Don Gage - Form 460 - 2012/10/21 - 2012/10/31- Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period Date of election if applicable:
from
October 21, 2012 (Month, Day, Year)
through
October 31, 2012 I November 6, 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
2. Type of Statement:
COVERPAGE
Date Stamp CALIFORNIA ,
.-
�gi L Page 1 of 7
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)
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 OPTIONAL: FAX I E -MAIL ADDRESS
dongage @verizon.net
4. Verification
1 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
Executed on ,1t
Date
Executed on f I '? w I Z'
Date
Executed on
Date
By
By
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 8661ASK -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
STREETADDRESS (NO PO BOX)
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
COVERPAGE -PART2
Page 2 of 7
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
COMMITTEE ADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary
FPPC Form 460 (January/OS)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
State of California
Campaign Disclosure Statement
Summary Page
- 0MICOCC
NAME OF FILER
Don Gaqe for Mayor 2012
Type or print in ink.
Amounts may be rounded
to whole dollars.
SUMMARY PAGE
Statement covers period
f- October 21, 2012
through October 31, 2012 page 3 of 7
Expenditures Made
Column A
Column B
Contributions Received
$
TOTALTHIS PERIOD
(FIR M ATTACHED SCHEDULES)
CALENDARYEAR
TOTALTO DATE
2500.00 $
38309.00
1. Monetary Contributions ...........................................
Schedule A, Line 3
$
0.00
8. SUBTOTALCASH PAYMENTS . ............................... ... Add Lines 6 + 7
$
0.00
$
2. Loans Received ....................... ...............................
Schedule B, Line 3
2500.00
38309.00
3. SUBTOTAL CASH CONTRIBUTIONS ..................... Add Lines 1 + 2
$ $
0.00
0.00
0.00
4. Nonmonetary Contributions ..... ...............................
Schedule C, Line 3
38309.00
4
$ 2500.00 $
7698.56
5. TOTAL CONTRIBUTIONS RECEIVED ••••••••••••••••••••••••••• Add Lines 3 +
11. TOTAL EXPENDITURES MADE .... ............................Add Lines 8 + 9
Expenditures Made
7698.56
23236.04
6. Payments Made ....................................................... Schedule E, Line 4
$
$
0.00
0.00
7. Loans Made ................................. ............................ Schedule H, Line 3
7698.56
23236.04
8. SUBTOTALCASH PAYMENTS . ............................... ... Add Lines 6 + 7
$
$
0.00
0.00
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F,, Linea
0.00
0.00
10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3
+ 10
$
7698.56
$ 23236.04
11. TOTAL EXPENDITURES MADE .... ............................Add Lines 8 + 9
Current Cash Statement
20271.52
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16
$
To calculate Column B, add
2500.00
amounts in Column A to the
13. Cash Receipts ..... ............................... .............. Column A, Line 3 above
0.00
corresponding amounts
14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4
from Column B of your last
7698.56
report. Some amounts in
15. Cash Payments ................... ............................... Column A, Line 8 above
Column A may be negative
$
15072. 96
figures that should be
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15
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
17. LOAN GUARANTEES RECEIVED ........................... Schedule s, 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
$
19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column 8 above
$
I.D. NUMBER
1346217
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received $
21. Expenditures
Made $
$
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)
Schedule A Type or print in ink. SCHEDULE A
Amounts may be rounded
Monetary Contributions Received to whole dollars.
Statement covers period
' •
October 21, 2012
from
•
through October 31, 2012
Page 4 of 7
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
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
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
i] IND
Michelle Rango
❑COM
Self Employed Marketer
100.00
100.00
10/25/12
131 Via Lucia
❑OTH
Alamo, Ca 94507
❑ PTY
❑ SCC
❑ IND
CAA Tri- County
❑COM
Business
250.00
250.00
10/25/12
980 Ninth Street, Ste 200
®OTH
Sacramento, Ca 95814
❑ PTY
❑ SCC
❑ IND
Bonfante Nurseries, Inc
❑COM
Business
200.00
200.00
10/25/12
3675 Hecker Pass Hwy
®OTH
Gilroy, Ca 95020
❑ PTY
❑ ScC
W] IND
Joel Goldsmith
❑COM
Retired
250.00
250.00
10/25/12
8321 Peppergrass Ct
❑OTH
Gilroy, Ca 95020
❑ PTY
❑ SCC
❑IND
Peter C Filice Exempt. Trust FBO Candace
❑COM
Trust
250.00
250.00
10/25/12
7888 Wrent Ave Ste D143
ZOTH
Gilroy, Ca 95020
❑ PTY
❑ SCC
SUBTOTAL$ 1050.00
I
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(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 $
2500.00
1 11
2500.00
*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 A (Continuation Sheet) Tvoeorarintinink. SCHEDULE (CONT.)
Monetary Contributions Received Amounts may be rounded
dollars.
Statement covers period
CALIFORNIAA
to whole
October 21, 2012
FORM
from
through October 31, 2012
Page 5 of 7
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
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
David Li
®IND
❑IOM
Self Employed- Physician
10/25/12
10185 Jean Ellen Ct
❑OTH
250.00
250.00
Gilroy, Ca 95020
❑ PTY
❑ Scc
William Reimal
®IND
❑coM
Self Employed- Real
50.00
50.00
10/25/12
7551 Kentwood Ct
❑OTH
Estate Broker
Gilroy, Ca 95020
❑ PTY
❑SCC
Jim Min US
g
®IND
❑coM
Self Employed - Mingus
100.00
100.00
10/25/12
7840 Westwood Dr
❑OTH
Pest Control
Gilroy, Ca 95020
❑ PTY
❑ SCC
Joanne Cunningham
ZIND
EICOM
Retired
100.00
100.00
10/25/12
20 Corwin Dr
❑OTH
Alamo, Ca 94507
❑ PTY
❑ SCC
Peter C Filice Exemption Trust FBO Craig
❑❑IOM
Trust
250.00
250.00
10/25/12
7888 Wren Ave Ste D143
LZOTH
Gilroy, Ca 95020
❑ PTY
❑ SCC
SUBTOTAL $ 750.00
*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)
Sr hPdillP_ A (Continuation Sheet) Tvne or orint in ink. SCHEDULE (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
,
'
to whole dollars.
October 21, 2012
• - •
from
through October 31, 2012
Page 6 of 7
I.D. NUMBER
NAME OF FILER
1346217
Don Gage for Mayor 2012
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
Gloria P Millen
®IND ❑COD
Retired
250.00
250.00
10/25/12
18364 Oak Dr
❑OTH
Monte Sereno, Ca 95030
❑ PTY
❑ SCC
Richard Freedman
®IND
❑COM
Real Estate - Intero
100.00
100.00
10/25/12
8675 Del Rey Court
F-1 OTH
Gilroy, Ca 95020
❑ PTY
❑ SCC
Brandt Bastow Trust
❑IND
❑COM
Trust
100.00
100.00
10/25/12
7888 Wren Ave, Ste D143
®OTH
Gilroy, Ca 95020
❑ PTY
❑ SCC
Greenwaste Recovery, Inc
❑IND
❑COD
Business
250.00
250.00
10/25/12
1500 Berger Drive
MOTH
San Jose, Ca 95112
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
CIIRTnTAI 4t 700.0
a
'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 Type or print in ink. Statement covers period
Amounts may be rounded
Payments Made to whole dollars. from October 21, 2012
sGa IWSTRI IrTIONS ON REVERSE
NAME OF FILER
Don Gage for Mayor 2012
through October 31, 2012 Page 7 of 7
I.D. NUMBER
1346217
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CIVP
campaign paraphernalia /misc.
IVBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
SAL
returned contributions
campaign workers' salaries
CTB
contribution (explain nonmonetary)'
OFC
PET
office expenses
petition circulating
TEL
t.v. or cable airtime and production costs
CVC
civic donations
PHO
phone banks
TRC
candidate travel, lodging, and meals
FIL
candidate filing /ballot fees
POL
polling and survey research
TRS
staff /spouse travel, lodging, and meals
FND
W
fundraising events
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
WEB
voter registration
information technology costs (internet, e-mail)
LIT
campaign literature and mailings
PRT
print ads
NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOLINTPAID
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Sanford Consulting, LLC Campaign Manager
1492 Quail Walk Drive CNS 4000.00
Gilroy, CA 95020
First Class Mailing Inc. 3098.56
10556 Cobie Rd PMB 6485 LIT
Auburn, Ca 95602
Sanford Consulting, LLC Design for Campaign Literature 600.00
1492 Quail Walk Drive LIT
Gilroy, CA 95020
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 7698.56
Schedule E Summary
7698.56
1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................... ............................... $
0.00
2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $
0.00
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ................................................ ............................... $
7698.56
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772)