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460 Recipient Committee Campaign Statement 12-31-2010 Recipient Committee N © V COVER PAGE p Type or print in ink. D Bete-Clen> Campaign Statement CALIFORNIA 460 Cover Page FORM JAN 2 4 2011 (Government Code Sections 84200 - 84216.5) " ", Page I_ of Statement covers period Date of electi 1n if applicable: 07/01/2010 (Month, Day, Y6...) For Official Use Only from CUPERTII\ 0 CITY CLERK SEE INSTRUCTIONS ON REVERSE through 12/31/2010 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement: ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Committee ® Semi - annual Statement ❑ Special Odd -Year Report O Recall 0 Controlled ❑ Termination Statement ❑ Supplemental Preelection (Also Complete Part 5) 0 Sponsored Also file a Form 410 Termination) ) Statement - Attach Form 495 (Also Complete Part 6) ❑ General Purpose Committee ❑ Amendment (Explain below) O Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D NUMBER Treasurer(s) 1320352 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Marty Miller for Council 2009 Claudette Miller MAILING ADDRESS MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlting Of6ceholder, Candidate, State Measure Proponent FPPC Form 460 (January/OS) FPPC Toil -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of Califomia Type or print in ink. COVER PAGE -PART2 Recipient Committee Campaign Statement CALIFORNIA FORM 460 Cover Page — Part 2 Page of T 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Marty Miller N/A OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT City Council for Cupertino ❑ OPPOSE RESIDENTIAL /BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees Not Included in this Statement: Listanycommittees not included in this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER N/A NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate /Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE /PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEE NAME I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD N/A ❑SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES ❑ NO ❑ SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period CALIFORNIA 460 Summary Page to whole dollars. from 07/01/2010 FORM SEE INSTRUCTIONS ON REVERSE through 12/31/2010 Page ■/ of f NAME OF FILER I.D. NUMBER Marty Miller For Council 2009 1320352 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTAL TO DATE g ry General Elections 1. Monetary Contributions Schedule A, Line 3 $ 0 $ 0 2. Loans Received Schedule B, Line 3 0 3448.90 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2 $ $ 20. Contr ived ed $ $ 4. Nonmonetary Contributions Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED AddLines3 +4 $ 0 $ 0 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made Schedule E, Line 4 $ $ Candidates 7. Loans Made Schedule H, Line 3 R CI IRTr1TAl (A 1 PAVNAF�ITC ,, , ; _ $ , 22. Cumulative Expenditures Made* R. •• •� � • •• • ^ • • �+ �+�� • -•�•�� w w (ii SubjeIA to VUIYIIIGIY EApelIYiiule' ,i 9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment Schedule C, Line 3 (mm /dd /yy) 11. TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10 $ 0 $ 0 _l_l $ Current Cash Statement /_i $ 12. Beginning Cash Balance Previous Summary Page, Line 16 $ O To calculate Column B, add 13. Cash Receipts Column A, Line 3 above amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B of your last reported in Column B. report. Some amounts in 15. Cash Payments Column A, Line 8 above Column A may be negative 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 0 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ 0 for this calendar year, only carry over the amounts Equivalents and Outstanding Debts any). from Lines 2, 7, ands (if Cash E q 9 0 any). 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2 + Line 9 in Column B above $ 3448.90 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Type or print in ink. SCHEDULE B - PART 1 Schedule B — Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. CALIFORNIA 07/01/2010 460 from FORM SEE INSTRUCTIONS ON REVERSE through 12/31/2010 Page T of f NAME OF FILER I.D. NUMBER Marty Miller For Council 2009 1320352 IF AN INDIVIDUAL, ENTER (a) (b) (c) (d) (e) (f) (g) FULL NAME, STREET ADDRESS AND ZIP CODE OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER BALANCE RECEIVED THIS BALANCE AT (IF COMMITTEE, ALSOENTERI.D.NUMBER) (IF SELF - EMPLOYED ENTER BEGINNING THI OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE Claudette T. Miller Realtor ID PAID CALENDAR YEAR Services ❑ FORGIVEN RATE PER ELECTION 3448.90 $ $ $ $ $ t21 IND ❑ COM p OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ $ % $ $ ❑ FORGIVEN RATE PER ELECTION ** $ $ $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ $ % $ $ FORGIVEN RATE El FORGIVEN ELECTION ** 1- 0 IND $ $ $ $ $ ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ (Enter (e) on Schedule B Summary Schedule E, Line 3) 1. Loans received this period $ 0 (Total Column (b) plus unitemized loans of less than $100.) tContributor Codes IND — Individual 2. Loans paid or forgiven this period $ 0 COM— RecipientCommittee (Total Column (c) plus loans under $100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH — Other (e.g., business entity) PTY — Political Party 3. Net change this period. (Subtract Line 2 from Line 1.) NET $ 0 SCC —Small Contributor Committee Enter the net here and on the Summary Page, Column A, Line 2. (Maybeanegativenumber) *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)