................................
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period ................• -"""
(Total Column (c) plus loans under $100 paid or forgiven-)
(Include loans paid by a third party that are also itemized on Schedule A.)
....... NET "$0 00
3- Net change this period- (Subtract Line 2 from Line 1.) ............._-.--.....-----...........--......---••------
(My eeanegaiive°umea }
Enter the net here and on the Summary Page, Column A, Line 2.
*Amounts forgiven or paid by another parry also must be reported on Schedule A.
I If required.
SCHEDULE B - PART 1
Page 5 of 11
I.D- NUMBER
1340395
INTEREST
ORIGINAL
CUMULATIVE
PAID THIS
AMOUNT OF
CONTRIBUTIONS
PERIOD
LOAN
TO DATE
CALENDAR YEAR
RATE
PER ELECTION"
CALENDAR YEAR
RATE
PER ELECTION'
DATEINCURRED I
RATE
(Enter (e) on
Schedule E, Line 3)
CALENDAR YEAR
PER ELECTION'
'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 T°]I-Free Helpline: 866"K-FPPC (8861275.3772)
Type or print in ink. SCHEDULE C
Schedule C Amounts may be rounded Statement covers period CALIFORNIA
Nonmonetary Contributions Received to whole dollars. from 1/1/2017 — FORM 460
6/30/2017 6 11
through Page of
NAME OF FILER
ASIAN PACIPTC-ISLANDER EMPOWERMENT_ PAC (API EME1C?MRMENT PAC)
IF AN INDIVIDUAL, ENTER AMOUNT/
DATE FULL NAME, STREET ADDRESS AND 0ONTR1BU7DR OCCUPATION AND EMPLOYER DESCRIPTION OF FAIR MARKET
ZFP CODE OF CONTRIBUTOR CODE* (iFSELF-EMPLOYED, ENTER NAME GOODS OR SERVICES VALUE
RECEIVED (1F COMMITTEE, ALSO ENTER IA, NUMBER) OF5VSINESS)
❑ :IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
OTH
❑ PTY
❑ SCC
❑ IND
❑ COM>-
❑ OTH
❑ PTY
sCG
IND
❑ COM:.
❑ OTH'
❑ PTY
❑ SCC
Attach additional information on a rb nate! labeled continuation sheets. 5[1BT07A $
Schedule C Summary
1. Amount received this period - itemized nonmonetary contributions.
(Include all Schedule C subtotals.) ........- ..••....
2- Amount received this period - uniternized nonmonetary contributions of less than $100 .......................................
3. Total nonmonetary contributions received this period. TOTAL
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ..---_........................
747rq Ie^n
I.D. NUMBER
1340395
CUMULATIVETO
PER ELECTION
DATE TO DATE
CAN. 1 - R YEAR (IF REQUIRED)
(JAN. i -DEC. 31)
*Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCG - Small Contributor Committee
FPPC Form 460 (Janaaryl05)
FPPC'rall-Free Helpline: 06VASK-FPPC (S66I276-3772)
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
NAME OF FILER
ASIAW PACIFIC—ISLANDER EMPOWERMENT PAC (APS EMPOWERMENT PAC)
NAME OF CANDIDATE, AND DISTRICT, OR
DATE MEASURE NUMBER OR LETTER AND JURISDICTION, . .
OR COMMITTEE
Type or print in -ink.
Amounts may be rounded
to whole dollars.
DESCRIPTION
TYPEOF PAYMENT (IF REQUIRED)
❑ Monetary
Contrlbutfon
❑-Nonmonetary
'.'Cdntnbutiorl
"❑ Independent
SCHEDULED
Statement covers period CALIFORNIA
1/1/2017 FORM
from
6/30/2017 7 11
through Page of
l.D. NUMBER
1340395
AMOUNT THIS CUMULATIVETO DATE PER ELECTION
PERIOD CALENDAR YEAR TO DATE
(JAN. 1 - DEC. 31) (IF REQUIRED)
Expenditure
❑ Support ❑ oppose
Monetary
:... .. . Contribution
❑ Non monetary
Canfribution
r
❑ .Independent
Expenditure
❑ Support ❑ Oppose
❑ Monetary
Contribution
ElNonmonetaryI`-
Contribution
0, "Independent
Expenditure'
❑ Support ❑ Oppose
SUBTOTAL'
Schedule D Summary
$0.00
1- itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ................
