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GILPAC - Form 460 - 20120101 - 20120630Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 84216.5) Type or print in ink. Statement covers period I Date of election if appl from January 1, 2012 (Month, Day, Year) MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS Date Stamp ` L z 2. Type of Statement: ❑ Preelection Statement ® Semi - annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVERPAGE Of 5 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Susan Valenta Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer ofSponsor Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature ofControlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAUBUSINESS 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 OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page 2 of 5 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 Listnames of officeholder(s) 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 (January/05) FPPC Toll -Free Helpline: 866 /ASK.FPPC (866/275 -3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period CALIFORNIA 1 Summary Page to whole dollars. • from January 1, 2012 FORM through June 30, 2012 [Page 3 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Gilroy Business Political Action Committee (GILPAC), Sponsored by the Gilroy Chamber of Commerce 1347327 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR g Primary Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTALTODATE General Elections Line 3 $ 240.01 $ 240.01 1. Monetary Contributions ............ ............................... Schedule A, 1/1 through 6/30 7/1 to Date 0.00 0.00 2. Loans Received ....................... ............................... Schedule e, Line 3 240.01 $ 240.01 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ Received $ $ 0.00 0.00 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 240.01 $ 240.01 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 11.00 $ 11.00 Candidates 7. Loans Made .............................. ............................... Schedule H, Line 3 0.00 0.00 22. Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 +7 $ 11.00 $ 11.00 (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 0.00 0.00 (mm /dd /yy) 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ 11.00 $ 11.00 $ $ Current Cash Statement -� 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 0.00 To calculate Column B, add 13. Cash Receipts .................... ............................... Column A, Line 3 above 240.01 amounts in Column A to the 0.00 corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 from Column B of your last reported in Column B. 11.00 report. Some amounts in 15. Cash Payments .................. ............................... Column A, Line 8 above Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 229.01 figures that should be subtracted from previous if this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed for this calendar year, only a, Part 2 $ 0.00 17. LOAN GUARANTEES RECEIVED ........................... Schedule carry over the amounts Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any) 18. Cash Equivalents ......... ............................... See instructions on reverse $ o.00 19. Outstanding Debts ......................... Add Line 2 + Line g in Column B above $ 0.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) A Tvne or print in ink. SCHEDULE VV1 / Amounts may be rounded y Monetary Contributions Received to whole dollars. Statement covers period e " WA WA ' January 1, 2012 0 *61: from through June 30, 2012 Page 4 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Gilroy Business Political Action Committee (GILPAC), Sponsored by the Gilroy Chamber of Commerce 1347327 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN 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 * (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) IF REQUIRED ( ) OF BUST NESS) FIND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ Schedule A Summary 1. Amount received this period — itemized monetary contributions. 0.00 (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 $ 240.01 240.01 "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 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER Gilroy Business Political Action Committee (GILPAC), Sponsored by the Gilroy Chamber of Commerce Statement covers period from January 1, 2012 through June 30, 2012 Page 5 of 5 I.D. NUMBER 1347327 E CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants IVITG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PEf 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 FND 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 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.) ............................. TOTAL $ 0.00 11.00 0.00 11.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)