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460 Debt Semi-Annual 2ndRecipient Committee Campaign Statement (Government Code Sections 84200 - 84216.5) ~. 07/01/:002 through 12/31/2002 1. Type of Recipient Committee: [] Officeholder, Candidate Controlled Committee [] Ballot Measure Committee I~) State Candidate Election Committee O Pdmadly Formed 2. Type of Statement: - LONG FORM ~Li~I 1 of ~ 7 AA.Forj Official Use Only [] Pre-election Statement [] Semi-annual Statement [] Quarterly Statement [] Special Odd-Year Report 0 Recall 0 Controlled 0 Sponsored [] General Purpose Committee O Sponsored O Small Contributor Committee 0 Political Party/Central Committee [] Primarily Formed Candidate Officeholder Committee [] Termination Statement [] Amendment (Explain below) [] Supplemental Pre-election Statement - Attach Form 495 3. Committee Information Dolly Sandoval for Supervisor - Debt Retirement Committee Cupertino CA 95014 ( OPTIONAL: VAX~E-MAIL ADDRESS ( ) / Treasurer(s) Dolly Sandoval San Jose CA 95014 ( ( ) 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of correct Executed on By DATE By S/CCW PCAB05 01380 (Rev. 9/99) State of California Fair Political Practices Commission. Recipient Committee Campaign Statement Cover Page - Part 2 COVER PAGE - PART 2 Page 2 of 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF BALLOT MFASURE NAME OF OFFICEHOLDER OF CANDIDATE Ms. Dolores Sandoval OFFICE SOUGHT OR HELD (INCLU~ LCCATI~ AND DI~RICT NUMBER IF ~PLICAB~) Board o~ Supervisors, District 5 Cupertino CA 95014 Related Committees Not Included in this Statement: List any committees not included ir) this consolidated statement that are controlled by you or which are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. BALLOT NO. OR LETTER JURISDICTION [] SUPPORT ]OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OEFICEHOLDER. CANDIDATE OR, PROPONENT OFFICE SOUGHT OR HELD ~DISTRICT NO. IF ANy I Friends of Dolores Sandoval 851028 Cupertino CA 95014 ( 7. 'Primarily Formed Committee NAME OF OFFICEHOLDER OR CANDIDATE FFICE SOUGHT OR HELD [] SUPPORT NAME OF O. FFICEHOLDER OR CANDIDATE [] SUPPORT [] OPPOSE Campaign Disclosure Statement Summary Page from 07/01/2002 through 12/31/2002 NAMEOFRLER MS. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement Committee Contributions Received Column A Column S $ 20,000.00 $ 20,000.00 0.00 110,000.00 SUMMARY PAGE Page LD. NUMBER 990787 I Monetary Contributions ..................................... Schedule A, Line 3 2. Loans Received ................................................ Schedule B, Line 7 3. SUBTOTAL CASH CONTRIBUTIONS .................. AddLines I + 2 4. Non-monetary Contributions ............................. Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .............. AddLines 3 + 4 $ 20,000.00 $ 130,000.00 0.00 0.00 $ 20,000.00 $ 130,000.00 Expenditures Made 6. Cash Payments ................................................ Schedule E, Line 4 7. Loans Made ...................................................... Schedule H, Line 7 8. SUBTOTAL CASH PAYMENTS ............................ AddLines 6 + 7 9. Accrued Expenses (Unpaid Bills) ...................... Schedule F, Line 3 10. Nonmonetary Adjustment ................................ Schedule C, Line 3 11. TOTAL EXPENDITURES MADE .................. Add Lines 8 + 9 + 10 $ 0.00 $ 0.00 0.00 0.00 $ 0.00 $ 0.00 0.00 0.00 0.00 0.00 $ 0.00 $ 0.00 Current Cash Statement 12. Beginning Cash Balance .......... Previous Summary Page, Line 16 13. Cash Receipts ......................................... Column A, Line 3 above 14. Misceilaneous increases to Cash ..................... Schedule I, Line 4 15. Cash Payments ................................... Column A, Line 8 above 16. ENDING CASH BAt~MdCE~es 12 + 13 + 14. then subtract Line 15 If this is a Termination Statement, Line 16 must be zero. $ 3,236.58 20,000.00 14.34 0.00 $ 23,250.92 17. LOAN GUARANTEES RECEIVEDSchedule B, PaR I, Column (b) $. 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................................................ 19. Outstanding Debts .......... Add Line 2 + Line 9 in Column C above 0.00 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 20. ContdbctJons Received _.. $_ 21. Expenditures Made .......... 