$0.00
2. Unitemized contributions and independent expenditures made this period of under $1 GO ..... ................................................. `........ ........................... ..-.---------------------
3. Total contributions and independent expenditures made this period. (Add Lines 9 and 2. Do not enter on the Summary Page.) ......................................................... $0'. 00
FPPC Form 460 (J6
nuary/05)
FPPC TalWree Helpline: 8661ASK-FPPC (868f.275-3772)
9175314-r)
E
Schedule E Type or print in ink.
Payments Made Amounts may be rounded Statement covers period
CALIFORNIA
to whole dollars. 2017 •' f
from
6/30/2017
through Page S of 11
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
NAME OF FILER 1340395
ASIAN PACIFIC -ISLANDER EMPOWERMENT PAC (API EMPOWERMENT PAC)
-
CODES: If one of the following codes accurately describes tfie payment, you may enter the code.
Otherwise, describe the payment.
CMP
campaign paraphernalia/mise.MSR
member communications
RAD
radio airtime and production
CNS
campaign consultants
MTG
:meetings and appearances
RFD
returned contributions
CTScontribution
(explain nonmonetary)'
OFC.
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circuiating°
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 Tesearch
TRS
stafflspouse travel, lodging, and meals
IND
independent expenditure sup(3drtinglopposing others (explain)*
POS
postage, delivery and messenger services
TSF
transfer between committees of the. same candidatelsponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
PRT
print ads
WES
information technology costs (internet, e-mail)
LIT
campaign literature and mallings
NAMEMD OF PAYE
(IF COMMITTEE, ALSO ENTER I.D. NC
Meetuo-com
Nation Builder
{). CODE OR
is
WEB
WEB
DESCRIPTION OF PAYMENT
AMOUNT PAID
$90.00
$179.00
' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTO AL $
Schedule E Summary
$269.00
1, Itemized payment made this period. (Include all Schedule E subtotals.) •••"""••.. ................................................................
$129-00
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).) ...-------•••".......... "'"'"'""'""
$368.00
4. Total payments made this period- (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................................................ ...................
-
FPPC Foam 460 (January105)
FPPC ToV-Free Helplim: 8661ASK-FPPC (9661275-2M)
9175314-n
Schedule F Type or print in ink. SCHEDULE F
Amounts may be rounded Statement covers period CALIFORNIA
Accrued Expenses (Unpaid Bills) 460
to whole dollars. 1/1/2017 FORM
from
6/30/2017 9 11
through Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER
ASIAN PACIFIC-IST_,ANDER EMPOWERMENT PAC (API EMPOWERMENT PAC) 1340395
CODES: If one of the following codes accurately descrirbes 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 nonmonetaryr
OFC
office ex.penses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulatinga;, .
TEL
t.v. or cable airtime and production costs
FIL
candidate filinglballotfees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FNL7
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
independent expenditure supportmglopposing balers (explain)'
POS .
postage, delivery and messenger services
TSF
transfer between committees of the same candidatelsponsor
LEG
legal defense
PRO
professional services (legal accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, email)
(d)
-
NAME AND ADDRESS OF�6RFD17OR'
(IF COMM"EE,ALSOENTERLb.NOMBE)'.DESCRIPTIONOFPAYMENT
CODE OR
OUTSTANDING
BALANCE BEGINNING
AMOUNT INCURRED
THIS PERIOD
AMOUNT PAID
THIS PERIOD
OUTSTANDING
BALANCE AT CLOSING
OF THIS PERIOD
(ALSO REPORT ON E)
OF THIS PERIOD
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................... ............................. ...... INCURRED TOTALS
2. Total accrued expenses paid this period. (Include all Schedule F. Column (c) subtotals for payments on
accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ............................................ ..--...PAID TOTALS
$0.00
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and $0.00
on the Summary Page, Column A, Line 9.).. ..... ................................................................. ..................................................................................................NET
(May 6e a negapve numher)
FPPC Form 460 (JanuaryIDS)
FPPC ToIFFw Helaine: 8661A5K-FPPC (8 6 61275 37 7 2)
917F;13 4-n
Schedule H
Loans Made to Others*
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
1/1/2017
from
6/30/2017
SCHEDULE H
Schedule H Summary
1. Loans made this period............................................................................................................. ...:,i ....
