465 Amend. Supp. Ind. Expend. Rept. supporting Nihalani 2/1/2010 upplemental Independent
Expenditure Report
(Government Code Section 84203.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded to
whole dollars.
® Amendment (Explain Below)
Amendment to reflect
corrected amounts and
subvendors
1. CommitteelFilerlnformation II.D.NUMBER(Ifrecipientwmmittee)
1299673
Cupertino Chamber PAC (Sponsored by Cupertino Chamber of Commerce)
STREETADDRESS(NO
CITY STATE ZIP CODE AREACODEIPHONE
Cupertino CA, 95014
OPTIONAL: FAXIE-MAILADDRESS
SUPPLEMENTALINDEPENDENTEXPENDITURE
Report covers period ~ ~- DMe Sump
,~- ~•
from ol/0l/2009 ~~ ~~'-""""'----- `' ~ ~
~; r
throw h 10/17/2009 ;I ry~t
4 ~
Date of election if applicable: or Official Use only
(Month, Day, Year)
11/03/2009 `'G~~~r!1"'O CIiY Cl RK
Treasurer (If recipient committee)
NAMEOFTREASURER
Bob Adams
CITY STATE ZIP CODE AREACODEIPHONE
Cupertino CA, 95014
OPTIONAL: FAXIE-MAILADDRESS
2. Name of Candidate or Measure Supported or Opposed
CHECKONE
NAME OF CANDIDATE OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE SUPPORT OPPOSE
Mahesh Nihalani City Council Member City of Cupertino g
NAME OF BALLOT MEASURE BALLOT NO,ILETTER JURISDICTION
SUPPORT OPPOSE
3. Independent EXpendltureS Made Attach additionalinformationonappropriatelylabeledcontinuationsheets.
ri ie~i a nnvo m n.r~
DATE NAMEANDADDRESSOFPAYEE DESCRIPTIONOFEXPENDITURE AMOUNT CALENDAR YEAR
Robinson Comm
i
ti JAN.1- DEC. 31
un
ca
ons Inc.
10/09/2009
P
ifi
ac
c Printing
10/12/2009
621.89
Subpayment made
through:
Robinson Commun cations
Inc.
Pacific Printing
10/12/2009
Subpayment made
Robinson Commun through:
cations
Inc.
FPPC Form 465
FPPC Toll•Free Helpline: 8661ASK•FPPC (8861275.3772)
upplemental Independent
Expenditure Report
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Date
suPPLF~ErrraL Iwl:P~iDOJr F~riom~
For use by an o~icehokier, candidate, or committee making independent expenditures totaling $500 or
mare in a calendar year to support or oppose a single candidate or a single measure. This form must
be filed at the same times and places as the campaign statements filed by the candidate supported or
opposed or by a committee primarily formed to support or oppose the measure. A separate form must
be filed for each candidate or measure being supported or opposed. This form is filed in addition to
any other required campaign statements.
Report covers period
from- of/ol/zoo9
through l0/1~/2009
Date of election if applicable;
(Month, Day, Year)
11/03/2009
IV Independent EXpendltUreS Made Attach additionalinfomiation on appropriatelylabeled continuation sheets.
DATE I NAME AND ADDRESS OF PAYEE I DESCRIPTION OF EXPENDITURE
10/12/2009 (Pacific Printing
AMOUNT
Postage for mailer to support Nihalani, 508.08
Mahoney and Paul (See Sch D) MEMO
Subpayment
Robinson C
Inc.
Page? of 3
For Official Use Only
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN.1 -DEC. 31)
through:
upplemental Independent Type or print in ink. SUPPLEMENTAL INDEPENDENT EXPENDITURE
Ex enditure Re ort Amounts maybe rounded Report covers period ~ . ,
p p to whole dollars. ~ ~
of/ol/zoo9 ~'
from
SEE INSTRUCTIONS ON REVERSE through 10/17/2009 page 3 of 3
NAMEOFFILER I.D. NUMBER (If recipient com.)
Cupertino Chamber PAC (Sponsored by Cupertino Chamber of Commerce) 1299673
4. Summary
2,149.55
1. Total independent expenditures of $100 or more made this period. (Part 3.) ........................................................................................... $
2. Total independent expenditures under $100 made this period. (Not itemized.) ........................................................................................ $ o. 00
3. Total independent expenditures made this period (Atltl Lines 1 + 2.) .......................................................................................... TOTAL $ z, 149.55
5. Flling Officers Enter the name and address of each filing o~cer with whom the filer's most recent campaign statements (Form 450, 460 or 461) have been filed.
1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER
City of Cupertino -City Clerk
ADDRESS (NO. AND STREET) ADDRESS (NO, AND STREET)
10300 Torre Avenue
CITY STATE ZIP CODE
Cupertino, CA 95014
ADDRESS (N0. AND STREET)
CITY
CITY
4) NAMEOFFILINGOFFICER
STATE ZIP CODE
ADDRESS (NO. AND STREET)
STATE ZIP CODE CITY
STATE ZIP CODE
6. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on "~ ~ ~ i ~ ~
PATE
Executed on r
DATE
Executed on
DATE
Executed on
DATE
~~ ---~
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 485
FPPC Toll•Free Helpline: 8661ASK•FPPC (8661275.3772)