460 Termination ecipientCommittee
Campaign Statement
Cover Page
(Government Cade Sections 114200.84216.5)
Type ar print in ink,
Statement covers period
from
11112010
SEE INSTRUCTIONS ON REVERSE through 21512010
1. Type of Recipient Committee: AIICommltteea-CompkteParta1,2,3,and4.
0 Officeholder, Candidate Controlled Committee ^ Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
Q Recell Q Controlled
(AlsoComplelePartS) Q Sponsored
(NaoComplelePart6J
^ General Purpose Committee
Q Sponsored ^ Primary Formed Candidate)
Q Small Contributor Committee Officeholder Committee
QPDlifinalParrylCentralCommittee (asoCompefePart7)
3. Committee Information
I.D. NUMBER
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Orrin Mahoney for Council • 2009
CITY
STATE ZIP CODE AREA CODEIPHONE
Cupertino CA 95014
MAILING ADDRESS (IF DIFFERENT) N0. AND STREET OR P.O. a0X
CITY STATE ZIP CODE AREA CODEIPHONE
CA 95015
1 EMAIL ADDRESS
^ Preelection Statement
^ Semi-annual Statement
0 Termination Statement
(Also file a Form 410 Termination)
^ Amendment (Explain below)
CITY
of 6
Official Use Only
^ Quaderiy Statement
^ Special Odd•Year Report
^ Supplemental Preelection
Statement -Attach Form 495
Treasurerrs)
NAME OF TREASURER
Carolyn Krizek•Mahoney
MAILING ADDRESS
CITY STATE ZIP CODE
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL: FAx I EMAIL ADDRESS
4, Verification
I have used all reasonable diligence in preparing and revievtlng this statement and to and complete. I certify
under penalty of perjury underthe laws ofthe State of California that the foregoing is b
Executed on 21512010
Dee
Executed on 21512010
Dale
Executed on
Date
Executed on
Dale
By
By
By
SignatureotConudling0lftceholder,CanCdate,StateMeasureProponent FPPC Fomt 460 (Januaryl05)
FPPC Toll•Free Helpllne: 6661ASK•FPPC (6661275•J772)
State of CalHornia
Date of election if appl'.
(Month, Day, Year)
111312009
COVERPAGE
~~~UU
FEB 11 ~
2, Type of Statement:
By
SignatureotContrdlirg Olficehalder,Candidate, State Measure Proponent
ecipientCommittee
Campaign Statement
Cover Page -Part 2
Type or print in ink, COVER PAGE-PART2
Page 2 of 6
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
RESIDENTIAIJBUSINESSRDDRESS (NO. AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: Lisranycommittees
not included in this statement that are controlled by you or are primarily formed ro receive
contdbutlons or make expenditures on behalf of your candidacy.
COMMITTEE NAME
NAME OF TREASURER
COMMITTEEADDRESS
I.D. NUMBER
CONTROLLED COMMITTEE?
Q YE5 ~ NO
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
COMMITTEE NAME
NUMBER
NAMEOFTREASURER ICONTROLLEDCOMMITTEE?
YES Q NO
COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
6. Primarily Formed Ballot Measure Committee
NAME OFBALLOTMEASURE
BALLOTNO.ORLETTER JURISDICTION 0 SUPPORT
Q OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD
DISTRICT N0. IF ANY
1. I'rlmarlly Formed l:andldatel~lTlCeholder Committe8 List names of
o/(iceholder(s) or candidate(s) for which this cammlttee is primarily Conned.
