460 Debt Semi-Annual 2ndRecipient Committee
Campaign Statement
(Government Code Sections 84200 - 84216.5)
~. 07/01/:002
through 12/31/2002
1. Type of Recipient Committee:
[] Officeholder, Candidate Controlled Committee [] Ballot Measure Committee
I~) State Candidate Election Committee O Pdmadly Formed
2. Type of Statement:
- LONG FORM
~Li~I 1 of ~ 7
AA.Forj Official Use Only
[] Pre-election Statement
[] Semi-annual Statement
[] Quarterly Statement
[] Special Odd-Year Report
0 Recall 0 Controlled
0 Sponsored
[] General Purpose Committee O Sponsored
O Small Contributor Committee
0 Political Party/Central Committee
[] Primarily Formed Candidate
Officeholder Committee
[] Termination Statement
[] Amendment (Explain below)
[] Supplemental Pre-election
Statement - Attach Form 495
3. Committee Information
Dolly Sandoval for Supervisor - Debt Retirement
Committee
STREET ADDRESS (NO PO BOX)
10720 Alderbrook Lane
Cupertino CA 95014 (408) 725-8939
OPTIONAL: VAX~E-MAIL ADDRESS
( ) /
Treasurer(s)
Dolly Sandoval
10720 Alderbrook Lane
San Jose CA 95014 (408)725-8939
( )
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 aRached schedules
is true and complete. I certify under penalty of perjury under the laws of that the ~ is true and correct
Executed on By
DATE
By
S/CCW PCAB05 01380 (Rev. 9/99) State of California Fair Political Practices Commission.
Recipient Committee
Campaign Statement
Cover Page - Part 2
COVER PAGE - PART 2
Page 2 of
5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee
NAME OF BALLOT MFASURE
NAME OF OFFICEHOLDER OF CANDIDATE
Ms. Dolores Sandoval
OFFICE SOUGHT OR HELD (INCLU~ LCCATI~ AND DI~RICT NUMBER IF ~PLICAB~)
Board o~ Supervisors, District 5
10720 Alderbrook Lane Cupertino CA 95014
Related Committees Not Included in this Statement: List any committees
not included ir) 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.
BALLOT NO. OR LETTER JURISDICTION [] SUPPORT
]OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OEFICEHOLDER. CANDIDATE OR, PROPONENT
OFFICE SOUGHT OR HELD ~DISTRICT NO. IF ANy
I
Friends of Dolores Sandoval 851028
10720 Alderbrook Lane
Cupertino CA 95014 (408)725-8939
7. 'Primarily Formed Committee
NAME OF OFFICEHOLDER OR CANDIDATE FFICE SOUGHT OR HELD [] SUPPORT
NAME OF O. FFICEHOLDER OR CANDIDATE
[] SUPPORT
[] OPPOSE
Campaign Disclosure Statement
Summary Page
from 07/01/2002
through 12/31/2002
NAMEOFRLER MS. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement
Committee
Contributions Received Column A Column S
$ 20,000.00 $ 20,000.00
0.00 110,000.00
SUMMARY PAGE
Page
LD. NUMBER
990787
I Monetary Contributions ..................................... Schedule A, Line 3
2. Loans Received ................................................ Schedule B, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS .................. AddLines I + 2
4. Non-monetary Contributions ............................. Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .............. AddLines 3 + 4
$ 20,000.00 $ 130,000.00
0.00 0.00
$ 20,000.00 $ 130,000.00
Expenditures Made
6. Cash Payments ................................................ Schedule E, Line 4
7. Loans Made ...................................................... Schedule H, Line 7
8. SUBTOTAL CASH PAYMENTS ............................ AddLines 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
$ 0.00 $ 0.00
0.00 0.00
$ 0.00 $ 0.00
0.00 0.00
0.00 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 BAt~MdCE~es 12 + 13 + 14. then subtract Line 15
If this is a Termination Statement, Line 16 must be zero.
$ 3,236.58
20,000.00
14.34
0.00
$ 23,250.92
17. LOAN GUARANTEES RECEIVEDSchedule B, PaR I, Column (b) $.
0.00
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................................................
19. Outstanding Debts .......... Add Line 2 + Line 9 in Column C above
0.00
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30
20. ContdbctJons
Received _.. $_
21. Expenditures
Made ..........
