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460 Recipient Committee Campaign Statement - Semi Annual 7-1-17 to 12-31-17Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 7/01/2017 through 12/31/2017 1. Type of Recipient Committee: All Committees - Complete Paris 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also complete Part 5) O Sponsored (also Complete Parf 6) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee O Political Party[Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1364110 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Paul for Council 2014 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX I E-MAIL ADDRESS ECE O V E COVERPAGE Date Stamp L11 JAN 3 G 2018 Date of election if applicabl p e1 of (Month, Day, Year)�� LERRr ficial Use Only 2, Type of Statement: © Preelection Statement ❑ Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also tine a Form 410 Termination) Statement -Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) 1/29/18 NAME OF TREASURER By Sharon Lee Dale Executed on By Dale Signature of Cwt>rollf ng Officeholder; Candidate, State MeasureProponent Executed on By Data Signat re ofControlling Officeholder, Candidate, State Measure Proponent FPPC Foran 460 (January/05) FPPC Toll -Free Helpline: 86WASK-FPPC (8661275 772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Darcy Paul OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Cupertino City Council RESIDENTIALIBUSINESS ADDRESS (NO. 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 CODEIPHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.D. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE - PART 2 Page 2 of , 5 6. Primarily Formed 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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Listnames of ofceholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME Or 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 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (86612753772) State of California Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. Statement covers period from 7/01/2017 SUMMARY PAGE through 12/3112017 Page 3 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Paul for Council 2014 1364110 Column A Column I3 Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR r RunningIn Both the State Primary and (FROMATTACHEDSCHEDULES) TOTALTODATE General Elections 1. Monetary Contributions ........................................... Schedule A Line 3 $ $ ill through 6130 711 to Date 2. Loans Received...................................................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ $ 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3+4 $ $ Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ....................................................... Schedule >_, Line 4 $ $ 30 Candidates 7. Loans Made............................................................. Schedule H, Line 3 22. Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ $ (IF Subject to VoluntaryapenditureLimit) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 (mm/dd/yy) 11. TOTAL EXPEN DITU RES MADE ................................ Add Lines 8+g+10 $ $ $ $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 1689'40 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash.. --_--------------------- Schedule 1, Line 4 from Column B of your last reported in Column B- 15. Cash Payments ........................................... Column A, Line a above """""' 30.00 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1659.40 figures that should be subtracted from previous If this is a temaination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17- LOAN GUARANTEES RECEIVED Schedule S, Parte $ for this calendar year, only ........................... carry over the amounts Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any)- 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Columns above $ 5000.00 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Schedule C Type or print in ink. SCHEDULE C Amounts may be rounded Nonmonetary Contributions Received to whole dollars. Statement covers period • - , ' from 7/01/2017 • - . through 12/31/2017 Page 4 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Paul for Council 2014 1304110 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OGCU PATION AN D EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER LD. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) GOODSORSERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) (IF REQUIRED) [:]IND Kaiser Foundation Health Plan, Inc. Gift Gift 10/20/17 El PTY ❑ SCC ❑[ND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY E] SCC ❑ IND ❑COM ❑ OTH ❑ PTY ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 150.00EEIfE{I��;F�', Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)..................................................................................................................... $ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 .................................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10-) ...................... TOTAL $ *Contributor Codes IND—Individual 150.00 COM—Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY—Political Party 150.00 SCC—Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7/01/2017 through 12/31/2017 Page 5 of 5 f NAME OF FILER I.D. NUMBER Paul for Council 2014 1364110 CODES: if one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphemalia/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 PEr petition circulating TEL t.v. or cable airtime and production costs F1L candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS stafflspouse travel, lodging, and meals IND independent expenditure supportinglopposing 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 Lrr campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail) * 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. Unitemized payments made this period of under $100 ........................ $ 30,00 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. ........... TOTAL $ 30.00 p Y p { Summary g )------------------ FPPC Form 460 (January/05) FPPC Toll -Free helpline: 8661ASK-FPPC (8661275-3772)