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Semi-Annual 460 Debt . I I. Dme 01 EJedon If (\I.IIOR'\1 \ 460 FOH\I Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) Page lor 6 SI8Iemer4 CGV8IS pedad A For Official Use Only from 01/01/2006 (Mo.llh, OIly, VRI') CllD RT!~10 CITY CLER. ~J , ~~ 06/30/2006 N /ll. 1. Type of Recipient Committee: III Officeholder, Candidate Controlled Committee 0 Ballot Measure Committee o State Candidate Election Committee 0 Primarily Formed o Recall 0 Controlled o Sponsored o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee 2. Type of Statement: o Pre.election Statement [!!I Semi~annual Statement o Termination Statement o Amendment (Explain below) o Quarterly Statement o Special Odd.Year Report o Supplemental Pre-election Statement ~ Attach Form 495 o Primarily Formed Candidate Officeholder Committee 3. Committee Information 1.0. NUMBER 990787 Treasurer(s) COMMITTEE NAME Dolly Sandoval for Supervisor - Debt Retirement Committee STREET ADDRESS (NO P.O. BOX) 10720 Alderbrook Lane CITY STATE ZIP CODE Cupertino CA 95014 MAIUNG ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX NAMEOFTREASURER Dolly Sandoval MAIUNG ADDRESS 10720 Alderbrook Lane r,tTV STATE ZIP CODE CA 95014 AREA COOEIPHONE (408)725-8939 AREA CODEIPHONE (408)725-8939 NAME OF ASSISTANT TREASURER, IF ANY MAlUNG ADDRESS CITY STATE ZIP CODE AREA CODElPHONE CITY STATE ZIP CODE AREA COOEIPHONE ) OPTIONAL: FAXIE-MAll ADDRESS ( / OPTIONAl.: FAXIE-MAll ADDRESS 4. Verification I have used all reasonable diligence in preparing . "og is true and correct. J . ) '----. ,) Executed on v l"-l Lv I W 0 b By , DATE Executed on ~ \..i G-, L7 1 20 D lo OATE By ~TURE OF RER OR ASSISTANT TREASURER . J . , SIGNATURE OF CONTROlUNG OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT OR RESPONSiBlE OFACER OF SPONSOR Executed on DATE By SIGNATURE OF CONTROlUNG OFACEHOLOER, CANDID"TE, STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROlLING OFFlCEHOLOER. CANDIDATE. STATE MEASURE PROPONENT State of California Fair Political Practlces Commission. S1CCW. PCAB05 01380 (Rev. JanuarylO5) Recipient Committee Campaign Statement Cover Page - Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFlCEHOLOER OF CANDIDATE Ms. Dolores Sandoval Of'FIGE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPUCABLE) Board of Supervisors, District 5, Santa Clara County RESIDENT1ALlBUSINESS ADDRESS (NO. AND smEET) CITY STATE 10720 Alderbrook Lane Cupertino CA 95014 Related Committees Not Included In this Statement: List any committees not included in this consolidated statement that arB contro/led by you or which arB primarily formed to recsiv8 contributions or to make expenditUrBs on behalf of your candidacy. COMMITTEE NAME 1.0. NUMBER Friends of Dolly Sandoval NAME OF TREASURER 1277455 CONTROLLED COMMITTEE? Sarah Hathaway-Felt COMMITTEE (NO P.O. BOX) 10720 A1derbrook Lane CITY STATE ZIP CODE AREA CODEIPHONE Cupertino COMMITTEE NAME CA 95014 (408)725-8939 1.0. NUMBER NAME OF TREASUR!:R CONTROLLEO COMMITTEE? COMMITTEE ADORESS STREET ADDflESS (NO P.O. BOX) CrTY STATE ZIP COOE AREA CODElPHONE COVER PAGE - PART 2 ( \111 1I1{,! \ 460 H)I{\1 Page 20r 6 6. Primarily FOm.ed Ballot Measure Committee NAME OF BALlOT MEASURE BALlOT NO. OR lETTER I JURISDICTION I [J SUPPORT [J OPPOSE Identity the controlling officeholder, candld.te, or state measure proponent, If .ny. NAME OF OFfICEHOlDER, CANDIDATE. OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF AN'( 7. Primarily FOm.ad CandidatelOfficeholder Committee NAME OF OFFlCEHOLOER OR CANDIDATE OFfICE SOUGHT OR HELD DsuPFORT o OPPOSE NAME OF OFRCEHOLOEA OR CANDIDATE OFFICE SOUGHT OR HELD DsuPPOAT o OPPOSE NAME OF OFFICEHOlDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OffiCEHOLDER OR CANDIDATE OFRCE SOUGHT OR HELD o SUPPORT o OPPOSE Campaign Disclosure Statement Summary Page NAME OF FILER MS. Dolores Sandoval, Committee Contributions Received Column A TOTAL THIS PERIOO (FROM ATTACHED SCHEDULES) 1. Monetary Contributions ..................................... Schedule A, Line 3 $ 2. Loans Received ................................................ Schedule B, Line 7 0.00 0.00 0.00 0.00 0.00 3. SUBTOTAL CASH CONTRIBUTIONS .................. Add Lines 1 + 2 $ 4. Nonmonetary Contributions .............................. Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ................. Add Lines 3 + 4 $ Expenditures Made 6. Cash Payments ................................................ Schedule E, Line 4 $ 7. Loans Made ...................................................... Schedule H, Line 7 8. SUBTOTAL CASH PAYMENTS ............................ Add Lines 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 $ Current Cash Statement 12. Beginning Cash Balance .......... Previous Summary Page, Line 16 $ 13. Cash Receipts ......................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ..................... Schedule I, Line 4 15. Cash Payments ....................................... Column A, Line 8 above 16. ENDING CASH BALANCE ............ Lines 12+13+14. less Line 15 $ If this is a Termination Statement, Line 16 must be zero. 0.00 0.00 0.00 0.00 0.00 0.00 25.891. 05 0.00 25.83 0.00 25.916.88 17. LOAN GUARANTEES RECEIVED Schedule a, Part " Column (b) $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................................................$. 19. Outstanding Debts .......... Add Line 2 + Line 9 in Column C above $ 0.00 0.00 110.000.00 S1CCW - PCAB05 01380 (Rev. January/05) SUMMARY PAGE ( \1 II OW\I \ 460 I ()R\! Sbab:.lnent co IIeI'S period Column B CALENDAR YEAR TOTAL TO DATE $ 0.00 110.000.00 110.000.00 0.00 110.000.00 ftom 01/01/2006 through 06/30/2006 Dolly Sandoval for Supervisor - Debt Retirement $ $ $ 0.00 0.00 0.00 0.00 0.00 0.00 $ $ Page 3 of l.D. NUMBER 6 990787 Calend8r Year Summary for Candld8tes Running In Both the Stale PrImary and CeneraI EJecUons 1/1 through 6/30 7/1 to Date 20. Contributions Received.... ., 21. Expenditures Made .......... $ Expenditure Umlt SuI1'll1By for Slate Candidates 22. Cumulative Expenditure Made* (If Subject to Volunlary Expenditure Umit) Date of Election (mm/ddIyy) Total to Date . Amounts in this section may be different from amounts reported in Column B. Schedule B - Part I Loans Received SCHEDULE B - Part I ( \1 II OR.... I \ 460 lOR\! Sbolbnaent covers period &am 01/01/2006 through 06130/2006 Dolly Sandoval for Supervisor - Debt Retirement NAME OF FILER Ms. Dolores Sandoval, Committee FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF 0. NUMBER) Ms. Dolores Sandoval 10720 Alderbrook Lane Cupertino, CA 95014 a OUT ANDING BALANCE BEGINNING THIS ANDING BAlANCE AT CLOSE OF THIS (b) AMOUNT RECEIVED THIS PERIOD (c) AMOUNT PAID OR FORGIVEN THIS PERlOO IF AN INDlVlDUAl, ENTER OCCUPATIQIII AND EMPLOYER (IF SELF-EMPLOYED, I!NTER NAME OF BUSINESS Councilrnember o PAlO $ o FORGIVEN s 20,000 o City of Cupertino JjIIND 0 COM 0 OTH 0 PTY 0 see Ms. Dolores Sandoval (Continued) $ 20,000 $ 0 $ 0 12/31/2006 $ DATE DUE o PAlO $ 0 $ 25,000 o FORGIVEN $ 25,000 $ 0 $ 0 12/31/2006 $ DATE DUE o PAID $ 0 $ 40,000 o FORGIVEN o IND 0 COM 0 OTH 0 PTY 0 sec MS. Dolores Sandoval (Continued) (Continued) o IND D COM 0 OTH 0 PTY 0 sec $ 40,000 S o $ o 12/31/2006 $ DATE DUE SUBTOTAL $ 0.00 $ 0.00 $ 85,000.00 $ Schedule B Summary 1. Loans received this period.............................................. ................ .............................................. $ (Total Column (b) plus un itemized loans less than $100.) 0.00 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.) 0.00 3. Net change this period. (Subtract Line 2 from Line 1.) ................................................... Enter the net here and on the Summary Page, Column At Line 2 NET $ 0.00 Page 4 of 1.0. NUMBER 6 (a) IfIlTEREST PAID THIS PERIOO 990787 (I) ORIGINAL AMOUNT OF LOAN (0) C S TO DATE CALENDAR YEAR 0.000 % $ RATE 20,000 $ PER ELEcnON o 09/30/1999 $ DATE INCURRED CALENDAR YEAR 0,000 % S RATE o 02/29/2000 S DATEINCUAAEO CALENDAR YEAR 0.000 % $ RATE o 11/06/2000 $ DATE INCURRED 0,00_ SCHEDULE B . Part I (cont.) Schedule B - Part I (Continuation Sheet) Loans Received Sbdement covers perlod kom 01/01/2006 Ihrough 06/30/2006 Dolly Sandoval for Supervisor - Debt Retirement NAME OF FILER Ms. Dolores Sandoval, Conunittee FUll NAME, smEET ADORESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO 811TER 1.0. NUMBER) Ms. Dolores Sandoval (Continued) (Continued) (Continued) a OUT ANDING BALANCE BEGINNING THIS OUT ANDING BALANCE AT CLOSE OF THIS (b) AMOUNT RECEIVED THIS PERIOD (e) AMOUNT PAID OR FORGIVEN T1-IIS PERIOO IF AN INDIVIDUAL, ENTER OCCUPATlON AND EMPlOYER (IF SELF-EMPLOYED, ENTeR NAME OF BUSINESS o PAID $ 0 $ o FORGIVEN 10,000 $ 10,000 $ 0 $ 0 12/31/2006 $ o IND 0 COM 0 OTH 0 PTY 0 sec DATE DUE Ms. Dolores Sandoval o PAID (Continued) (Continued) s 0 $ 15,000 (Continued) (Continued) o FORGIVEN (e) INTEREST PAlDTHlS PERIOD (" \111 OI{\I \ 460 FOR\I Page 1.0. NUMBER 5 of 6 990787 (I) ORIGINAL AMOUNT OF LOAN (Q) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR 0.000 % $ 10,000 RATE $ PER ELECTION o 11/13/2000 S DATE INCURRED D IND 0 COM 0 OTH 0 PTY 0 sec $ 15,000 $ o $ o 12/31/2006 $ DATE DUE CALENDAR YEAR o PAID $ o FORGIVEN $ o INo 0 COM 0 OTH 0 PTY 0 sec $ $ $ DATE DUE o PAID $ $ o FORGIVEN $ DATE DUE o PAID $ $ o FORGIVEN $ o INO 0 COM 0 OTH 0 PTY 0 sec s $ o IND 0 COM 0 OTH 0 PTY 0 see $ $ DATE DUE DATE INCURRED SUBTOTAL $ 0.00 $ 0.00 $ 25,000.00 $ L.. QJ CALENDAR YEAR 0.000 % $ RATE o 11/18/2000 S DATE INCURRED % $ S RATE PER ELECTION $ S DATE INCURREO CALENDAR YEAR % $ $ RATE PER ELECTION $ S DATE INCURREO CALENDAR YEAR RATE s % $ $ PER ELECTION $ 0.00_ Schedule I Miscellaneous Increases to Cash SCHEDULE I Sbdbment co.... period · \1 II Ol{\l \ 460 H)[nl NAMEOFFILER Ms. Dolores Sandoval, Committee hum 01/01/2006 through 06130/2006 Dolly Sandoval for Supervisor - Debt Retirement Page 6 of 1.0. NUMBER 6 990787 DATE RECEIVED FUll NAME AND ADDRESS OF SOURCE (IF COMMITTEE, IN ADDITION TO CO"lMITTEE'S NAME AND ADDRESS, ENTER 1.0. NUMBER OR, IF NO 1.0. NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'S NAME & ADDRESS) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH SUBTOTAL $ 0.00 Schedule I Summary L Itelllized increases to cash this period. ............................................................................................... 2. Unitemized increases to cash under $100 this period. .,.~ P....... "..~ P...... P... P. P., _. P. P. P............ P. P. P. P. P. P. P.... P... P. P... P. P. P. P.~. P. P...... P... p. P. P.......... P... P. P. P. ... P. P. P. p.o.... p. p. P......... $ $ $ $ 25.83 0.00 3. Total of all interest received this period on loans made to others. (1)chedule 1tI, ~011lIIlI1 (e).) ................................................................................................................. 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the 1)ummary Page, Line 14.) ........................... TOTAL 0.00 25.83