(Total Column (b) plus unitemized loans of less than $100.)
2. Payments received on loans.....................................................................
$D ,
(Total Column (c) plus unitemized payments of less than $1 GO.) f€ required.
3. Net
change this period. Subtract Line 2 from Line 1. .NET
Enter the net here and on the Summary Page, Column A, Line 7. (May be a negative number)
FPPC Form 460 (January/05)
FPPCT04-FTea Helpline: 966lASK-FPPC (866275-3772)
217SR14-0
through
page 10
of 11
SEE INSTRUCTIONS ON REVERSE
LO. NUMBER
NAME OF FILER
1399395
ASIAN PACIFIC—ISLANDER EMPOWERMENT PAC
(AFI EMPOWERMENT PAC)
{a)
(b)
(c)
(d)
(e)
M
(9)
FULL NAME, STREET ADDRESS AND ZIP CODE
IFAN INDHVIDUAL,ENTER .
OCCUPATION AWEMPLOYER
OUTSTANDING
AMOUNT
REPAYMENT OR
OUTSTANDING
INTEREST
ORIGINAL
AMOUNT OF
CUMULATIVE
LOANS
OFRECIPIENT
(IF SELF-EMPLOYED ENTER
BALANCE
BEGINNING THIS
LOANEDTHIS
PERIOD
FORGIVENESS
THIS PERIOD'
BALANCE AT
CLOSE OF THIS
RECEIVED
LOAN
TO DATE
(IF COMMITTEE, ALSO ENTER LD. NUMBER)NAME
Oi<su51NES5}
PERIOD
PERIOD .
❑ PAID
CALFNDARYEAR
RATE
- - -
-
❑ FORGIVEN
PER ELECTION"
DATE DUE
DATE INCURRED
-,❑ PAID
CALENDARYEAR
-
.:
.-.
..
RATE
❑ FORGIVEN,..
` -
PER ELECTION-
-
DATE nUE, -.L.
DATE INCURRED
`Loans that are contributions to another candidate or committee
must also be summarized on Schedule O. Loans forgiven must
-
SUBTOT41-
-$
$
$
$
also be reported an Schedule E.
-
-
(Enter (e) on
_--
-
Schedule I, line 3)
Schedule H Summary
1. Loans made this period............................................................................................................. ...:,i ....
(Total Column (b) plus unitemized loans of less than $100.)
2. Payments received on loans.....................................................................
$D ,
(Total Column (c) plus unitemized payments of less than $1 GO.) f€ required.
3. Net
change this period. Subtract Line 2 from Line 1. .NET
Enter the net here and on the Summary Page, Column A, Line 7. (May be a negative number)
FPPC Form 460 (January/05)
FPPCT04-FTea Helpline: 966lASK-FPPC (866275-3772)
217SR14-0
Schedule
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
ASIAN PACIFIC—ISLANDER EMPOWERMENT PAC {APT EMPOWERMENT PAC}
DATE FULL NAME AND ADDRESS OF SOURCE
RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
1/1/2017
from
6/30/2017
through
DESCRIPTION OF RECEIPT
SCHEDULEI
Page 11 Of 11
€.D. NUMBER
1390395
AMOUNT OF
INCREASE TO CASH
SUBTOTAL $
Schedu[e i Summary
$0.00
1- Itemized increases to cash this period........................................................................................................... ::.:........................
$0-00
2- Unitemized increases to cash of under $100 this period.
$0.00
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 $0.00
SummaryPage, Line 14.)................................................................................................................................ ............... TOTAL
FPPC Form 460 panuary105)
FPPC TeIFFree Helpline: 8661A$K-FPPC f866M75.37727
9175.214_0