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GILPAC - Form 460 - 20120701 - 20121231 - AmendmentRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE fro Type or print in ink. Statement covers period I Date of election if applicable: m July 1, 2012 (Month, Day, Year) through December 31, 2012 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 Part 5) O Sponsored ® (AlsoCom General Purpose Committee oletePart 6) ® Sponsored Q Small Contributor Committee 0 Political Party /Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1347327 IF NO COMMITTEE) Gilroy Political Action Committee (GILPAC), Sponsored by the Gilroy Chamber of Commerce STREET ADDRESS (NO P.O. BOX) 7471 Monterey Street CITY STATE ZIP CODE AREA CODE /PHONE Gilroy Ca 95020 408 - 842 -6437 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS 2. Type of Statement: Dade Stamp iy COVER PAGE Page 1 of For Official Use Only ❑ 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) Fix Summary Page and Add Schedule E Page Treasurer(s) NAME OF TREASURER Susan Valenta MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX / E -MAIL ADDRESS STATE ZIP CODE AREA CODE /PHON 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 ControllingOificeholder ,Candidate,StateMeasureProponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from July 1, 2012 SUMMARYPAGE through December 31, 2012 page 3 of SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER Gilroy Business Political Action Committee (GILPAC), Sponsored by Gilroy Chamber of Commerce 1347327 Expenditures Made 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 7. Loans Made .............................. ............................... Schedule H, Line 3 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 +9 +10 $ 12420.13 $ 0.00 12420.13 $ 226.50 0.00 12646.63 $ Current Cash Statement Column A Column B Calendar Year Summary for Candidates Contributions Received 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 TOTALTHISPERIOD CALENDARYEAR Running in Both the State Primary and 14053.60 (FROMATTACHED SCHEDULES) TOTALTO DATE General Elections 14053.60 $ 14293.61 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ 12420.13 1/1 through 6/30 7/1 to Date 0.00 0.00 1862.48 2. Loans Received ....................... ............................... Schedule B, Line 3 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 14053.60 $ 14293.61 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ $ Received $ $ 0.00 655.00 $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 21. Expenditures 14053.60 $ 14948.61 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ Expenditures Made 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 7. Loans Made .............................. ............................... Schedule H, Line 3 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 +9 +10 $ 12420.13 $ 0.00 12420.13 $ 226.50 0.00 12646.63 $ Current Cash Statement 229.01 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 14053.60 13. Cash Receipts .................... ............................... Column A, Line 3 above 0.00 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 12420.13 15. Cash Payments ................... ............................... Column A, Line 8 above Line 15 $ 1862.48 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 0.00 226.50 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 12431.13 0.00 12431.13 226.50 0.00 12657.63 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) I $ Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule E j. (Continuation Sheet) Payments Made SEE INSTRUCTII NAME OF FILER Type or print in ink. Amounts may be rounded to whole dollars. Gilroy Business Political Action Committee (GILPAC), Sponsored by Gilroy Chamber of Commerce SCHEDULE E (CONT.) Statement covers period CALIFORNIA from July 1, 2012 FORM through December 31, 206 Page of I.D. NUMBER 1347327 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 RAD 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 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) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Don Gage for Mayor 2012, Gilroy Ca 95020 #1346217 CTB 250.00 Cat Tucker for City Council, Gilroy Ca 95020 #1298566 CTB 250.00 Terri Aulman for Gilroy City Council 2012, Gilroy Ca 95020 #1348250 CTB 250.00 Committee to Elect Woodward (Perry Woodward), Gilroy Ca 95020 #1348961 CTB 250.00 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1000.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772)