Semi-annual Debt Retire
COVER PAGE· LONG FORM
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Recipient
Campalgl
PIIge 1 of 7
A For OffIcial Uss Only
1
ISTRAR bF VOTERS
N 'ANTA CLARA
2006
JAN 3
DatI øI_ n oppIloobIi
co
(-. DIIr. Y"¡ By
Bbd. naenlccmnpll'lod
07/01/2005
CUPERTINO CITY CLERK
(Govemment
D
from
o Quarterly Statement
o Special Odd-Year Report
o Supplemental Pre-election
Statement - Attach Form 495
2. Type of Statement:
o Pre-election Statement
I!I Semi-annual Statement
o Termination Statement
o Amendment (explain below)
12/31/2005
1. Type of Recipient Committee:
III OffIceholdsr, Csndldete Controlled Committee 0 Ballot Msasure Committee
a Stats Candldete Election Committee a Primarily Formed
a Recall a Controlled
a Sponsored
..........
o Primarily Formed Csndldate
OffIcsholder Committee
o Gensral Purpose Committee
a Sponeored
a Small Contributor Committee
a Political Party/Central Committee
MEA CODEJPHONE
(408) 725-8939
ZIP CODE
95014
STATE
CA
Treasurer(s)
NAME OF TREASUFIEA
Dolly Sandoval
STREET ADDRESS
10720 Alderbrook Lane
CITY
"r):¡)E~/1I! 0
NAME OF ASSISTANT TREASURER, IF AN'(
I,D. NlIMBEFI
990787
Retirement
AREA CODElPHONE
(408) 725-8939
3. Committee Information
COMMITTEE NAME
Dolly Sandoval for Supervisor
Committee
STREET ADDRESS (NO P.O. BOX)
10720 Alderbrook Lane
CITY STATE ZIP CODE
Cupertino CA 950t4
STREET ADDRESS (IF DIFFERENT) NO. AND STREET OR p,o, BOX
Debt
STREET ADDRESS
AREA CODElPHONE
( )
ZIP CODE
STATE
CITY
AREA COOEIPHONE
CODE
ZIP
STATE
CITY
OPTIONAl: FAXIE-MAIL ADDRESS
4. Verification
I have used all ressonable diligence In preparing and revlewln9 this statement and to the besl of my knowledge tha information conlalned hareln and In Ihe attached schedules
Is lrue and complele. I certify under penalty of pe~ury under Ihe lewe of of Call1ol thallhe IQJ Ing is lrue and correct.
I
URER OR ASSISTANT TREASURER
By
;I/~
DATr
/ ~I l0/'"
DATE
OPTIONAL: FAX!E4.tAIL. ADDRESS
( ) - /
Executed on --J..
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATe. STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR
By
ëxecuted on "
SIGNATURE OF CONTROlLING OFFICEHOlDER, CANDIDATE, STATE MEASURE PROPONENT
SIGNATURE OF CONTAOWNß OFFICEHOlDER, CÞ.tÐIDATE, STATE MEASURE PROPONENT
State of California Fair Polftlcal Practlcea COmmlaalon.
By
By
DATE
Executed on
OATE
SICCW· PCABOS 01380 (Rev. 1/0S)
ëxewlsd on
PART 2
COVER PAGE
Recipient Committee
Campaign Statement
Cover Page - Part 2
7
of
2
PIIge
6. Ballot Measure Committee
NAME OF BÞ.L.lDT MEASURE
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OF CANDIDATE
C SUPPORT
o OPPOEE
LETTER
BALLOT NO. OR
MS Dolores Sandoval
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPUCABLE)
Santa Clara County
STATE ZIP CODE
5
Board of Supervisors, District
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY
mte measure proponent, If any.
identify \he controlling officeholder, candidate,
NAME Of' OFfiCEHOLDER, CANDIDATE OR, PROPONENT
DISTRICT NO. IF Am
or
OFFIce SOUGHT OR HELD
10720 Alderbrook Lane Cupertino CA 95014
Reletad Committees Not Included In this Statement: Us! any committees
not included in this consolidated statement that are controlled by you or which are primarily
formed to reœive contributions or to make expenditUres on behalf of your candidacy.
7. Primarily Formed Committee
COMMITTEE NAME
Friends of Dolly Sandoval
NAME OF TREASURER
1277455
CONTROLLED COMMITTEE?
NAA'lE 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
NAME OF OFFICEHOlDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT
o OPPOSE
AREA CODElPHONE
408) 725-8939
to. NUMBER
CCOE
"p
95014
P.O. BOX)
STATE
CA
Sarah Hathaway-Felt
COMMITTEE ADDRESS STREET ADDRESS (NO
Alderbrook Lane
Cupertino
COMMITTEE NAME
10720
CITY
CONTROLLED COMMITTEE?
NAME Of TREASURER
AREA CODEIPHONE
ZIP CODE
STREET ADDRESS (NO P.O. BOX)
STATE
COMMITTEE ADDRESS
CITY
SUMMARY PAGE
s..."",_ COVW1l period
Campaign Disclosure Statement
Summary Page
7
of
3
PIIge.
I.D. NUMBER
07/0l/2005
thnIugh.12/31/20 05
Debt Retirement
from
990787
CIII._ V_1Iumnwy for CIInd.......
Running In Both !he ~ PrInwy and
~ EIecIIona
Column B
CAlENDAR YEAR
TOT At TO DATE
2.....QQQ.OO
Dolly Sandoval for Supervisor
Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
a 00.00
!l.00
Sandoval
MS. Dolores
Committee
Contributions Received
NAME DF FILER
toOate
1/1lhrough 6130
20. Contributions
Received .... ~
21. Expenditures
Mads .......... $
Expendltunl LImIt IIumnwy for SbdIt
CIInd.......
71
00
00
00
00
00
110.000
112.000
o
112.000
o
5
5
00
0.00
~OOO.O~
000
2
5
5
Schedule A,
Schedule B, Line 7
Add Lines
Line 3
+2
Schedul. C, Line 3
Add Un.s 3 + 4
1
Monetary Contributions
Received
3. SUBTOTAL CASH CONTRIBUTIONS
4. Non·mon.tary Contributions ...............
5. TOTAL CONTRIBUTIONS RECEIVED
Loans
1.
2.
5
5
0.00
0.00
º-.cOO
5
5
5
Schedul. E, Line 4
Schedule H, Lin. 7
Add Lines 6 + 7
Expenditures Made
6. Cash Payments
Loans Mad.
22. CumuleUv. Expenditure Mad.·
(If Subject to Voluntary Expenditure Limi'
0.00
7.
0.00
º-.cOO
5
Total to Date
Date of Election
(mm/ddIyy)
º-.cOQ
0.00
0.00
0.00
Schedul. F, Line 3
Schedule C, Line 3
Add Lines 8 + 9 +
0.00
5
876.15
!lOO.OQ
2;2.
2
5
5
10
16
Previous Summary Pege, Line
Column A. Line 3 above
Schedul.
8. SUBTOTAL CASH PAYMENTS
Accru.d Expens.s (Unpaid Bill.)
10. Nonmonetary Adju.tm.nl..........
11. TOTAL EXPENDITURES MADE
Current Cash Statement
12. B.ginning Cash Balanc.
13. Cash R.ceipts
14. Misc.llan.ous
9.
14.90
...Q..,.QQ
25~1.05
I,
Lln. 8 above
Line 4
Column A,
, 12+ 13+ 14,
16 must be z.ro.
to Cash
Cash Paym.nts
ENDING CASH BALANCE
Increases
15.
5
15
less Line
Lines
16.
If this is a Tennination Statement, Line
º-'-OO
0.00
l~OOO.Q.Q
5
$.
5
Column (b)
Cash Equivalents and Outstanding Debts
18. Cash Equival.nts .
19. Outstanding D.bts
1,
17. LOAN GUARANTEES RECEIVED Schedule B, Part
Add Line 2 + Line 9 in Column C above
10S)
PCABOS 01380 (R.v.
SICCW
SCHEDULE A
Schedule A --- 1: I ~
Monetary Contributions Received from 07/01/2005
1hrough.12131/2 005 _ PIIge 4 of 7
NAME OF FILER Ms. Dolores Sandoval, Dolly Sandoval for Supervisor - Debt Retirement I.D. NUMBER
Committee 990787
CUMULATIVE TO DATE PER ELECTION
CALENDAR YEAR TO DATE
(JAN 1-DEC31) (IF REQUIRED)
2,000.00
AMOUNT RECEIVED
THIS PERIOD
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED ENTER NAME
OF BUSINESS}
CONTRIBUTOR
CODE *
NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE. ALSO ENTER I.D. NUMBER)
FULL
2,000.00
2,000.00
2,000.00
0.00
2,000.OJL
IND
COM
OTH
PTY
see
IND
eOM
OTH
PTY
see
IND
COM
OTH
PTY
see
IND
COM
OTH
PTY
see
IND
eOM
OTH
PTY
see
o
o
iii
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Cupertino Housing Partners LLC
490 California Avenue, 4th Floor
Palo Alto, CA 94306
DATE
RECEIVED
11/09/2005
$
SUBTOTAL
$
$
$
.TOTAL
)
Monetary Contributions Summary
1. Amounl received this period - contributions of $100 or more.
(Include all Schedule A subtotals.) ...........................................
2. Amount received this period - contributions ofless than $100.
(Do not itemize.) .......................................................................
3. Total monetary contributioos received this period.
(Add Lines I and 2. Enter here and on the Summary Page. Column A, Line
SCHEDULE B - Part
S.......nent conra peotad
Schedule B - Part
Loans Received
7
of
5
PIIge
1.0. NUMBER
07/01/2005
thr1lllalL12/31/2005
Debt Retirement
from
(01
CUMULATIVE
CONTRIBlJTIONS
TO DATE
CALENDAR YEAR
990787
(~
ORIGINAl.
AMOUNT OF
LOAN
$
20,000
$
PER ELECTION
(.)
INTEREST
PAID THIS
~
0.000 %
RATE
o
oUTsiÃNDtNG
BALANCE AT
CLOSE OF THIS
20.000
$
(0)
AMOUNT PAID
OR FORGIVEN
THIS PERIOD
DpAJO
$ 0
o FORGIVEN
$ 0
Dolly Sandoval for Supervisor
(b)
AMOUNT
RECEIVED THIS
PERIOD
OUTSTANDING
BAlANCE
BEGINNING THIS
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER
NAME OF BUSINESS1
Councilmember
MS. Dolores Sandoval
Committee
FULL NAME, STREËT ADDRESS AND ZIP CODe
OF LENDER
(IF COMMITTEE, ALSO ENTER to. NUMBER)
NAME OF FILER
Ms. Dolores Sandoval
10720 Alderbrook Lane
Cupertino CA 95014
City of Cupertino
$
CALENDAR YEAR
09/30/1999
DATE INCURRED
$
12/3112006
DATE Due
PER ELECTION
$
$ 25.000
0.000 %
RATE
~
$ 25,000
Q
o
$-
o FORGIVEN
$
Q
$
20.000
o COM 0 OTH 0 PTY 0 see
Dolores Sandoval
Continued)
INO
iii
Ms
PAID
$
CALENDAR YEAR
02/29/2000
DATE INCURRED
$
12/31/2006
OA TE DUE
Q
o
$-
o FORGIVEN
$
PAJO
Q
$
$ 25.000
o Do," Om Osee
Dolores Sandoval
Continued) (Continued
COM
INO
o
Ms
PER ELECTION
$
$
S 40,000
0.000 %
RATE
Q
$
40,000
12/3112006
DATE DUE
$
Q
o
o
$
40,000
$
o PTY 0 see
OTH
o COM 0
DIND
0.00
$
85,000.00
0.00
$
0.00
$
$
0.00
SUBTOTAL $
received this period
in~emized loans less than $100.)
