460 Recipient Committee Campaign Statement 12-31-2010 Recipient Committee COVER PAGE
p Type or print in ink. Date Stamp CALIFORNIA
Campaign Statement CORM 460
Cover Page n [ g (g (j U
(Govemment Code Sections 84200- 84216.5) U 12!! 1 of _ 3
Statement covers period Date of election if appli ,
July 1, 2010 (Month, Day, Year) j J AN 3 For Official Use Only
from 2011 1!)
SEE INSTRUCTIONS ON REVERSE through
December 31, 2010
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2. Type of State
_ CRT INO CITY uLtt1K
❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement
Q State Candidate Election Committee Committee 21 Semi - annual Statement ❑ Special Odd -Year Report
Q Recall 0 Co Termination Statement
(Also Complete Part 5) 0 Sponsored ❑ El S - n
a
(Also file a Form 410 Termination) Statat ment Attach Form 495
(Also Complete Part 6)
® General Purpose Committee ❑ Amendment (Explain below)
Q Sponsored ❑ Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
Q Political Party /Central Committee (Also Complete Part 7)
3. Committee Information I.D NUMBER Treasurer(s)
1287471
COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) NAME OF TREASURER
CONCERNED CITIZENS OF CUPERTINO Marolyn O.Chow
MAILING ADDRESS
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowled ht information contained herein and in the attached schedules is true and complete. I certify
under penalty of perjury under the laws of the State of California that the foregoing is true and correct., ` ,
January 31, 2011
Executed on By
Date Signature of Treasurer or Assistant Treasurer
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772)
State of California
Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE
Amounts may be rounded Statement covers period CALIFORNIA 460
Summary Page to whole dollars.
from July 1, 2010 FORM
SEE INSTRUCTIONS ON REVERSE through December 31, 2010 Page 2 of 3
NAME OF FILER I.D. NUMBER
CONCERNED CITIZENS OF CUPERTINO 1287471
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running Both the State Primary and
(FROM ATTACHED SCHEDULES) TOTALTO DATE g • m rY
General Elections
1. Monetary Contributions Schedule A, Line 3 $ 125 $ 125
1/1 through 6/30 7/1 to Date
2. Loans Received Schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 $ $ 20. Contributions
Received $ $
4. Nonmonetary Contributions Schedule C, Line 3 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED AddLines3 +4 $ $ Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made Schedule E, Line 4 $ $ Candidates
7. Loans Made Schedule H, Line 3
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS Add Lines 6 +7 $ $ (H Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 Date of Election Total to Date
10. Nonmonetary Adjustment Schedule C, Line 3 (mm /dd /yy)
11. TOTAL EXPENDITURES MADE Add Lines 8 +9+ 10 $ $ _____I_J $
Current Cash Statement _I 1 $
12. Beginning Cash Balance Previous Summary Page, Line 16 $ 1080
To calculate Column B, add
13. Cash Receipts Column A, Line 3 above 125 amounts in Column A to the
corresponding amounts *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B of your last reported in Column B.
15. Cash Payments Column A, Line 8 above report. Some amounts in
Column A may be negative
16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 1,205.51 figures that should be
subtracted from previous
If this is a termination statement, Line 16 must be zero. period amounts. If this is
the first report being filed
17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ for this calendar year, only
carry over the amounts
Cash Equivalents and Outstanding Debts from
Lines 2, 7, and 9 (if
18. Cash Equivalents See instructions on reverse $
1205.51 a
19. Outstanding Debts Add Line 2 + Line 9 in Column B above $ FPPC Form 460 (January/05)
FPPC Toil -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule A (Continuation Sheet) Type or print in ink SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA 460
to whole dollars. July 1, 2010 FORM
from
through December 31 2010 Page 3 of 3
NAME OF FILER I.D. NUMBER
CONCERNED CITIZENS OF CUPERTINO 1287471
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED
(IF COMMITTEE .ALSO ENTER I.D CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
(IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED)
OF BUSINESS)
IND
12/20/10 James Walker Ll Certified Public $125 $125
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
n COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 125
*Contributor Codes
IND— Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party FPPC Form 460 (January/05)
SCC — Small Contributor Committee FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)