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470 Annual Officeholder and Candidate Campaign Statement- Short Form (Government Code Section 84206) Type or print in ink. Date of election If applicable: 0 Amendment (Explain Below) (Month, Day, Year) 11/8/2005 1. Statement Covers Calendar Year 20 ~ . 2. Officeholder or Candidate Information NAME OF OFACEHOLOER OR CANDIDATE Orrin Mahoney STREET ADDRESS 3. Office Sought or Held OFFICE SOUGHT OR HELD 10940 Miramonte Rd CITY Cupertino AREA CODEJDAYTIME PHONE NUMBER City Council JURISDICTION (LOCATION) Cupertino DISTRICT NUMBER (IF APPLICABLE) STATE ZIP CODE CA 95014 OPTIONAL: FAX I E-MAIL ADDRESS 408-725-1767 orrinmahoney@comcast.net 4. Committee Information List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME AND 1.0. NUMBER COMMITTEE ADDRESS NAME OF TREASURER none 5. Verification I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than $1,000 and that I will spend less than $1,000 during the calendar year and that I have used all reasonable diligence in preparing this statement. I certify und~)lenalty' Fonn 470/470 Supplement (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)