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460 Recipient Committee Campaign Statement - Termination 1-2-19 Recipient Comrr�ittee COVER PAGE • Campaign Statement � a � • ' ' � , ' Co�er Page ' ' Sta#ement covers period Date of election if appfi ti�f;c�; ^ ��^j j� � °f 6 from 10/21/2018 ((vtonth,Day,Year} or otCicial use ony SEE INSTRUCTFONSDN REVERSE #hrOugh 12/28l2038 11/6/2Q18 � '�'�[��{�Q �j�� j` �� 'I. T�/fJ@ O'F ReCI�?Teflt COIY11711�C@�: AII Committees—Complete Parts 1,2,s,and 4. 2. Type of Statement: 0 Officeholder,Candidate Conirolfed Committee ❑ Primanly Formed Ballot Measure � Preetection Staiement � Quarterty Statement � State Candidate Election Committee Commiitee �] Semi-annual Statemeni ❑ Special Odd-Year Report � f2ecaA � Controlied [t� Terrnination Statement (AlsoCompfeteFart5) � Sponsored (Rlso file a Form 410 7ermination) {Also Comptete Part 6J ❑ General Purpose Committee ❑ Amendment(Explain befow) � Sponsored � Primarily Formed Candidate/ � Smati Contribufor CommitEee Officeholder Committee � Political Party/Central Committee f�soCompleteParf7J 3. Comrnittee IrvForma#ion �•D.NUMSER Treasurer(s) '1407834 COMMITFEE NAMP(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Mahoney for Council-2�18 Carolyn Krizek-Mahoney 4. Verifica#ion I have used ail reasonabfe diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schecfules is true and complefe. I certify under penafty of perjury underthe laws of tk�e State af Cafifornia that the foregoing Sponsor Executed on gy �� Signature of Controllmg Qfficeholder,Cartdidate,State Measure Proponen# Executed on B� Date Signature of Controlling Officeholder,Candidate,S#ate Measure Proponent FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866J275-3772) www fppc.cagov COVER PAGE-PAfZT 2 Recipien�t Committee Campaign Statement � ,`. ' ' �' • 1 Cover Page — Part 2 Page 2 of 6 5. Officeholder or Candidate Con#ralled Cornmittee 6. Primarily Formed Ballo#Measure Commiitee NRME OF OFFICEHOlDER OR CANDIDATE NAME OF BALLOT MEASllRE Orrin Mahoney OFFfCE S011GHT OR HElD(INCLUDE LOCAFION RND DISTRfCT NUMBER IF APPLICABLE) BALLOT NO.OR LE7TER JURISDICTION ❑SUPPORT Cupertino City Council ❑ o�Pose NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Nof Included in this Statement: �stany�o„►.r,;t€ees not included in this statemenf that are controlled by you ar are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NQ.IF ANY confributions or make expenditures on behalf of your can�dacy. COMMITTEE NAME I.D.NUMBER NAME OF TREASURER CONTRQLLED COMMfTTEE? 7• Pr�marily formed Candidate/Officeholder Committee Listnames of o�ceholder(s)or candidate(s)for which this commiftee is primarily formed ❑YES ❑NO COMMITTEEP.DDRESS STREETADDRESS (NO P.O.BO� NAME OF OFFICEHOLDER OR CANDIDATE OFFlCE SOUGHT OR HELD ❑SUPPORT �OPPOSE C��' STATE ZIP CODE AREACODEfPHONE N}\ME OF OFFICENOLDER OR CAPFE3iDATE OFFJCE SOUGHT OR HELD ❑SUPPORT COMMITiEE NAME l.D.NUMBER ' ❑OPPOSE iVAME OF OFFICEHOLDER OR CANDIDATE QFFICE SOUGHT OR HELD ❑ SUPPORT ❑OPP08E NAME OF TREASURER CE3NTROLLED C�MMITTEE? NAME OF OFFICENOLDER OR CANDIDATE OFFfCE SOUGHT OR HELD ❑YES Q p!p ❑SUPPORT COMMI7TEEADDRESS STREETApIIRESS {NO P.D.BOX} ❑QPPOSE �� STATE ZIP CODE AREA CODE/PHONE Aftach eontinuation sheets if necessary FPPC Form 460(1an/2015) FPPC Advice:advice�a fppc.ca.gov(866/275-3372) www fppc.ca.gov �ampaign Disclosure Statemen� Amounts may be rounded sunannaRv aa�e M Summ� Pa e ta�`'o�e do„a�. Statement covers period � rY g , .