711 to Date Expenditure Limit Summa~ for State Candidates 22. Cumulative Exenditure Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) S/CCW - PCAB0501380 (Rev. 9/99) SCHEDULE A Schedule A "-MonetaryContdbutions Received Mm 07/01/2002 ~rough 12/31/2002 Page 4 of 7 NAME OF FILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor Debt Retirement LD. NUMBER Committee 990787 12/05/2002 MS. Anita Yu [] IND Homemaker 20,000.00 20,000.00 [] COM Atherton, CA 94027 [] OTH N/A [] PTY [] SCC [] ~ND [] COM [] OTH [] PT'( [] scc [] ,NO [] COU [] O'rH [] SCC [] COM [] OTH [] scc [] COM [] OTH [] PTY [] scc SUBTOTAL $ 20,000.00 Monetary Contributions Summary 1. Amount received this period - contributions of $100 or more (Include all Schedule A subtotals.) .................................................................................................. $ 2. Amount received this period - contributions of less than $100. (Do not itemize.) .............................................................................................................................. $ 3. Tolal monelary conlributions received this period. (Add Lines I and 2. Enter helc and on the Summary Page, Column A, Linc 1.) .............. IOIA[ $ 20,000.00 0.00 20,000.00 Schedule B - Pad I Loans Received NAME OF FILER MS. Dolores Sandoval, Committee FULL NAME. STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER [0 NUMBER) Ms. Dolores Sandoval Cupertino, CA 95014 [] ,.D [] CO. [] 0.. [] P~ [] scc Ms. Dolores Sandoval (Continued) [] 'ND [] COM [] 0TM [] PTY [] SCC Ms. Dolores Sandoval (Continued) [] ,ND [] eOM [] oT. [] .~' [] scc Dolly Sandoval for Supervisor It- AN IN~VIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF ~MPLOYED, ENTER !Councilmember City of Cupertino a) $ 20r000 $ 25,000 $ 40,000 f~orn 07/01/2002 through 12/31/2002 Debt Retirement $. 0 $ 0 $ 0 [] PAID $ 0 E] FORGIV}EN $ 0 (d) OUTSTANDING BALANCE AT CLOSE OF THIS $ 20,000 o9/~o/20Ol DATE DUE DATE DUE $ 40,000 12/31/2002 SCHEDULE B - Part I Page 5 of I.D. NUMBER 990787 s 0 0~/~0/1999 0 02/29/2000 CONTRIBUTIONS CALENOAR YEAR 0 PER ELECTION 46r060 GOO $ 461060 GOO $ 401000 $ 0 pER ELECTION 11/06/2000 $ 46,060 GOO SUBTOTAL $ o.oo $ o.oo $ sS,ODD.OD $ o.oo Schedule B Summmy 1, Loans received this period ............................................................................................................ $ (Total Column (b) plus initemized loans 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,) 3. Net change this period. (Subtract Line 2 from Line 1.) ................................................... NET $ Enter lhe net here and on the Summary Page, Column A, Line 2 0.00 0.00 0.00 SCHEDULE B - Part I (cont.) Schedule B - Part I (Continuation Sheet) s~ .... ~over, m.~ ~ Loans Received nm 07/01/2002 I~hrough.12/31/2002 Page 6 of 7 NAMEOFFILER MS. Dolores Sandoval, Dolly Sandovat for Supervisor - Debt Retirement I.D. NUMBER Committee 990787 MS. Dolores Sandoval [] PAID ( Continued) ( Continued ) [] IND [] gOM [] OTM [] PTY [] SOO DATE DUE DATE INCUR"ED [] IND [] COM [] 0TM [] PTY [] SeC OATEDUE DATEINCURRED [] 'ND [] CO~ [] OTH [] P~F [] $CC DATEDUE OATEINCLI"~D ' SUBTOTAL $ n D0 $ o.oo $ 2s.ooo.oo $ o.oo GOO SCHEDULEI Schedule I Miscellaneous Increases to Cash ~. 0v/0~/2002 through.12/31/2002 Page 7 of 7 qAMEOFFILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor Debt Retirement kD. NUMBER Committee 990787 FULL NAME AND ADDRESS OF SOURCE DATE 0F COMMITTEE tN ADDfTION TO C°MMITTEE'S NAME AND AODRESS, ENTER I D NUMBER DESCRIPTION OF RECEIPT AMOUNT OF SUBTOTAL $ o. 00 0.00 Miscellaneous Increases to Cash Summary 1. Increases to cash of $100 or more fids period .................................................................................... $ 2. Increases to cash under $100 this period. (Do not itemize.) ............................................................................................................................... $ 3. Total of all interest received this period on loans made to others. (Schedule H, Part II (b).) .................................................................................................................... $ 4. Total miscellaneous increases to cash this period. (Add Lines l, 2, and 3. Enter here and on the Summary Page, Line 15.) ........................ TOTAl_ $ 0.00