460 Semi-Annual (Oct-Dec) OVERPAGE
RecipientCommittee
Campaign Statement
Cover Page
(Government Code Sections 84200.84216.5)
Type or print in ink.
Statement covers period
from 1011812009
Date of election if
(Month, Day,
~) ~;De~ St9d~b
FE8 -1 ~
of
For Official Use Onty
1213112009 1110312009 p RTINO CITY CLEH
SEE INSTRUCTIONS ON REVERSE through
1, Type of Recipient Committee; All CommKteea -Complete Part 1, 2, 3, and 4, 2, Type of Statement:
® Officeholder, Candidate Controlled Committee ^ Primarily Formed Ballot Measure ^ Preelecion Statement ^ Quartedy Statement
Q Slate Candidate Election Committee Committee ~ Semiannual Statement ^ Special Odd-Year Report
Q Recall Q Controlled ^ Termination Statement ^ Supplemental Preelection
(AlsocomplelePanS) Q Sponsored (Also file a Form 410 Termination) Statement -Attach Form 495
(AlarocomprerePart6) ^ Amendment (Explain below)
^ General Puryose Committee
Q Sponsored
^ Pdmarily Formed Candidate)
Q Small Contributor Committee Officeholder Committee
~PoliticalPartylCentralCommitlee (A~socompbreFen7)
3, Committee Information I.D. NUMBER
1319770
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Orrin Mahoney for Council • 2009
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
Cupertino CA 95014
MAILING ADDRESS (IF DIFFERENT) N0. AND STREET OR P.O. SOX
CITY STATE ZIP CODE AREA CODEIPHONE
CA 95015
OPTIONAL: FAX I
OPTIONAL: FAX I EMAIL ADDRESS
4. Verification
I have used all reasonable diligence in prepadng and revievtlng this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete,
under penalty of perjury under t2he laws of the State of California that the foregoing is
Executed on 1 " ~ I ~ ~ti BY
e
Executed on / 3 ~ / b BY
Date
Executed on BY
~ Signature of Conhdling Officeholder,Candidate, State Measure Proponent
Treasurerts)
NAME OF TREASURER
Carolyn Krizek-Mahoney
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
CA 95015
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
I Dettlfy
Executed on BY SignalureolControllingORcehokler,Candidate,StateMeasureProponent
Date FPPC Form 460 (January106)
FPPC Toll•Free Nelpllne: 8661ASK•FPPC (8661275.9772)
State of California
ecipientCommittee
Campaign Statement
Cover Page -Part 2
Type or print in ink,
6. Primarily Formed Ballot Measure Committee
Page 2 of
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Orrin Mahoney
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Cupertino City Council
RESIDENTIALIBUSINESSRDDRESS (N0. AND STREET) CITY STATE ZIP
10940 Miramonte Rd Cupertino, CA 95014
Related Committees Not Included in this Statement: I.istanycommitteea
not Included !n this statement that are controlled by you or are primarily formed to receive
contributions or make expenditures on behaH of your candidacy.
COMMITTEE NAME II.D. NUMBER
NAMEOFTREASURER CONTROLLEDCOMMITTEE?
YES ~ NO
COMMITTEEADDRESS STREETADDRESS (NO P.O,BOX)
CITY STATE ZIP CODE AREA CODEfPHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLEDCOMMITTEE9
Q YES ~ NO
COMMITTEEADDRESS STREETADDRESS (NOP,O.BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
NAME OF BALLOT MEASURE
BALLOTNO.ORLETTER I JURISDICTION I ~ SUPPORT
Q OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
SOUGHT OR HELD
COVER PAGE-PART2
DISTRICT NO. IF ANY
7. Primarily Formed CandidatelOfficeholderCornmittee Ust names of
o-flceholder(sJ or candidate(s) (or which this cammlttee (s 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 0 SUPPORT
OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ~ SUPPORT
Q OPPOSE
Attach continuation sheets H necessary
FPPC Form 450 (January105)
FPPC Toll•Free Helpline: 8661ASK•FPPC (866@75.9772)
State of California
Campaign Disclosure Statement
Summary Page
Type or print in ink,
Amounts may be rounded
to whole dollars,
Statement covers period
from 1011812009
SUMMARYPAGE
through 1213112009 page 3 of 7
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER
Orrin Mahoney for Council • 2009 1319770
Contributions Received
ColumnA ColumnB
TOTALTHISPERIOD CALENDAAYEAR
(FROMATTACHEDSCHEDlILE5) TOTALTO DATE
1. Monetary Contributions ........................................... scneduleA,Line3 $ 1,300.00
2, Loans Received ...................................................... scneduiee,t.ine3 -4,000,00
3. SUBTOTALCASHCONTRIBUTIONS ....................... .. Add Linesr+2 $ -2,700,00
4. Nonmonetary Contributions .................................... scneauiec,line3 0.00
5. TOTALCONTRIBUTIONSRECEIVED •,••„•,.,•,.•••,•.~• •,.••~Addunes3+q $ -2700.00
$ 6,468.00
6,000,00
$ 12,468.00
0.00
$ 12,468.00
Expenditures Made
6. Payments Made ....................................................... scneduieE,Lineq $
7. Loans Made ............................................................. scnedubH,Line3
8, SUBTOTALCASHPAYMENTS ................................. ... adduness+~ $
9. Accrued Expenses (Unpaid Bills) ............................ ...Scneauie F,iine3
10. Nonmonetary Adjustment ........................................ .. scneaule c, Line 3
11. TOTALEXPENDITURESMADE ................................ AddLinesfi+e+ro $
Current Cash Statement
12, Beginning Cash Balance ....................... wevioussummaryFege,unere $
13. Cash Receipts ................................................... coiumnA,i.ine3eaove
14. Miscellaneous Increases to Cash ........................... scnedulei,Lineq
15. Cash Payments .................................................. column A,Lineaadove
16. ENDINGCASHBALANCE.,..,.....AddUnesr2+r3+rq,thensubtradLinerS $
I(this is a termination statement, Line 16 must be zero.
