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460 Recipient Committee Campaign Statement - Semi Annual 7-1-17 to 12-31-17Recipient Committee Campaign Statement Cover Page from Statement covers period 0710112017 SES INSTRUCTIONS ON REVERSE through 1213112017 1. Type Of Recipient CiliB'tMIttee: All Committees — Complete Parts 1, 2, 3, an;l 4. 7 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Q Recall (Also Canplela Pe, 5,1 ❑ General Purpose Committee Q Sponsored O Small Contributor Committee O Political PartylCentral Committee Committee 0 Controlled a Sponsored (Also Complele Part 6j ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complole foal i) 3. Committee Information W. NUMBER 1359332 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) MC COY FOR COUNCIL 2018, ROBERT STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODEIPHONE OPTIONAL: FAX I E-MAIL ADDRESS COVER PAGE Date Stamp (9)1._WLrq,7 Date of election if appiic : —�� age 1 �¢ (Month, Cay, Year) { JA� _ 3 2D78 X) For Official Use only ,.,1 PFQ ;1N Q' 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement 2 Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also Bile a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER BLOSSOM MCCOV MAI LING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEfPHONE OPTIONAL: FAX/ E-MAILADDRESS 4. Verification € 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. 1 certify under penalty of perjury under the laws of the State of California that the foregoing Responsible Officer of Sponsor Exemrted on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate; state Measure Praponerr# FPPC Form 460 (Ian/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) uuunru fnnc.ca_vnv Recipient Committee Campaign Statement Over Page — Part 2 v. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE ROBERT MCCOY OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CUPERTINO CITY COUNCIL RES] DENTIALIBUS!NESSADDRESS (NO.ANDSTREET) CITY STATE ZIP Related Committees Not lnciuded in this Statement: List any committees not included in this statement that are controlled by you or are primadly formed to receive contributions or make expenditures on behalf afyour candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. 80X) CITY STATE ZIP CODE AREACODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.C. BOX) COVER PAGE - PART 2 Page 2 of 4 6. PrImariiy Fan-ned Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME, OF OFFICEHOLDER, CANDIDATE, OR PROPONENT CE SOUGHT OR HELI DISTRICT NO. IF ANY 7. Primarily Formed Can didate/OfI;eholder Committee Listnames of of fceholder(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 CITY STATE ZIP CODE AREA CODEIPHONE ,attach continuation sheets ifnecessary FPPC Forma 460 (Jan/2016) FPPC Advice: advice@ffppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers period , s - Summary Page 47!4112417 e - � ® l from Expenditures Made 6. Payments Made .................. ..... through 12!3112017 Page 3 of 4 SEE INSTRUCTIONS ON REVERSE 4 8. SUBTOTAL CASH PAYMENTS ......................................... Add Lines 6+ 7 S 146.00 9. Accrued Expenses (Unpaid Bills) ...... ...... ......... -.................. schedule F Line 3 0 NAME OF FILER 10. Nonmenetary Adjustment......................................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE ......................... .. I.D. NUMBER MC COY FOR COUNCIL 2018, ROBERT 1369332 Contributions Received Column A TOTAL THIHFERIOD Column B CALENDAR YEAR Calendar Year Summary for Candidates (FROMA7-1 ACHED SCHEDULES) TO'rALTODATE Running in Both the State Primary and General Elections1. 0 4 Monetary COntdbutlons................................................... Schedule A, Line 3 $ $ 0 0 711 through 6130 7I1 to bate 2. Loans Received................................................................ schedule 3, Line s 0 0 2S. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ Received $ $ 0 0 4. Nonrnonetary Contributions ..........................................- schedule C, line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $ 0 $ 0 Made $ $ Expenditures Made 6. Payments Made .................. ..... Schedule E, Line 4 $ 146.00 7. Loans Made.... ........................................................ - ....... Schedule N. Line 3 4 8. SUBTOTAL CASH PAYMENTS ......................................... Add Lines 6+ 7 S 146.00 9. Accrued Expenses (Unpaid Bills) ...... ...... ......... -.................. schedule F Line 3 0 10. Nonmenetary Adjustment......................................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE ......................... .. Add Lines 8 + s + 10 $ 146.00 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 t, Line 4 15. Cash Payments ...................... -....... .......................... cohimr. A, Line 8 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 6, Parte $ Cash Equivalents and Outstanding debts 18. Cash Equivalents. ............................ - ................. See instructions on reverse $ 19. Outstanding Debts .............................. Add Lime 2 + Lhie gin Calumn 8 above $ 1256.45 0 0 146.00 1110.45 0 0 0 $ 242.00 0 $ 242.00 0 0 $ 242.00 To calculate Column B, add amounts in Column Atothe corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made (If Subject to voluntary Expenditure Limit) Date of Election Total to Hate (mmlddlyy) I 1. t $ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 450 (Jan12015) FPPC (Advice. advice@fppc.ca.gov (865]275-3772) tartaner.fppe.ta.gnv Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE MC COY FOR COUNCIL 2018, ROBERT Amounts may be rounded to whole dollars. E Statement covers from 07/0112017 through 12/31/2017 I Page 4 of CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1369332 CMP campaign paraphernalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmenetary)' OFC office expenses SAL campaign workers'salaries CVC civic donations PET petition circulating TEL Lv, 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 staftlspouse travel, lodging, and meals IND independent expenditure supportinglopposing others (explain)* PUS 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 UVEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE ,IF COMMrr7E2� ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID BANK OF AMERICA SERVICE FEES SECRETARY OF STATE * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).._. ................................................................................. $ 2. Uniternized payments matte this pedod of under $100.......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Fart 1, Column(e).)............................................................................. $ 4. Tatal payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary mage, Column A, Line B.)........................... TOTAL $ 146.00 0 0 146.00 FPPC Form 460 (1an/2015) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov