497 Contribution Report 5 - Contributions Received on 11-7-22497 Contribution Report
Amounts may be rounded to whole dollars.
NAME OF FILER
Date of
Date Stamp
_
J.R. Fruen for Cupertino City Council 2022
This Filing 11/08/2022
_
AREA CODE/PHONE NUMBER
I.D. NUMBER (if applicable)
Report No. 5
For Official Use Only
(
1447662
❑Amendment
Filed Date:
STREET ADDRESS
to Report No.
11/08/2022 06:44
(explain below)
PM
CITY STATE ZIP CODE
Cupertino CA 95014
No. of Page 2
1. Contribution(s) Received
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
**
IF AN INDIVIDUAL,
ENTER OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
❑/ IND
1,000.00
Chun Ya Chen
❑ COM
11/7/2022
❑ OTH
Insurance Sales
❑ Check if Loan
Self
❑ PTY
San Jose CA 95129
❑ SCC
%
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
Provide interest rate
❑ IND
❑ COM
❑ OTH
❑ Check if Loan
❑ PTY
❑ SCC
Provide interest rate
Reason for Amendment:
—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 497 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
497 Contribution Report Partl (Continuation
Sheet)
NOTES
CALIFORNIA
FORM
Page 2 of 2
NAME OF FILER I.D. NUMBER
J.R. Fruen for Cupertino City Council 2022 �1447662
11/7/2022 - Chen Chun Ya - 1000.00 - Check No. 150