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460 Recipient Committee Campaign Statement - Semi Annual 7-1-21 to 12-31-21Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 07/01/2021 through 12131 /2021 Date of election if applicable: (Month, Day, Year) 11 /08/2018 Date Stamp R C C CE O M CEn JAN 30 2022 U CUPERTINO CITY CLERK COVER PAGE Page —Lof For Official Use Only 1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. 2. Type of Statement: W Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement O State Candidate Election Committee Committee ® Semi-annual Statement ❑ Special Odd -Year Report O Recall O Controlled ❑ Termination Statement (Also Complete Part5) O Sponsored (Also file a Form 410 Termination) El General Purpose Committee (Also cc;oplete Part s) ❑ Amendment (Explain below) O Sponsored ❑ Primarily Formed Candidate/ • Small Contributor Committee Officeholder Committee • Political Party/Central Committee (Also complete Part7) 3. Committee Information COMMITTEE I.D. NUMBER 1370390 SAVITA VAIDHYANATHAN FOR CUPERTINO CITY COUNCIL 2018 CITY STATE ZIP CODE ARFA r nDF/PHONF CUPERTINO MAILING ADDRESS CA 95014 CITY STATE ZIP CODE AREA CODE/PHONE 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and certify under penalty of perjury under the laws of the State of California that the fore Executed on ?4' By Date Executed on f�/�' 3---rL—®"� By Date Executed on Date Executed on Data Treasurer(s) NAME OF TREASURER RAMAMURTHY VAIDHYANATHAN MAILINGADDRESS CITY STATE ZIP CODE AREACODEIPHONE CUPERTINO CA 95014 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS R CITY STATE ZIP CODE AREA CODE/PHONE By Signature of Controlling Officeholder, Candidate. State Measure Proponent By Signature of Controlling Officeholder. Candidate, State Measure Proponent :s is true and complete. FPPC Form 460 (Jan/2016) FPPC Advice: adviceta?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 SAVITA VAIDHYANATHAN OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CUPERTINO CITY COUNCIL RESIDENTIAL/BUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP CUPERTINO, CA 95014 Related Committees Not Included in this Statement: Listany 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 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 COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) COVER PAGE - PART 2 Page 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. IFANY 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 STATE ZIP CODE_ AREA CODE/PFIONE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/2753772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. Statement covers period from _ 07/01 /2021 SUMMARY PAGE 12/31/2021 3 SEE INSTRUCTIONS ON REVERSE through g Page _ of NAME OF FILER I.D, NUMBER 1370390 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 0 0 1. Monetary Contributions. ............... .................................. Schedule A. Line 3 $ $ — 0 0 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule B. Line 3 0 0 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 $ _ 0 $ 0 Made $ $ 6. Payments Made.... ... ........................................................ Schedule E, Line 4 $ 159.00 $ 209.00 7. Loans Made....................................................................... Schedule H. Line 3 0 0 8, SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7 $ _ 159.00 $ 209.00 9. Accrued Expenses (Unpaid BINS) ..... ............. ...................... Schedule F Line 3 O 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE........................................Add Lines 6+9+10 $ _ _159.00 $ 209.00 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 i, 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 A- Line 9 in Column B above $ 4564.13 0 0 159.00 4405.13 0 0 1 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 arty). 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 eported in Column B. FPPC Form 460 (9an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gev SCHEDULE E Schedule E rI'll 1. r SEE INSTRUCTIONS ON REVERSE E OF FILER Amounts may be rounded to whole dollars. Statement covers period from 07/01/2021 through 12/31 /2021 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment Page = of I.D. NUMBER 1370390 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)* OFC 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 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 I_IT campaign literature and mailings PRT print ads WF_B information technology costs (internet, e-ma.il) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.U. NUMBER) CODE OR DESCRIPTION OF PAYMENT Wix.COM Online Hosting Annual website hosting fee WEB * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)..................................................................... 2. Unitemized payments made this period of under$100.................................................................................................. 3. Total interest paid this period on.loans. (Enter amount From Schedule B, Part. 1, Column(e).)..................................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) SUBTOTAL $ AMOUNT PAID 149.00 149.00 10.00 0.00 159.00 FPPC Form 460 (9an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE Schedule F Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 07/01 /2021 through 12/31 /2021 Page � of__ NAME OF FILER I.D, NUMBER 1370390 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 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 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 CREDITOR (IF COMMITTEE. ALSO ENTER LID. NUMBER) CODE OR DESCRIPTION OF PAYMENT ( OUTSTAA NDING BALANCE BEGINNING ( AMOUNT INNCURRED THIS PERIOD (c! AMOUNT PAID THIS PERIOD { OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD T Services WEB 177 0 0 177 Oakland, CA 94612 Payments that are contributions or independent expenditures must also be SUBTOTALS $ 177 $ 0 $ 0 $ 177 summarized on Schedule D. 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.) .............................................. INCURRED TOTALS $ ._ 0 2. Total accrued expenses paid this period. (include all Schedule F, Column (c) SUbtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100) ................... .. PAID TOTALS $ 0 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A. Line 9.)........................... NET $ 0 �� May be a negative number FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov