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465 Amend. Supp. Ind. Expend. Rept. 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 Bebw) Amendment to reflect corrected amounts and subvendors ~. CommitteelFilerlnformation II.D.NUMBER(Ifrecipientcommittee) 1299673 Cupertino Chamber PAC (Sponsored by Cupertino Chamber of Commerce) STATE ZIP CODE OPTIONAL: FAXIE•MAILADDRESS Mailer 2. Name of Candidate or Measure Supported or Opposed NAME OF CANDIDATE CHECK ONE OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE SUPPORT OPPOSE Darcy Paul City Council Member City of Cupertino X OPPOSE 3. indepenaentEXpendltUreSMade Attach additionalinformationonappropriatelylabeledcontinuationsheets. DATE I NAMEANDADDRESS OF PAYEE Communications Inc. 10/09/2009 Pacific Printing 10/12/2009 Pacific Printing 10/12/2009 Report covers period from o1/0l/2009 through 10/17/2009 Date of election if applical (Month, Day, Year) 11/03/2009 ~D~sSU~pPP~L~E/MENTALINDEPENDENT EXPENDITURE ~l~JL~~U U ~~ ~ e~ ~ / . FEB - ~ 2v'10 ERTlNO CI i Y 1 of 3 For Official Use Only Treasurer (N recipientcommittee) NAMEOFTREASURER Bob Adams CITY STATE ZIP CODE AREACODEIPHONE Cupertino CA, 95014 OPTIONAL: FAXIE-MAILADDRESS DESCRIPTION OF EXPENDITURE Printing for mailer to support Nihalani, Mahoney and Paul (See Sch D) Mailing services for mailer to support Nihalani, Mahoney and Paul (See Sch D) CUMULATIVE TO DATE AMOUNT I CALENDAR YEAR 2,149.56 ~ 2,149.56 MEMO 621.89 Subpayment made through: Robinson Commun cations MEMO 395.90 Subpayment made through Robinson Commun cations Inc. FPPC Form 465 FPPC Toll•Free Helpline: 8661ASK-FPPC (66612753771) upplemental Independent Expenditure Report SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Date st~MENrAI Ir~oEPEh~DENr F~riorn~RE For use by an officeholder, candidate, or commtttee making independent ezpendrtures totaling $5D0 or more in a calendar year to suppott 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 fhe candidate suppoded or opposed or by a committee primariy 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 addttion to any other required campaign statements. Report covers period from- of/ol/zoo9 through to/17/zoo9 Date of election if applicable: (Month, Day, Year) 11/03/2009 IV Independent EXpendltureS Made Attach adddional information 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 Onty 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. ~ ~ 01/01/2009 ~' from SEEINSTRUCTIONSONREVERSE through 10/17/2009 page 3 of 3 NAME OF FILER I.D. NUMBER (If recipient com.) Cupertino Chamber PAC (Sponsored by Cupertino Chamber of Commerce) 1299673 4. Summary 1. Total independent expenditures of $100 or more made this period. (Part 3.) ........................................................................................... $ 2,149.56 2. Total independent expenditures under $100 made this period. (Not itemizetl,) ........................................................................................ $ o. o0 3. Total independent expenditures made this period (Add Lines 1 + 2.) ............................................................. ,,.,.,,TOTAL $ 2,199.56 5. Filing Officers Enter the name and address of each filing o~cer with whom the filer's most recent campaign statements (Form 450, 460 or 461J have been filed. 1) NAME OFFILINGOFFICER 3) NAMEOFFILINGOFFICER City of Cupertino -City Clerk ADDRESS (N0. AND STREET) ADDRESS NO. AND STREET 10300 Torre Avenue ( ) CITY STATE ZIPCODE Cupertino, CA 95014 ADDRESS (NO. AND STREET) CITY CRY 4) NAME OF FILING OFFICER STATE ZIPCODE ADDRESS (N0. AND STREET) STATE ZIP CODE CRY 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 ~ / %~ ~ ' DATE 1 Executed on _.!~ ' ' ~!' DnrE %% /"' ~.-' - -~. ASSISTANT TREASURER