460 Amendment
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01 election W eppll
(Month, Day, Vear)
Type or print In Ink.
Dote
Statement cove... period
9/25/2005
Recipient Committee
Campaign Statement
Cover Page
(Govemment Code Sections 84200-84216.5)
OfftcIaI Use Only
or
from
Commltteel - Camp'" P... 1, 2, 3. .nd 4,
o Primarily Fonned Ballot Measure
Commillea
a Controlled
a Sponsored
(AIaoComp/láPwt5J
o Primarily Fonned Candid'
OfIiœholder Committee
(Al.o Complete Part 7)
RK
o Quartarily SCatement
o Spacial Odd·Vear Report
o Supplemental Praalactlon
Stetemant . Attach Fonn 496
CUþERTiNa CITY CL
Type of Statement:
o Praalactlon Statement
D Semi-annual Statement
D Termination statement
(Also file a Form 410 Termination)
í2I Amendment (Explain below)
To correct Summary, Column B,
11/08/2005
2.
10/22/2005
through
SEE INSTRUCTIONS ON REVERSE
Type of Recipient Committee: All
í2I Offlcehoider, Candidate Controlled Committee
a State Candidate Election Committee
a Recall
(Also Ccmplete Pelt ð)
1.
Lines 9 and 11. Line 9 did not
include balance from Statement 1/1/2005 thru 9/24/2005.
atel
D General Purpose Committee
a Sponsored
a Small Contributor Commitlaa
a Poltilcal ParilylCantral Committee
Treasurer(s)
NAME OF TREASURER
Carolyn Krizek-Mahoney
MAILING ADDRESS
10940 Miramonte Road
.0. NUMBER
NAME IF NO COMMITTEE)
3. Committee information
COMMITTEE NAME (OR CANDIDATE'S
Citizens for Orrin Mahoney
AREA CODE/PHONE
408-725-1767
ZIP CODE
95014
STATE
CA
CITY
Cupertino
NAME OF ASSISTANt -fRI:ASURER";"lf
STREET ADDRESS (NO P.O. BOX)
10940 Miramonte Road
ANY
AREA CODE/PHONE
408-725-1767
AREA CODE/PHONE
408-725-1767
CITY STATE ZIP CODE
Cupertino CA 95014
MAILING ADDRESS (IF DIFFERENT) NO. AND S'TRËËT OR P.O. BOX
P.O. Box 1523
ëi"TY
MAILING ADDRESS
AREA CODE/PHONE
ZIP CODE
STATE
CITY
ZIP CODE
95014
STATE
CA
Cupertino
OPTIONAL: FAX
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 comptete.
under penalty 01 perjury under the laws oltha Stete 01 Callfomia that the foregoing is true and ~ct. ' ¿. )J&l¡ CJ
By /J~
By
By SigMU'e of QIIœhoIdør, CWddate. Stele MeasI.n Proponent
By SignatI.nofControllingOllloeholder,CandicIatII,StatsMe8ll6eProponen!
FPPC ToH-F.... Helpline:
E·MAll ADDRESS
FAX
OPTIONAl:
E·MAlL ADDRESS
4.
certify
1/30/2006
....
1/30/2006
¡;;¡;
Executed on
on
Executed
FPPC Form 480 ("'nuaryJ05)
8It1ASK·FPPC 18881278-3772)
... of C~lfomill
....
....
Executed on
Executed on
Type or print In Ink. COVER PAGE· PART2
Recipient Committee ORNIA 460
Campaign Statement RM
Cover Page - Part 2
2 01 3
- -
5. OffIceholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE -
NAME OF BALLOT MEASURE
Orrin Mahoney
OFFICE SOUGHT OR HELO (INCLUOE LOCATION ANO OISTRICT NUMBER IF APPLICABLE) - BALLOT NO. OR LETTER I JURISOICTION
o SUPPORT
Cupertino City Council o OPPOSE
RESIOENTIALJBUSlNESS AOORESS (NO. AND STREET) CITY STATE ZIP
10940 Miramonte Road Cupertino, CA 95014 Identify the controlling officeholder, CIIndldete, or atete me.sure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
Related Committees Not included in this Statement: LIllI any comm_
not Included In this atatement that are controlled by you or are ptlmarlly foImed to receive OFFICE SOUGHT OR HELD DISTRICT NO. IF Am
contributions or make upendltures on bells" of your candldlJcy.
