460 Debt Semi-Annual COVER PAGE o LONG FORM
Recipient Committee r~m s~,,.. ~,, ,, ~,..,,
Campaign Statement ) JE $ ~ D V ~ , 4 60
(Government Code Sections 84200 - 84216.5) ; I of . 6
a.,,,., ,..,.. ,,,., ,,, ,m,,., , .,,,,u, dAN 3 1 2002 ?.~/C~rOffictalUseOnly
~,,_. 10/23./2001 (Momh, D~A Y~
~ 12/31/~OOl 1=/3[/200[ CUPERTINO CJTYC.ERK
1. Type of Recipient Committee: 2. Type of Statement:
[] Officeholder, Candidate [] Primarily Formed Candidate/ [] Pre-election Statement [] Quarterly Statement
Controlled Committee Officeholder CommJttae [] SsmJ-annual Statement [] Special Odd-Year Report
[] Termination Statement [] Supplemental Pm.election
[] Ballot Measure Committee [] General Purpose Committee [] Amendment (Explain below) Statement - Attach Form 495
O Prfmarily Formed O Spensomd
O Controlled O Broad Based
O Sponsored
3. Committee Information 1'~"~078~'~
Treasurer(s)
COMMITrEE NNdE NNME OF I~KSURER
Do'lly S&ndova'l f=oz' Supervisor - Debt. Eet:±rement.
Coaaait:t:ee Dolly SandovaZ
MAILING ,~Z)DRES$
10720 Alderbrook Lane
STREET AD.ESS (NO P.O. 90~) CrTY STATE npCODE AREACC~g~dONE
10720 Alderbrook Lane San Jose CA 95014 (408)725-8939
CITY STATE :qP CODE AREA COOKE NAME OF ASSISTANT I~EASURER, IF ~
Cupertino CA 95014 (408) 725-8939
MAIUNG ADDRE~8 (IF ~FFEREN~ NO. AND SlREET OR P.O. BOX k~dLING AD~RE8~
( )
( ) - /
S/CCW - PCAB05 01380 (Rev. 9/99) S'.,;~ of California Fair Political Pracb~e~ Commission.
COVER PAGE - PART 2
r'_~ ,~;~,Recipient Committeestatement ~ ~, ,, ~ ,,~x, ~ 4 6 0
Cover Page - Part 2
4. Officeholder or Candidate Controlled Committee 5. Ballot Measure Committee
NAME OF OFFICEHOLDER OF CANDIDATE NAME OF BAM.OT MEASURE
t4~;. Dolores Sa~dova].
OFFICE ~ OR HELD (INCt. UDE LOCA~ AND DISI~ICT NUMBER IF APPLICABLE) ~ALLOT NO. OR LETTER I JURISOIC~ON [] SUPPORT
RESlBENTINJBUSINESS ADDRESS (NO. AND STBEET) CITY STATE ZIP CODE
Idontlfy the controlling officeholder, candidate, or state measure proponent, If ,,ny.
'10'720 A].c].ez-]~z'oo~: ~,a. ne (~l.tpe:~.'i~o C~ 950'1~ WEOFOFFICEHOLDE~,CAN=DATEOR,;~OPOBEHT
Related Committees Not Included in this Statement: List any comm~teas
not Included in this consolidated statement that are controlled by you or which are primarilyOFFIBE SOUe,T OR ,E~D ImTRICT NO. I~ ANY
formed to receive contributions or to make expenditures on behaff of your candidacy.
I
COMMITIEE NAME I.D. NUMBER
Formed
Committee
Y
o-,¥ ua.a=ova, ~o= c~cy cou=¢~, 8~'10=8/'12~6'7~;~.6. Primaril_
WE OF 11~=ASURER CONTROU.ED COMM~ ~ r.t=7 WE OF OFFICEHOLDER OR CN~DIDAll; OFFICE SOUGHT OR HELD
COklM~ ~ r.t: ADDRESS STREET/~DDREES (NO P.O. SOX) WE OF OFRCEHOLDER OR CN~IDICATE OFFICE SOUGHT OR HELD
CITY STATE ZIP coDE AREA COOE~PHONE NAME OF OFFICF. HOI.CER OR C~NDIDATE OFFICE EOUGHT OR HELD
Cu~pe=t.';no CA 950~.4 (408) '725-8939
7. Verification
I have used all reasonable diligence in preparing and mvtewing this statement and to the best of my knowledge the information contained herein and in the attached schedules
is t~ue and complete. I co~fy under penalty of pedury under the laws of the State of California that the foregoing is true and correct.
~ ~ By
Executed on By
DATE SIGNAllJBE OF CONTROLLING OFFICEHOLDER, C/~NDIDATE. STAR; MEASURE Ft~OPONI~IT
SUMMARY PAGE
Campaign Disclosure Statement ~~~ ~ ~,,,~,,~,l~
Summary Page ~.~ 10/22/200:[
II~r~ 22/3:[/2001
NN~IE OF FILER MB. Dolores Saztdoval, Dolly Sandoval for Supez-visor - Debt Retirement kD. NUMBER
Comittee 990787
Conl~ibutlons Received Celumn A C~umn B Calem~r Year ~mma~ f~r Candldata~
· o~ mm ~.~oo C~EN~ Y~ Rannin~ In Be~t Ihe ~'---'-- I~ and
(FROM ATFACHED 5CHED~JLES) TOT~. TO DA~E
~eneral Beotlees
1. Monetary Contributions ..................................... ScheduleA, Line 3 $ 0.00 $ 1,3.50.00
2. Loans Received ................................................ Schedule B, Une 7 0.00 110,000.00 111 through 8/30 711 to Date
20.
3. SUBTOTAL CASH CONTRIBUTIONS .................. AddLineal+2 $ 0.00 $ 111,150.00 Re=eived....~
4. Non-monetary Contributions ............................. Schedule C, Line 3 O. 00 0.00 21. ~...~.u....~.
5. TOTAL CONTRIBUTIONS RECEIVED ................. Add Lines 3 + 4 $ 0.00 $ 111,150.00
Expenditures Made E~d~u~ Unit Sun~a~ f~r S~ato
6. Cash Payments ................................................ Schedule E, Dna 4 $ 0.00 $ 3. 80.65 Candklatas
7. Loans Made ...................................................... Schedule H, Line 7 0.00 0.00 22. Cumulative Exeodltum Maria*
(If Subject to Voluntary Expenditure Umit)
8. SUBTOTAL CASH PAYMENTS ............................ AddLines6+7 $ 0.00 $ 180.65
Dato of Elec~n To~al to Date
9. Accrued Expenses (Unpaid Bills) ...................... Schedule F, Line 3 0.00 0.00 {mm/dd/yy)
10. Nonmonetary Adjustment ................................ Schedule C, Line 3 0. O0 O . O0
11. TOTAL EXPENDITURES MADE .................. AddLinesS+9+lO $ 0.00 $ 180.65
Currant Cash Statement
12. Beginning Cash Balance .......... Previous Summary Page, Dna 16 $ 3,215.97
13. Cash Receipts ......................................... Column A, Line 3 above O . O0
14. Miscellaneous Increases to Cash ..................... Schedule I, Dna 4 7.03
15. Cash Payments ....................................... Column A, Line 8 above 0. O0
16. ENDING ~ Pam~'"-~ea 12 + 13 + 14, then subtract Line 15 $ 3,223.00
If this ia a Termination Statement, Dna 16 must be zero.
17. LOAN GUARANTEES RECEIVEDSChedule B, Part 1, Column (b) $ 0. O0
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................................................ $. 0.00
19. Outstanding Debts .......... Add Line 2 + Line g in Column C above $ 110,000.00
S/CCW - PCAB05 01380 (Rev. 9/99)
SCHEDULE B - Part I
Schedule B- Part I
Loans Received
fmat 10/21/2001
lbro~ 12/31/2001 Page 4 ~f 6
NAMEOFFILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement I.D. NUMBER
Co-m~ittee 990787
Ms. Dolores Sandoval Teacher/Trustee []
10720 Alderbrook Lane
Cupertino, CA 95014 $ o $ 20,oo0 0.o00 % $ 2o.000 $ o
L.G.S.J. Unified [] mRC~EN R~T~
School District s 20,000 $ 0 S 0 09/3012001 $ 0 09/30/1999 $ 46.060
tlN~ DCOM ~o1~ DPTY •scc DATEDUE DATEINCURRED
~S · Dolores Sandoval [] P~JD C~.ENDAR%~AR
(Continued)
S 0 $ 25.000 0.000 % $ 25.000 $ O
[] FORe,YEN ~ATE ~ER ELECT~ON
I"liND •COM I--IOl1-1 r--IPTY []SCC $ 251000 $ 0 $ 0 12/33./2003. $ 0 02/29/2000 $ 46.060
MS. Dolores Saz~dova'l [] eND C. aU. END~R~rdU~
(Continued) (Continued)
$ 0 $ 40.000 0.000~ ~ 40.000 $ 0
r-I~.o []coul-Iom DeTY []scc s 40.000 $ 0 $ 0 ~2/3~/2002 $ 0 [~/0~/2000 $
SUBTOTAL $ o.oo $ o.oo $ as,ooo.oo $ o.oo
~:hedule B Summary
1. Loans received this period ............................................................................................................ $ o. oo
(Total Column (b) plus initemized loans less than $100.)
2. Loans paid or forgiven this pedod ................................................................................................ $ o. oo
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that am also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) ................................................... NET $ o. oo
Enter the net here and on the Summmy Page, Column A, Line 2
SCHEDULE B - Part I (cont.)
Schedule B- Part I (Continuation Sheet)
Loans Received ~,~ ~o/2~/2oo~
NAME OF FILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement I.D. NUMBER
Committee 9 9 0 7 8 7
Ms. Dolores Sand~al
(Continued ) ( Continued )
(Continued) ~ ~ ~ lO.Ooo o.~0o ~ ~ lo.ooo ~ o
Ms. Dolores Sandoval
(Continued) (Continued)
(Continued) (Continued) ~ o s lS,Ooo o.ooo ~ ~ lS.Ooo s o
S S S S S
S $ % S $
S S S S
S~ $ o.oo $ o.oo $ ~s,ooo.oo $ ~.oo
SCHEDULE I
Sch u,e, 4 6 0
Miscellaneous Increases to Cash ~ 10/21/2003. I'( )R\I
~ 12/31/2001 Pa~e 6 ~f 6
NAME OF FILER Ms. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement I.D. NUMBER
Committee 990787
FULL NAME AND ADORES$ OF SOURCE
DATE ~F couun'mE, ~ aDornoN To ¢o~un-m_E,s ~ ~NDN3ORESS, ENm~ tO. ~BER DESCRIPTION OF RECEIPT AMOUNT OF
RECEIVED oR. IF NO i.D, NUMBER I-~ BE~N AS~Ii~IED, ENI~R 11~.A~URER'~ N~g~ & ~N3DRE~) INCREASE TO CASH
SUBTOTAL $ o. oo
Miscellaneous Increases to Cash Summary
l. Increases to cash of $100 or more this period. ................................................................................... $ 0.00
2. Increases to cp-,~h under $100 this period.
(Do not itemize.) ................................................................................................................................ $ 7.03
3. Total of all inter~st received this period on loans made to others.
(Schedule H, Part I1 (b).) .................................................................................................................... $ 0.00
4. Total miscellaneous increases to cash this period.
(Add Lines 1, 2, and 3. Enter here and ~m the Summary Page, Line 15.) ........................... TOT~/ $ 7.03