460 Recipient Committee Campaign Statement 7-1-15 to 12-31-15 Recipient Committee COVER PAGE
p (� a pp� Ar c-
• Campaign Statement D l5 C V ;r;�I;IFORNIA, .'4 'O
Cover Page
r i ORM.
Statement covers period Date of election if appllc r•E B 2 2016
from � � ', / of c
�// /2o/J> (Month,Day,Year) r CFor Official Use Only SEE INSTRUCTIONS ON REVERSE through /2/3//2--°/-t- i ( I Si /z°/SI- CIUPERTINO CITY CLERK
1. It
of Recipient Committee: AllCommittees—Complete Parts 1,2,3,and 4. 2. Type of Statement: ,I
IOfficeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement 0 Quarterly Statement
State Candidate Election Committee Committee [RI, Semi-annual Statement 0 Special Odd-Year Report
O Recall O Controlled 0 Termination Statement
(Also Complete Pert 5) 0 Sponsored (Also file a Form 410 Termination) •
(Also Complete Pmt 6)
❑ General Purpose Committee 0 Amendment(Explain below)
o Sponsored ❑ Primarily Formed Candidate/
o Small Contributor Committee Officeholder Committee
o Political Party/Central Committee (Also CoiipletoPert n
I.D.NUMBER
3. Committee Information /3 ,-/S-OS. Treasurer(s) •
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
. Sum of-/kiJ6
MAILING ADDRESS
B4-,2/et CK4i-461 'ion couilczt )-6 /e // <.
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/EMAIL 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.
•
Executed en _7/ /> / b By -
of Sponsor
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder Candidata,Stale Measure Proponent
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
•
www.fppc.ca.gov
• COVER PAGE-PART 2
Recipient Committee 60
CAL-IFRivi C
Campaign Statement F,oRnn. 4.VU
Cover Page — Part 2 1-
Page Z of J
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
PMiZ l2V Cf'!/k/f 67 PDR Co-u IBJ art ) /c4
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION
❑ SUPPORT
❑ OPPOSE
CA-T. 7-z/J o C%-r� uor /J
cCxL
RESIDENTIALBUSINESS ADDRESS (NO.A DSTREET) CITY STATE ZIP
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 QSUPPORT
❑ OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
El YES ❑ NO 111 SUPPORT
El OPPOSE
COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE
Summary to whole dollars. Statement covers period
Page 'CALIFORNIA 460
from 7/i/) /y FORM
SEE INSTRUCTIONS ON REVERSE through ,>/3 !/yo/� Page 3 of S
NAME OF FILER
// .D.NUMBER
B4ey/ CwAzI3rj Fo-R Cott/,/c L y0/Y' /32 /..C-05
Column A Column a Calendar Year Summary for Candidates
Contributions Received TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and
General Elections
1. Monetary Contributions Schedule A,Linea $ 935- - $ /6'7 3±-
•
in through 6130 7/1 to Date
2. Loans Received
Schedule 8,Line 3 O 0
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ 9 3S $ g 73 20. ContributionsReceived $ $
4. Nonmonetary Contributions Schedule C,Line 3 U 0 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines3+4 $ 93±- ---- $ /8731- r Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made Schedule E,Line 4 $ D $ i" ?'-t-7 Candidates
7. Loans Made Schedule H,Linea 0 0
8. SUBTOTAL CASH PAYMENTS Add Lines s+7 $ 0 22. Cumulative Expenditures Made*
$ (It Subject to Voluntary Expenditure Limit)
9. Accrued Expenses(Unpaid Bills) Schedule P Line 3 o eP 0 O 0 Date of Election Total to Date
10. Nonmonetary Adjustment Schedule C,Linea 0 0 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ f7 $ e1/7•-ry ___/_J $
Current Cash Statement _/___/ $
12. Beginning Cash Balance Previous Summary Page,Line 16 $ ( aPt °
O To calculate Column B,
13. Cash Receipts Column A,Line 3 above / 31. — add amounts In Column
A to the corresponding *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash Schedule I,Line 4 0 amounts from Column B reported in Column B.
15. Cash Payments Column A,Line 8 above 0 of your last report. Some
amounts in Column A may
16. ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $ >" a6, ?, be negative figures that
should be subtracted from
If this is a termination statement,Line 16 must be zero. previous period amounts. If '
this Is the first report being
17. LOAN GUARANTEES RECEIVED Schedule e,Parte $ b filed for this calendar year,
only carry over the amounts
Cash Equivalents and Outstanding Debts from Lines 2,7,and 9(if
any).
18. Cash Equivalents See instructions on reverse $
19. Outstanding Debts Add Line 2+Line 9 in Column 8 above $ tr&t' '
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Schedule A Amounts may be rounded SCHEDULE A
to whole dollars. Statement covers period
Monetary Contributions Received p ;cALIF..ORisirb �,�"j.0.i
from 7///>V/S FORM 46'0
SEE INSTRUCTIONS ON REVERSE through /1/4// /r Page1. of -
NAME OF FILER
I.D.NUMBER
9anRy cHA/J6/ -Pir4 Gau4 �L 7-0 Hi /22-/¢os
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTORIF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED
OF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION- AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
QF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED)
OF BUSINESS)
alr�,//•� pUzLZp P- ppLArca6r(z D❑OODM _
/I �.
❑scC f�
• `/ .f+ r MIND LAB GIcz.FC-tzvr ore
8/ '6-bu/J7 pLN y ❑cOM �GG.�
7/� /
❑SCC en,1(6-Iz. S
�y 01t7 CR / El IND
r
7/ /'/// --i. C l7&Cy ❑COM /�IPT(f � IyC61(Y�
i� S, /
❑SCC
-7/7/y d Int z L6 DCODM pity/CZ-CAL -Methf''r9
/ -
❑❑PTY
c P.y�• ??r�-
L ',h 2 Eril G �( IND y'�
7/v7/v1 q(5, r f . COM k(01-1O/`i� /` fl
SUBTOTAL$ )-Cb, ' t '-OQ, r
Schedule A Summary `Contributor Codes
1. Amount received this period—itemized monetary contributions. IND—Individual
•(Include all Schedule A subtotals.) $ y.)--k- ' COM—Recipient Committee
(other than PTY or SCC)
2. Amount received this period—unitemized monetary contributions of less than $100 $ 7 / 0• — OTH-Other(e.g.,business entity)
PTY-Political Party
3. Total monetary contributions received this period. / SOC-small Contributor committee
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ 9 3 k-
FPPC Form 460 clan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.)
Monetary Contributions Received to whole dollars. Statement covers period rCAJ;LIFO,RNIA` AC6
O
from 7/f /YD If FORM �1 V
through /311 /R-13 //1— y
Page 7 of 5-
NAME OF FILER
I.D.NUMBER
B 4-c g cgA J 6/ R to u/J evL -›-o> 4 / 3 )-/fib
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.B.NUMBER) CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
OF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DEC.31) IF
OF BUSINESS) t REQUIRED)
7, y�4( MA-0 MIND s ou�� eo P
❑OTH f�t'Ul"C�3t7'2 '-- — ,+—
�, l�
❑SCC � dL(7L 7i�TRLy1
❑IND
❑OOM
❑OTH
❑PTY
' ❑SCC
❑IND
❑COM
❑OTH •
❑PTY
❑SCC
❑IND
❑COM
❑OTH
❑PTY
❑SCC
❑IND
❑COM
❑OTH
❑PTY
❑SCC
•
SUBTOTAL$ )--.,: — c > r
`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(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov