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460 Recipient Comittee Campaign Statement 10-22-11Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 9/25/11 through 10/2211 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee O Recall Q Controlled (Also Complete Part 5) O Sponsored Date (Also Complete Part 6) ❑ General Purpose Committee Executed on By Date Sigilature of Controllin older, Candidate, SMIe 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/OS) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee Type or print in ink. NAME OF OFFICEHOLDER OR CANDIDATE Donna Austin OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Cou n c il M C ity o f Cupertino RESIDENTIAL/BUSINESS ADDRESS (N0. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COVER PAGE - PART 2 Page __9_L_ of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY 7. Primarily Formed Candidate /Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary BALLOT NO. OR LETTER I JURISDICTION I F SUPPORT ❑ OPPOSE FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement To calculate Column B, add Type or print in ink. 3894.00 SUMMARYPAGE Summary Page 3225.00 $ Amounts may be rounded to whole dollars. 7. Loans Made .............................. ............................... Statement covers period CALIFORNIA I 0.00 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 +7 $ 3225.00 $ l5 83.65 9. Accrued Expenses (Unpaid Bills • 0.00 0.00 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line from 9/25/11 • - Add Lines 6 + 9 + 10 $ 3225.00 $ 16853.65 10/2211 page 7 SEE INSTRUCTIONS ON REVERSE through _a__ of NAME OF FILER I.D. NUMBER Donna Austin 1339133 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHISPERIOD (FROM ATTACHED SCHEDULES) CALENDARYEAR TOTALTO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ............ ............................... schedule A, Line 3 00 $ 3894. $ 19998.20 2. Loans Received ....................... ............................... schedule B, Line 3 0.00 1000.00 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 3894. $ 20998. 20 20. Contributions 1000.00 20998.20 Received Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 0.00 1070.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... AddLines3 +4 $ 3894.00 $ 22068.20 40604 16853.65 Made $ . $ Expenditures Made To calculate Column B, add 3894.00 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 3225.00 $ 15783.65 7. Loans Made .............................. ............................... Schedule H, Line 3 0.00 0.00 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 +7 $ 3225.00 $ l5 83.65 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 0.00 0.00 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 0.00 1070.00 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 6 + 9 + 10 $ 3225.00 $ 16853.65 Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 13. Cash Receipts .................... ............................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15. Cash Payments ................... ............................... Column A, Line s above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ if this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 4139.51 To calculate Column B, add 3894.00 amounts in Column A to the corresponding amounts from Column B of your last 0.00 3225.00 report. Some amounts in Column A may be negative 4808.51 figures that should be subtracted from previous period amounts. If this is the first report being filed 0.00 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 1000.00 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Schedule A Type or print in ink. SCHEDULE A Monetar Contributions Received Amounts may oe rounaea ry to whole dollars. Statement covers period CALIFORNIA from 9/25/11 • ' - through 10/2211 SEE INSTRUCTIONS ON REVERSE Page of NAME OF FILER I.D. NUMBER Donna Austin 1339133 DATE FULL NAME, EET A DE O STREET DDRESS AND ZIP CODE OF CONTRIBUTOR RALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED ( COM MITT E E, I.D. NU CODE * (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) BIND 9/27/2011 Bruce Wool pert p ❑COM CEO Manager Granite $ 250.00 $ 250.00 ❑OTH Rock, Watsonville ❑ PTY ❑SCC MIND 9/30/2011 Nancy H Burnett ❑COM Retired $100.00 $100.00 ❑OTH ❑ PTY ❑ SCC ®IND 10/5/2(l11 Myong Shin Woo ..,..,, — ._ __ — ._.._ , _ _ „,._ _ ,. ,, UV I h ❑ PTY ❑ SCC E]IND 10/7/2011 Charles T.Munger ❑COM Physicist, self employed $2000.00 $2000.00 ❑ OTH ❑ PTY [:]SCC a- 10/21f2011 Luis Buhler ®IND ❑COM CFO, Rockledge $250.00 $350.00 ❑OTH Association t om ✓ ❑ PTY ❑ SCC SU BT O TAL$ 3350.00 Schedule A Summary Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ............. ............................... 2. Amount received this period — unitemized monetary contributions of less than $100 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...... 3350.00 544.00 TOTAL $ 3894.00 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • . to whole dollars. ' 9 /2 5/11 from • - through 10/2211 page of NAME OF FILER I.D. NUMBER Donna Austin 1339133 DATE FULL NAME STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ❑IND John Zirelli ❑COM Recology 7/7/11 W] OTH $250.00 $250.00 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND n rnnn ❑ OTH ❑ PTY []SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL 250.00 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SCHEDULE B - PART 1 Schedule B — Part 1 u m ay Amounts may be rounded Statement covers p eriod P . Loans Received to whole dollars. 9/27/11 � _ ' • from , through 10/2711 page Cam— of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Donna Austin 1339133 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER , a OUTSTANDING (b) AMOUNT (c) AMOUNTPAID (d) OUTSTANDING (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTERI.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD" PERIOD PERIOD LOAN TO DATE Donna Austin, Retired Teacher ❑ PAID CALENDARYEAR $ 0.00 $ 1000.00 0 , $ 1000.00 $ 1000.000 ❑ FORGIVEN RATE PER ELECTION - $ 1000.00 $ 0.00 $ 0.00 $ 6/26/11 $ tW IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION ** RATE UMI C UUC UHI C IINUUMMMU Lj IND I COM LJ OTH U PTY U SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION"' RATE $ $ $ $ $ DATE DUE DATE INCURRED to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0.00$ 0.00 $ 1000.00 $ 0 Schedule B Summary 1 . Loans received this period ..................................................................................... ............................... $ (Total Column (b) plus unitemized loans of 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 the net here and on the Summary Page, Column A, Line 2. 'Amounts forgiven or paid by another party also must be reported on Schedule A. '" If required. 0.00 0.00 0.00 (May be a negative number) (Enter (e) on Schedule E, Line 3) tContributor Codes IND – Individual COM – Recipient Committee (other than PTY or SCC) OTH – Other (e.g., business entity) PTY– Political Party SCC – Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER Donna Austin SCHEDULEE Statement covers period CALIFORNIA from 9/27/11 FORM through 10/2711 Page of I.D. NUMBER 1339133 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment CMP campaign paraphernalia /misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing /ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals IND independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Barry Wyatt Associates Campaign consultants CNS $ 1000.00 Mail #1, "Introduction" Mail File &Postage Barry Wyatt Associates LIT $ 1275.00 Barry Wyatt Associates <ail # 2, "PureWomen" Design, printing, mail file, LIT hand match, postage $950.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3225.00 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. 3225.00 2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 0.00 3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e). 0.00 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 3225.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772)