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460 Recipient Committee Campaign Statement - Semi-Annual 01-01-2016 to 06-30-2016 COVER PAGE Rec6�ient Comrr��t�ee , �ate�m P �� . , Carnp�ign State��nt #,�� (� l� I�' ��l ��t ' � m ' • � Cov�r Page 1 q c i j�P'c�e � of 4 Statement covers period Date of election if applica. I JUL — 7 tQ�u � from 01/01/2016 (Monsh,Day,Yeaf) .•s' For Official Use Only SEE INSTRUCTIONS ON REVERSE througFa 06/30/2016 �vosi2o�s `. u JPEr�Tlf�O CITY CLE�K 1. Type of ReCiplerlt Committee: au committees-comp�ete warts�,z,s,a�a a. 2. Tjv e of Statement: � � Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement � State Candidate Clection Committee Commitfee � Semi-annual Statement ❑ Special Odd-Year Report � Recall � Contrd�lled ❑ Termination Statement ;nrsuCompletePartS) (� Sponsored (Also file a Form 41Q T�ermination) (Also CompleU�F�art 6) ❑ General Purpose Committee ❑ Amendment(Explain bc�low) �} Sponsored ❑ Primarily Formed Candidate/ � Small Contributor Committee Officeho9der Committee � Political Party/Centr�l Committee (aiso comp��c�Pa�f i� 3. Committee Inform.. . . , . . , ation I i.o.Nu""BER Treasa�rer(s) 1369332 . . COMMITTEE NAME(OR CAMDIDATE'S NAME IF NO COMMITTEE) NAME OFTREASURER MG COY FOR COUI�CIL 2016, ROBERT BL(�SSOM MCCOY MAILINv ADDRESS { NANIEOFASSISTANTTREASURER,IFANY CU6'ERTtNO CA 95014 669-231-4155 MABLINGADDRESS(IF DIFFERENI�NO.AND STREET OR P.O.BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CIN STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX 1 E-MAILADDRESS OPTIONAL: FAX/E-MAILADDRESS 4. Veri ... ..... . . ... fication 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 u�nder penalty of perjury under the laws of the State of California that the Oificer of Sponsor Executed on BY Date Signature of Contr91G Officeholder,Candidate,State Measure Proponent Executed on BY Date Signatura of ControEling Officeholder,Candidaie,State Measure Proponent FPf�C Form 460(Jan/2(D16) FPPC Advice:advice@fppc.ca.gov(866/275-3772} www.fnnc_ca.cnv GO�.�ER PAGE-PART 2 �''�� Recipient Comrr�i�tee � • �do4°;� � , � Campaign Staterraent � �� ' Co�rer Page — Part 2 Page 2— of 4 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed B�In�t Measure Co�arnittee NAME OF OFFICEHOLDER GR CANDIDATE NAME GF BALLOT MEASURE Robert McCoy . OFFICE SOUGHT OR HELD{6NCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER I JURISDICTION � � SUPPORT Cupertino City Council ❑ OPPOSE NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Rela�ed Committe�s 9Vot Included er� this Statement: zisranycomminees not fncluded in this staEement that are controlled by you or are piimardly formed to ieceive OFFICE SOUGHT OR HELD I DISTRICT NO.IF ANY contributions or make ezp�nditures on behalf of qrour candidacy. COMMITTEE NAME I.D.NUA4EER NAME OF TREASURER CONTROLLED COMMITTEE? 7• Pr�i��a�ily Formed C�a�edidate/Officet�o9�er Committee Listnames of officeholder(s)or candidat�(s)for which this coonmrttee is primaril y formed. ❑ YES ❑ NO _ CUPAMITTEE ADDRESS STREETADDRESS tN0 P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELU ❑ 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 � NAAAE OF OFFICEHOLDER UR CANDIDATE OFFICE SOUGHT OR HELl7 ❑ SUPPORT ❑ OPPOSE NAh�IE OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ Y'ES ❑ NO ❑ OPPOSE COP��MITTEEADDRESS STREETADDRE55 (NO P.O.BOX) • CITI�' STATE ZIP CODE AREA CODElPHOIVE AtCach continuation sheets if necessary FPPC Form 460(1an/2016} FPPC Advice:advice@fppc.ca.gov(866/275-3772} www.fppc.ca.go� Cia�ll c'�1 n Discic��re Statern��t Amounts snay be rounded SUMMARY PAGE p J t�o wl�ole dollars. Statement covers�ermod . ,-,� _ . � Surr�rrsary Page f�� 01/01/201�i -� _, ' • thrc�ugh 06/30/2�16 pa9e 3 of 4 SEE INSTRUCTIONS ON REVER9E NAME OF FILER I.D.NUMBER MC COY FOR COUNC9L 2016, ROBER.T 1369332 0 Colcamn A Column B Calendar�'ear Summary fcar Candidates Contributions Received TOTp,LTHISPERIOD CALENDARYEAR (FROMATfAGHEDSCHEDULESj TOTALTODATE Running iru �oth the Stat� F�rimary and General �9�ctions 1. Monetary Contribution�................................................... sonedui�a,r_��e s $ 0 � 1/1 through 6/30 7/1 to Date 2. L0811S RECeIV2d................................................................ Schedufe B,Line 3 � 20. Contributions 3. SUBTOTALCASHCO�lTRIBUTIONS.............................. .adaunes�+2 $ � �; Received $ $ 4. Nonmonetary Contributians............................................ s�ned�ie c,ti�e s � 21. Expenditures Made $ $ 5. TOTALCONTRIBUTIONS RECEIVED....................................AddCrnes3+4 $ � $ Exp�r�ditures Mad� Expenditaar� Limit Summary for State 6. Payrnents Made................................................................ soned��e F,u�e a $ 96.00 g Candidates 7. Loans Made....................................................................... Schedule H,Cine 3 � 22. �Lumulative Expenditures Made" 8. SU BTOTAL CASH PAYMENTS.......................................... Add Lines 6+7 g 96.00 � Qlf Subject to Voluntary Fxpenditure Limit) 9. Accrued Expenses (Unpaid Bills)..........................................soned�rP F,Line s � Date mf E9ection Total to Date 10. Nonmonetary Adjustm�nt........................................................soneduie r.,trne 3 0 (mrnldd�yy) 11. TOTAL EXPENDITU�,'ES MADE........................................Add�ines 8+g+�o $ 96.00 � _J_� � Curre . _. nt Cash Stat��ent —J---� � 12. Beg➢�1�11ftg CeSh B21�fYCe............................ Pr�vious Summary Page,Lrne 16 $ 1415.33 To calculate Column B, 13.Cash ReCeipts................... ........................... ColumnA.Line 3 above � add amounts in Column ............. A to the correspondino� *Amounts in this section may be different from amounts 14.Miscellaneous Increases to Cash.................................. Schedule r.Line 4 � amounts from Column B reported in Ccal�.amn B. 15. Cash Payments......................................................... co�umn a,�ine a anove 96.00 of your last report. Some a�rriounts in Column F�criay 16. ENDING CASH BALANCE ...................4dd�ines 12+13+14,then subtr,�ct Line 15 $ 1319.33 be negative figures that shoiild be subtracted from lf this is a termination staterrrent, Line 16 must he zero. prr�vious period amounts. If . . . .. .. thus os the first report beinq� 17. LOAN GUARANTEES RECEIVED................................ schedute�,Part 2 $ 0 filed for this calendar year, . anly carry over the amounts Cash �quivalents ��d Outstan�dor�g Debts frors}Lines 2.7,a� s nf 18. C35h EqUiVelents................................................ See instructions on reverse $ � �ny�. 19. OUtSt8f1dII19 DBb1S.............................. Add Line 2+Lrne 9 in Column 8 above $ � EPPC Form 460(Jan�2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772} www.fppc.ca.gov SCHEDUL�E Sched�le E Amounts may be rounded �tatement covers�e+eriod �w� - � Pa rra�nts Made to whole doitlars. � � . � y 01/01/20'16 � "" from through 06/30f2016 pa9� `� of 4 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER MC COY FOR COUNCIL 2016, ROBERT 1369332 CODES: If one of the fo6lawing codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernaloa/rvaisc. MBR member communications RAd radio airtime and production costs CNS campaign consultanis MTG meetings�nd appearances RFD returned contributo�mns CTB contribution(explain nonmonetary)' OFC office experases 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 banlcs TF�C candidate travel,io�ging,and meals FND fundraising events POL polling and survey research TP.S staff/spouse traveB,Eodging,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 professionaG services(legal,accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEE3 information technnEogy costs(internet,e-o�ail) NAMEANDADDRESS OF PAYEE (IFcoMMlrrEe,n�so eniTFi�i.o.NurneeR� CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID 96.00 Cupertana, CA 95014 *Payments that are contributions or independent expenditures must also be summarized on Scl7edule D. SUBTOTAL:� 96.00� Schedule E Summar� 1. Itemized payments made this period. (include all Scheduie � subtotals.)............................................................................................................. $ 96.00 2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 0 3. Total interest paid this pPriod on loans. (Er�ter amount from 5chedule B, P�rt 1, Column (e}.)............................................................................. $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Er�ter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 96.00 FPPC Form 460(Jan/2016) FPPC Adaice:advice@fppc.ca.gov(866/275-3772D www.fppc.ca.gov