460 Recipient Committee Campaign Statement - Semi Annual 1-1-17 to 6-30-17Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
COVER PAGE
fl JUL J f �lT�
Statement covers period Date of election if applica of —
from
1/11/20117 F
(Month, Day, Year) !Jr I For Official use Only
through
06/31/2017
1. Type of Recipient Committee: All Committees – Complete Parts 1, 2, 3, and 4.
Q Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
O State Candidate Election Committee Committee
O Recall O Controlled
(AisoCompla:ePart 5) 0 Sponsored
rAlso Complete Part 6)
❑ General Purpose Committee
• Sponsored ❑ Primarily Formed Candidate/
• Small Contributor Committee Officeholder Committee
• Political PartylCentral Committee (Aft ComplefePart 7)
D. NUMBER
3. Committee Information I.l;%Lo q
COMMITTEE NAME. (OR CANDIDATE'S NAME IF NO COMMITTEE)
Bharwad for City Council 2016
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL: FAXtE-MAILADDRESS
4, Verification
� i � I C PER71N0 CITY CLERK
T
2. Type of Statement:
❑ Preelection Statement ❑ Quarterly Statement
Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Jakshi Bharwad
MAILINGADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
NAME OF ASSISTANT TREASURER, IFANY
MAILING ADDRESS
CITY STATE ZIP CODE AREACODEIPHONE
OPTIONAL: FAXIE-MAILADDRESS
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.
certify under penalty of perjury under the laws of the State of California that the
Executed on 07/30/2017
Date
Executed on 07/30/2017
Date
Executed on
Date
Executed on
Date
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Parth Bharwad
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE)
Cupertino City Council
RES IDENTIALIBUS INESS ADDRESS (NO. 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.
COMMITTEE NAME
I.D. NUMBER
NAME OFTREASURERI CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODElPHONE
COMMITTEE NAME
I.D. NUMBER
NAME OF TREASURERI CONTROLLED COMMITTEE?
❑ YES ❑ NO
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
CALIFORNIA•
.-
Page Z of 'n
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO, OR LETTER JURISDICTION
❑ SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee List names of
officeholders) 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
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
To calculate Column B,
Amounts may be rounded
schedule E, Line 4 $
SUMMARY PAGE
Summary Page
l► r
8_ SUBTOTAL CASH PAYMENTS ..........................................
to whole dollars.
Statement covers period
Schedule F Line 3
10. Nonmonetary Adjustment..... .........................................
...... schedule C, Line 3
11. TOTAL EXPENDITURES MADE---------------
1/1/2017 • - •
this is the first report being
from
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
through
06131/2017 page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.pD. NUMBER
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
CALENDARYEAR
TOTAL TO DATE
Running in Both the State Primary and
General Elections
292.00
21635.54
1. Monetary Contributions...................................................
SchedufeA, Linea
$ $
111 through 613D 711 to Date
0
0
2. Loans Received................................................................
Schedule B, Line 3
292.00
21635.54
20. Contributions
0
3. SUBTOTAL CASH CONTRIBUTIONS... ...........................
Add Lines 1 +2
$ $
Received $ 292 $
0
0
4. Nonmonetary Contributions ............................................
Schedule C, Line 3
21. Expenditures
292.00
21635.54
Made $ 3 $ 0
5. TOTAL CONTRIBUTIONS RECEIVED...... ................ .......
......Add Lines 3 + 4
$ $
Expenditures Made
To calculate Column B,
6. Payments Made..... ....... -..................................................
schedule E, Line 4 $
7. Loans Made......................................................................
schedule H, Line 3
8_ SUBTOTAL CASH PAYMENTS ..........................................
Add Lines 6+ 7 $
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line 3
10. Nonmonetary Adjustment..... .........................................
...... schedule C, Line 3
11. TOTAL EXPENDITURES MADE---------------
....................... Add Lines 8 + 9 + 10 $
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 8 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 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ See instructions on reverse $
19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column B above $
v $
0
0 $
0
0
a $
3659.22
17565.17
17565.17
17565.17
L'1
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)
11 1 08 / 16 $ 17565.17
$
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
To calculate Column B,
292.00
add amounts in Column
A to the corresponding
amounts from Column B
0
3
of your last report. Some
amounts in Column A may
3948.22
be negative figures that
should be subtracted from
previous period amounts. If
this is the first report being
0
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
any).
L'1
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)
11 1 08 / 16 $ 17565.17
$
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Sr-hpl hillP A
Amounts may be rounded
SCHEDULE A
Monetary Contributions Received to wnole sonars.
Statement covers period
CALIFORNIA ,
1/1/2017
from
•
06/31/2017
LA,of J
through
page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IFAN 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)
City of Cupertino
❑❑ COM IND
Refund from city for fees
292
02/24/17
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL $ 292
Schedule A Summary
1. 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.)...........
........... $
............$
TOTAL $
292
0
292.00
"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 (!an/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULE E
Schedule E Amounts may be rounded Statement covers period
to whole dollars. CALIFORNIA / 6
Payments Made from 1/1/2017 FORM
through
06131/2017 page � of
_—
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER E.D. NUMBER
( 39.003
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalia/mist.
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
FIND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
[ND
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
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.).....................................................................
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 payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)
AMOUNT PAID
SUBTOTAL $ 0
................................... $ 0
................................... $
3
.................................. $ 0
...................... TOTAL $
3
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov