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460 Recipient Committee Campaign Statement - Semi Annual 1-1-21 to 6-30-21Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 01 /01 /2021 through 06/30/2021 1. Type Of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 0 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall O Controlled (Afro Complete Part 5) 0 Sponsored ❑ General Purpose Committee (Also Complete Part 6) 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part? 3. Committee Information I.D. NUMBER 137039( SAVITA VAIDHYANATHAN FOR CUPERTINO CITY COUNCIL 2018 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE CUPERTINO CA 95014 - MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE RDR[EC 10MG �} AUG 2, 2021 U CUPERTINO CITY CLERK Date Stamp Date of election if applicable: (Month, Day, Year) 11 /08/2018 1 2. Type of Statement: ❑ Preelection Statement .W Semiannual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE Page of For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER RAMAMURTHY VAIDHYANATHAN MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CUPERTINO CA 95014 - NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX I E-MAILADDRESS OPTIONAL: FAX / E-MAILADDRESS 4. Verification have used all reasons le diligence in preparing and reviewing this statement and to schedules is true and complete. I certify under penalty of erjury under the laws of the State of California that the foreg Executed on ! o ( `' G� ` g Date �% �j y Executed on Ql �c--r-i� gy Date ponsor Executed on By Date Signature of Controlling ORceholder, 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 OFFICEHOLDER OR CANDIDATE SAVITA VAIDHYANATHAN OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE) CUPERTINO CITY COUNCIL REST DENTIALIBUSI NESS ADDRESS (NO.ANDSTREET) 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 CODEiPHONE COMMITTEE NAME, I.D. NUMBER 1 NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE COVER PAGE - PART 2 Page 2- of 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 SUMMARY PAGE Summary page to whole dollars. Statement covers period , . from 01/01/2021 • - • 06/30/2021 7�:g--N SEE INSTRUCTIONS ON REVERSE through ofNAME OF FILERUMBER 1370390 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD FROM ATTACHED SCHEDULES] CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and 0 General Elections 1 . (Monetary Contributions ............... ..................... ............... Schedule A, Line 3 $ $ 2. Loans ReCelVed....._...__...................__ ... Schedule B. Line3 0 1/1 through 6130 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ............. Add 1 +2 0 $ $ 0 20. Contributions ............ G. Nonmonetary Contributions ................ ............ ............. ... Schedule C. Line 3 D 0 Received $ $ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 $ 0 $ 0 Made $ $ Expenditures Made 6. Payments Made.... .............................. ................... Schedule E. Line 4 $ 50.00 $ 50.00 7. Loans Made.. .... ...... ......... ....._............. ............ .... _. Schedule N. Line 3 0 0 S. SUBTOTAL CASH PAYMENTS ................... .......... Add Lines 6+7 $ 50.00 $ 50.00 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 $ 50.00 $ 50.00 Current Cash Statement 12. Beginning Cash Balance.— ........................ Previous Summary Page, Line 16 $ 13. Cash Receipts......_ ................. ....._.................. ........ Column A, tine 3above 14. Miscellaneous Increases to Cash .................................. schedule 1. Line 4 15. Cash Pavments ........_.._.....__......_.._.._._............... Column A. Line 6above fib. ENDING CASH BALANCE .._....._.._...Add Lines 12 + 13 + 14. then subtract Line 15 $ , f this is a termination statement. Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ............. ._.__._........ Schedule B. Part2 $ �cc.asx >maf c.fav GabaaLJ BRIiY vMLu'lipelAAiH IL�. LJCLJ Le? 18. Cash Equivalents .................... ..................... See instructions on reverse $ 19. Outstanding Debts......, ....................... Add Line 2+ Line 9 in Column B above $ To calculate Column B. 0 add amounts in Column 0 A to the corresponding amounts from Column B 50.00 of your last report. Some 4564.13 amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being 0 filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). I Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subjectto Voluntary Expenditure Limit) Date of Election Total to Date (m mlddi yy) Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (!an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded Statement covers period Payments Made to whole dollars. I from 01 /01 /2021 SEE INSTRUCTIONS ON REVERSE `� through 06/30/2021 Page rl of i 1370390 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP 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 workerssalaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POE 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 \NEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE IFGCMMiTTEE.ALSOENTER J.o.NUMBER) CODE OR DESCRIPTION OF PAYMENT ,AMOUNT PAID I I i I Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1. Itemized payments made this period. (Include all Schedule E subtotals.)................................................................................. 0.00 2. Uniternized payments made this period of under$100............................................................................... 50.00 ........... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 0.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 50.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule F Amounts may be rounded SCHEDULE F to whole dollars. Statement covers period • - Accrued Expenses (Unpaid Bills) 01/01/2021 • -M from through 06/30/2021 f' SEE INSTRUCTIONS ON REVERSE I Page of NAME OF FILER I.D. NUMBER 1370390 I CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/mist. MBR member communications RAID radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* DEC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees RHO phone banks TRC candidate travel; lodging. and meals END fundraising events ROL polling and survey research TRS staff/spouse 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 LIT campaign literature and mailings PRT print ads WEB information technoloav costs (internet. e-maih ,,AME AND ADDRESS OF CREDITOR !F coMMnreE, ALSO ENTER o NUMBER) I I CODE OR (a) OUTSTANDING (b) AMOUNT INCURRED (c) AMOUNT PAID (d) OUTSTANDING DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON s) OF THIS PERIOD Comp Tech Services WEB 177 I 0 0 177 I I - Fayments +.hat are contributions or independent expenditures must also be SUBTOTALS $ summarized on Schedule D. 177 $ 0 $ 0 $ 177 Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100. 0 p p p ) ..............................................INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on 0 accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under$100.)................................... PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)..............................................................................................................................................NET $ 0 M., be a -g.b e number FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www,fppc.ca.gov