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Terri Aulman - Form 460 - 2012/11/01 - 2012/12/31 - TerminationRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) fro Type or print in ink. Statement covers period m November 1, 2012 SEE INSTRUCTIONS ON REVERSE I 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 O Recall O Controlled (Also Complete Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1348250 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) TERRI AULMAN FOR GILROY CITY COUNCIL 2012 STREET ADDRESS (NO P.O. BOX) CA 95020 408 - 391 -6268 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE GILROY CA 95020 SAME OPTIONAL: FAX / E -MAIL ADDRESS COVER PAGE Date Stamp Date of election if applicable: w ,,, , Page 1 of 17 (Month, Day, Year) RKS 4' For Official Use Only November 6, 2012 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) Treasurer(s) NAME OF TREASURER DENISE BROLIN MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE 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 t*rD& .( Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer ofSponsor 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/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) State of California Recipient Committee Type or print in ink. COVER PAGE - PART 2 Campaign Statement O CALIFORNIA RM 460 Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE TERRIAULMAN OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) GILROY CITY COUNCIL RESIDENTIAL /BUSINESS 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) Page 2 of 7 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION I F-1 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 List names 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 ci i r airat ur i,vut ,vrct,v wutirnvrvt 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 Summary Page Amounts may be rounded Statement covers period p • - to Whole dollars. 460 from November 1, 2012 • - SEE INSTRUCTIONS ON REVERSE through December 31, 2012 Page 3 of 7 NAME OF FILER I.D. NUMBER TERRI AULMAN FOR GILROY CITY COUNCIL 2012 1348250 Contributions Received Column Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ............ ............................... schedule A, Line 3 $ 299. 00 $ 6532.00 2. Loans Received ....................... ............................... Schedule B, Line 3 (612.00) 0.00 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines/ +2 $ (313.00) $ 6532.00 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ (313.00) $ 6532.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 819.67 $ 6574.67 Candidates 7. Loans Made .............................. ............................... Schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 819.67 $ 6574.67 22• Cumulative Expenditures Made* (If Subjectto 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 a + 9 + 10 $ 819.67 $ 6574.67 $ $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 1090.00 To calculate Column B, add 13. Cash Receipts .................... ............................... Column A, Line 3 above (313.00) amounts in Column A to the 14. Miscellaneous Increases t0 Cash ........................... Schedule 1, Line 4 42. 67 corresponding amounts from Column B of your last *Amounts in this section may be different from amounts reported in Column B. 15. Cash Payments ................... ............................... column A, Line 6 above 819.6 7 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 0.00 figures that should be If this is a termination statement, Line 16 must be zero. subtracted from previous period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ 0.00 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 0.00 any). 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ 0.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule A Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from November 1, 2012 SCHEDULE A Schedule A Summary 1. Amount received this period — itemized monetary contributions. 299.00 (Include all Schedule A subtotals.) ......................................................................... ............................... $ 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. 299.00 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ '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 (866/275 -3772) December 31, 2012 4 7 SEE INSTRUCTIONS ON REVERSE through 9 Page of NAME OF FILER I.D. NUMBER TERRI AULMAN FOR GILROY CITY COUNCIL 2012 1348250 DATE EET A DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, .D.N CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND 11/5/12 JACQUELINE K. STEVENS ❑COM TEACHER 99.00 99.00 99.00 1487 LUPINE CT [I OTH GILROY UNIFIED GILROY, CA 95020 ❑ PTY SCHOOL DISTRICT ❑SCC ® IND 11/5/12 KATHERINE TSUJIMOTO ❑COM RETIRED 200.00 200.00 200.00 776 RAMONA WAY E] OTH GILROY, CA 95020 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 299.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. 299.00 (Include all Schedule A subtotals.) ......................................................................... ............................... $ 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. 299.00 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ '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 (866/275 -3772) SCHEDULE B- PART 1 Schedule B — Part 1 Amo'unr` ts �m' " ay " "b` e " r o"u n ­ded Statement covers P eriod CALIFORNIA ' • Loans Received to whole dollars. November 1, 2012 FORM from December 31, 201: 5 7 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER TERRI AULMAN FOR GILROY CITY COUNCIL 2012 1348250 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER a OUTSTANDING (b) AMOUNT (c) AMOUNTPAID (d) OUTSTANDING (e) INTEREST M ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE TERRI AULMAN ® PAID CALENDARYEAR 1512 BIANCA WAY $ 569.33 $ 0.00 0 , $ 3112.00 $ 3112 Q FORGIVEN PER ELECTION- GILROY, CA 95020 RATE $ 612.00 $ $ 42.67 12/31/12 $ 0.00 09/14/12 $ 3112 DATE DUE DATE INCURRED to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION "* RATE $ $ E E E DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PERELECTION** RATE $ E $ E $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC I 0.00 SUBTOTALS $ $ 612.00 $ 0.00 $ Schedule B Summary 1. Loans received this period ..................................................................................... ............................... $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period .......................................................................... ............................... $ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ................................ ............................... NET $ Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. 0.00 612.00 (612.00) (May be a negative number) (Enter (e) on Schedule E, Line 3) tContributor 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 (866/275 -3772) Schedule E Type or print in ink. Amounts may be rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER TERRI AULMAN FOR GILROY CITY COUNCIL 2012 Statement covers period from November 1, 2012 through December 31, 201; CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment Page 6 of 7 I.D. NUMBER 1348250 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 Lrr 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 STATION 55 MEALS FOR ELECTION DAY GATHERING 55 5TH STREET 300.77 GILROY, CA 95020 DENISE BROLIN, CPA 785 NICOLE COURT PRO 500.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 800.77 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. 800.77 2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 18.90 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 $ 819.67 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule I cruFnl u F I Miscellaneous Increases to Cash Amounts may be rounded to whole dollars. Statement covers period NOVEMBER 1, 2012 from • . 460 FORM SEE INSTRUCTIONS ON REVERSE through DEC. 31, 2012 Page 7 of 7 NAME OF FILER I.D. NUMBER TERRI AULMAN FOR GILROY CITY COUNCIL 2012 1348250 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH TERRI AULMAN FORGIVENESS OF DEBT 12/31/12 1512 BIANCA WAY 42.67 GILROY, CA 95020 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 42.67 Schedule I Summary 1. Itemized increases to cash this period ..................................................................... ............................... 2. Unitemized increases to cash of under $100 this period .......................................... ............................... 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ............. 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ......................................................................................... ............................... .................... $ .................... $ .................... $ 42.67 TOTAL $ 42.67 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)