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2012/07/01 - 2012/12/31 - AFSCME - Form 460 - AmendmentRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) Type or print in ink. Statement covers period from 07/01/12 Date of election if applicable (Month, Day, Year) Date Stamp COVER PAGE Page 1 of 2 For Official Use Only 3. Committee Information I.D. NUMBER 821697 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) AFSCME LOCAL 101AFL -CIO PAC STREET ADDRESS (NO P.O. BOX) 1150 N. 1ST ST CITY STATE ZIP CODE AREA CODE /PHONE SAN JOSE CA 95112 408 - 998 -2070 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX SAME CITY STATE ZIP CODE AREA CODE /PHONE Treasurer(s) NAME OF TREASURER CAROL GARCIA MAILING ADDRESS Executed on BY Date By of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on p BY Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on BY Date By of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) State of California Schedule D (Continuation Sheet) Type or print in ink. SCHEDULE D (CONT.) Summaof Expenditures Amounts may be rounded Summary P Statement covers period CALIFORNIA to whole dollars. • 1 Supporting /Opposing Other 07/01/12 FORM Candidates, Measures and Committees from 12/31/12 2 2 through page of NAME OF FILER I.D. NUMBER AFSCME LOCAL 101 AFL -CIO 821697 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OR COMMITTEE ELECT DAVID GINSBORG FOR WATER ® Monetary CHECK #1513 10/03/12 DISTRICT 2012 Contribution PAC CONTRIBUTION 500.00 500.00 500.00 C/O 911 FRUITDALE PLACE ❑ Nonmonetary SAN JOSE, CA 95126 FPPC# 1342512 Contribution ❑ Independent ® Support ❑ Oppose Expenditure ARMENDARIZ FOR CITY COUNCIL 2012 ® Monetary Contribution CHECK #1514 10/18/12 490 LAS ANIMAS PAC CONTRIBUTION 250.00 250.00 250.00 GILROY, CA 95020 FPPC# 1352040 ❑ Nonmonetary Contribution ❑ Independent Support ❑ Oppose Expenditure TERESA CASTELLANOS FOR SJUSD 2012 Monetary CHECK #1515 10/18/12 789 N. 3RD ST Contribution PAC CONTRIBUTION 250.00 250.00 250.00 SAN JOSE, CA 95112 FPPC# 1343111 ❑ Nonmonetary Contribution ❑ Independent 21 Support ❑ Oppose Expenditure CAT TUCKER FOR CITY COUNCIL 21 Monetary CHECK #1516 10/18/12 9440 EAGLE VIEW WAY Contribution PAC CONTRIUTION 250.00 250.00 250.00 GILROY, CA 95020 FPPC# 1298566 ❑ Nonmonetary Contribution ❑ Independent 0 Support ❑ Oppose Expenditure SUBTOTAL $ 1,250.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661276 -3772) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 07/01/12 through 12/31/12 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also complete Pan 5) O Sponsored (Also Complete Part 6) ® General Purpose Committee t Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee 0 Political Party /Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 821697 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) AFSCME LOCAL 101AFL -CIO PAC STREET ADDRESS (NO P.O. BOX) 1150 N. 1ST ST CITY STATE ZIP CODE AREA CODE /PHONE SAN JOSE CA 95112 408 - 998 -2070 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX SAME CITY STATE ZIP CODE AREA CODE /PHONE Date of election if applicable: (Month, Day, Year) Date Stamp COVER PAGE Page 1 of 2 For Official Use Only 11/03/12 ( I 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ❑ Semi- annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 Amendment (Explain below) ADDED FPPC NUMBER TO ARMENDAIZ FOR CITY COUNCIL Treasurer(s) NAME OF TREASURER CAROL GARCIA MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS 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 Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of 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 (January/06) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Schedule D (Continuation Sheet) Type or print in ink. SCHEDULE D(CONT.) Summary of Expenditures Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. • Supporting /Opposing Other 07/01/12 FORM Candidates, Measures and Committees from 12/31/12 2 2 through Page of NAME OF FILER I.D. NUMBER AFSCME LOCAL 101 AFL -CIO 821697 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUM O DATE CALL ENDAR ENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE (IF REQUIRED) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) ELECT DAVID GINSBORG FOR WATER ® Monetary CHECK #1513 10/03/12 DISTRICT 2012 Contribution PAC CONTRIBUTION 500.00 500.00 500.00 C/O 911 FRUITDALE PLACE ❑ Nonmonetary SAN JOSE, CA 95126 FPPC# 1342512 Contribution ❑ Independent ® Support ❑ Oppose Expenditure ARMENDARIZ FOR CITY COUNCIL 2012 ® Monetary CHECK #1514 10/18/12 490 LAS ANIMAS Contribution PAC CONTRIBUTION 250.00 250.00 250.00 GILROY, CA 95020 FPPC# 1352040 ❑ Nonmonetary Contribution ❑ Independent 0 Support ❑ Oppose Expenditure TERESA CASTELLANOS FOR SJUSD 2012 Monetary CHECK #1515 10/18/12 789 N. 3RD ST Contribution PAC CONTRIBUTION 250.00 250.00 250.00 SAN JOSE, CA 95112 FPPC# 1343111 ❑ Nonmonetary Contribution ❑ Independent Support ❑ Oppose Expenditure CAT TUCKER FOR CITY COUNCIL W1 Monetary CHECK #1516 10/18/12 9440 EAGLE VIEW WAY Contribution PAC CONTRIUTION 250.00 250.00 250.00 GILROY, CA 95020 FPPC# 1298566 ❑ Nonmonetary Contribution ❑ Independent Q� Support ❑ Oppose Expenditure SUBTOTAL $ 1,250.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)