0.00
195,00
4,672.17
-2,700,00
.03
195.00
1,777,20
17, LOAN GUARANTEES RECEIVED ........................... Schedule e, Part 2 $ 0,00
Cash Equivalents and Outstanding Debts
18, Cash Equivalents ........................................ See instructions on reverse $ 0,00
195.,00
0,00
195,00
0.00
$ 10,690.86
0,00
$ 10,690,86
0.00
0,00
g 10,690,86
To calculate Column B, add
amounts in Column A to the
wrresponding 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 fled
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
111 through 6130 711 to Date
20. Contributions
Received $ $
21, Expenditures
Made $ $
Expenditure Limit Summary for State
Candidates
..... ,,, ,. ..r .............. ,..,...
(a SubJectto Volunhry Ezpendauro LImaJ
Date of Election Total to Date
(mmlddlyy)
-J-J $
~ ~-~ $
*Amounts in this section may be different from amounts
reported in Column B.
19. OUtStanding DebtS ......................... Ada Line2+Line9incolumnBa6ove $ 6'000'00 I I FPPCForm460(January105)
FPPC ToIEFree Helpline: 8561ASK•FPPC (8661275.3772)
chedule A Type or print in ink. SCHEDULE A
Moneta Contributions Received Amounts may oe rounded
ry to whole dollars Statement covers period
~'
,
from 1011812009 ~ ~ I
e
1213112009 4
7
SEE INSTRUCTIONS ON REVERSE
through
page
of
NAME OF FILER I.D. NUMBER
Orrin Mahoney for Council - 2009 1319770
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER AMOUNT
RECEIVED THIS CUMULATIVETO DATE
CALENDAR YEAR PER ELECTION
TO DATE
RECEIVED UFCOMMOTEEALSOENTERLO.NUVBER) CODE* (IFSELF•EMPLOYED,ENTERNAME PERIOD (JAN.1 • DEC. 31) (F REQUIRED)
OF BUSINESS)
