460 Recipient Committee Campaign Statement - Preelection 9-20-20 to 10-17-20 Recipient Committee COVER PAGE
Campaign Statement Date Stamp CALIFORNIA
I
Cover Page '
RM 60
Statement covers period Date of election if applicable: Flied Date- Page 1 of 4
from 09/20/2020
(Month, Day,Year) 10/20/2020 03:45 For Official Use Only
PM
SEE INSTRUCTIONS ON REVERSE through 10/17/2020 11/03/2020
1. Type of Recipient Committee: All Committees—Complete Parts 1,29 3,and 4. 2. Type of Statement:
Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ./❑ Preelection Statement ❑Quarterly Statement
3 State Candidate Election Committee Committee ❑ Semi-annual Statement ❑Special Odd-Year Report
3 Recall 0 Controlled ❑Termination Statement
(Also Complete Part 5) d Sponsored (Also file a Form 410 Termination)
❑ General Purpose Committee (Also Complete Part 6) ❑Amendment(Explain below)
3 Sponsored ❑ Primarily Formed Candidate/
3 Small Contributor Committee Officeholder Committee
3 Political Party/Central Committee (Also Complete Part 7)
3. Committee Information I.D.NUMBER 1369332 Treasurer(s)
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
Robert McCoy for Council 2020 Blossom McCoy
MAILING ADDRESS
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREACODE/PHONE
Cupertino CA 95014
CITY STATE ZIP CODE AREACODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Cupertino CA 95014
MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE CITY STATE ZIP CODE AREACODE/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 and correct.
Executed on 10/20/2020 By
Date Signature of Treasurer or Assistant Treasurer
Executed on 10/20/2020 By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent or Responsible Officerof 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(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
COVER PAGE-PART 2
Recipient Committee CALIFORNIA
Campaign Statement FORM 4 • 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 BALLOT MEASURE
Robert McCoy
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑SUPPORT
❑OPPOSE
RESIDENTIAL/BUSINESS ADDRESS(NO.AND STREET) CITY STATE ZIP
Identify the controlling officeholder,candidate,or state measure proponent,if any.
NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT
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 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? 7• Primarily Formed Candidate/Officeholder Committee Listnames of
❑YES ❑NO officeholder(s)or candidate(s)for which this committee is primarily formed.
COMMITTEE ADDRESS STREET ADDRESS(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 ONO ❑SUPPORT
❑OPPOSE
COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE 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 Amounts may be rounded SUMMARY PAGE
to whole dollars. Statement covers period • _
Summary Page
from 09/20/2020 •
SEE INSTRUCTIONS ON REVERSE through 10/17/2020 IPage 3 of 4
NAME OF FILER NUMBER
Robert McCoy for Council 2020 9332
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Prima and
(FROM ATTACHED SCHEDULES) TOTAL TO DATE g Primary
General Elections
1. Monetary Contributions ................................................ Schedule A,Line 3 $ 0.00 $ 0.00
1/1 through 6/30 7/1 to Date
2. Loans Received ............................................................ Schedule a,Line 3 0.00 0.00
Contributions
3. SUBTOTAL CASH CONTRIBUTIONS............................. Add Lines 1+2 $ 0.00 $ 0.00 20. Received $ $
4. Nonmonetary Contributions......................................... Schedule C,Line 3 0.00 0.00 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ 0.00 $ 0.00 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made.............................................................. Schedule e,Line 4 $ 414.45 $ 414.45 Candidates
7. Loans Made..................................................................... Schedule H,Line 3 0.00 0.00
22.Cumulative Expenditures Made"
8. SUBTOTAL CASH PAYMENTS........................................ Add Lines 6+7 $ 414.45 $ 414.45 (If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses(Unpaid Bills)................................ Schedule F,Line 3 0.00 0.00 Date of Election Total to Date
10. Nonmonetary Adjustment............................................. Schedule C,Line 3 0.00 0.00 (mm/dd/yy)
11.TOTAL EXPENDITURES MADE............................... Add Lines s+9+10 $ 414.45 $ 414.45 / / $
Current Cash Statement / / $
12. Beginning Cash Balance............................ Previous Summary Page,Line 16 $ 6,030.45
To calculate Column B, / /
13. Cash Receipts.......................................................... Column A,Line 3 above 0.00 add amounts in Column
A to the corresponding *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash................................ Schedule 1,Line 4 0.00 amounts from Column B
reported in Column B.
of your last report.Some
15. Cash Payments........................................................ column A,Line s above 414.45 amounts in Column A may
16. ENDING CASH BALANCE...... Add Lines 12+13+14,then subtract Line 15 $ 5,616.00 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
0.00 filed for this calendar year,
17. LOAN GUARANTEES RECEIVED Schedule B,Part 2 $ only carry over the amounts
from Lines 2,7,and 9(if
Cash Equivalents and Outstanding Debts any).
18. Cash Equivalents................................................. See instructions on reverse $ 0.00
FPPC Form 460(Jan/2016)
19. Outstanding Debts............................... Add Line 2+Line 9 in Column e above $ 0.00 FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Amounts may be rounded SCHEDULE E
Schedule E statement covers period • _
to whole dollars.
Payments Made from 09/20/2020 • '
SEE INSTRUCTIONS ON REVERSE through 10/17/2020 Page 4 of 4
NAME OF FILER I.D.NUMBER
Robert McCoy for Council 2020 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 RAID 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
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 CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
SPRINT
WEB 414.45
Los Angeles CA 900540977
Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 414.45
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................ $ 414.45
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 $ 414.45
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov