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460 Recipient Committee Campaign Statement 10-23-22 to 12-31-22Recipient Committee Campaign Statement Cover Page from Statement covers period I Date of election if applicable: 10/23/2022 (Month, Day, Year) SEE INSTRUCTIONS ON REVERSE I through 12/31/2022 1. Type of Recipient Committee: All Committees— Complete Parts 1, 29 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 3 State Candidate Election Committee Committee 3 Recall 0 Controlled (Also Complete Part 5) O Sponsored ❑ General Purpose Committee (Also Complete Part 6) 3 Sponsored ❑ Primarily Formed Candidate/ 3 Small Contributor Committee Officeholder Committee 3 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I I.D. NUMBER 1448574 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Sheila Mohan For Cupertino City Council 2022 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE Cupertino CA 95014 AREACODE/PHONE ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 11 /08/2022 Date Stamp Filed Date- 01 /27/2023 02:43 PM COVER PAGE .- .1 Page 1 of 10 For Official Use Only 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ./❑ Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Ram Mohan MAILING ADDRESS CITY STATE ZIP CODE Cupertino CA 95014 AREACODE/PHONE ( NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 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 perjury under the laws of the State of California that the foregoing Officeholder, Candidate, State Measure Proponent or Responsible Officerof Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Ms Sheila Mohan OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member: Cupertino RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Cupertino CA 95014 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 contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑YES ONO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑YES ONO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 10 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE 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 SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Listnames of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded to whole dollars. Summary Page Statement covers period from 10/23/2022 SUMMARY PAGE through 12/31/2022 Page 3 of 10 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Sheila Mohan For Cupertino City Council 2022 1448574 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Prima and g Primary (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 1. Monetary Contributions Schedule A, Line 3 $ 3,850.00 $ 58,594.00 1/1 through 6/30 7/1 to Date 2. Loans Received............................................................ Schedule a, Line 3 0.00 10,500.00 3. SUBTOTAL CASH CONTRIBUTIONS ............................. Add Lines 1 +2 850.00 , $ 3$ 69,094.00 20. Contributions Received $ 27,650.00 $ 41,444.00 4. Nonmonetary Contributions ......................................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............................ Add Lines 3 +4 , $ 3$ 69,094.00 Made $ 400.00 $ 65,029.14850.00 Expenditures Made 6. Payments Made ................................ 7. Loans Made ....................................... 8. SUBTOTAL CASH PAYMENTS ..... 9. Accrued Expenses (Unpaid Bills) .. 10. Nonmonetary Adjustment ............... 11. TOTAL EXPENDITURES MADE.. .......................... Schedule E, Line 4 $ 6,487.58 ........................... Schedule H, Line 3 0.00 ............................... Add Lines 6 + 7 $ 6,487.58 .......................... Schedule F, Line 3 0.00 .......................... Schedule C, Line 3 0.00 ........................ Add Lines 8 + 9 + 10 $ 6,487.58 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 6,302.44 13. Cash Receipts.......................................................... Column A, Line 3 above 3,850.00 14. Miscellaneous Increases to Cash ................................ Schedule 1, Line 4 0.00 15. Cash Payments........................................................ Column A, Line 8 above 6,487.58 16. ENDING CASH BALANCE ...... Add Lines 12 + 13 + 14, then subtract Line 15 $ 3,664.86 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................. See instructions on reverse $ 19. Outstanding Debts ............................... Add Line 2 +Line 9 in Column B above $ E M 10.500.00 $ 65,429.14 0.00 $ 65,429.14 0.00 0.00 $ 65,429.14 To calculate Column B, 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) 11/08/2022 $ 65,429.14 *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A to whole dollars. Monetary Contributions Received Statement covers period . - from 10/23/2022 • - .1 through 12/31/2022 Page 4 of 10 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Sheila Mohan For Cupertino City Council 2022 4448574 DATE FULL NAME, STREET ADDRESS AND 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 (IF SELF-EMPLOYED, ENTER NAME RECEIVED CALENDAR YEAR TO DATE OF BUSINESS) THIS PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ./❑ IND Legislator Evan Low ❑ COM State of California 10/25/2022 ❑ OTH 500.00 500.00 500.00 G-22 ❑ PTY Sacramento CA 95818 ❑ SCC ❑./ IND Senior Manager - Govt Affairs Rod Diridon ❑ COM Apple Inc 10/29/2022 ❑ OTH 250.00 250.00 250.00 G-22 ❑ PTY Santa Clara CA 95050 ❑ SCC ❑./ IND Engineer Khanh Nguyen ❑ COM Google Inc 11/1/2022 ❑ OTH 100.00 100.00 100.00 G-22 ❑ PTY Cupertino CA 95014 ❑ SCC ❑./ IND Business Owner Lawrence Dean ❑ COM McBride Holdings 11/2/2022 ❑ OTH 750.00 750.00 750.00 G-22 ❑ PTY Cupertino CA 95014 ❑ SCC Thomas Hutton ❑./ IND ❑ COM Retired 11/2/2022 ❑ OTH 100.00 100.00 100.00 G-22 ❑ PTY Cupertino CA 95014 ❑ SCC SUBTOTAL $ 1,700.00 Schedule A Summary 1. Amount received this period — itemized monetary contribution (Include all Schedule A subtotals.)...................................................................................................... $ 2. Amount received this period — unitemized monetary contributions of less than $100 .......................... $ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) .................. TOTAL $ 3,850.00 • •• *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 3,850.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) to whole dollars. Monetary Contributions Received Statement covers period � from 10/23/2022 • - .1 through 12/31/2022 Page 5 of_10 NAME OF FILER I.D. NUMBER Sheila Mohan For Cupertino City Council 2022 4448574 DATE FULL NAME, STREET ADDRESS AND 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 (IF SELF-EMPLOYED, ENTER NAME RECEIVED CALENDAR YEAR TO DATE OF BUSINESS) THIS PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) John Zhao ❑ IND ❑ COM Student 11/4/2022 ❑ OTH 100.00 150.00 150.00 G-22 ❑ PTY Cupertino CA 95014 ❑ SCC Leslie Crowell ❑./ IND ❑ COM Retired 11/16/2022 ❑ OTH 500.00 1,000.00 1,000.00 G-22 ❑ PTY Santa Clara CA 95051 ❑ SCC ❑./ IND retired Prasad Vepa ❑ COM 11/16/2022 ❑ OTH 100.00 200.00 200.00 G-22 ❑ PTY Cupertino CA 95014 ❑ SCC ❑./ IND retired Savita Vaidyanathan ❑ COM 11/20/2022 ❑ OTH 950.00 950.00 950.00 G-22 ❑ PTY Cupertino CA 95014 ❑ SCC M M Sathyanarayan ❑./ IND ❑ COM Retired 11/28/2022 ❑ OTH 500.00 500.00 500.00 G-22 ❑ PTY Carlsbad CA 92010 ❑ SCC *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 SUBTOTAL $ 2,150.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Notes NOTES CALIFORNIA ._ i • Page 6 Of 10 NAME OF FILER I.D. NUMBER Sheila Mohan For Cupertino City Council 2022 �1448574 11/16/2022 - Vepa Prasad - 100.00 - check 588 11/16/2022 - Crowell Leslie - 500.00 -check 2249 A mi. +� m y hn r ­AA SCHEDULE B - PART 1 Schedule B —Part 1"'��"`� "'�' to whole dollars. Statement covers period • - Loans Received - I • , from 10/23/2022 • SEE INSTRUCTIONS ON REVERSE through 12/31/2022 9 7 of 10 pa e NAME OF FILER I.D. NUMBER Sheila Mohan For Cupertino City Council 2022 1448574 IF AN INDIVIDUAL, ENTER (a)ANDING OUTST (b) (c) (d)ANDI OUTSTNG (a) M (g) FULL NAME, STREET ADDRESS AND ZIP CODE OCCUPATION AND EMPLOYER BALANCE AMOUNT AMOUNT PAID BALANCE AT INTEREST ORIGINAL CUMULATIVE OF LENDER (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE 0 PAID CALENDAR YEAR Ram Mohan Retired $ 0.00 $ 100.00 0.00 100.00 $ 10,500.00 � $ 0FORGIVEN PER ELECTION** 10960 Cupertino CA 950144768 10,500.00 G-22 $ 100.00 $ 0.00 $ 0.00 $ 0.00 05/17/2022 $ t O IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED PAID CALENDAR YEAR Ram Mohan Retired $ 0.00 $ 400.00 0.00 400.00 $ 10,500.00 � $ 1iFORGIVEN PER ELECTION** 10960 Cupertino CA 950144768 10,500.00 G-22 $ 400.00 $ 0.00 $ 0.00 $ 0.00 05/18/2022 $ t O IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED PAID CALENDAR YEAR Ram Mohan Retired $ 0.00 $ 10,000.00 0.00 10,000.00 $ 10,500.00 � $ 1iFORGIVEN PER ELECTION** 10960 Cupertino CA 950144768 10,500.00 G-22 $ 10,000.00 $ 0.00 $ 0.00 $ 0.00 06/06/2022 $ t O IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0.00 $ 0.00 $ 10,500.00 $ 0.00 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 change this period. (Subtract Line 2 from Line 1.) .................. Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. e E LI NET $ 0.00 (May be a negative number) (Enter (a) on Schedule E, Line 3) *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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period from 10/23/2022 SEE INSTRUCTIONS ON REVERSE I through 12/31/2022 I Page 8 of 10 NAME OF FILER Sheila Mohan For Cupertino City Council 2022 I.D. NUMBER 1448574 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 RAID 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 FIND 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 CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) ActBlue WEB Processing fee for contributions 85.87 Somerville MA 02144 Precision Communications Enterprises Inc PHO calls made 10/28 and 10/29 2,000.00 Lewes DE 19958 Axial Media and Communications LLC LIT Chinese and Indian mailers 1,290.00 Oakland CA 94605 Subvendor: Roadrunner Printing $1290.00 LIT Chinese and Indian mailers 0.00 San Ramon CA 94583 Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) . 2. Unitemized payments made this period of under$100.................................................................................................. 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)...................................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.). SUBTOTAL $ 3,375.87 6,487.58 M 0.00 6,487.58 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Yyaam�� K.�rrr Schedule E Amounts may be rounded Statement covers period - to whole dollars. (Continuation Sheet) FPage Payments Made from10/23/2022 �SEE INSTRUCTIONS ON REVERSE through 12/31/2022 of 10 NAME OF FILER I.D. NUMBER Sheila Mohan For Cupertino City Council 2022 1448574 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 RAID 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 FIND 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 CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) ActBlue WEB Processing fee for contributions 30.00 Somerville MA 02144 BJ's restaurant & brewhouse OFC Thank you lunch for campaign team 1,481.71 Cupertino CA 95014 Neil McClintick CNS consulting 500.00 Cupertino CA 95014 Chamu Palaniappan CNS Volunteer coordination 500.00 Fremont CA 94539 Axial Media and Communications LLC LIT For campaign material 600.00 Oakland CA 94605 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 3,111.71 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Yyaam�� K.�rrr Schedule E Amounts may be rounded Statement covers period - to whole dollars. (Continuation Sheet) FPage Payments Made from10/23/2022 �SEE INSTRUCTIONS ON REVERSE through 12/31/2022 0 of 10 NAME OF FILER I.D. NUMBER Sheila Mohan For Cupertino City Council 2022 1448574 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 RAID 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 FIND 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 Subvendor: Original Union Printer $600.00 Lake Orion MI 48359 LIT Door hangers 0.00 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 0.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov