460 Recipient Committee Campaign Statement - Preelection Statement 09-25-16 - 10-22-16 Recipient Committee COVER PAGE
Gampaign Statement � ((� �e���� (� z ' ' � ' � � ' � • 1
Cover Page D ;
'�' 1 4
Statement covers period Date of election if appli b : OCT 2 5 2016 �age of
from
09/25/2016 (Month, Day,Year; i I i For offcia�use on�y
' �
� I
SEEINSTRUCTIONSONREVERSE th�OUgh 10/22/2016 11/08/2016 CUF ERTINO CITY CL�R!� '
1. Type of Recipient Committee: All Committees—Complete Parts 1,s,s,and 4. 2. Type of Statement:
0 Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure � Preelection Statement ❑ Quarterly Statement
� State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report
� Recall � Controlled
(A/SoCompletePaA5) ❑ Termination Statement
� Sponsored (Also file a Form 410 Termination)
(Also Complete PaR 6)
❑ General Purpose Committee ❑ Amendment(Explain below)
� Sponsored ❑ Primarily Formed Candidate/
� Small Contributor Committee O�ceholder Committee
� Political Party/Central Committee (/Uso Complete Pa�t7)
3. Committee Information I I.D.NUMBER Treasurer(s)
1369332
COMMITTEE NAME(OR CANDIDATE`S NAME IF NO COMMITTEE) NAME OF TREASURER
MC COY FOR COUNCIL 2016, ROBERT BLOSSOM MCCOY
MAILING ADDRESS
STREETADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
CUPERTINO CA 95014
MAILING ADDRESS(IF DIFFERENT)N0.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 knowledge the 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 a�
Sponsor
Executed on By
Date Signature of Controlling Officeholder,Candidate.State Measure Proponent
Executed on By
Date Signature of Controlling Offceholder,Candidate,State Measure Proponent
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
COVER PAGE-PART 2
Recipient Committee � _ ,
Campaign Statement � . _ ' • 1
Cover Page — Part 2
Page 2 of 4
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOTMEASURE
ROBERT MCCOY
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER I JURISDICTION I � SUPPORT
CUPERTINO CITY COUNCIL ❑ oPPosE
RESIDENTIAL/BUSINESSADDRESS (NO.AND STREET) CITY STATE ZIP
Identify the controlling officeholder,candidate,or state measure proponent, if any.
CUPERTINO CA 95014
NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT
Related Committees Not Included in this Statement: ustanycomm�nees
not included in this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO.IF ANY
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D.NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE? �• Primarily Formed Candidate/Officeholder Committee Listnames of
officeholder(s)or candidate(s)for which this committee is primarily formed.
❑ YES ❑ NO
COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
COMMITTEE NAME I.D.NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ YES ❑ NO ❑ SUPPORT
COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX) ❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuafion sheets ifnecessary
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
�ampaign Disclosure Statement Amounts may be rounded SUMMARY PAGE
to whole dollars. Statement covers period � _
Summary Page � , � �
from 09/25/2016 • -
SEE INSTRUCTIONS ON REVERSE
through 10/22/2016 page 3 of 4
NAME OF FILER I.D.NUMBER
MC COY FOR COUNCIL 2016, ROBERT 1369332
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTALTHISPERIOD CALENDARYEAR
(FROMATTACHEDSCHEDULES) TOTALTODATE Running in Both the State Primary and
General Elections
1. Monetary Contributions................................................... scnedu�ea,unes $ 0 $ 0
O O 1/1 through 6/30 7/1 to Date
2. Loans Received................................................................ scnedu�e e,�ine s
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add�ines�+2 $ 0 $ 0 Received $ $
4. Nonmonetary Contributions............................................ scnedu�e c,�ine s � � 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED....................................Add�ines 3+4 $ � $ 0 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made................................................................ scnedu�e E,�rne a $ 236.88 $ 364.88 Candidates
7. L08f1S M8d@....................................................................... Schedule H,Line 3 0 0
236.88 364.88 22• Cumulative Expenditures Made'
8. SUBTOTAL CASH PAYMENTS.......................................... Add�ines s+� $ $ (If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills)..........................................scnedu�e F�ine s � � Date of Election Total to Date
10. Nonmonetary Adjustment.........................................................scnedu�e c,Line 3 0 0 (mm/dd/yy)
11. TOTAL EXPENDITU RES MADE........................................Add�ines s+s+�o $ 236.88 $ 364.88 �_J $
Current Cash Statement _�� �
12. B2glllfllll9 CBSh B8I8f1C2............................ Previous Summary Page,Line 16 $ 1287.33
To calculate Column B,
13. CBSh ReCeipts........................................................... Column A,Line 3 above � add amounts in Column
� A to the corresponding *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash.................................. scneduie�,�ine a amounts from Column B reported in Column B.
15. CaSh Payments......................................................... Column A,Line 8 above 236.88 of your last report. Some
amounts in Column A may
16. ENDING CASH BALANCE ...................4dd�ines�2+�3+14,then subtract Line 15 � 1050.45 be negative figures that
should be subtracted from
If this is a termination statement, Line 16 must be zero. previous period amounts. If
this is the first report being
17. LOAN GUARANTEES RECEIVED................................ scnedu�e e,Part 2 $ 0 filed for this calendar year,
only carry over the amounts
Cash Equivalents and Outstanding Debts from Lines 2,�,and 9(if
18. Cash EqUlValents................................................ See instructions on reverse $ � any).
19. Outstanding Debts.............................. Add Line 2+Line s in Column e above $ � FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
�chedule E Amounts may be rounded SCHEDULE E
Statement covers period
to whole dollars. • � � � '
Payments Made 09/25/2016 • '
from
SEE INSTRUCTIONS ON REVERSE
through 10/22/2016 page 4 of 4
NAME OF FILER I.D.NUMBER
MC COY FOR COUNCIL 2016, ROBERT 1369332
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,AL50 ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
BANK OF AMERICA SERVICE FEES
SPRINT
SPRINT.COM WEB 220.88
*Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 236.88
Schedule E Summary
1. Itemized a ments made this eriod. Include all Schedule E subtotals. 236.88
p Y P � )............................................................................................................. $
2. Unitemized payments made this period of under$100.......................................................................................................................................... $ �
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)............................................................................. $ �
4. Total a ments made this eriod. Add Lines 1, 2, and 3. Enter here and on the Summa Pa e, Column A, Line 6. TOTAL $ 236.88
P Y p � rY 9 )...........................
FPPC Form 460(1an/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov