460 Recipient Committee Campaign Statement - Semi Annual 7-1-23 to 12-31-23Recipient Committee COVER PAGE
Campaign Statement Date Stamp
CALIFORNIA
Cover Page FORM
Statement covers period
from 07/01/2023
SEE INSTRUCTIONS ON REVERSE I through 12/31/2023
1. Type of Recipient Committee: All Committees— Complete Parts 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee
❑ Primarily Formed Ballot Measure
O State Candidate Election Committee
Committee
3 Recall
C ] Controlled
(Also Complete Part 5)
O Sponsored
❑ General Purpose Committee
(Also Complete Part 6)
3 Sponsored
❑ Primarily Formed Candidate/
O Small Contributor Committee
Officeholder Committee
13 Political Party/Central Committee
(Also Complete Part 7)
3. Committee Information
I I.D.NUMBER 1448574
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Sheila Mohan For Cupertino City Council 2022
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIPCODE AREACODE/PHONE
Cupertino CA 95014 (
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P O BOX
CITY STATE ZIPCODE AREACODE/PHONE
OPTIONALFAX / E-MAIL ADDRESS
sheilamohanl
of election if applicable: Filed Date: Page 1 of 4
(Month, Day, Year) 01/15/2024 02:33 For Official Use Only
PM
11 /08/2022
2. Type of Statement:
❑ Preelection Statement
.!❑ Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
❑ Quarterly Statement
❑ Special Odd -Year Report
Treasurer(s)
NAME OF TREASURER
Ram Mohan
MAILING ADDRESS
10960
STATE
Cupertino CA
ZIP CODE AREACODE/PHONE
95014 (408)
OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE
ZIP CODE AREACODE/PHONE
OPTIONAL' FAX / E-MAIL ADDRESS
ram@singularventures.
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.
Executed on 01/15/2024 By Ram
Signature of Treasurer or Assistant Treasurer
Executed on 01/15/2024 By Ms
Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661276-3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Ms Sheila Mohan
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
City Council Member: Cupertino
RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Cupertino CA 95014
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 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)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
Page 2 of 4
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
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
to whole dollars.
Summary Page
Statement covers period
from 07/01/2023
SUMMARYPAGE
SEE INSTRUCTIONS ON REVERSE
through
12/31/2023
Page 3 of 4
NAME OF FILER
I.D. NUMBER
Sheila Mohan For Cupertino City Council 2022
1448574
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTAL THIS PERIOD
CALENDARYEAR
Running in Both the State Prima and
Primary
(FROM ATTACHED SCHEDULES)
TOTAL TO DATE
9
General Elections
1. Monetary Contributions ................................................
Schedule A, Line 3
$ 0.00 $
107.00
1/1 through 6/30 7/1 to Date
2. Loans Received............................................................
Schedule B, Line 3
0.00
10,500.00
3. SUBTOTAL CASH CONTRIBUTIONS .............................
Add Lines 1 +2
$ 0.00 $
10,607.00
20. Contributions
Received $ 10,607.00 $ 0.00
4. Nonmonetary Contributions .........................................
schedule C, Line 3
0.00
0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED. .. . .
.. . Add Lines 3+4
$ 0.00 $
10,607.00
Made $ 650.00 $ 0.00
Expenditures Made
6. Payments Made...............................................................
Schedule e, Line 4 $
7. Loans Made......................................................................
Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS ........................................
Add Lines 6+7 $
9. Accrued Expenses (Unpaid Bills) ................................
Schedule F, Line 3
10. Nonmonetary Adjustment .............................................
Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ...............................
Add Lines 8+9+10 $
0.00 $
650.00
0.00
0.00
0.00 $
650.00
0.00
0.00
0.00
0.00
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $
3,121.86
13. Cash Receipts.......................................................... Column A, Line 3 above
0.00
14. Miscellaneous Increases to Cash ................................ Schedule 1, Line 4
0.00
15. Cash Payments........................................................ Column A, Line 8 above
0.00
16. ENDING CASH BALANCE...... Add Lines 12+13+14, then subtract Line 15 $
3,121.86
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED .............................. Schedule e, Part 2 $ 0.00
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................. See instructions on reverse $ 0.00
19. Outstanding Debts ............................... Add Line 2 +Line 9 in Column B above $ 10,500.00
$
0.00
650.00
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 (8661275-3772)
www.fppc.ca.gov
SCHEDULE B - PART 1
Schedule B - Part 1 ""'v le dollars. �
to whole dollars.
Statement covers period
Loans Received
•
from 07/01/2023
�
SEE INSTRUCTIONS ON REVERSE
through 12/31/2023
4 of 4 Pa e
9
NAME OF FILER
I.D. NUMBER
Sheila Mohan For Cupertino City Council 2022
1448574
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
�a)
OUTS ANDING
BALANCE
(b)
AMOUNT
(c)
AMOUNT PAID
(4)
OUTSTANDING
BALANCE AT
(a)
INTEREST
(f)
ORIGINAL
(g)
CUMULATIVE
OF LENDER
(IF SELF-EMPLOYED, ENTER
BEGINNING THIS
RECEIVED THIS
OR FORGIVEN
CLOSE OF THIS
PAID THIS
AMOUNT OF
CONTRIBUTIONS
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
NAME OF BUSINESS)
PERIOD
PERIOD
THIS PERIOD*
PERIOD
PERIOD
LOAN
TO DATE
[-)PAID
CALENDAR YEAR
Ram Mohan
Retired
$ 0.00
$ 100.00
0.00
100.00
$ 0.00
$
DFORGIVEN
PER ELECTION**
RATE
Cupertino CA 950144768
$ 100.00
$ 0.00
$ 0.00
$ 0.00
05/17/2022
10,500.000-22
tOIND LJCOM DOTH 0 PTY 0 SCC
DATE INCURRED
$
DATE DUE
PAID
CALENDAR YEAR
Ram Mohan
Retired
0.00
400.00
0.00
400.00
0.00
$
$
$
$
FORGIVEN
RATE
PER ELECTION**
Cupertino CA 950144768
$ 400.00
$ 0.00
$ 0.00
$ 0.00
05/18/2022
10,500.00 G-22
$
tQIND LJCOM LJOTH Lj PTY LJSCC
DATE DUE
DATE INCURRED
PAID
CALENDAR YEAR
Ram Mohan
Retired
0.00
$ 10,000.00
0.00 �
10,000.00
$ 0.00
$
$
PER ELECTION**
0 FORGIVEN
RATE
Cupertino CA 950144768
10,000.00
$ 0.00
$ 0.00
$ 0.00
06/06l2022
10,500.000-22
$
t D IND COM OTH Lj PTY Lj SCC
$
DATE DUE
DATE INCURRED
SUBTOTALS $ 0.00 $ 0.00 $ 10,500.00 $ 0.070
Schedule B Summary
1. Loans received this period....................................................................................................................... $
(Total Column (b) plus unitemized loans of 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.)................................................................... NET $
Enter the net here and on the Summary Page, Column A, Line 2.
*Amounts forgiven or paid by another party also must be reported on Schedule A.
** If required.
0.00
0.00
0.00
(May be a negative number)
(Enter (a) on
Schedule E, Line 3)
*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