Loading...
460 Recipient Committee Campaign Statement - Preelection 1-01-18 to 9-22-18Recipient Committee COVER PAGE Campaign Statement- - . _ • 1 Cover Page - SEE INSTRUCTIONS ON REVERSE Statement covers period from 1/1/2018 through 9/22/2018 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. FV Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall O Controlled (Also Complete Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1407834 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Mahoney for Council - 2018 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE Date of election if applica (Month, Day, Year) Or- O _ U L.s 1.. 6,10 ' of Official Use Only 11/6/2018 2. Type of Statement: ® Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Carolyn Krizek-Mahaney MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ E-MAILADDRESS 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 _ •- Executed on 9/24/2018 Date Executed on 9/24/2018 Date Executed on Date Executed on By Signature of Controlling Officeholder, Candidate, State Measure Proponent By 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 Orrin Mahoney OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Cupertino City Council 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 NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page 2 of f 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 to whole dollars. Statement covers period from 1/1/2018 SUMMARY PAGE Expenditures Made 6. Payments Made................................................................ 9/22/2018 3 SEE INSTRUCTIONS ON REVERSE 7. Loans Made..... .................. ............ - ............. ................... Schedule H, Line 3 0.00 through 8. SUBTOTAL CASH PAYMENTS ...... ............... --................. Page of 4,670.14 $ NAME OF FILER 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0.00 0.00 I.D. NUMBER Mahoney for Council - 2018 0.00 0.00 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 $ 1407834 Contributions Received 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 Column A TOTAL THIS PERIOD Column B CALENDAR YEAR Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and previous period amounts. If General Elections this is the first report being 10,219.00 10,219.00 $ 1. Monetary Contributions................................................... Schedule A, cine 3 $ $ only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 5,050.00 5,050.00 1/1 through 6/30 7/1 to Date 2. Loans Received ............................... ................................. Schedule B, Line 3 $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 15,269.00 15,269.00 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1+2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 85.00 85.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............ ........................ Add Lines 3+4 $ 15,354.00 $ 15,354.00 Made $ $ Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 4,670.14 $ 4,670.14 7. Loans Made..... .................. ............ - ............. ................... Schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS ...... ............... --................. Add Lines 6+ 7 $ 4,670.14 $ 4,670.14 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0.00 0.00 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 $ 4,670.14 $ 4,670.14 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 0.00 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above 15,269.00 add amounts in Column 0.00 A to the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule t, Line 4 amounts from Column B 15. Cash Payments......................................................... Column A, Line a above 4,670.14 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 10,59$.86 be negative figures that 9 9 should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part2 $ filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 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) J1 $ 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 Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA from 1/1/2018FORM, 460 4 9/22/2018 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Mahoney for Council - 2018 1407834 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Recology Inc ❑ IND 9/11/2018 ❑ PTY ❑ SCC Amar Gupta ® IND ElcoM Retired 9/2/2018 ❑ PTY ❑ SCC Chuck Harper ® IND El COM Retired 7/26/2018 ❑ PTY ❑ SCC Daryl Stow IND Q Retired 8/21/2018 OT E] OTH E]OT PTY ❑ scC David Fung 9IND Engineering Consultant 7/24/2018 ❑ PTY ❑ SCC SUBTOTAL $ 2,200.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (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 $ 9,550.00 669.00 10,219.00 `Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCG — Small Contributor Committee FPPC Form 460 (1an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA 460 from 1/1/2018 FORM Page 5 of through 9/22/2018 NAME OF FILER I.D. NUMBER Mahoney for Council - 2018 1407834 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE {IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Don Allen la IND Retired 9/2/2018 ❑ PTY ❑ SCC Hsing Hsien Kung ® IND Partner 8/11/2018 ❑ OTH ❑ PTY ❑ SCC Hung Wei ® IND Board of Trustee 7/31/2018 ❑ OTH ❑ PTY School District ❑ scc Jayne Ham 62IND Self Employed 7/22/2018 ❑ PTY ❑ SCC Jeanne Bradford ® IND Self Employed 7/23/2018 ❑ OTH ❑ PTY ❑ SCG SUBTOTAL $ 2,600.00 "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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period _ from 1/1/2018 • - s � Page 6 of through 9/22/2018 NAME OF FILER I.D. NUMBER Mahoney for Council - 2018 1407834 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Jeff Foster la IND Retired 9/11/2018 El OTH ❑ PTY ❑ SGC Jim Walker ® IND Retired 8/30/2018 ❑ OTH ❑ PTY ❑ SCG Keet Hamilton ® IND Retired 9/11/2018 ❑ OTH ❑ PTY ❑ SCc Lynn Youngs IND Engineer 9/1/2018 ❑ OTH ❑ PTY ❑ SCC Minh Le ® IND President 9/1/2018 El OTH Institute ElPTY ❑ SCC SUBTOTAL $ 1,850.00 *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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA 460 from 1/1/2018 FORM Page 7 ofR through 9/22/2018 NAME OF FILER I.D. NUMBER Mahoney for Council - 2018 1407834 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Patrick Aherns J21 IND Senior District 9/19/2018 El OT PTY Assemblyman Evan Low ❑ SCC Richard Lowenthal ® IND Retired 8/12/2018 ❑ OTH ❑ PTY ❑ SCC Wendell Stephens is IND Retired 7/12/2018 ❑ OTH ❑ PTY ❑ SGC Redwood Grove Management Inc ❑ IND 7/24/2018 62 OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 2,900.00 `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 FPPC Form 460 (!an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 Schedule — a to whole dollars. Statement coversperiod Loans Received 1/1/2018 CALIFORNIA , • ' from FORM 8 9/22/2018 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Mahoney for Council - 2018 1407834 FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING (b) AMOUNT (c) AMOUNT PAID OUTSTANDING (e INTEREST ORIGINAL g CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE Orrin Mahoney Retired ❑ PAID CALENDAR YEAR ED FORGIVEN FORGIVEN PER ELECTION $ 0 $ 5,050.00 $ 1/1/2019 $ 7/17/2018 $ t ® IND ❑COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR FORGIVEN El FORGIVEN PER ELECTION*` DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR FORGIVEN El FORGIVEN PER ELECTIONE4 t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 5,050.00$ 0.00 $ 5,050.00 $ 0.00 Schedule B Summary 1. Loans received this period....................................................................................................................$ 5 nsn nn (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ n nn (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.).............................................................. NET $ 5105000 Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number) 'Amounts forgiven or paid by another party also must be reported on Schedule A. *` If required. (Enter (e) on Schedule E, Line 3) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (1an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded I i ,,_„___ SCHEDULE C Nonmonetary Contributions Received �� .. �� 4� o Statement covers period CALIFORNIA 460 from 1/1/2018 s - 9 through 9/22/2018 SEE INSTRUCTIONS ON REVERSE Page of NAME OF FILER I.D. NUMBER Mahoney for Council - 2018 1407834 DATE FULL NAME, STREETADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) IF REQUIRED ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)......................................................................................................................$ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ..................................$ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.).....................TOTAL $ 85.00 85.00 *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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Mahoney for Council - 2018 Amounts may be rounded to whole dollars. SCHEDULE E Statement covers period from 1/1/2018 through 9/22/2018 Page 10 of ft 1407834 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 PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID My Campaign Store Yard signs https://mycampaignstore.com/ (online purchase) CMP 1,180.22 City of Cupertino Filing fee Rancho Deep Cliff HOA FND Fundraising event * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 3420.22 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 4,337.60 2. Unitemized payments made this period of under $100........................................................................................................... 332.54 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 $ 4,670.14 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Best Value Copy SCHEDULE E (CONT.) Amounts may be rounded Statement covers period . (Continuation Sheet) to whole dollars. Staples Walk piece flyers + , • (r Payments Made LIT 211.52 from 1/1/2018 FORM Paypal Transaction fees 9/22/2018 11of SEE INSTRUCTIONS ON REVERSE 183.25 through Page NAME OF FILER I.D. NUMBER Mahoney for Council - 2018 1407834 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 stafNspouse 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 PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Best Value Copy Walk piece flyers (online purchase) LIT 522.61 No address available Staples Walk piece flyers Paypal Transaction fees PRO 183.25 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 917.38 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov