460 Recipient Comittee Campaign Statement 10-22-11Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from 9/25/11
through
10/2211
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
® Officeholder, Candidate Controlled Committee
❑ Primarily Formed Ballot Measure
Q State Candidate Election Committee
Committee
O Recall
Q Controlled
(Also Complete Part 5)
O Sponsored
Date
(Also Complete Part 6)
❑ General Purpose Committee
Executed on
By
Date
Sigilature of Controllin older, Candidate, SMIe Measure Proponent or 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/OS)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
State of California
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
Type or print in ink.
NAME OF OFFICEHOLDER OR CANDIDATE
Donna Austin
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Cou n c il M C ity o f Cupertino
RESIDENTIAL/BUSINESS ADDRESS (N0. AND STREET) CITY STATE ZIP
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
contributions or make expenditures on behalf of your candidacy.
COMMITTEENAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE /PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE /PHONE
COVER PAGE - PART 2
Page __9_L_ of
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY
7. Primarily Formed Candidate /Officeholder Committee List names of
officeholder(s) or candidate(s) for which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
BALLOT NO. OR LETTER I JURISDICTION I F SUPPORT
❑ OPPOSE
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
State of California
Campaign Disclosure Statement
To calculate Column B, add
Type or print in ink.
3894.00
SUMMARYPAGE
Summary Page
3225.00 $
Amounts may be rounded
to whole dollars.
7. Loans Made .............................. ...............................
Statement covers period
CALIFORNIA I
0.00
8. SUBTOTALCASH PAYMENTS ..... ...............................
Add Lines 6 +7 $
3225.00 $
l5 83.65
9. Accrued Expenses (Unpaid Bills
•
0.00
0.00
10. Nonmonetary Adjustment ........... ...............................
Schedule C, Line
from
9/25/11
• -
Add Lines 6 + 9 + 10 $
3225.00 $
16853.65
10/2211
page 7
SEE INSTRUCTIONS ON REVERSE
through
_a__ of
NAME OF FILER
I.D. NUMBER
Donna Austin
1339133
Contributions Received
Column A
Column B
Calendar Year Summary for Candidates
TOTALTHISPERIOD
(FROM ATTACHED SCHEDULES)
CALENDARYEAR
TOTALTO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions ............ ...............................
schedule A, Line 3
00
$ 3894. $
19998.20
2. Loans Received ....................... ...............................
schedule B, Line 3
0.00
1000.00
1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 + 2
$ 3894. $
20998. 20
20. Contributions
1000.00 20998.20
Received
Received $ $
4. Nonmonetary Contributions ..... ...............................
Schedule C, Line 3
0.00
1070.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ...........................
AddLines3 +4
$ 3894.00 $
22068.20
40604 16853.65
Made $ . $
Expenditures Made
To calculate Column B, add
3894.00
6. Payments Made ........................ ...............................
Schedule E, Line 4 $
3225.00 $
15783.65
7. Loans Made .............................. ...............................
Schedule H, Line 3
0.00
0.00
8. SUBTOTALCASH PAYMENTS ..... ...............................
Add Lines 6 +7 $
3225.00 $
l5 83.65
9. Accrued Expenses (Unpaid Bills
Schedule F, Line 3
0.00
0.00
10. Nonmonetary Adjustment ........... ...............................
Schedule C, Line
0.00
1070.00
11. TOTAL EXPENDITURES MADE . ...............................
Add Lines 6 + 9 + 10 $
3225.00 $
16853.65
Current Cash Statement
12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $
13. Cash Receipts .................... ............................... Column A, Line 3 above
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4
15. Cash Payments ................... ............................... Column A, Line s above
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $
if this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED
Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ......... ............................... See instructions on reverse $
19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $
4139.51
To calculate Column B, add
3894.00
amounts in Column A to the
corresponding amounts
from Column B of your last
0.00
3225.00
report. Some amounts in
Column A may be negative
4808.51
figures that should be
subtracted from previous
period amounts. If this is
the first report being filed
0.00
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
1000.00
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm /dd /yy)
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772)
Schedule A
Type or print in ink.
SCHEDULE A
Monetar Contributions Received Amounts may oe rounaea
ry to whole dollars.
Statement covers period
CALIFORNIA
from 9/25/11
• '
-
through 10/2211
SEE INSTRUCTIONS ON REVERSE
Page of
NAME OF FILER
I.D. NUMBER
Donna Austin
1339133
DATE
FULL NAME, EET A DE O
STREET DDRESS AND ZIP CODE OF CONTRIBUTOR
RALSAND ZIP
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
( COM MITT E E, I.D. NU
CODE *
(IFSELF- EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
BIND
9/27/2011
Bruce Wool pert
p
❑COM
CEO Manager Granite
$ 250.00
$ 250.00
❑OTH
Rock, Watsonville
❑ PTY
❑SCC
MIND
9/30/2011
Nancy H Burnett
❑COM
Retired
$100.00
$100.00
❑OTH
❑ PTY
❑ SCC
®IND
10/5/2(l11
Myong Shin Woo
..,..,, — ._ __ — ._.._ , _ _ „,._ _ ,. ,,
UV I h
❑ PTY
❑ SCC
E]IND
10/7/2011
Charles T.Munger
❑COM
Physicist, self employed
$2000.00
$2000.00
❑ OTH
❑ PTY
[:]SCC
a-
10/21f2011
Luis Buhler
®IND
❑COM
CFO, Rockledge
$250.00
$350.00
❑OTH
Association
t om ✓
❑ PTY
❑ SCC
SU BT O TAL$ 3350.00
Schedule A Summary
Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.) ............. ...............................
2. Amount received this period — unitemized monetary contributions of less than $100
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ......
3350.00
544.00
TOTAL $ 3894.00
'Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
• .
to whole dollars.
'
9 /2 5/11
from
• -
through 10/2211
page
of
NAME OF FILER
I.D. NUMBER
Donna Austin
1339133
DATE
FULL NAME STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
❑IND
John Zirelli
❑COM
Recology
7/7/11
W] OTH
$250.00
$250.00
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
n rnnn
❑ OTH
❑ PTY
[]SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL 250.00
*Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
SCHEDULE B - PART 1
Schedule B — Part 1 u m ay
Amounts may be rounded
Statement covers p eriod
P
.
Loans Received to whole dollars.
9/27/11
�
_ ' •
from
,
through 10/2711
page Cam— of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Donna Austin
1339133
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL ENTER
,
a
OUTSTANDING
(b)
AMOUNT
(c)
AMOUNTPAID
(d)
OUTSTANDING
(e)
INTEREST
(f)
ORIGINAL
(g)
CUMULATIVE
OF LENDER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
BALANCE
BEGINNING THIS
RECEIVED THIS
OR FORGIVEN
BALANCEAT
CLOSE OF THIS
PAID THIS
AMOUNTOF
CONTRIBUTIONS
(IF COMMITTEE, ALSO ENTERI.D. NUMBER)
NAME OF BUSINESS)
PERIOD
PERIOD
THIS PERIOD"
PERIOD
PERIOD
LOAN
TO DATE
Donna Austin,
Retired Teacher
❑ PAID
CALENDARYEAR
$ 0.00
$ 1000.00
0 ,
$ 1000.00
$ 1000.000
❑ FORGIVEN
RATE
PER ELECTION -
$ 1000.00
$ 0.00
$ 0.00
$
6/26/11
$
tW IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION **
RATE
UMI C UUC
UHI C IINUUMMMU
Lj IND I COM LJ OTH U PTY U SCC
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION"'
RATE
$
$
$
$
$
DATE DUE
DATE INCURRED
to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
SUBTOTALS $ 0.00$ 0.00 $ 1000.00 $ 0
Schedule B Summary
1 . Loans received this period ..................................................................................... ............................... $
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period .......................................................................... ............................... $
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) ................................ ............................... NET $
Enter the net here and on the Summary Page, Column A, Line 2.
'Amounts forgiven or paid by another party also must be reported on Schedule A.
'" If required.
0.00
0.00
0.00
(May be a negative number)
(Enter (e) on
Schedule E, Line 3)
tContributor Codes
IND – Individual
COM – Recipient Committee
(other than PTY or SCC)
OTH – Other (e.g., business entity)
PTY– Political Party
SCC – Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
NAME OF FILER
Donna Austin
SCHEDULEE
Statement covers period CALIFORNIA
from 9/27/11 FORM
through 10/2711 Page of
I.D. NUMBER
1339133
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment
CMP
campaign paraphernalia /misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)*
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing /ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff /spouse travel, lodging, and meals
IND
independent expenditure supporting /opposing others (explain)*
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate /sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR
DESCRIPTION OF PAYMENT
AMOUNT PAID
Barry Wyatt Associates Campaign consultants
CNS $ 1000.00
Mail #1, "Introduction" Mail File &Postage
Barry Wyatt Associates LIT $ 1275.00
Barry Wyatt Associates <ail # 2, "PureWomen" Design, printing, mail file,
LIT hand match, postage $950.00
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3225.00
Schedule E Summary
1. Itemized payments made this period. Include all Schedule E subtotals. 3225.00
2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 0.00
3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e). 0.00
4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 3225.00
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772)