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460 Recipient Committee Campaign Statement - Semi Annual 7-1-20 to 12-31-20Recipient Committee COVER PAGE Date Stamp CALIFORNIA I 60 Campaign Statement Cover Page ' RM Statement covers period Date of election if applicable: Flied Date- Page 1 of 5 For Official Use Only (Month, Day, Year) 02/01 /2021 05:52 from 07/01/2020 PM SEE INSTRUCTIONS ON REVERSE through 12/31/2020 1. Type of Recipient Committee: All Committees— Complete Parts 1, 29 3, and 4. 2. Type of Statement: Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement 3 State Candidate Election Committee Committee Semi-annual Statement ❑ Special Odd -Year Report 3 Recall 0 Controlled ❑ Termination Statement (Also Complete Part 5) O Sponsored (Also file a Form 410 Termination) ❑ General Purpose Committee (Also Complete Part 6) ❑Amendment (Explain below) 3 Sponsored ❑ Primarily Formed Candidate/ 3 Small Contributor Committee Officeholder Committee 3 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1408452 Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Jon Willey for Cupertino Council 2018 Joan Lawler Chin MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE Cupertino CA 95014 CITY STATE ZIP CODE AREACODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Cupertino CA 95014 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE CITY STATE ZIP CODE AREACODE/PHONE Cupertino CA 95015-1241 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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 01 /31 /2021 Executed on By Date Signature of Treasurer or Assistant Treasurer 02/01 /2021 Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officerof 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 (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) RESIDENTIAL/BUSINESS 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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑YES ONO 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 ONO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 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 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 Summary Page Amounts may be rounded to whole dollars. Statement covers period from 07/01/2020 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE through 12/31/2020 Page 3 of 5 NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1408452 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Prima and g Primary (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 1. Monetary Contributions Schedule A, Line 3 $ 200.00 $ 200.00 1/1 through 6/30 7/1 to Date 2. Loans Received............................................................ Schedule a, Line 3 0.00 0.00 3. SUBTOTAL CASH CONTRIBUTIONS ............................. Add Lines 1 +2 $ 200.00 $ 200.00 20. ContributionsReceived $ $ 4. Nonmonetary Contributions ......................................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............................ Add Lines 3+4 $ 200.00 $ 200.00 Made $ $ 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 $ current casn 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. 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................. See instructions on reverse $ 19. Outstanding Debts ............................... Add Line 2 +Line 9 in Column B above $ 0.00 $ 0.00 0.00 0.00 0.00 $ 0.00 0.00 0.00 0.00 0.00 0.00 $ 0.00 534.00 To calculate Column B, 200.00 add amounts in Column A to the corresponding 0.00 amounts from Column B of your last report. Some amounts in Column A may 0.00 734.00 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 0.00 any). 0.00 In 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 to whole dollars. Monetary Contributions Received Statement covers period . - from 07/01/2020 • - .1 SEE INSTRUCTIONS ON REVERSE through 12/31/2020 Page 4 of 5 NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 1 008452 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) * CODE (IF SELF-EMPLOYED, ENTER NAME THIS PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ./❑ IND Professional Engineer Jon Willey ❑ COM Applied Materials 8/3/2020 ❑ OTH 2O0.00 200.00 ❑ PTY Cupertino CA 95014 ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 200.00 Schedule A Summary 1. Amount received this period — itemized monetary contribution (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 $ 200.00 • •• *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 200.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Notes NOTES CALIFORNIA ._ i • Page 5 of 5 NAME OF FILER I.D. NUMBER Jon Willey for Cupertino Council 2018 �1408452 8/3/2020 - Willey Jon - 200.00 - Candidate self -funding to maintain bank balance