- . from �0I2112018 . - d • � SEE INSTRUCTIONS ON REVERSE tfirough 12/28/2018 page 3 of 6 NAAAE OF FiLER t.D.IVUMBER Mahoney for Council-2018 1407834 Column A Column B Calendar Year Summary for Candidates Con#ributions Received TOTALTHISPERIOD CALENDARYEhR (PROMAT(ACHEDSCHEDULES) TOTALTODATE Running in Bo#h the State Primary and � � 1. Monetary Contributions.....................•--._...........-•-•••••-_... scheduiea,Line 3 $ 1,448.96 � 19,316.15 General Elections -5,050.00 1/1 ttrrough 6/3Q 7/1 io Date 2. Loans Received................................................................ scneau�e a,tine 3 D.00 3. SUBTOTALCASH CONTRIBl1TIONS.............................. Addtinesl+2 $ -3,6Q9.84 $ �g,3��,�{5 20. Contributions Received $ $ 4. Nonmonetary Contributions.................. ... s�nedu�e c,vne s �•�� 85.00 ••....•••••---•-.••-_• 21. Expenditures �` 5. TOTALCONTRIBf1710NSRECEIVED....................................AddLines3+4 $ -3,60�.84 � 19,401.15 Made $ $ � Expenditures I�lade �� Expenditure Limit Summary for State , 6. Paymenfs Made................................................................ s�hedu�e,Une a � 309.27 � 19,316.15 Candidates � 7. LOaRS MctdE....................................................•••-............... Schedule H,Line 3 QAQ Q.00 _ ,.,.._ 8. SUBTOTRL CASH PAYMENTS.......................................... .4dd unes s+7 $ 309.27 $ 19,316.15 �• ��ative Expenditures Made* (ff Subject to iloiunYary E�cpenditure Limit) 9. Accrued Expenses(Unpaid Bilis)..........................................s�nedute F cine s O.OD O.OII Dafe of Election Tofai to Daze 10.Nonmonetary Adjustment...............................••---..._....----.........scnedu�e c,Line 3 Q.�Q 85.OQ (mmiddfyy) 11. TOTALEXPENDITURESMADE........................................Add�ines8+9+�0 $ 309.27 � 19,401.15 ^�_J $ Current Cash Statement _�_� � "I2.BBglll(1111g CaSl1 B2I8t1C2............................ Previous Summary Page,Line 16 $ 3,911.19 To calculate Column B, 13.Cash Receipts................................. ........ Co�umnA,tane 3 above -3,601.84 add amounts in Column 14.Miscellaneou&fncreases to Cash.................................. Schedule I,Line 4 0.00 Ato the corresponriing *Rmounts in this sectiort may be different from amounfs amounts from Calumn B reported in Cotumn B. 15.Cash Payments......................................................... columnA,Line Sabove 309.27 of your last report. Some 0.00 amounts in Golumn A may 16.ENDING CASH BALANCE ..................add unes�2+�3+��,fken subtract Une 15 $ be negative figures that lf#his is a terminafion statemsnt,Line 96 musf be zera. should be subtracted from previous period amounts. ff this is the first reparE beir�g 17.LOAN GUARAMEES RECEIVED................................ scnedu�e e,Part 2 $ 0.00 fiied for#his ca#endar year, only carry aver the amounts Cash Equivalents and Outstanding Debts from Lines 2,7,and 9(if � 0.00 apy�� 18. Cash Equ�valents...........-•--•••...•-•••--......-•.--......... Seeinstrac6onsonreve�se $ 19_ OufStandiilgDebts.............. ...... Addlrne2+LiResinCoFumnBabove $ O.flQ .......... FPPC Form 460(Jan/2015j �PPC Advice:advice@fppc-q•gov(866/275-3772) www.fppc.ca.gov SCFIeEIUIe A Amounts may 6e rounded SCHEDULE A £o whole dotlars_ Statement covers period Monefary Contribu�ions Recei�ed . . - . � � i from 1 fll21/201$ s- SEE Ii�fSTRUCTiDNS ON REVERSE through �y28��$ Page 4 of 6 NRME OF FiLER I.D.NUtvYBER Mahoney for Council-2018 9407834 DATE Ft7LL NAME,STREEfADDRESSAfVDZIP CODE OF CONTRIBI}TOR COMRIBUTOR aFAN INDIVIDUAL,ENTER AMOUNT CUMULATNETO DATE PER ELECTION (IFCOMMITfEE,ALSOENTERI.D.NUMBER) OCCUPATIONANDEMPLOYER � RECEIVEDTH[S CALENDARYERR TODATE RECE4VE!} CODE* . (IFSELF—EMPLOYED,ENTERNAME PER�pD (JAN.1-DEC.31) (IF REQUIRED) OF SUS WESS) CC Yin ��D Owner 10/24/2018 L�OTH Yin McDonatd's ❑p-rY Restaurants ❑scc Afbert Liu 0�ND Retired 14/30/20'18 �P�, ❑scc Orrin Mahone loan for iven �IND y{ g } ❑eOM Retired 12/28/2016 �P�, ❑scc ❑ir�o ❑eo�n ❑o-rH Q PTY ❑S�� ❑IND ❑GOM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 1,398.'f 6 Schedule A Summary 'Contributor Codes 1. Amounf received this period-itemized monetary contributions. �tv�-�ndividuaa {Include all Schedule A subtotals.}............. � 1,398_16 COM—Reapient Comrttiftee .............�.........................................................._........._....... (other than PTY or SCC) 2. Amount received this periad-unitemized monetary contributions of less than$1Q0...........................$ 50.00 Ol'H—Other(e.g.,business entity) PTY—Political Party 3. Tota#monetary contributions received this period. sc�-s�,au contributor committee Add Lines 1 and 2. Enter here and on the Summa Pa e, Cotumn A, Line 1. �°`�8�� rY 9 }......................TOTAL $ FPPC Form 460(Jan/202fi) FPPC Advice:advice[)a#ppc.ca.gov(866J275-3772) www.fppc.ca.gov Amour�fs may be rounded SCHEDULE B-PART 1 Scheduie B — Part 1 to whofie daltars_ S#atemen#covers period . s ' � i � Loans Received �om �o�2v2Q�s .- SEE INSTRUCTIONSON REVERSE through ��2��201$ Page � of 6 NAME OF FILER I.D.NUMBER Mahoney for Council-2018 1407834 1FAN INDIVIDUAL,EPITER a INTE#2EST ORiGIf�lAL CUMULATIVE d FULL NAME,STREETADDRESS AND ZFP CODE OUTSTANDING RMOUNT �c� OUFSTAND#NG � OFLENUER OCCUPATIONANDEMPLOYER gRLANCE �+1E3llNTP/XID BAL4NCEAT (IF COMMITfEE,ALS6 EMER 1.D.NUMBER) (IF SELE-EMPLOYED,ENTER gEGINNING TH1S RECEIVED THIS� OR FORGtVEN PA1D TH1S AMOt1NT QF CONTRIBUTIONS NAMEOFBt/SINESS) P��aQ PERIOD THISPERIOD" eLOPE��OF�THiS p�RIOD LOAN TODATE Orrin Mahoney Retired 0 PAID CALENDARYEAR 10870 Kester Dr $4,759.84 $ 0.40 fl,00 � $5.050.00 $ 5,050A0 Cupertino,CA 95014 �„� �FORGNEIV PERELECTIQN"" $ 5,050.00 � � 298.16 $ fl.QO 7/17/2018 $ t� 1fdD �COM 0 OTH ❑ PTY ❑SCC QAT£DUE DATEiMCURRED ❑pq}p CALENDAR YEAR $ $ I $ $ �re ❑FORGIVEN PERELECTION"' t❑ IND �COM � OTH ❑ PTY ❑ SCC � $ $ DATEDUE $ DATEINCURRED � �pq�p CALENDARYEAR � $ % $ $ RasE �FORGIVEN PERELECTION`F" t� IND Q COM 0 OTH ❑ PTY ❑ SCC $ $ � DATE DUE $ DATE INCURRm $ SUBTOTALS $ 5,05D.Q0$ 5,0�0.00 $ O.DO $ OAO (Enter(e)on Schedule B Summary ScheduleE,Line3) 1. Loans received this period.................................................... .......,...........$ n Rn .......................�--�---.... (Tota1 Cotumn(bj pfus unitemized loans of less than$100.) tContributor Codes 2. Loans paid or forgiven this period.................. ..................._. $ �n�n nn �PID—Individual ..................... ............---�--•------... (Total Column (c)pfus foans under$10�paid orforgiven.) �� cot�-RectPientcommittee (other than PTY or SCC) (Include loans paid by a third party tha#are also itemized on Schedule A.) OTH—Other(e.g.,business entity) PTY—Polifical Party 3. Net change this period. {Subtract Line 2 from Line'�.)..............................................................NET $ -�,05(3_0o SCC—Smalt Contributor Committee Enter#he net here and on the Summary Page, Gotumn A,L.ICIe�. (Maybeanegaiivenumber) �Amounts forgiven or paid by another party also must be reported on Schedule A. FPPC Form 460(lan/2015� **tf required. FPPC Advice:advice@fppc.ca.gov(86bJ2753772) www.fppc.ca.gov SChgdu{g E Amounts may be raunded SCHEDULE E to whole doltars. Statement covers period � Payments Made �o�2�i2o�s •• � • 1 from 12/28i2�18 6 6 SEE+NSTRUCTIONS ON ftEVERSE ' through Page of NAME OF FILER I.D.NUMBER Mahoney for Council-201$ 9407834 CODES: lf one of the followiRg codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/misc. MBR member communications RAD radio airttme and production costs CNS campaign consulfarrts MTG meetings and appearances RFD returned confibutions CTB contribufion{exptairt rronmonetary)* OFC offrce expenses SAL campaign workers'saEaries CVC civlc donations PET petition eirculating TEL #.v.or cable airYime and producfion costs FIL candida#e fifing/batlot fees PHO phone banks TRC candidate fravel,iodging,and meals FND fundraising euents POL polling and survey research TRS staff/spouse travel,lodging,and meals IND independerrt expenditure supporting/opposing others(explain)* POS postage,delivery arad messenger services TSF Yransfer beiween committees of the same candidafe/sponsor LEG legal defense PRO prafessionaf services(legal,accounting) VOT voter registration LIT campagn fiterafure and mailings PRT print ads WEB information technology costs(intemef,e-mail) fVAMEAfVDADDRESS OF PAYEE (IF COMMITfEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID CostCo Walk piece flyers *Payments that are contributions or independent expendftures must aiso be summarized on Schedule D. SU$TQTAL$ 235.43 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............. � 235.43 2. Unitemized payments made this period of under$100................................. . ........................_..............................$ 102.84 3. Tatal interest paid this period on loans. (Enter amount from Schedule B, Part 1, Coiumn (e).).............................................. .._..._.� 0.00 4. Total payments made this period. (Add Lines 1,2, and 3. Enter here and on the Summary Page, Ca#umn A, Line 6.)...........................TOTAL $ �D9'27 FPPC Farm 460(Jan/2016) FPPC Advice:advice@fippc.ca.gov(866/2753772) � vuww.fppcca.gov