Loans
(Total Column (b) plus
Schedule B Summary
1
0.00
$
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 ~emized on Schedule A.)
0.00
NET $
from Line 1.)
Column A, Line 2
Net change this period. (Subtract Line 2
Enter the net here and on Ihe Summary Page,
3.
SCHEDULE B - Part
Schedule B Part I (Continuation Sheet) s..._ co.... peI10d (\]II¡)]~'\]\ 4
Loans Received 07/01/2005 I OJ{ \1
from
\htou h 12/31/2005 PIIge 60f 7
=
NAME OF FILER Ms. Dolores Sandoval, Dolly Sandoval for Supervisor Debt Retirement I.D. NUMBER
Committee 990787
-
FULL NAME, STREET ADORESS AND ZIP CODE IF AN INDIVIDUAL. ENTER , (b) (,) OU",:SJ;DING (.) I~ (,)
OUTS ANDING AMOUNT AMOUNT PAID INTEREST ORIGINAL CUMULATIVE
OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN BAlANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS
(IF SELF-EMPLOYED, ENTER BEGINNING THIS CL~å'c>9ÄrYHlS
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) NAME Qf BUSINESSI PERIOD THiS PERIOD PERIOD LOAN TO DATE
Ms. Dolores Sandoval CALENDAR YEAR
DpAJO
(Continued) (Continued) 0 10,000 0.000 % $ 10,000 $
(Continued) $ $
o FORGIVEN RATE PER ELECTION
$ 10,000 $. -.Q. $ 0 12/31/2006 $. --º- 11/1312000 $
o INO o COM 0 OT!< 0 PTY 0 see DATE DUE DATE INCURRED
Ms. Dolores Sandoval DpAJO CALENDAR YEAR
(Continued) (Continued) 0 15,000 0.000 % 15.000 $
(Continued) (Continued) $ $ $
o FORGIVEN RATE PER ELECTION
$ 15.000 $. -.Q. $ 0 12/31/2006 $ ----1L 11/18/2000 $
o IND o COM 0 OTH 0 PTY 0 see DATE DUE DATE INCURRED
CALENDAR YEAR
o PAID
$ $ _% $ $
o FORGIVEN RATE PER ELECTION
$ $ - $ $ - $
o INO o eOM 0 OTH 0 PTY 0 see DATE DUE DATE INCURRED
CALENDAR YEAR
DpAJO
$ $ _% $ $
D FORGIVEN RATE PER ELECTION
$ $ - $ $ - $
o INO 0 COM 0 OTH 0 PTY 0 see DATE DUE DATE INCURRED
CALENDAR YEAR
DpAJO
$ $ _% $ $
o FORGIVEN RATE PER ELECTION
$ $ - $ - $ - $
o INO 0 COM 0 OTH 0 PTY 0 see DATE DUE
-
SUBTOTAL $ 0.00 $ 0.00 $ 25,000.00 $ 0.00
SCHEDULE
S..._'.....I co... period
Schedule I
Miscellaneous Increases to Cash
7
of
7
PIIge.
I.D. NUMBER
990787
07/01/2005
lIIrcIUII'L12/31/2005
Debt Retirement
!rom
for Supervisor
Dolly Sandoval
MS. Dolores Sandoval
Committee
NAME OFFILER
AMOUNT OF
INCREASE TO CASH
DESCRIPTION OF RECEIPT
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTeE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS. ENTER 1.0. NUMBER
OR, IF NO 1.0. NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'S NAME & ADDRESS)
DATE
RECEIVED
0.00
SUBTOTAL $
00
90
00
90
Q
14
...Q
14
$
$
$
$
TOTAL
15.)
Mlscetløneous Increan. to Cash Summary
1. Increases to cash of $100 or more this period. ..
2. Increases to cash under $100 this period.
(Do not itemize.) ........................................................................
3. Total of all interest rcceived this period on loans made to others.
(Schedule H, Part II (b).) ..............................................................
4. Total miscellaneous increases to cash this period.
(Add Lines 1,2, and 3. Enter herc and on the Summary Page, Line