Don Gage - Form 460 - 2012/01/01 - 2012/06/30Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from January 1, 2012
through
June 30, 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) Q Sponsored
(Also complete Part 6)
❑ General Purpose Committee
Q Sponsored ❑ Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
Q Political Party /Central Committee (Also Complete Part 7)
3. Committee Information I.D. NUMBER
1346217
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Don Gage for Mayor 2012
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
Date of election if applicable
(Month, Day, Year)
November 6, 2012
2. Type of Statement:
Date.. Stamp
❑ Preelection Statement
Semi- annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
COVER PAGE
of 5
For Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement -Attach Form 495
Treasurer(s)
NAME OF TREASURER
Sara Humphrey -Nino
MAILING ADDRESS
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
4. Verification
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 12 By
Executed on
Date
By
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 /ASK -FPPC (8661275 -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
Don Gage
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Mayor of Gilroy, Ca
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)
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 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
CITY STATE ZIP CODE AREA CODE/PHONE 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.
Amounts may be rounded
Summary Page to whole dollars.
SUMMARY PAGE
Statement covers period CALIFORNIA
4
from January 1, 2012 FORM
through June 30, 2012 page 3 of 5
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Don Gage for Mayor 2012
1346217
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTALTHIS PERIOD
CALENDARYEAR
Running in Both the State Primary and
g
(FROM
ATTACHED SCHEDULES)
TOTALTO DATE
General Elections
A, Line 3
$
18824.00
$ 18824.00
1. Monetary Contributions ............ ............................... Schedule
1/1 through 6/30 7/1 to Date
0.0
O.O
2. Loans Received ....................... ............................... Schedule e, Line 3
18824.00
$ 18824.00
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2
$
Received $ $
0.0
0.0
4. Nonmoneta Contributions ..... ............................... Schedule C, Line 3
ry
21. Expenditures
$
18824.00
$ 18824.00
Made $ $
5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made ........................ ............................... Schedule E, Line 4
$
1180.00
$ 1180.00
Candidates
0.0
0.0
7. Loans Made ............................ Schedule H, Line 3
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 +7
$
118000
.
$ 1180.00
(IfSubjectto Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills Schedule F, Line 3
200.00
200.00
Date of Election Total to Date
0.0
0.0
(mm/dd /yy)
10. Nonmonetary Adjustment ........... ............................... Schedule C, Line
11. TOTAL EXPENDITURES MADE .... ............................Add Lines a + 9 + 10
$
1380.00
$ 1380.00
$
$
Current Cash Statement
-��
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16
g g
$
"�
To calculate Column B, add
13. Cash Receipts .................... ............................... Column A, Line 3 above
18824.00
amounts in Column A to the
0
corresponding amounts
*Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4
"0
from Column B of your last
reported in Column B.
1180.00
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
$
17644.00
figures that should be
subtracted from previous
1f this is a termination statement, Line 16 must be zero.
period amounts. If this is
the first report being filed
0.0
for this calendar year, only
17. LOAN GUARANTEES RECEIVED ........................... Schedule e, Part 2
$
carry over the amounts
from Lines 2, 7, and 9 (if
Cash Equivalents and Outstanding Debts
any).
18. Cash Equivalents ......... ............................... See instructions on reverse
$
0.0
19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above
$
200.00
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
0-1. Annle A TYDe or print in ink. SCHEDULE
Monetary Contributions Received Amounts may be rounded S
Statement covers period
• I ,
from January 1, 2012
June 30, 2012 P
4 o
through J
Page 4
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I
I.D. NUMBER
Don Gage for Mayor 2012 1
1346217
DATE F
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR C
CONTRIBUTOR I
IF AN INDIVIDUAL, ENTER A
AMOUNT C
CUMULATIVE TO DATE P
PER ELECTION
RECEIVED (
(IF E
CODE * O
(IF SELF - EMPLOYED, ENTER NAME P
PERIOD (
(JAN. 1 - DEC. 31) (
(IF REQUIRED)
OF BUSINESS)
❑IND
See Attached ❑
❑COM 1
18824.00 1
18824.00
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 18824.00 A
Aa g
g
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
Include all Schedule A subtotals. ....................................................... ............................... $ 18325.00
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 $
499.00
18824.00
*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 E
Payments Made
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from January 1, 2012
SEE INSTRUCTIONS ON REVERSE
through June 30, 2012 Page 5 of 5
NAME OF FILER I.D. NUMBER
Don Gage for Mayor 2012 1346217
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CNP
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
PD
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
AMOUNTPAID
Seledon, Vanni, Humphrey, & Kawafuchi CPA's
7937 Hanna Street, Gilroy, CA 95020
PRO
Accounting, Bookkeeping, & Treasury Fees
1170.00
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1170.00
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 $
1170.00
10.00
1180.00
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
Don Gage for Mayor 2012
I.D. Number 1346217
Dab
Name
Street
Ciry
State
Zip
Cant COde
OceupatloNEmpbyer
Amount
03!22121112
Dm Gage
T71 4th Street
Gilroy
CA
95020
DeNova Hares
250.00
18,325.00