711 to Date
Expenditure Limit Summa~ for State
Candidates
22. Cumulative Exenditure Made*
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
S/CCW - PCAB0501380 (Rev. 9/99)
SCHEDULE A
Schedule A
"-MonetaryContdbutions Received Mm 07/01/2002
~rough 12/31/2002 Page 4 of 7
NAME OF FILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor Debt Retirement LD. NUMBER
Committee 990787
12/05/2002 MS. Anita Yu [] IND Homemaker 20,000.00 20,000.00
83 Mesa Court [] COM
Atherton, CA 94027 [] OTH N/A
[] PTY
[] SCC
[] ~ND
[] COM
[] OTH
[] PT'(
[] scc
[] ,NO
[] COU
[] O'rH
[] SCC
[] COM
[] OTH
[] scc
[] COM
[] OTH
[] PTY
[] scc
SUBTOTAL $ 20,000.00
Monetary Contributions Summary
1. Amount received this period - contributions of $100 or more
(Include all Schedule A subtotals.) .................................................................................................. $
2. Amount received this period - contributions of less than $100.
(Do not itemize.) .............................................................................................................................. $
3. Tolal monelary conlributions received this period.
(Add Lines I and 2. Enter helc and on the Summary Page, Column A, Linc 1.) .............. IOIA[ $
20,000.00
0.00
20,000.00
Schedule B - Pad I
Loans Received
NAME OF FILER MS. Dolores Sandoval,
Committee
FULL NAME. STREET ADDRESS AND ZIP CODE
OF LENDER
(IF COMMITTEE, ALSO ENTER [0 NUMBER)
Ms. Dolores Sandoval
10720 Alderbrook Lane
Cupertino, CA 95014
[] ,.D [] CO. [] 0.. [] P~ [] scc
Ms. Dolores Sandoval
(Continued)
[] 'ND [] COM [] 0TM [] PTY [] SCC
Ms. Dolores Sandoval
(Continued)
[] ,ND [] eOM [] oT. [] .~' [] scc
Dolly Sandoval for Supervisor
It- AN IN~VIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF ~MPLOYED, ENTER
!Councilmember
City of Cupertino
a)
$ 20r000
$ 25,000
$ 40,000
f~orn 07/01/2002
through 12/31/2002
Debt Retirement
$. 0
$ 0
$ 0
[] PAID
$ 0
E] FORGIV}EN
$ 0
(d)
OUTSTANDING
BALANCE AT
CLOSE OF THIS
$ 20,000
o9/~o/20Ol
DATE DUE
DATE DUE
$ 40,000
12/31/2002
SCHEDULE B - Part I
Page 5 of
I.D. NUMBER
990787
s 0 0~/~0/1999
0 02/29/2000
CONTRIBUTIONS
CALENOAR YEAR
0
PER ELECTION
46r060 GOO
$ 461060 GOO
$ 401000 $ 0
pER ELECTION
11/06/2000 $ 46,060 GOO
SUBTOTAL $ o.oo $ o.oo $ sS,ODD.OD $ o.oo
Schedule B Summmy
1, Loans received this period ............................................................................................................ $
(Total Column (b) 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 party that are also itemized on Schedule A,)
3. Net change this period. (Subtract Line 2 from Line 1.) ................................................... NET $
Enter lhe net here and on the Summary Page, Column A, Line 2
0.00
0.00
0.00
SCHEDULE B - Part I (cont.)
Schedule B - Part I (Continuation Sheet) s~ .... ~over, m.~ ~
Loans Received nm 07/01/2002
I~hrough.12/31/2002 Page 6 of 7
NAMEOFFILER MS. Dolores Sandoval, Dolly Sandovat for Supervisor - Debt Retirement I.D. NUMBER
Committee 990787
MS. Dolores Sandoval [] PAID
( Continued)
( Continued )
[] IND [] gOM [] OTM [] PTY [] SOO DATE DUE DATE INCUR"ED
[] IND [] COM [] 0TM [] PTY [] SeC OATEDUE DATEINCURRED
[] 'ND [] CO~ [] OTH [] P~F [] $CC DATEDUE OATEINCLI"~D '
SUBTOTAL $ n D0 $ o.oo $ 2s.ooo.oo $ o.oo
GOO
SCHEDULEI
Schedule I
Miscellaneous Increases to Cash ~. 0v/0~/2002
through.12/31/2002 Page 7 of 7
qAMEOFFILER MS. Dolores Sandoval, Dolly Sandoval for Supervisor Debt Retirement kD. NUMBER
Committee 990787
FULL NAME AND ADDRESS OF SOURCE
DATE 0F COMMITTEE tN ADDfTION TO C°MMITTEE'S NAME AND AODRESS, ENTER I D NUMBER DESCRIPTION OF RECEIPT AMOUNT OF
SUBTOTAL $ o. 00
0.00
Miscellaneous Increases to Cash Summary
1. Increases to cash of $100 or more fids 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 l, 2, and 3. Enter here and on the Summary Page, Line 15.) ........................ TOTAl_ $
0.00