Don Gage - Form 460 - 2012/10/01 - 2012/10/20Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from October 1, 2012
through
October 20, 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 Q Controlled
(Also Complete Part 5) Q Sponsored
(Also Complete Part 6)
❑ General Purpose Committee
O Sponsored ❑ Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
O Political Parry /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
r.Date Stamp
OCT 2012 _?^
Date of election if applicable:
(Month, Day, Year) r
November 6, 2012 1
2. Type of Statement:
V Preelection Statement
❑ Semi - annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
COVER PAGE
Page 1 of 6
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 CITY
OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS
dongage @verizon.net
STATE ZIP CODE AREA CODE /PHONE
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 true and correct.
Executed= 1, ' � By �
Sponsor
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 1ASK -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
Don Gage
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Mayor of Gilroy, CA
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.
COMMITTEENAME 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 STREET ADDRESS (NO P.O. BOX)
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
COVER PAGE - PART 2
Page 2 of 6
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 Listnamesof
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/06)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (86612763772)
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Don Gage for Mayor 2012
Type or print in ink.
Amounts may be rounded
to whole dollars.
SUMMARYPAGE
Statement covers period CALIFORNIA /v
from
October 1, 2012 FORM
through October 20, 2012 page 3 of 6
I.D. NUMBER
1346217
Expenditures Made
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
7. Loans Made .............................. ...............................
TOTALTHISPERIOD
CALENDARYEAR
g Primary
Running in Both the State Prima and
Add Lines 6 + 7 $
7278.76 $
(FROM ATTACHED SCHEDULES)
TOTALTO DATE
General Elections
10. Nonmonetary Adjustment ........... ...............................
Schedule C, Line 3
$ 1162.00 $
35809.00
Add Lines 6 + 9 + 10 $
1. Monetary Contributions ............ ...............................
Schedule A, Line 3
1/1 through 6/30 7/1 to Date
2. Loans Received ....................... ...............................
Schedule B, Line 3
0.00
0.00
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 +2
1162.00
$ $
35809.00
20. Contributions
Received $ $
0.00
0.00
4. Nonmonetary Contributions ..... ...............................
Schedule C, Line 3
21 Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ...........................
Add Lines 3 +4
$ 1162.00 $
35809.00
Made $ $
Expenditures Made
6. Payments Made ........................ ...............................
Schedule E, Line 4 $
7278.76 $
7. Loans Made .............................. ...............................
Schedule H, Line 3
0.00
8. SUBTOTAL CASH PAYMENTS ..... ...............................
Add Lines 6 + 7 $
7278.76 $
9. Accrued Expenses (Unpaid Bills
Schedule F, Line 3
0.00
10. Nonmonetary Adjustment ........... ...............................
Schedule C, Line 3
0.00
11. TOTAL EXPENDITURES MADE . ...............................
Add Lines 6 + 9 + 10 $
7278.76 $
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $
13. Cash Receipts .................... ............................... Column A, Line 3 above
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4
15. Cash Payments ................... ............................... Column A, Line 8 above
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $
If this is a termination statement, Line 16 must be zero.
26388.28
1162.00
0.00
7278.76
20271.52
17. LOAN GUARANTEES RECEIVED .......................... Schedule B, Part 2 $ I
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ......... ............................... See instructions on reverse $
19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $
15537.48
0.00
15537.48
0.00
0.00
15537.48
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)
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)
Sr- hpcili ilp A Type or print in ink. SCHEDULE A
-- "—"" Amounts may be rounded
Monetary Contributions Received to whole dollars.
Statement covers period
CALIFORNIA '
from October 1, 2012
• -
through October 20, 2012
Page 4 of 6
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Don Gage for Mayor 2012
1346217
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
( IFCOMMITTEE , ALSO ENTER I.D.NUMBER)
CODE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
® IND
Anthony Coletto
❑COM
Self Employed; Anthony
100.00
100.00
10/15/2012
811 Eschenburg Drive
❑OTH
Coletto & Associates
Gilroy, CA 95020
❑ PTY
❑ ScC
❑ IND
10/15/2012
Agriprise
❑COM
Business
100.00
100.00
285 Quinhill Ave.
®OTH
Los Altos, CA 94023
❑ PTY
❑ SCC
® IND
Gary Stauble
❑COM
Self Employed; The
25.00
25.00
10/15/2012
6452 Poppyfield St.
❑oTH
Recruiting Lab
Gilroy, CA 95020
❑ PTY
❑ SCC
® IND
All Denice
❑COM
Partner; ABK Cherry Co.
250.00
250.00
10/15/2012
4640 Meritage Court
❑OTH
Gilroy, CA 95020
❑ PTY
❑ ScC
®IND
Dean Filice
❑COM
Self Employed; All
87.00
87.00
10/15/2012
2320 Stonecress Street
❑OTH
Seasons Pool Service
Gilroy, CA 95020
❑ PTY
❑ SCC
SUBTOTAL$ 562.00
r
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
1162.00
(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 $
1 11
1162.00
*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 (8661275 -3772)
Schedule A (Continuation Sheet) Tvoe or orint in ink. SCHEDULE (CONT)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
October 1, 2012
•
FORM
from
through October 20, 2012
Page 5 of 6
I.D. NUMBER
NAME OF FILER
Don Gage for Mayor 2012
1346217
, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
FULL NAME,
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IFCOMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
(IFSELF- EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
❑ IND
CA League of Conservation Voters
❑COM
250.00
250.00
10/15/2012
350 Frank H. Ogawa Plaza Suite 1100
E] OTH
Oakland, CA 94612
® PTY
❑ SCC
❑IND
10/15/2012
GILPAC
7471 Monterey Street
®coM
❑OTH
250.00
250.00
Gilroy, CA 95020 FPPC #1347327
❑ PTY
❑ SCC
❑ IND
PG &E Corporation
❑COM
100.00
100.00
10/15/2012
111 Almaden Blvd.
W] OTH
San Jose, CA 95113
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 600.00
*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 (8661275 -3772)
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Don Gage for Mayor 2012
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from October 1, 2012
through October 20, 2012
Page 6 of 6
I.D. NUMBER
1346217
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
RAID
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
First Class Mailing, Inc.
LIT
3916.96
10556 Cobie Rd. PMB 6485
Auburn, CA 95602
Curry Graphics
CMP
557.05
23482 Foley St. Unit C
Hayward, CA 94545
The Print Spot
LIT
2804.75
501 1 st Street
Gilroy, CA 95020
' Payments that are contributions or independent expenditures must also be summarized on Schedule D.
SUBTOTAL$ 7278.76
Schedule E Summary
$
7278.76
1. Itemized payments made this period. Include all Schedule E subtotals.
$
0.00
2. Unitemized payments made this period of under $100 ........................................................................................................... ...............................
3. Total interest aid this period on loans. Enter amount from Schedule B, Part 1, Column (e).)
$
0.00
4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summa Page, Column A, Line 6.
TOTAL $
7278'76
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)