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460 Recipient Committee Campaign Statement - Preelection 1-01-18 to 9-22-18Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE COVER PAGE Date�StampCALIFOF ; 0 - INIA/ FORM Statement covers period Date of election if appltcablle` ser s Page' 1 of from 01/01/201 8 (Month, Day Year) 5 For Official Use Only through 09/22/2018 1. Type of Recipient Committee: All Committees— Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) El General Purpose Committee Q Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information Jon Willey for Cupertino Council 2018 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX NAME OF ASSISTANT TREASURER, IF ANY Eric Shaefer MAILING ADDRESS OPTIONAL: FAX/E-MAIL 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. By By By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (1an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 09/25/2018 Executed on Date 09/25/2018 Executed on Date Executed on Date Executed on By By By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (1an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Jon Willey OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Cupertino City Council 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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMM IT -FEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page 2 of 1k 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 List names of officeholder(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 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 Statement covers period . Summary Page to whole dollars. , from 01/01/2018 • - • , Expenditures Made 6. Payments Made................................................................ 09/22/2018 3 7817.58 7. Loans Made....................................................................... Schedule H. Line 3 0 through 8. SUBTOTAL CASH PAYMENTS .......................................... Page of SEE INSTRUCTIONS ON REVERSE 7817.58 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0 0 10. Nonmonetary Adjustment......................................................... NAME OF FILER 0 0 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 $ I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 Contributions Received Column A TOTAL THIS PERIOD Column B Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 11375.64 11375.64 1. Monetary COntrlbUtlOf1S................................................... Schedule A, Line 3 $ $ 0 0 1!1 through 6130 7/1 to Date 2. Loans Received ................................................................ Schedule B, Line 3 11375.64 11375.64 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ Received $ $ 0 0 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED_ ................ ---------- Add Lines 3 + 4 $ 11375.64 $ 11375.64 Made $ $ Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 7817.58 $ 7817.58 7. Loans Made....................................................................... Schedule H. Line 3 0 0 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 +7 $ 7817.58 $ 7817.58 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 $ 7817.58 $ 7817.58 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 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. 0 11375.64 0 7817.58 3558.06 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $ 1 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ To calculate Column B, add amounts in Column A to the 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 Date (mm/dd/yy) $ -�� $ *Amounts in this section may be different from amounts reported in Column B. 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 Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA 01/01/2018 from , , 0 . 09/22/2018 4 INSTRUCTIONS ON REVERSE through of Page NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Ignatius and Josephine Ding 0 IND El COM Retired 8/2/2018 ❑ OTH ❑ PTY ❑ scc Catherine and John Moore ® IND ❑ COM Volunteer Engineer 8/6/2018 ❑ PTY ❑ SCC Wayne and Joan Chin is IND 171ere COM Retired 8/6/2018 ❑ PTY ❑ SCC Lisa and Michael Warren 0IND El COM Realtor, Intero 8/8/2018 ❑ OTH ❑ PTY ❑ SCC Tessa Parrish ® IND Realtor, RHM Realty 8/8/2018 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 3600.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 11050.00 325.64 11375.64 '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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period . from 01/01/2018 . 1 ' page 5 of through 09/22/2018 NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 DATE SS FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED F COMMITTEE, ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Danessa Techmanski is IND Retired 8/9/2018 ❑ PTY ❑ SCC Liana Crabtree ® IND Community Activist 8/9/2018 ❑ OTH ❑ PTY ❑ scc Pamela Hershey lia IND Retired Teacher 8/13/2018 ❑ OTH ❑ PTY ❑ SCC James Moore 621 IND Retired 8/15/2018 ❑ PTY ❑ SCC Gregory Schaffer ® IND Retired 8/17/2018 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 3700.00 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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA from 01/01/2018 FORM 460 Page 2_ through 09/22/2018 of NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR F COMMITTEE, CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Phyllis Dickstein is IND Retired 9/12/2018 E] OT TY servant ❑ scC Loan T Tran 2 IND Library Specialist, 8/27/2018 ❑ OTH ❑ PTY ❑ SGC Caryl Gorska ® IND Graphic Designer, 8/27/2018 ❑ OTH ❑ PTY ❑ SCC Yuwen Su is IND Engineer, Amazon 8/27/2018 ❑ PTY ❑ SCC Alan Penn ® IND Retired 8/27/2018 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 1300.00 *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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA from 01/01/2018 FORM Page 7 of I'll, through 09/22/2018 NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR COMMITTEE, CONTRIBUTOR CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Cathy and David Tsang ® IND Retired 08/80/2018 ❑ OTH ❑ PTY ❑ SCC Balaji Sesbachalan ® IND IT and HR, Self-employed 9/2/2018 ❑ OTH ❑ PTY ❑ SCC Vicky Yutronic ® IND Requested 9/7/2018 ❑ OTH ❑ PTY ❑ SCC Yue Wang 62IND Marketing, ASI 9/10/2018 ❑ PTY ❑ SCC Muni Madhdhipatia 0IND Software Professional, 9/6/2018 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 1350.00 '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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period I CALIFORNIA from 01 /01 /2018• ' e 0 through 09/22/2018 Page 8 of NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Jiong Cao P IND SW QA Engineer, Apple 9/10/2018 ❑ OTH ❑ PTY ❑ SCC Candice Lucado O IND SAHM Not employed 9/7/2018 ❑ OTH ❑ PTY ❑ SCC Dongming Yao ® IND Engineer, Intel 9/11/2018 ❑ OTH ❑ PTY ❑ SCG Mary Ellen Chell (✓� IND Retired, The Universe 9/11/2018 ❑ PTY ❑ SCC Ray Wang ® IND Analyst, Self-employed 8/13/2018 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 900.00 `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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA 460 from 01101/2018 FORM Page 9 of through 09/22/2018 NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR ET AD TEE S SO ENTER CONTRIBUTOR � IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Herching Ku ® IND Retired 9/11/2018 ❑ PTY ❑ SCC Larry Russel 0IND Retired 9/17/2018 ❑ OTH ❑ PTY ❑ SCC Suzanne Keehn ® IND None 9/23/2018 ❑ OTH ❑ PTY ❑ SCC Requested 1�2 IND Requested 9/23/2018 ❑ COM 500.00 500.00 ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 1200.00 *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 Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period from 01/01/2018 SCHEDULE E SEE INSTRUCTIONS ON REVERSE through 09/22/2018 Page 10 of 11 NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/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 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 FIND 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID City of Cupertino Advantage Grafix Graphic Affect * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2563.07 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. 7649.60 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 167.98 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 0 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 7817.58 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule EAmounts may be rounded SCHEDULE E (CONT.) (Continuation Sheet) to whole dollars. Statement covers periodCALIFORNIA 460 Payments Made from 01/01/2018 FORM 11 11 SEE INSTRUCTIONS ON REVERSE through 09/22/2018 Page of NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/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 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 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Prismatic Signs City of Cupertino CardConnect eBay BuildASign Fortune Graphics GMP 275.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 5086.53 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov