460 Quarterly Amendment
Type or print In ink.
"'.j
Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
. ----~
~~..-.
Date of election If 81
(Month, Day, Ve,
Statement covera period
April 1, 2004
For OffIcial UN Only
from
PERTINO CITY CLEf1K
NA
June 30, 2004
through
SEE INSTRUCTIONS ON REVERSE
Quarterly Statement
Special Odd- Vear Report
Supplemental Preelection
Statement - Attach Form 495
,
i \
!XI
o
o
Type of Statement:
o Preelection Statemen'
o Semi-annual Statemen
o Termination Statement
~ Amendment
e
2,
CommlttMa - Complete Par'U 1, 2, 3, and 4,
œI Ballot Measure Committee
QII Primerily Formed
o Controlled
o Sponsored
(1tIBOComplet&PlVt6)
Committee: All
o Officeholder, Candidate Controlled Committee
o State Candidate Election Committee
o Recall
(AlsoCOmpJø/ePfJft8)
Type of Recipient
1.
o Primarily Formed Candldatel
OffIceholder Committee
(AlsQComp¡.MParl7J
o General Purpose Committee
o Sponsored
o Small Contributor Committee
o Political Party/Central Committee
NAME OF TREASURER
Elizabeth L. Whittaker
MAILING ADDRESS
Committee Information I.D. NUMBER
1264630
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Primarily Formed Committee for the Amendments
3.
AREA CODE/PHONE"
4081255-8527
ZIP CODE
95014
STATE
CA
20622 Cheryl Drive
CITY
Cupertino
NAME OF ASSISTANT TREÀSUREFf,"W ANY
the General Plan
AREA CODE/PHONE
408/255-8527
10
STATE lIP CODE
CA 95014
NO. AND sTRËEr OR P.O, BOX
STREET ADDRESS (NO P.O, BOX)
20622 Cheryl Drive
CITY
Cupertino
MAILING ADDRESS (IF DIFFERENT)
AREA CODE/PHON E
408/996-0842
ZIP CODE
95014
STATE
CA
Kathey Holland
MAILING ADDRESS
10318 Cold Harbor Ave.
ciTY
Cupertino
OPTIONAL; FAX
AREA CODE/PHONE
ZIP C-ODE
STATE
CITY
E-MAIL ADDRESS
4, Verification
I have used aU reasonable diligence In preparing and reviewing this statement and to the best of my knowledge the Information contained herein and
certify under penalty of perjury under the laws of the State of California that the foregoing Is true and correct.
E-MAil ADDRESS
FAX
OPTIONAL;
the attached schedules Is true and complete,
In
By
&00<1-
2tÐc9'-+
Executed on
Executed on
ofSpon6Of
By
Executed on
FPPC Form ~60 (JuneI01)
FPPC Tolf·Free Helpline: 8661ASK.FPPC
State of California
aïØMeaslW-Proponent
SignutureO/Coolrollng ölflœllolcler. COOdkJÐ\e, Slale Me9sumProponent
aiidtl8le,
IlI/\fIjUiõcJCori!roIfngûff!ceholder,
By
By
D"
0"
Executed on
SCHEDULE C
Statemant cover. poriod II
from April 1, 2004
through June 30, 2004 7 9
- P8ge~of_
¡.O. NUMBER
1264630
Type or print In Ink.
Amounts may be rounded
to whole dollars,
j
Schedule C
Nonmonetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Primarily Formed Committee for the Amendments to the General Plan
PER ElECTION
TO DATE
(IF REQUIRED)
CUMULATIVE TO
DATE
CALENDAR YEAR
(JAN 1· DEC 31)
$600,00
$862.50
"Contributor Codes
IND -Indlvlduel
COM - Recipient CommHtee
(other than PTY or SeC)
OTH - Other
PTY - PoIHlcal Party
see - Small Contributor Committee
$140,00
$279.00
$600,00
$140.00
$862.50
$279,00
FUll NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNTf
DATE FAIR MARKET
RECEIVED ZIP CODE OF CONTRIBUTOR CODe * OCCUPATION AND EMPLOYER GOODS OR SERVICES VALUE
(IF COMUlTTEI!, AlSO ENT£R 1-0. IIIUM&ER¡ (IF SELF·EMPLOYED, ENTER
NflME Of BUSINES5)
Susan Sievert IIIND \'\'85 Dð3i§Flsr Web
6/28/04 OCOM $600.00
10301 Byrne Ave. OOTH Sðlf CI"rslô)«f Development &
Cupertino, CA 95014 DPTY No he:. Hosting, Domain
osee Rag istrallon
Sheila Dolezal IIIIND Administrator Bumper Stickers
6/4/04 OCOM $70.00
10550 Whitney Way OOTH Stanford University
Cupertino. CA 95014 OPTY
osce
Rusty Britt IXIIND None Newspaper
5/4/04 OCOM $860.00
20850 Pepper Tree Lane OOTH Legal Notice
Cupertino. CA 95014 OPTY
osee
Maika Nagel IiIIND Realtor Newspaper Ad
4/17/04 OCOM $279.00
10180 Camino Vista OOTH Coldweil. Banker
Cupertino, CA 95014 OPTY
osee
AI/ach add/ilona/Information on appropriately labeled conllnuation sheets. SUBTOTAL $ 1809,00
Schedule C Summary
1. Amount received this period - nonmonetary contributions of$100 or more. See next page
(Include all Schedule C subtotals.) ............................................. ... ......... ...................... ............$
2. Amount received this period - un itemized 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 1O.) TOTAL $
FPPC Form 460 (June/01)
FPPC TolløFree Helpline: B66/ASK-FPPC