460 Recipient Committee Campaign Statement - Amendment 2-12-19 . rA� {�i ,f t�':�t�+� .
Recipient Committee ��� ` +� `�' ;' ; COVEft PAGE
Campaign S#atemen# � � � � .� ' t s �
Cover Page ���
Stafement covers period Da#e of election if appl'` b + , � � af 6
from
1/112019 (Month,�ay,Year . ���f ��� I � ���� For O�cial Use Only
SEE INSTRUCTIONS OIV REVEi�SE }�roug� 6130/2Q19 11/61209 8
� ��3T�N0 G(TY CLE K
'I. T5/p2 O�ReGipI21't$CUtTII'il�'Lt@6: All Committees—CompHete Parts 1,z,3,ana a. 2. Type ofi Sta#ement:
� Of(iceholder,GandicFate Controlled Committee ❑ Primariiy Formed Ba41ot Measure ❑ Preelection Statemenf ❑ Quarterly Statement
� Sta#e Candictate Etection Commiite2 Committee � Semi-aFlnuaFStatemertt
� Recall � Controkfed ❑ Special Odd-Year Report
(Ako Compfete Part 5J � Termination Statement
� Sponsored (Afso�te a Form 410 Termination)
(Also Complete Farf 6J
❑ Genera4 Purpose Cammittee � Amendmet�t(ExpJain below)
O Sponsored ❑ Primarily�ormed Candidate/ Received ca►�didate statement reimbursement after terminating
� Smait Cantributor Committee Officeholder Commi#ee
� Politica[Par(y/Cen#ral Commitfee tR+�o comPiere Pa�€n
3. Commiitee Information i.o.Nu"'BER Treasurer(s)
14Q7834
COMMITFEE NAME{pR CANDiDATE'S NAME 1F�10 COMMITTEE) NAME OF TREASURER
Mahoney for Councii-2f118 Carolyn Krizek-Mahoney
MAILING ADDRESS
MAILIN6ADDRfSS
C1TY STATE ZIPCQIIE AREACODElPHONE CITY STATE ZIPCODE AREACODE/PHONE
OPl70NRL: FAXIE-MAILADDRES9 OPTLONAL: FAX/E-MAtLADDRESS
orrinma haney@comcast.net
4. Verification
1 have used aif reasonabie diligence itt preparing and reviewing this statement and fo tfie best of my knDwledge the informafian-confained herein and in the attached schedules is true and compie#e. I
certify under penalty of perjury urtder the laws of fhe State of Cati#ornia that the foregoing is frue and correct. �
�"�,�
ofiSponsor
Exeeufed on gy
Date � � Sigrcature af Conholling Officehaidet,Canddate,State Measure Proportent
EXECIAFE(�OR �r �
Date � Signahue of Controlfing Officehoides,Candidate,State Measure Proponent �
FPPC Form 450(lanJ2016)
FPPC Advice;advice@fppc.ca.gov(866J275-3772)
www.fppc.ca.gov
COVER PAGE-PART 2
Recipient Committee
Carnpaign Statement � �� 3 � i 1
Cover Page— Part 2
Page � of �
5. Of#iceholcier or Candidate Controlled Committee 6. Frimarily Form�ed Bailot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
Orrin Mahoney
OFFICE SOUGHT OR HELD(INC�UQE�OCA'FION AND DISTRtCT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTIQN ❑ SUPPOfZT
Cupertino City Council ❑ OPPOSE
NAME OF OFFICEHOL�ER,CANDiDATE,OR PROPONENT
Related Corornittees Not tncluded in this Statement: c�sra„y�o,�mnte�
not included in this statemenf that are control(ed by you or aFe primanty formed to receive OFFICE SOUGHT OR HELD D1S"fRICT NO.fF RNY
confributions or make expenditures on behalf of yor�r candidacy.