01ND
1011812009 Vardy Stein
pPTY
pscc
BIND
Re-Elect Kris Wang for City Council OcoM
1012612009
~ PrY
pscc
01ND
1012112nno Dolly Sandoval pcoM Teacher
200
00
200
00
-
~ PTY
pscc
®IND
1012312009 Dorothy Stowe
p PTv
pscc
Jimmy Chien 01ND
pcoM
Banker
1012112009
p PTY
pscc
SUBTOTALS 700.00
Schedule A Summary
1. Amount received this period- itemized monetary contributions.
(Include all ScheduleAsubtotals.) ........................................................................................................ $
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 $
1,100,00
200.00
1,300.00
*Coniributor 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 480 (January105)
FPPC Toll-Free Helpline: 8661ASK-FPPC (866@75.3112)
chedule A (Continuation Sheet) Type or printlnink. SCHEDULER (CONY)
ANCf7 r9/ rAMf~lhn+iwnw ~wwwivwd e...~...~. •._.. ~_-_.._~_~ ___
nwnvax~~ vVnHIYNHVII.11\R{rG1YGU nmvm~w mar uo wulluuu Statementcovers period
to whole dollars. ~ ' '
~
1
from 1011812009 ~ •
through 1213112009 page 5 of ~
NAME OF FILER
I.D. NUMBER
Orrin Mahoney for Council - 2009
1319770
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED (IFCOMMIrrEE,aLSOENTERro.NUMSeRI CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
(IFSELF•EMPLOYED,ENTERNAME
OFBUSINESS) PERIOD (JAN,1 • DEC.31) (IF REQUIRED)
1011912009 Palviz Namvar 01ND
pcoM
Self•Employed
~ pTy
pscc
1012812009 Tom Anderson 01ND
pcoM Self•Em to ed
p y
^ pTy Consultant
pscc
BIND
^COM
~ OTH
Q PTY
SCC
^IND
~COM
BOTH
~ PTY
~ SCC
RIND
~COM
BOTH
Q PTY
pscc
SUBTOTALS 40000
'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 (January105)
FPPC Toll•Free Helpline: B661ASK•FPPC (866@75.3772)
una nn nrinf In In4
SCHEDULER-PARTi
JGneQUle D - raR'f Amounts may be rounded Statement covers period ~I
Loans Received to whole dollars. 1011812009 e ~ ,
. ' ~
from ,
1213112009 6 7
SEE INSTRUCTIONSON REVERSE through Page Oi
NAME OF FILER
I.D. NUMBER
Orrin Mahoney for Council - 2009 1319770
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER IF AN INDIVIDUAL, ENTER
OCCUPATIONANDEMPLOYER OUTSTANDING
BALANCE Ibt
AMOUNT lot
AMOUNT PAID
OUTSANDING
BALANCEAT le
INTEREST
ORIGINAL y
CUMULATIVE
(IFCOMMnTEE,ALSOEMEALD.NUMBERI prsELF•EMRLOYED,ENTEA BEGINNING THIS RECEIVED THIS
PERIOD OR FORGIVEN
" CLOSEOFTHIS PAID THIS AMOUNTOF CONTRIBUTIONS
NAMEOFBUSINES5) THIS PERIOD PERIOD LOAN TO DATE
Orrin Mahoney Retired ®PAID CALENDAR YEAR
10940 Miramonte Road s 4,000,00 s 6,000,00 0 % s 1,100.0 s 6,000.00
Cupertino, CA 95014 ~ FORGIVEN AATE PERELECTION*
s 10,000,0 s 0,00 s 11112010 s 0,00 71161200
t® IND ~ COM Q OTH ~ PTY ~ SCC
OATEDUE
DATEINCURRED s
Q PAID CALENDARYEAR
3 s % S S
Q FORGIVEN _
AATE
PER ELECTION *
s s s s
fn IMn n rne~ n nTU n o*v n crr
'- ""' "' u "' V ~
~..~,,,,.
~^~~~~~
_.__.,._ .____
UNIC IIW.URtttU s
p PAID CALENDAR YEAR
s s % a s
_
(] FORGIVEN RATE
PER ELECTION*
s s s a
t~ IND Q COM ~ OTH Q PTY ~ SCC
DATE DUE
DATEINCURRED s
SUBTOTALS $ 0.00 $ 4,000,00 $ 6,000,00 $ 0.00
Schedule B Summary
1. Loans received this period .................................................................................................................... $ 0,00
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid orforgiven Phis period 4,000,00
(Total Column (c) plus loans under $100 paid orforgiven.)
(Include loans paid by a third parry that are also itemized on Schedule A,)
3. Net change this period. (Subtract Line 2 from Line 1,) ............................................................... NET $ -4,000.00
Enter the net here and on the Summary Page, Column A, Lme 2, (Mey beanegetlve number)
"Amounts forgiven or paid by another party also must be reported on Schedule A,
" It required,
(Enter (e)on
Schedule E, Line 3(
tContributar Codes
IND-Indiv~ual
COM - Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g., business entity)
PTY-Political Party
SCC-Small ContnbutorCommittee
FPPC Form 480 (January105)
FPPC Toll•Free Helpline: 8681ASK•FPPC (8881275.3772)
chedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars,
NAME OF FILER
Orrin Mahoney for Council - 2009
Statement covers period
from 1011812009
through 1213112009 page ~
1319770
of ~
CODES; If one of the following codes accurately describes the payment, you may enter the code, Otherwise, describe the payment.
C1uP campaign paraphernalialmisc. IvER membercommunications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
CTB contdbution (explain nonmonetary)` OFC office expenses SAL campaign workers' salaries
CVC ravic donations PET petition circulating TF1 t,v. or cable airtime and production costs
FIL candidate filinglballof fees PHO phone banks TRC candidate travel, lodging, and meals
Fly fundraising events POL polling and survey research TRS sfatflspouse travel, lodging, and meals
rD independent expenditure supportinglopposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
Lfl campaign Ifterature and mailings PRT print ads WEB information technology costs (internet, a-mail)
NAME AND ADDRESS OF PAYEE
prcoMMnTSe,A~soeMesi.o.eu~teeal
CODE OR DESCRIPTIONOFPAYMENT
AMOUNTPAID
April Media Inc
LIT Courier Advertisement
150,00
"Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 150,00
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ 150,00
2, Unitemized payments made this period of under $100 45,00
3, Total interest paid this period on loans, (Enter amount from Schedule B, Part 1, Column (e),) ............................................................................... $ 0.00
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, ColumnA, Line 6.) ............................. TOTAL $ 195.00
FPPC Form 480 (January105)
FPPC Toll-Free Helpline: 8661ASK-FPPC (86612753772)