460 Recipient Committee Campaign Statement - Preelection 7-01-20 to 9-19-20 Recipient Committee Bete 81.1y I COVER PAGE
Campaign Statement
Cover Page FFP�
Statement covers period Date of election if applica I e 1 °f 3
from
07/01/2020 (Month, Day, Year) S E P 2020 For Official Use Only
SEE INSTRUCTIONS ON REVERSE through 09/19/2020 11/03/2020 OPERTINO CITY CLERK
1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement:
Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure E,(] Preelection Statement (]Quarterly Statement
0State Candidate Election Committee Committee Semi-annual Statement
� ❑Special Odd-Year Report
0 Recall QControlled
(Also Complete Part5) QSponsored ❑Termination Statement
(Also Complete Part 6) (Also file a Form 410 Termination)
❑ General Purpose Committee ❑Amendment(Explain below)
0 Sponsored Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
(Also Complete Part 7)
Q Political Party/Central Committee
3. Committee Information I I.D.NUMBER 1369332 Treasurer(s)
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
Robert McCoy for Council 2020 Blossom McCoy
MAILING ADDRESS
20488 Stevens Creek Blvd#1101
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
20488 Stevens Creek Blvd#1101 Cupertino CA 95014 (408)916-7558
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Cupertino CA 95014 (408)916-7558
MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL:FAX/E-MAIL 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.
certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on 09/22/2020 By
Blossom McCoy
Date Signature of Treasurer or Assistant Treasurer
Executed onZ2/2-0z0 By �C�U�
Signature of Controlling Officeholder,Candidate,State Measure Proponent or Responsible Officer of Sponsor
Executed on
Date By Signature of Controlling Officeholder,Candidate,State Measure Proponent
Executed on By
C
Recipient Committee OVER PAGE-PART 2
Campaign Statement
Cover Page — Part 2
Page 2 of 3
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
Robert McCoy
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION SUPPORT
OPPOSE
RESIDENTIAUBUSINESS ADDRESS(NO.AND STREET) CITY STATE ZIP
Identify the controlling officeholder,candidate,or state measure proponent, if any.
NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT
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 OFFICE SOUGHT OR HELD DISTRICT NO.IF ANY
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D.NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate/Officeholder Committee List names of
DYES ❑NO officeholder(s)or candidate(s)for which this committee is primarily formed.
COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 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
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT
OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
DYES ONO QSUPPORT
COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(8661275-3772)
Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE
Summary Page to whole dollars. Statement covers period
from 07/01/2020
SEE INSTRUCTIONS ON REVERSE through 09/19/2020 Page 3 of 3
NAME OF FILER
I.D.NUMBER
Robert McCoy for Council 2020 1369332
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and
General Elections
1. Monetary Contributions ................................. .............. Schedule A,Line 3 $ 0.00 $ 0.00
2. Loans Received ............................................................. schedule e,Line 3 0.00 0.00 1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS ............................. Add Lines 1+2 $ 0.00 $ 0.00 20. Contributions
Received $ $
4. Nonmonetary Contributions......................................... Schedule C,Line 3 0.00 0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED............................ Add Lines 3+4 $ 0.00 $ 0.00 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made.............................................................. Schedule E,Line 4 $ 0.00 $ 0.00 Candidates
7. Loans Made...................................................................... ScheduleH,Linea 0.00 0.00
8. SUBTOTAL CASH PAYMENTS .. . Add Lines 6+ 0.00 0.00 22.Cumulative Expenditures Made*
....... ......... ............ $ $ (If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills)................................ Schedule F Line 3 0.00 0.00 Date of Election Total to Date
10. Nonmonetary Adjustment............................................. Schedule C,Line 3 0.00 0.00 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE ............................... Add Lines s+9+ 10 $ 0.00 $ 0.00 / / $
Current Cash Statement / / $
12. Beginning Cash Balance............................ Previous Summary Page,Line 16 $ 6,030.45
To calculate Column B, / / $
13. Cash Receipts.......................................................... Column A,Line 3 above 0.00 add amounts in Column
000 A to the corresponding *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash................................ .
......... Schedule i,Line 4 amounts from Column B reported in Column B.
of your last report. Some
15. Cash Payments........................................................ Column A,Line s above 0.00 amounts in Column A may
16. ENDING CASH BALANCE...... Add Lines 12+13+14,then subtract Line 15 $ 6,030.45 be negative figures that
should be subtracted from
If this is a termination statement, Line 16 must be zero. previous period amounts. If
this is the first report being
filed for this calendar year,
17. LOAN GUARANTEES RECEIVED.............................. Schedule e,Part 2 $ 0.00 only carry over the amounts
from Lines 2, 7, and 9(if
Cash Equivalents and Outstanding Debts any).
18. Cash Equivalents................................................. See instructions on reverse $ 0.00
FPPC Form 460(Jan/2016)
19. Outstanding Debts............................... Add Line 2+Line 9 in Column e above $ 0.00 FPPC Advice:advice@fppc.ca.gov(866/275-3772)