COMMiTTEE NAME I.D.NllMBER
NAME QF TREASURER CONTROLLEE3 GOMMITTEE? 7. Rrimarily Formed Candidate/Ofificeholder CornmitEee Listrrames of
officeholder(s)or candidafe(s}for which this commiftee is primarilyformed.
❑YES ❑NO
COMMITTEEADDRESS STREETAQ�f2ESS (NO P.O.BOX) NAME OF OFFICEHdLDER OR CANDiDRTE OFFICE SOl1GHT OR HELD
❑ SUPPORT
❑ OPPQSE
CkTY STATE ZiP CODE AREA GODE/PHflNE NAME OF OFFICEHOLDER Of2 CRNDIDATE OFFICE S011GHT�R HELD
❑SUPPORT
❑ OPPQSE
COIVIf�tlli�EE NAME l.D.NUMB�R
NAME OF OF�ICEHC}LQER OR CANDIDATE OFFICE SOUGHF OR HELD
❑ SUPPORT
❑ L?PP06E
NAME OF FREASURER CONTROLLED CQMMITTEE? N,qME OF OFFICEHOLDER OR CANDfDATE OFFICE SOUGHT OR HELD
❑YES ❑ NO ❑ SUPPORT
❑ OPPOSE
COIVIMITTEEADQRESS ST}�EETADDRESS (NO P.O.BOX)
CITY STATE ZIP C(3DE AREA CODElPHQNE Atfath continuation sheets if necessary
FPPC Form 460{ian/2015)
FPPC Advice:advice@#ppc.ca.gov(865/275-3772)
wwwfppc_ca.gov
Campaign D'rsclosure Statement Amounts may be rounded SUMMARY PAGE
ta whofe dollars. �ement covers period
� g • • - •
umma a e v�i2o�g . - � • 1
from
SEE INSFRUCTIONS ON REVERSE
through 6/30/2019 paye � at �
NAME OF FILER 1.D.NUMBER
Mahaney for Gouncil-2018 1447834
Co�umn A Column B Calendar Year Summary for Gandidates
Contributions Received TOTALTFiISPERIOD �A��o�a�
(FROMATTACHEDSCHEDULES) TOTALTODATE Running in Soth#he Stat� Primary and
O.QD 19,316.15
C�neral Eleetions
1. Monetary Contributions................................................... sct,edu�ea,Line3 $ � 7H through 6l30 7/1 to Date
2. Loans Received........................:. .. scnedute e;Line 3 d.Qfl 0.00
-•••••-••••.........................
0.00 99,316.45 29- Contributions
3. SLlBTOTALCASHCONTR!$UTIQNS.............................. AddGinesi+2 $ $ Received $ $
4. NonmonetaryContribu#ions............................................ sct,edureC,Line3 �•00 85.fl0 21 �Penditures
5. TOTAL CONTRIBUTtONS RECEIVED.................._................ftdd V�es s+4 $ 4.OQ $ 19,401.15 Made $ $
F�cpenditures Made Exper�diture Limit Summary for State
6. Payments Made......................._:....................................... scnedute E:c�ne 4 � 611.76 g 19,827.91 Candidafes
7. LO��IS M2f18...............................:....................................... Schedule H,Line 3 flA0 O.flQ
511.76 �9827.g� 22• Cumula#ive Expenditures Made't
8. SllBTQTAL GASH PAYMENTS.......................................... Add lines s+� $ $ {IfSubjecttn Volur�ry F�cpendRure LimR)
9. ACCfUed EXpenSes(Unpaid BINS)..........................................Schedule F,Line s D.OQ 0.00 pate of Eiection Totat to Date
10.Nonmonetary Adjustment................................................_......_scneduie c,Li»e 3 0_00 85.00 (mmldd/yy)
11. TOi'ALEXPENDITURESMADE........................................AddC.ines8+s+10 $ 511.76 $ 19,912_91 _J_� �
C�rrent Cash Statemenf _J-J �
12.Beginning Cash Balance_.........••••.............. Previous summa�yPage,Line 16 $ �.�0
To calculate Column B,
13.C�Sh ReCeiptS..........................:................................ ColumnA,Line 3 abovs add amounts in Colurnn
591.76 Ato the corresponding *Amounts in this section may be different ftom amounts
'I4.MISCEII8nE0US I1lC�@8S0S t0 C2Sh................................_ Schedule/,line 4 amounts from Column B reported in Column B.
95.Cash Payments........................:................................ Co�umn A,Une a a�iove 511.76 of your last report. Some
amounts in Column A may
16.EMDING CASH BALANCE ...................4ddunes 1z+1s+14 then subtrectCine 15 $ Q•00 be negative figures fhat
should be subtracfed from
If this is a terminaSon statement,Line 96 must be zero. previous period amounts_ If
this is the firsi report being
17.LOAN GUARANTEES RECEfVED................................ Schedule6,Pan2 $ O.OQ filed forthis calendaryear,
on{y carry over the amounts
Cash Equivaients and Outstanding Debts from Lines 2,7,and 9(if
18. Cash EqUiVal2r�tS................._.._.....__................... Seeinstructionsnnreverse $
fl.fl0 any��
0.00
19. OUfiStandi�g�ebts.............................. Add line 2+Une 9 in Column e above $ EPPC ForrTt 460(Jan/2016)
FPPC Advicec advice@#ppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Schedule D
SUCI'lll'la Of EX enditures Amounts may be rounded SCNEDULE D
�/ p Statement covers period
Supporting/Opposing O#her to whole daifars. ' �• - � � � !
Candidates, Measa�res and Gommittees ��a�, 1/'Il2019
SEE INSTRUCTtONS ON REVERSE
through �l30l2099 pa� 4 op 6
NAME OF FILEf2 I.D.NUMBER
Mahoney#ar Courtcil-209 8 14�7834
DRTE NAME OF CRNDIDATE,OFFICE,AND DtSTRiCT,OR 7YP�pF PAYMENT �ESCRIPTION AMOIJNT THIS CUIt1lULATtVE TO DATE PER ELECTION
MEASURE NUMBER OR LETfERAND JURISDICTfON, (tF REG1171REta) CALENDAR YEAR TO DATE
OR CQ1tAMITTEE PERIOD {JAN.1-DEC.31) (tF REQUIRED}
Evan taw for Assembly m Nlonetary
1/31/2019 �ppC ID#1414197 contributian 260.00
25Q.00 250.00
� Nonmonetary
Confiribution
Q lndependent
�} Support ❑ Oppose Expenditure
� Monetary
Gont�ibutiart
❑ Nonmonetary
Gonfribufion
❑ Independent
❑ Supporf ❑ Oppose Expenditure
❑ Mortetary
CanfrEbution
� Nonmonetary
ConfriGnt+on
� independent
� Support ❑ Oppose Expenditure
SUBTOTAL $ 25D.00
Schedute D Summary
1. I#errtized contributians and independent e�enditures made this per�od. (tnclude all Schedule D subtotals.).......................................................$ 250_OQ
2. Unitemized contribu#ions and independen#expenditures made#his period of under$1 Qf�--•--•---.-•---•................................••---.........._......._._..........$
3. Total contributions and independent expenditures made this period.(Add Lines 1 and 2. Do not enter on the Summary Page.)..........TOT�L..$ 25D.t3Q
FPPC Eorm 460(lan/2016)
FPP£Advice:advice@fppc.ca.gov(865j2753772)
www fippc.ca.gov
Schedute E Amovnts may be rounded Staiement covers period � SCHEDlfLE E
to wfiofe dollars. �� � I � ,
Payments Made T��f2o�9 • '
#rom
SEE Ih1STR{ICTIONS ON REVERSE through 6/3{i/2049 pa�e . 5 of 6
NRME OF Fii.ER LD.Ni1MBER
Mahaney for Couneil-2�18 1407834
CODES: lf one of�he foliowing codes accuratety describes ft�e payment, yau may enter tMe code. Othetwise, describe the payment.