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
SUPPORT
Q OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
Q SUPPORT
OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT
OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ~ SUPPORT
OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (January106)
FPPC Toll•Free Helpline: 8661ASK•FPPC (8661275x772)
State of California
Campaign Disclosure Statement
Summary Page
Type or print in ink,
Amounts may be rounded
to whole dollars,
Statement covers period
from 11112010
SUMMARYPAGE
SEE INSTRUCTIDNS ONREVERSE through 21512010 page 3 of 6
NAME DF FILER I.D. NUMBER
Orrin Mahoney for Council • 2009 1319770
Contributions Received
Column A
TOTALTHIS PERbD
(FRCMATTACHED SCHEDULES)
Column B Calendar Year Summary for Candidates
CALENDARYEAR
TDTALTOO,TE
Running in Both the State Primary and
General Elections
6,468.00
$
0.00 111 through 6130 711 to Dete
$ 6,468.00 20. Contributions
Received $ $
0,00
21. Expenditures
$ 6,468,00 Made $ $
1. Monetary Contributions ........................................... scneaule A, Line 3 $ 0.00
2. Loans Received ...................................................... Schedule B, ~'ne 3 -6,000.00
3. SUBTOTALCASHCONTRIBUTIONS ........................ . Addll'nesl+z $ -6,000,00
4. Nonmonetary Contributions .................................... schedule c,Line3 0,00
5. TOTALCONTRIBUTIONSRECEIVED,~••,••„••••„•"•,"• •••~Addunes3+4 $ -6,000.00
Expenditures Made
6. Payments Made ....................................................... schedule e, Line q $ -356,00
1. Loans Made ............................................................. scneduleH,Line3 0.00
8. SUBTOTALCASHPAYMENTS .................................... Add Liners+~ s -356,00
9. Accrued Expenses (Unpaid Bilis) ...............................scneduleF,Llne3 0,00
10. Nonmonetary Adjustment .......................................... schedule c, Line 3 0.00
11. TOTALEXPENDITURESMADE ................................Addl.ines6+g+to $ -356.00
Current Cash Statement
12. Beginning Cash Balance ....................... Previous summary Page, Linels $
13. Cash Receipts ................................................... column A,Line3ahove
14. Miscellaneous Increases to Cash ........................... scnedulel,Lirreq
15. Cash Payments .................................................. column A,Lineaahove
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then suhtract line 15 $
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part z $
Cash Equivalents and Outstanding Debts
18. C2sh Equivalents ........................................ See inshuctions on reverse $
19, OUtStandln9 Debts ......................... Add Line2+LinegincolumnBabove $
g 10,334.86
0.00
a 10,334.86
0.00
0.00
$
10,334.86
I ~~ ~
1,777.20
-6,000.00
356.00
0,00
0,00
0,00
0.00
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column B of your last
report. Some amounts in
CDlumn 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, 1, and 9 (if
any).
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditurea Made"
IM SuhkMla VnluM~rv Fxn~nAlhn~ IamMl
Date of Election Total to Date
(mmlddlyy)
*Amounts in this section may be different from amounts
reported in Column 8.
FPPC Form 460 (January105)
FPPC ToIFFree Helpllne; 6661ASK-FPPC (6661275.3772)
vnn nr nrin4 in In4
SCHEDULEB-PARTt
~7Gtl~(1ul@ d - raR -t Amounts may be rounded Statement covers period
'
Loans Received to whole dollars.
11112010 '
~ , I
.
from ~
21512010 4
6
SEE INSTRUCTIONSON REVERSE through page
of
NAME OF FILER
I.D. NUMBER
Orrin Mahoney for Council - 2009 1319770
FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER
OCCUPATIONAND EMPLOYER OUTSTANDING
BALANCE tb)
AMOUNT IO)
AMOUNT PAID l
OUTSTANDING pl
INTEREST
ORIGINAL p)
CUMULATIVE
OF LENDER
(IFCDMMRTEE,ALSOENTERLD.NUMBER)
PFSELF•EMPLOYED,ENTER
BEGINNING THIS
RECEIVED THIS
PERIOD
OR FORGIVEN
* BALANCEAT
CLOSE OF THIS
PAID THIS
AMOUNTOF
CONTRIBUTIONS
NAMEOF BUSINESS) THIS PERIOD PERIOD LOAN TO DATE
Orrin Mahoney Retired ~ PAID CALENDARYEAR
®FORGIVEN RaTE PER ELECTION"
s 6,000.00 r 0.00 r 3,866.80 11112010 r 0.00 71161200
t~] IND Q COM Q OTH Q PTY Q SCC
DATEDUE
DATEINCURRED s
Q PAID CALENDAR YEAR
S S % S 3
_
Q FORGIVEN RATE PERELECTION*"
S S S E
fQ IND Q COM Q OTH Q PTY Q SCC
DATEDUE
DATEINCURRED S
Q PAID CALENDARYEAR
S S % S S
_
Q FORGIVEN RATE
PER ELECTION **
S S S E
tQ IND Q COM ^ OTH ^ PTY Q SCC
DATEDUE
DATEINCURRED S
SUBTOTALS $ 0.00 $ 6,000.00 $ 0.00 $ 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 this period 6,000,00
(Total Column (c) plus loans under $100 paid orforgiven.)
(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 $ -6,000.00
Enter the net here and on the Summary Page, Column A, Llne 2. (May beaoepative number)
*Amounls forgiven or paid by another party also must be reported on Schedule A.
"* If required.
(Enter (e)on
Schelde E, Linea)
tContributor Codes ,
IND-Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g., business entity)
PTY-Political Patty
SCC -Small Contributor Committee
FPPC Form 460 (January105)
chedule E
Payments Made
Type or print in ink,
Amounts may be rounded
to whole dollars,
Statement covers period
from 11112010
SEE INSTRUCTIONSON REVERSE through 21512010 page 5 of 6
NAME OF FILER
I.D. NUMBER
Orrin Mahoney for Council • 2009 1319770
CODES; If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CfvP
CNS campaign paraphernalialmisc.
i Iv1BR memberwmmunications RAD radio airtime and production costs
CTB campa
gn consuRants
contdbution (explain nonmonetary)' MTG
OFC meetings and appearances
office expenses RFD
SAL returned contributions
'
CVC
civic donations
PET
petition circulating
TEL campaign workers
salaries
t.v. or cable airtime and production costs
PIL
FrD candidate filinglballot fees
fundraising events PFIO phone banks TRC candidate travel, lodging, and meals
W
independent expenditure supportinglopposing others (explain)" POL
POS polling and survey research
postage, delivery and messenger services TRS
TSF stafflspouse travel, lodging, and meals
transfer between commitlees of the same candidatelsponsor
LEG
LfT legal defense PRO professional services (legal, accounting) VOT voter registration
campaign literature and mailings PRT print ads WEB information technology cosls (intemet, a-mail)
NAME AND ADDRESS OF PAYEE
QFCOMMITTEE, ALSOENTER LD. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Ciry of Cupertino
FIL Partial refund of candidate filing fee
-356.00
' Payments that are contributions or independent expenditures must also be summarized on Schedule D,
Schedule E Summary
SUBTOTALS
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, ColumnA, Line 6.) ............................. TOTAL $
-356.00
-356.00
0.00
0.00
-356,00
FPPC Form 460 (January105)
FPPC Toll-Free Helpline; 8661ASK•FPPC (8661275.3772)
chedule I Tvoa or erinr in ink. St,HF~I II F I
Misceiianeous Increases to Cash Amountamayberounded Statementcoveraperiod
•
towholedollara. ,
J ~'
11112010
from ~
SEEINSTRUCTIONSONREVERSE through 21512010 pa a li of 6
9
NAME OF FILER
I.D. NUMBER
Orrin Mahoney for Council - 2009 1319770
DATE
RECEIVED FULLNAMEANDADDRESSOFSOURCE
QF COMMITTEE, ALSO ENTER LD. NUMBER)
DESCRIPTION OF RECEIPT AMOUNT OF
INCREASE TO CASH
City of Cupertino Partial refund for 09 candidate filing fee
21512010
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 356.00
Schedule I Summary
1. Itemized increases to cash this period. 356.00
2. Unitemized increases to cash of under $100 this period ............................................................................................. $ 0.00
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $ 0.00
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ........................................................................................................................... TOTAL $ 356,00
FPPC Fonn 460 (January105)
FPPC ToIEFree Helpline: 5661ASK•FPPC (8661275.3772)