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460 Recipient Campaign Statement Amended 12-31-2010 Recipient Committee , --1L-, COVER PAGE p Type or print in ink. ; 1 ( D s 4 m p\ � i, - C LIFORNIA Campaign Statement i .- FORM 460 Cover Page (Government Code Sections 84200 - 84216.5) , � - 5 2 010 �� 1 4 Statement covers period Date of election if appli '. , AUG Fi o 10 -19 -2009 (Month, Day, Year) For Official Use Only from _ SEE INSTRUCTIONS ON REVERSE through 12 -31 -2009 11/03/2009 CL PERTIN0 CITY CLE1K 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement: O Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee 0 Semi - annual Statement ❑ Special Odd -Year Report O Recall 0 Controlled ❑ Termination Statement Sponsored ❑ Supplemental Attach (AIsoCompletePart 5) 0 P (Also file a Form 410 Termination) Statement - Attach Form 495 (Also Complete Part 6) ❑ General Purpose Committee 0 Amendment (Explain below) O Sponsored ❑ Primarily Formed Candidate/ Donations missed in previous filing. 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D NUMBER Treasurer(s) 1319625 COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) NAME OF TREASURER Darcy Paul for Cupertino City Council 2009 Betsy Shoup MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS Same 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 best of my knowledge the information contained herein and in the attached schedules 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. Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Type or print in ink. COVER PAGE - PART2 Recipient Committee CALIFORNIA Campaign Statement FORM 460 Cover Page — Part 2 Page 2 of 4 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Darcy Paul for Cupertino City Council 2009 OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Cupertino City Council RESIDENTIAUBUSINESS 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: List any committees 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 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 ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES ❑ NO ❑ SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREETADDRESS (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 10 -19 -2009 FORM SEE INSTRUCTIONS ON REVERSE through 12 -31 -2009 Page 3 of 4 NAME OF FILER I.D. NUMBER Darcy Paul for Cupertino City Council 2009 1319625 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) TOTALTO DATE g Primary Monetary Contributions Schedule A, Line 3 $ 416 $ 27,032.18 General Elections 1/1 through 6/30 7/1 to Date 2. Loans Received Schedule 8, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2 $ 416.20 $ 27,032.18 20. Contributions 27 032.18 Received $ $ 4. Nonmonetary Contributions Schedule C, Line 3 21. Expenditures 5. TOTALCONTRIBUTIONS RECEIVED AddLines3 +4 $ 416.20 $ 27,032.18 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made Schedule E, Line 4 $ $ Candidates 7. Loans Made Schedule H, Line 3 22 Cumulative E • Made* 8. SUBTOTAL CASH PAYMENTS Add Lines 6 +7 $ $ (If Subject to Voluntary Expenditure Limit) 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 $ $ _I _I $ Current Cash Statement / —___/ $ 12. Beginning Cash Balance Previous Summary Page, Line 16 $ 760 To calculate Column B, add 13. Cash Receipts Column A, Line 3 above 416.20 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. 15. Cash Payments Column A, Line 8 above repo Some amo in Column negative 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 1,177.14 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 $ for this calendar year, only carry over the amounts Equivalents and Outstanding Debts any). Lines 2, 7, and 9 (if Cash E q 9 any). 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2 + Line 9 in Column B above $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Schedule A Type or print in ink. SCHEDULE A Monetary Contributions Received Amounts may be rounded Statement covers period ry to whole dollars. CALIFORNIA 460 from 10 -19 -2009 FORM SEE INSTRUCTIONS ON REVERSE through 12 -31 -2009 Page 4 of 4 NAME OF FILER I.D. NUMBER Darcy Paul for Cupertino City Council 2009 1319625 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I .D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF ENTER NAME PERIOD (JAN. 1- DEC. 31) (IF REQUIRED) OF BUSINESS) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ID COM ❑ OTH ❑ PTY ❑ SCC ❑IND f COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ Schedule A Summary *Contributor Codes 1. Amount received this period - itemized monetary contributions. IND Individual (Include all Schedule A subtotals.) $ COM - Recipient Committee (other than PTY or SCC) 2. Amount received this period — unitemized monetary contributions of less than $100 $ 416.20 OTH - Other (e.g., business entity) PTY - Political Party 3. Total monetary contributions received this period. scC- Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ 416.20 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)