CMP campaign paraphematia/mise. MBR member communicatiorts RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances R�D retumed co+�#ribufions
CTB contribution(explain nonmonetary)* �FC offrce expenses SAE campaign workers'sataries
CVC civic donations P�7 peti#ion circuta6ng TEL t.v.or cable airEime and production costs
FiL candidate fifing/ballot#ees PHtJ phnne banks TRC cartdidate travel,todging,and meats
FND fimdraising events P(}L polling and sunrey research TRS stafflspouse travet,iodging,and meals
lND independent expend�ure stappor5ngtopposing others(explain)� POS postage,defivery and messenger serviees TSF trans#er between commitFees of the same candidatelspBnsor
LEG legal defense PRO professionai senrices(fegaT,accounfmg) VOT vo#er registrafion
LIT campaign literatuFe and mailings PRT print ads WEB informafion technotogy costs(interne�,e-maii}
NAMEANQADDRESS OF PAYEE
� (IF COMMIFTEE,AL50 ENTER LD.NUNIBER) CODE OR DESCRIPTION OF PAYMENT AAAOUNT PAtD
Orri� Mahoney Paid back candidate with balanee o€candidate
Evan Low for Assembfiy 2i12Q
FPPC ID#1414197 CTB 2b0.t3Q
*Paqments that are contribufions or independent expsnd'ttures must alsa be summarized on Sched�le D. SllBTOTAL$ 511_78
Schedule E Summary
1. Itemized payments made this period. (Include af!Schedule E subtotals.}.................. 511'7fi
..............................�-�--...................--------��---........................$
2. Unitemized payments made this period ofi under$100.................... .....$ �'��
3. Tota}interest paid this period on loans. (Enter amount from Schedute S, Part 1, Cotumn(a}.)........................ ............$ 0.��
....... . .
4. Totat payments made this period.{Add Lines 1,2, and 3. Enter here and on the Summary Page, Column A, Line 6.)............. . TOTAL$ 511.76
FPPC Form 4b0(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppt.ca.gov
Schedule I Amounts may be rounded SCHEDllLE(
Misceltaneous Increases to Cash to whoie dollars. S#atement covers period � .
� • 1
from 1/1/2019 • '
througM 6130/2019 Pa� 6 of 6
SEE INSTRUCTIONS ON REVERSE
NAME OF FfLER
I.D.NUMBER
Mahoney for Councii-2018 14Q7834
DATE FULL NAMEANbADDftESS OF SOURCE i3ESCRIPTION OF RECEIPT AMOUNT OF
RECEtVED {IF COMMtTTEE,qLSO ENTER I.D.NUMBER) INCREASE TO CASH
Cify o#Cupertino Candida#e statement reimbursement
2/1/2099 1Q300 Torre Avenue 511.76
Cupertino, CA 95014
Attach additional information on appropriately labefed continuation sheets. SUBTOTAL$ 511.76
SCi'i@C�U�E � SUIflRia1'�(
1_ Itemized increases to eash this per+od. ...........................................•-•---..............,� .................$ 511.76
2. Uniternized increases to cash of under$100 this periad................. ..----•.---......-.---......................$ O.�fl
3. Total of ail interest received this period on laans made to others. (Schedule H,Column(e).) ................... a.a0
........-•-•-----�--�
4, To#af miscet�aneous inereases to cash this periad. {Add Lines 1,2,and 3_Enter h�re and on the
Summa Pa e,Line 14. .•---.. TOTAL $ 511.76
rY 9 ) ..................................................................................................................•--�
PPPC form 460(3an/2016)
FPPC Advice:advice@fpp�ca.gov(8S6/2753772)
www.fppc.ca.gov