460 Semi-Annual (Debt Retirement)
Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
~~
~!
from
01/01/2007
06/30/2007
Date of Election ~ !NO CITY CLERK
(Month, Day, Year)
Page 1 of 6
A For Official Use Only
Statement covers period
through
1. Type of Recipient Committee:
III Officeholder, Candidate Controlled Committee 0 Ballot Measure Committee
o State Candidate Election Committee 0 Primarily Formed
o Recall 0 Controlled
o Sponsored
2. Type of Statement:
o Pre-election Statement
III Semi-annual Statement
o Termination Statement
o Amendment (Explain below)
o Quarterly Statement
o Special Odd-Year Report
o Supplemental Pre-election
Statement - Attach Form 495
o General Purpose Committee
o Sponsored
o Small Contributor Committee
o Political Party/Central Committee
o Primarily Formed Candidate
Officeholder Committee
3. Committee Information
I.D. NUMBER
990787
Treasurer(s)
COMMITTEE NAME
(408)725-8939
NAME OF TREASURER
Dolly Sandoval
MAILING ADDRESS
10720 Alderbrook Lane
CITY
San Jose
NAME OF ASSISTANT TREASURER, IF ANY
STATE ZIP CODE
CA 95014
AREA CODE/PHONE
(408)725:"'8939
Dolly Sandoval for Supervisor-Debt Retirement
Committee
STREET ADDRESS (NO P.O. BOX)
10720 Alderbrook Lane
CITY STATE ZIP CODE
Cupertino CA 95014
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
AREA CODE/PHONE
MAILING ADDRESS
CITY
STATE
ZIP CODE
AREA CODE/PHONE
CITY
STATE
ZIP CODE
AREA CODE/PHONE
OPTIONAL: FAXlE.MAll ADDRESS
/
OPTIONAL: FAXlE.MAll 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 tate of California e for~g is true and correct.
. \
Executed on ~ ~ <g \ WOl By .
DATE
Executed on ---=:JJ l ~ \ 2.c u '}
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF 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
State of California Fair Political Practices Commission.
S/CCW - PCAB05 01380 (Rev. January/OS)
Recipient Commi1fteEipient Committee
Campaign Stateme6Bmpaign Statement
Cover Page -<mare~ Page - Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OF CANDIDATE
Ms. Dolores Sandoval
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Board of Supervisors, District 5, Santa Clara County
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP CODE
10720 Alderbrook Lane
Cupertino
CA 95014
Related Committees Not Included in this Statement: List any committees
not included in this consolidated statement that are controlled by you or which are primarily
formed to receive contributions or to make expenditures on behalf of your candidacy.
COMMITTEE NAME
I.D. NUMBER
Friends of Dolly Sandoval
NAME OF TREASURER
1277455
CONTROLLED COMMITTEE?
Sarah Hathaway-Felt
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
10720 Alderbrook Lane
CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 95014 (408)725-8939
COMMITTEE NAME 1.0. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
Page
2 of
6
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION
o SUPPORT
o 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
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT
o OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT
o OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT
o OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT
o OPPOSE
Campaign Disclosure Statement
Summary Page
SUMMARY PAGE
Statement covers period
C\L1FORNI\ 460
FORI\I
kom 01/01/2007
through 06/30/2007
Dolly Sandoval for Supervisor-Debt Retirement Committee
NAME OF FILER Ms. Dolores Sandoval,
Contributions Received Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
1. Monetary Contributions ""..............................". Schedule A, Line 3 $ 0 . 0 0
Column B
CALENDAR YEAR
TOTAL TO DATE
$
0.00
110,000.00
110,000.00
0.00
110,000.00
2. Loans Received .........."................"...........".".. Schedule 8, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS .................. Add Lines 1 +2 $
0.00
0.00
0.00
0.00
$
4. Nonmonetary Contributions ......................."..". Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED "...""""".. Add Lines 3 + 4 $
$
Expenditure Limit Summary for State
Candidates
Expenditures Made
6. Cash Payments """"".""..........."..............""" Schedule E, Line 4 $
7. Loans Made ..."""...................................."...".. Schedule H, Line 7
8. SUBTOTAL CASH PAYMENTS ........"."""........... Add Lines 6 + 7 $
0.00
0.00
0.00
0.00
0.00
0.00
$
0.00
0.00
0.00
0.00
0.00
0.00
$
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 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 "......"" Lines 12+13+14, less Line 15 $
$
25,942.73
0.00
25.89
0.00
25,968.62
If this is a Termination Statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVEDSchedule 8, Part 1, Column (b) $
Cash Equivalents and Outstanding Debts
0.00
18. Cash Equivalents .."............................................................"......"......$.
19. Outstanding Debts .......... Add Line 2 + Line 9 in Column C above $
0.00
110,000.00
S/CCW - PCAB05 01380 (Rev. January/OS)
Page 3 of
I.D. NUMBER
6
990787
Calendar Year Summary for Candidates
Running in Both the State Primary and
General ElecUons
1/1 through 6/30 7/1 to Date
20. Contributions
Received "" $
21. Expenditures
Made ".""". $
22. Cumulative Expenditure Made*
(If Subject to Voluntary Expenditure Limit)
Date of Election
(mm/dd/yy)
Total to Date
. Amounts in this section may be different
from amounts reported in Column B.
