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470 Officeholder and Candidate Campaign Statement 08-03-2010 Officeholder and Candidate SHORTFORM Campaign Statement — Type or print! n ink D a a PR , Short Form (GovernmentCodeSedon84206) Date of election ifapplicable: El Amendment (E )pIanBebw) ,, �t0 OfraelUseOny (Month, Day, Year) 1 1/8/2009 C PERTINO CITY CLE 1K 1. Statement Covers Calendar Year 20 10 . 2. Officeholder or Candidate Information 3. Office Sought or Held NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT ORHELD Orrin Mahoney City Counciimember STREET ADDRESS JU RISDICTION (LOCATION) DISTRICT NUMBER (IF APPLICABLE) 10940 Miramonte Rd City of Cupertino CITY STATE ZIPCODE Cupertino CA 95014 AREA CO DE/DAYTIME PHONE NUMBER OPTIONAL: FAX /E -MAIL ADDRESS 408- 725 -1767 oninmahoney @comcas 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 I.D. NUMBER COMMITTEE ADDRESS NAME OF TREASURER Orrin Mahoney for Council -2009 10940 Miramonte Rd Carolyn Krizek- Mahoney 1319770 terminated 2- 5-2010 Cupertino, CA 95014 5. Verification I declare under penalty of perjury that to the best of my knowledge I anticipate that I will ORCANDIDATE FPPC Form 470 (June/01) FPPC Toll -Free Helpline: 866 /ASK -FPPC