460 Debt Semi-Annual 1st ecipient Committee
Campaign Statement
(Govemmenl Code Sections 84200 - 84216.5)
f.m~ 01/01/2003
~rou~h 06/30/2003
1. Type of Recipient Committee:
[] Officeholder, Candidate Controlled Committee [] Ballot Measure Committee
0 State Candidate Election Committee
O Recall
[] General Purpose Committee 0 Sponsored
0 Small Contributor Committee
O Political Party/Central Committee
0 Pdmadly Formed
0 Controlled
O Sponsored
[] Primarily Formed Candidate
Officeholder Committee
990787
3. Committee Information
Dolly Sandoval for Supervisor - Debt Retirement
Committee
STREET ADDRESS (NO P.O. BOX)
10720 Alderbrook Lane
Cupertino CA 95014 (408) 725-8939
N/A
COVER PAGE - LONG FORM
2003 __. o, 6
CL
OPTIONAL: FAY'JE~MAIL ADDRESS
( ) /
PERTINO CITY (
2. Type of Statement:
[] Pre-election Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
For Official Use Only
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
Dolly Sandoval
STREET ADDRESS
10720 Alderbrook Lane
CITY STATE ZIP CODE AREA CODE~IPHONE
San Jose CA 95014 (408)725-8939
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
(
OPTIONAL: F A.v~'E 4,~ Al L 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 or~e~ate of Cal[~J~ia that the foregoing is true and correct.
Execut.,o. j zoo e, [,_...1_.
DATE
DATE
Executed on
DATE
Ex.tutti on
DATE
S/CCW - PC^B0501380 (Rev. 9/99)
SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE. STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR
By
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLtNG OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
State of California Fair Political Practices Commission.
ecipient Committee
Campaign Statement
Cover Page - Part 2
COVER PAGE - PART 2
Page 2 of
5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee
NA~ME OF OFFICEHOLDER OF CANDIDATE
MS. Dolores Sandoval
OFFICE SOUGHT OR HELD (INCLUDE LOCATION ~O OISTR~T NUMBER IF ~PUCABLE)
Board of Supervisors, District 5
RESIDE~IAL~USIN~$S ADDRESS (ND. AND STREW) Cl~ STATE Z~P CODE
10720 Alderbrook Lane Cupertino CA 95014
BALLOT NO. OR LE~FER JURISDICTION [] SUPPORT
D OPPOSE
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 consolidated statement that are controlled by you or which are pdmadly
formed to receive contributions or to make expenditures on behaff of your candidacy.
Friends of Dolores Sandoval 851028
Ed Hof fman
COMMI~EE ADDRESS STREET ADDRESS (NO P.O BOX)
10720 Alderbrook Lane
Cupertino CA 95014 (408) 725-8939
OFFICE SOUGHT OR HELD
7. Primarily Formed Committee
IDISTRICT NO IF ANY
NAME OF OFFICEHOLDER OR CANDIDATE
[] SUPPORT
[] OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE 3FFICE SOUGHT OR HELD [] SUPPORT
Campaign Disclosure Statement
Summary Page
from 01/01/2003
~rough 06/30/2003
SUMMARY PAGE
Page 3 of
NAME OF FILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement LD. NUMBER
Committee 990787
Contributions Received Column A Column B Calendar Year Summa~ for Candidates
1. Monetary Contributions ..................................... Schedule A, Line 3
2. Loans Received ................................................ Schedule B, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS .................. Add Lines I + 2
4. Non-monetary Contributions ............................. Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED ................. Add Lines 3 + 4
(~cROM ATTACHED SCHEDULES)
0.00
0.00
0.00 $
0.00
TOTAL TO DATE
$ 0.00
Expenditures Made
6. Cash Payments ................................................ Schedule E, Line 4
7. Loans Made ...................................................... Schedule H, L~We 7
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
110,000.00
110,000.00
0.00
0.00 $ 110,000.00
$ 0.00 $
0.00
$ 0.00 $
Current Cash Statement
12. Beginning Cash Balance .......... Previous Summary Page, Line 16
13. Cash Receipts ......................................... Column A, Line 3 above
14. Misceilaneous Increases to Cash ..................... Schedule I, Line 4
15. Cash Payments ....................................... Column A, Line 8 above
16. ENDING CASH BAI/~ICE~es 12 + 13 + 14, then subtract Line 15
If this is a Termination Statement, Line 16 must be zero.
0.00
0.00
$ 0.00
17. LOAN GUARANTEES RECEIVEDSchedule B, Part 1, Column (b) $
$ 23,250.92
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................................................ $.
19. Outstanding Debts .......... Add Line 2 + Line 9 in Column C above $
0.00
73.38
0.00
$ 23,324.30
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
General Ele~tens
111 through 6/30
20. Contdbutions
Received .... $_
21. Expenditures
Made .......... $
Ezpenditum Umit Summary for State
Candidates
22. Cumulative Exenditure Made*
(If Subjec~ to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/d6/yy)
SICCW - PCAB05 01380 (Rev. 9/99)
chedule B - Part I
Loans Received
Statement covers period
from 01/01/2003
through 06/30/2003
SCHEDULE B - Pad I
NAME OF FILER
Ms. Dolores Sandoval,
Committee
Ms. Dolores Sandoval
10720 Aide,brook Lane
Cupertino, CA 95014
Dolly Sandoval for Supervisor - Debt Retirement
FULL NAME. STREET ADDRESS AND ZIp CODE IF AN INDIVIDUAl., ENTER
OF LENDER OCCUPATION AND EMFt-OYER
(IF SE[J'EMPLOYED. ENTER
(IF COMMI~EE, ALSO EN]ER ID NUMBER) NAME OF BUSINESS)
Councilmember
[] 'ND [] COM [] OT" [] pl~ [] SCC
Ms. Dolores Sandoval
(Continued)
[] ,.D [] COM [] OTH [] P~¥ [] SCC
Ms. Dolores Sandoval
(Continued) (Continued)
City of Cupertino
a)
OUTSTANDING
~ALANCE
BEGINNING THIS
$ 20,000
$ 25~000
$ 40 000
(b) (c)
AMOUNT A~MO UNT PAID
RECEIVED THiS OR FORGIVEN
PERIOD THIS PERIOD
$ 0
$ 0
[],.o []COM[]O~H []~ []SCC
[] PAID
$ 0
[] FORGIVEN
$ 0
[] PAIO
$ 0
[] FORGIVEN
$__o
OUTS](AN DiNG
BALAN~ E AT
CLOSE OF THIS
PERIOQ
20~000
L2/3i/2004
DATE DUE
25,000
DATE DUE
$ 40~000
DATE DUE
(e) (0
INTEREST ORIGINA[. CUMULATIVE
PAID THIS AMOUNT OF CONTRIBUTIONS
O.000
RATE
$ 0
0,000 %
$ 0
0.000 .%
RATE
$ 0
$ 20,000
DATEINCURREO
25,000
02/29/2000
DATEINCURRE~
$ 40,000
11/06/2000
IATEINCURRED
CALENDAR yEAR
$
PER ELECTION
$
CALENDAR yEAR
$ PER ELECTIO~
SUBTOTAL $ 0.00 $ o.oo $ sS,ODD.OD $ o.oo
Schedule B Summary
1. Loans received this pedod ............................................................................................................ $
(Total Column (bi plus initemized loans 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 par%/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
0.00
0.00
0.00
SCHEDULE B - Pad I (cont.)
Schedule B - Part I (Continuation Sheet)
Loans Received ~m 01/Ol/2003
through.06/30/2003 Page 5 of 6
NAME OF FILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement I.D. NUMBER
Committee 990787
(
a) (b) (c) ~d)
Ms. Dolores Sandoval []
(Continued) (Continued)
(Continued) $ ° $ 3°'°°° °'°°° RATE % $ 1Or 000
$ 10,000 0 $ 0 12/31/2004 $ 0 11/13/2000
[] IND [] COM [] OTH [] pTY [] SCC OATEOUE DATE INCURRED
Ms. Dolores Sandoval []
(Continued) (Continued)
(Continued) (Continued) $ 0 $ 15,000 O.O00RATE % $ 15,000
15,000 $ 0 ; 0 12/31/2004 $ 0 11/18/2000 $
[] IND [] COM [] OTH [] PTY [] SCC DATEDUE DATEINCURRED
[] lED [] COM [] OTH [] PTY [] SCC DATE DUE DATE INCURRED
[] IND [] COM [] OTH [] P"~f [] $CC DATE DUE DATE INCURRED
SUBTOTAL $ o.oo $ o.oo $ 25,000.00 $ o.oo
SCHEDULEI
Schedule I Statement cove*~ period ~ i, ,~A~I
Miscellaneous Increases to Cash ~. 01/01/2003
through 06/30/2003 Page 6 of 6
qAMEOFFILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement I.D. NUMBER
Committee 990787
FULL NAME AND ADDRESS OF SOURCE
DATE (~F COMMITTEE, IN ~DOITION TO COMMITTEE~ NAME AJ~D ADDRESS, ENTER I.D. NUMBER DESCRIPTION OF RECEIPT AMOUNT OF
RECEIVED OR. iF NO ID NUMBER ~,AS BEEN A~SIGNED, ENTER TREASURER'S NAM~ & AOORESS) INCREASE TO CASH
SUBTOTAL $ 0.0o
0.00
Miscellaneous Increases to Cash Summary
l. Increases to cash of $100 or more this period ....................................................................................
2. Increases to cash under $100 this period.
(Do not itemize.) ................................................................................................................................
3. Total of all interest received this period on loans made to others.
(Schedule H, Part II (b).) ....................................................................................................................
4. Total miscellaneous increases to cash this period.
(Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 15.) ........................... TOTAL
73.38
0.00
73.38