SCHEDULE B - Part I
Schedule B - Part I
Loans Received
Statement covers period
C\LHORNI \ 460
FORI\I
NAME OF FILER Ms. Dolores Sandoval,
~om 01/01/2007
through 06/30/2007
Dolly Sandoval for Supervisor-Debt Retirement Committee
Page 4 of
1.0. NUMBER
6
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
990787
IF AN INDIVIDUAL. ENTER a (b) (0) (e) (I) (g)
OUTSTANDING OUTS ANDING
OCCUPATION AND EMPLOYER BALANCE AMOUNT AMOUNT PAID BALANCE AT INTEREST ORIGINAL CUMULATIVE
(IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS
NAME OF BUSINESS PERIOD THIS PERIOD PERIOD LOAN TO DATE
Councilmernber o PAID CALENDAR YEAR
$ 0 $ 20,000 0.000 % $ 20,000 $
o FORGIVEN RATE PER ELECTION
City of Cupertino
$ 20,000 $ 0 $ 0 12/31/2008 $ 0 09/30/1999 $
DATE DUE DATE INCURRED
o PAID CALENDAR YEAR
$ 0 $ 25,000 0.000 % $ 25,000 $
o FORGIVEN RATE PER ELECTION
$ 25,000 $ 0 $ 0 12/31/2008 $ 0 02/29/2000 $
DATE DUE DATE INCURRED
o PAID CALENDAR YEAR
$ 0 $ 40,000 0.000 % $ 40,000 $
o FORGIVEN RATE PER ELECTION
$ 40,000 $ 0 $ 0 12/31/2008 $ 0 11/06/2000 $
DATE DUE DATE INCURRED
SUBTOTAL $ 0.00 $ 0.00 $ 85,000.00 $ 0.00
Ms. Dolores Sandoval
10720 Alderbrook Lane
Cupertino, CA 95014
Ijj IND 0 COM 0 OTH 0 PlY 0 SCC
Ms. Dolores Sandoval
(Continued)
o IND 0 COM 0 OTH 0 PTY 0 SCC
Ms. Dolores Sandoval
(Continued) (Continued)
o IND 0 COM 0 OTH 0 PTY 0 SCC
Schedule B Summary
1. Loans received this period ............................................................................................................ $
(Total Column (b) plus unitemized loans less than $100.)
0.00
2. Loans paid or forgiven this period .................................................................................................$
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
0.00
3. Net change this period. (Subtract Line 2 from Line 1.) ...................................................
Enter the net here and on the Summary Page, Column A, Line 2
NET $
0.00
Schedule B - Part I (Continuation Sheet)
Loans Received
SCHEDULE B - Part I (cont.)
(',\L1FORNI \ 460
FORM
Statement covers period
NAME OF FILER Ms. Dolores Sandoval,
kom 01/01/2007
through 06/30/2007
Dolly Sandoval for Supervisor-Debt Retirement Committee
Page 5 of
1.0. NUMBER
6
990787
IF AN INDIVIDUAL, ENTER a (b) (0) (e) (I) (g)
FULL NAME, STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE
OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS
(IF SELF-EMPLOYED, ENTER BEGINNING THIS CLOSE OF THIS
(IF COMMITTEE. ALSO ENTER I.D. NUMBER) NAME OF BUSINESS PERIOD THIS PERIOD PERIOD LOAN TO DATE
Ms. Dolores Sandoval o PAID CALENDAR YEAR
(Continued) (Continued) 0 10,000 0.000 % 10,000
(Continued) $ $ $ $
o FORGIVEN RATE PER ELECTION
$ 10,000 $ 0 $ 0 12/31/2008 $ 0 11/13/2000 $
o IND o COM 0 OTH 0 PlY 0 SCC DATE DUE DATE INCURRED
Ms. Dolores Sandoval o PAID CALENDAR YEAR
(Continued) (Continued) 0 15,000 0.000 % 15,000
(Continued) (Continued) $ $ $ $
o FORGIVEN RATE PER ELECTION
$ 15,000 $ 0 $ 0 12/31/2008 $ 0 11/18/2000 $
o IND o COM 0 OTH 0 PTY 0 SCC DATE DUE DATE INCURRED
o PAID CALENDAR YEAR
$ $ % $ $
o FORGIVEN RATE PER ELECTION
o COM 0 OTH 0 PTY 0 SCC $ $ $ $ $
o IND DATE DUE DATE INCURRED
o PAID CALENDAR YEAR
$ $ % $ $
o FORGIVEN RATE PER ELECTION
o COM 0 OTH 0 PTY 0 SCC $ $ $ $ $
o IND DATE DUE DATE INCURRED
o PAID CALENDAR YEAR
$ $ % $ $
o FORGIVEN RATE PER ELECTION
o COM 0 OTH 0 PTY 0 SCC $ $ $ $ $
o IND DATE DUE DATE INCURRED
SUBTOTAL $ 0.00 $ 0.00 $ 25,000.00 $ 0.00
ScheduleSchedule I
Miscellaneous Increases t~laneous Increases to Cash
SCHEDULE I
Statement covers period
(' \ 1.1 FOlf\J I \ 460
FonlVI
NAMEOFFILER Ms. Dolores Sandoval,
fnxn 01/01/2007
through 06/30/2007
Dolly Sandoval for Supervisor-Debt Retirement Committee
Page 6 of
1.0. NUMBER
6
990787
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, ENTER I.D. NUMBER
OR. IF NO I.D. NUMBER HAS BEEN ASSIGNED. ENTER TREASURER'S NAME & ADDRESS)
DESCRIPTION OF RECEIPT
AMOUNT OF
INCREASE TO CASH
SUBTOTAL $
0.00
Schedule I Summary
1. Itemized increases to cash this period. ...............................................................................................
2. Unitemized increases to cash under $100 this period.
............................................................................................................................................................
$
$
$
$
25.89
0.00
3. Total of all interest received this period on loans made to others.
(Schedule H, Column (e).) .................................................................................................................
4. Total miscellaneous increases to cash this period.
(Add Lines 1,2, and 3. Enter here and on the Summary Page, Line 14.) ........................... TOTAL
0.00
25.89