7. Primarily Formed Candldate/Ofllcehoider Committee Ust names of
offlceholdat(s¡ or csndldote(s¡ for which f1Ils commlltoe Is prlmerlly fOrmed.
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELO 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
Attech contlnuatlon ..hee" " nec....ry
COMMITTEE NAME .0. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
DYES o NO
COMMITTEEAOORESS STREET ADORESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA COOEIPHONE
COMMITTEE NAME 1.0. NUMBER
NAME OF TREASURER CONTROLLEO COMMITTEE?
DYES ONO
COMMITTEEAOORESS STREET AOORESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
FPPC Form 480 (J.nultlYlOI)
FPPC TolI-F.... Helpline: øe&lASK-FPPC (8181275-3772)
State of C.IIforn..
SUMMARY PAGE
SUit.ment cove... period
1 9/2512005
rom
Type or print In Ink.
Amounts may be rounded
to whole dollars.
Campaign Disclosure Statement
Summary Page
3
Page ~ 01
1.0. NUMBER
10/22/2005
through
see INSTRUCTIONS ON REVERSE
NAME OF FILER
Citizens for Orrin Mahoney
Calendar Year Summary for Candidates
Running In Both the State Primary and
General Elections
08te
to
7/
$
through 6130
1
$
20. Contributions
Received
Expendnuras
MadIe
21
Column B
"-'<£NCAA VEAA
TOTAL TO DATE
3,878.00
7,000.00
10,878.00
0.00
10,878.00
$
$
3,778.00
0.00
3,778.00
0.00
3,778.00
ColumnA
TOTAL THIS PERIOD
(FROMA.TTACHEDSCHEDlIlES)
Contributions Received
$
$
Schedule A, Une 3
Schedule 8. Line 3
AddUnes1+2
Schedule C, Line 3
AddUnø3+4
Monetary Contributions
Loans Received ..........
SUBTOTAL CASH CONTRIBUTIONS
Nonmonetary Contributions ..............
TOTAL CONTRIBUTIONS RECEIVED
1.
2.
3.
4.
5.
$
Summary for State
$
Expenditure Limit
Candidates
22. Cumulative Expenditures Mad.·
IIf lubjKI to VoIuntar)' ExpendItuN UmIt)
Total to Date
Date of Election
(mmlddlyy)
9,302.01
0.00
9,302.01
6,120.00
0.00
15,422.01
$
$
$
6,409.48
0.00
6.409.48
4,704.20
0.00
11,113.68
$
Expenditures Made
6. Payments Made
7.
$
Schedule E, Une 4
Schedule H, Une 3
AddUnes6+ 7
$
Schedule F, Une 3
Schedule C, Une 3
AddUnes8+9+ 10
Loans Made
SUBTOTAL CASH PAYMENTS
Accrued Expenses (Unpaid Bills)
Nonmonetary Adjustment ........
TOTAL EXPENDITURES MADE
8.
9.
10.
11
from amounts
$
$
*Amounts În this section may be different
reported in Column 8.
-----1-----1_
-----1-----1_
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column B of your last
report. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts. If this is
the first raport being filed
for this calendar year, only
carry over the amolmts
from Lines 2, 7, and 9 (W
any).
$
4,207.47
3,778.00
0.00
6,409.48
1,575.99
$
$
Previous Summary- Page, Line 16
Column A, Line 3 above
Schedule I, Une 4
$
Column A, Line 8 above
Add Unes 12 + 13 + 14, then subtract Line 15
Une 16 must be zero.
Current Cash Statement
12. Beginning Cash Balance .......
13. Cash Receipts .......................
14. Miscellaneous Increases to Cash
Cash Payments .....................
ENDING CASH BALANCE .......
ff this is a termination statement,
15.
16.
0.00
$
5_8._2
17. LOAN GUARANTEES RECEIVED
FPPC Form 460 (JonueryI05)
FPPC Toll-Frao Helpline: 8661ASK·FPPC (8861275-3772)
0.00
0.00
$
$
See instnJc:1ion$ on reverse
Add Une 2 + Line 9 in Column B above
Cash Equivalents and Outstanding Debts
18. Cash Equivalents.
19. Outstanding Debts