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460 Recipient Committee Campaign Statement 1-1-15 to 6-30-15Recipient Committee COVER PAGE Campaign Statement Type or print in ink. Cover Page D .1 (Gov ernment Code Sections 84200 - 84216.5) . Statement covers period Date of election if app JUL 3 1 L 2U15 11F.r from 1/1/2015 (Month, Day, Year of Official Use Only SEE INSTRUCTIONS ON REVERSE through 6/30/2015 ERTINO CITY CLER 1. Type of Recipient Committee: All Committees - complete Parts 1, 2, 3, and 4. 2. Type of Statement: ® Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee O Recall O Primarily Formed ® Semi - annual Statement ❑ Special Odd -Year Report (Also Complete Part 5) O Controlled 0 Sponsored Termination Statement ❑ Supplemental Preelection (Also Complete Part 6) ❑ Amendment (Explain below) Statement - Attach Form 495 ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1370390 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) VAIDHYANATHAN FOR CUPERTINO CITY COUNCIL 2014 STREET ADDRESS (NO P.O. BOX) 7704 OROGRANDE PL CITY STATE ZIP CODE AREA CODE /PHONE CUPERTINO CA 95014 408 - 489 -5048 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE Treasurer(s) NAME OF TREASURER RAMAMURTHY VAIDHYANATHAN MAILING ADDRESS 7704 OROGRANDE PL CITY STATE ZIP CODE AREA CODE /PHONE CUPERTINO CA 95014 408 - 420 -7629 NAME OF ASSISTANT TREASURER, IF ANY CAROLYN KRIZEK - MAHONEY MAILING ADDRESS 10870 KESTER DR. CITY STATE ZIP CODE AREA CODE /PHONE CUPERTINO CA 95014 408 - 725 -1767 OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS Savita4Council @gmail.com 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 Executed on Date Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Recipient Committee Type or print in ink. COVERPAGE -PART2 Campaign Statement CALIFORNIA 460 FORM Cover Page — Part 2 Page of 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE SAVITA VAIDHYANATHAN ❑ SUPPORT OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION SUPPORT CITY COUNCIL, CUPERTINO, CA J-1 :1 OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 7704 OROGRANDE PL., CUPERTINO, CA 95014 Identify the controlling officeholder, candidate, or state measure proponent, if any. ❑ SUPPORT NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees Not Included in this Statement: List any committees ❑ OPPOSE 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 ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? 7• Primarily Formed Committee List names of officeholder(s) or candidate(s) for ❑ SUPPORT which this committee is primarily formed. E] YES F-1 NO ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (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 STREET ADDRESS (NO P.O. BOX) 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 CITY STATE ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Campaign Disclosure Statement To calculate Column B, add Type or print in ink. 0 SUMMARY PAGE Summa Page g 122 $ Amounts may be rounded to whole dollars. 7. Loans Made .............................. ............................... Statement covers period CALIFORNIA , 0 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 122 $ from 1/1/2015 . FORM 0 0 10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 0 6/30/2015 4 SEE INSTRUCTIONS ON REVERSE 122 $ 122 through page of NAME OF FILER I.D. NUMBER RAMAMURTHY VAIDHYANATHAN 1370390 Contributions Received Column Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD (FROMATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Runnin in Both the State Primary and g 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ 0 $ 0 General Elections 2. Loans Received ....................... ............................... Schedule e, Lane 3 0 0 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ 0 $ 0 20. Contributions 4. Nonmonetary Contributions ..... ............................... Schedule C, Lane 3 0 0 Received $ $ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 0 $ 0 Made $ $ L—^FG'IIW1LU1C.7 W1112U11V To calculate Column B, add 0 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 122 $ 122 7. Loans Made .............................. ............................... Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 122 $ 122 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 0 0 10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 0 0 11. TOTAL EXPENDITURES MADE ................................ AddLines8 +g +lo $ 122 $ 122 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 6 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 $ 686 To calculate Column B, add 0 amounts in Column A to the corresponding amounts from Column B of your last 407 122 report. Some amounts in Column A may be negative 971 figures that should be subtracted from previous period amounts. If this is the first report being filed 0 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 51 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) / $ *Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Tv •. ...F ;— ...1. St :HFni II F R _ PART 1 %aL.l 1cuu1C o — rarL I Amounts may be rounded Statement covers period Loans Received to Whole dollars. _ ' • from 1/1/2015 . 6/30/2015 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER RAMAMURTHY VAIDHYANATHAN 1370390 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER a OUTSTANDING (b) AMOUNT (c) (d) OUTSTANDING (e) (f) (g) OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS AMOUNT PAID BALANCEAT INTEREST ORIGINAL CUMULATIVE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF - EMPLOYED, ENTER BEGINNING THIS PERIOD OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS NAMEOFBUSINESS) PER OD THIS PERIOD' PERIOD PERIOD LOAN TO DATE SAVITA VAIDHYANATHAN COMMUNITY LEADER ❑ PAID CALENDAR YEAR 7704 OROGRANDE PL "none" $ $ 51 0 3,051 $ 0 CUPERTINO, CA 95014 % RATE $ E] FORGIVEN PER ELECTION- $ $ $ t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR E] FORGIVEN FORGIVEN PER ELECTION ** to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ $ DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR E] FORGIVEN FORGIVEN PER ELECTION ** t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ DATE DUE DATE INCURRED SUBTOTALS $ 0 $ 0 $ 51 $ Schedule B Summary 1. Loans received this period .......................................... ............................... (Total Column (b) plus unitemized loans 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.) ............................. Enter the net here and on the Summary Page, Column A, Line 2. NET $ (Enter (e) on Schedule E, Line 3) 0 0 0 (May be a negative number) I Contributor Codes ND–Individual COM – Recipient Committee (other than PTY or SCC) OTH – Other PTY –Political Party SCC – Small Contributor Committer *Amounts forgiven or paid by another party also must be reported on Schedule A. If required. FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER RAMAMURTHY VAIDHYANATHAN Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 1/1/2015 through 6/30/2015 Page 5, of I.D. NUMBER 1370390 SCHEDULE E CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia /misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants NffG 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 (IFCOMMITrEE, ALSO ENTERLD. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Wells Fargo Bank OFC Service Charges - Bank Fees for account Maintenance 72.00 Secretary of State - California FIL Annual filing fee for FPPC ID 50.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 122.00 Schedule E Summary 1. Payments made this period of $100 or more. Include all Schedule E subtotals. 0 2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 122.00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ................................................ ............................... $ 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summa Page, Column A, Line 6. 122.00 P Y P ( Summary g ) ............................. TOTAL $ FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule I Tvve or print in ink. SCHEDULE I Miscellaneous Increases to Cash Amounts may be rounded Statement covers period to whole dollars. CALIFORNIA I ' from 1/1/2015 FORM through 6/30/2015 r _ SEE INSTRUCTIONS ON REVERSE Page J of NAME OF FILER I.D. NUMBER RAMAMURTHY VAIDHYANATHAN 1370390 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH City of Cupertino Refund of excess money paid for printing of 2/20/2015 ballot document (2/20/2015) 407 Attach additional information on appropriately labeled continuation sheets. Schedule I Summary 1. Increases to cash of $100 or more this period ............................................................................ ............................... $ 2. Unitemized increases to cash under $100 this period ................................................................ ............................... $ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) .. ............................... $ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ............................................................................................ ............................... TOTAL $ SUBTOTAL $ 407 0 0 407 407 FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC