Don Gage - Form 460 - 2012/10/21 - 2012/12/31Recipient 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
December 31, 2012 I November 6, 2012
Date Stamp
COVER PAGE
1 of 8
For Official Use Only
1. Type of Recipient Committee: All Committees - complete Parts 1, 2, 3, and 4.
2. Type of Statement:
-
® Officeholder, Candidate Controlled Committee
❑ Primarily Formed Ballot Measure
❑ Preelection Statement
❑ Quarterly Statement
Q State Candidate Election Committee
Committee
[Z Semi - annual Statement
❑ Special Odd -Year Report
0 Recall
Q Controlled
❑ Termination Statement
❑ Supplemental Preelection
(Also Complete Part 5)
Q Sponsored
(Also file a Form 410 Termination)
Statement -Attach Form 495
(Also Complete Part 6)
[J Amendment (Explain below)
r-1 General Purpose Committee
0 Sponsored
❑ Primarily Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
0 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
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
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 on -_2 By
Date
)� nvlleOfficerofSponsor
Executed on
Date
By
Signature ofControlling Officeholder, Candidate, State Measure Proponent
Executed on By
Dye Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/OS)
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
COMMITTEENAME 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 8
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 1ASK -FPPC (8661276 -3772)
State of California
Campaign Disclosure Statement
Type or print in ink.
SUMMARY PAGE
Statement
covers period
CALIFORNIA . '
Amounts may be rounded
Summary Page to whole dollars.
October 21, 2012
• -
from
through
December 31, 2012
Page 3 of 8
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
TOTALTHISPERIOD
SCHEDULES)
CALENDARYEAR
TOTALTO DATE
g Primary
Running in Both the State Prima and
(FROM ATTACHED
General Elections
1. Monetary Contributions ............ ............................... schedule A, Line 3
$
2500.00 -
$ 38309.00
0.00
0,00
1/1 through 6/30 7/1 to Date
2. Loans Received ....................... ............................... schedule e, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add lines 1 +z
$
2500. 00
$ 38309.00
20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ............................... schedule C, Line 3
0.00
0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4
$
2500.00
$ 38309.00
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made ........................ ............................... Schedule E, Line 4
$
11688.56
$ 27226.04,
Candidates
7. Loans Made .............................. ............................... schedule H, Line 3
0.00
0.00
11688.56
27226.04
22. Cumulative Expenditures Made*
8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 +7
$
$
(if Sub jectto Voluntary Expenditure Urnit)
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 8 +9 +10
$
11688.56
$ 27226.04
) $
$
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16
$
20271.52-
To calculate Column B, add
13. Cash Receipts .................... ............................... Column A, Line 3 above
2500.00
amounts in Column A to the
0.00
corresponding amounts
*Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash ........................... Schedule t, Line 4
from Column B of your last
reported in Column B.
15. Cash Payments ................... ............................... column A, Line a above
11688. 56
report. Some amounts in
Column A may be negative
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15
$
11082.96"
figures that should be
subtracted from previous
If this is a termination statement, Line 16 must be zero.
period amounts. If this is
the first report being filed
17. LOAN GUARANTEES RECEIVED ........................... schedule e, Part z
$
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
Cash Equivalents and Outstanding Debts
y
18. Cash Equivalents ......... ............................... See instructions on reverse
$
19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column a above
$
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772)
Schedule A Type or print in ink. SCHEDULE
Monetary Contributions Received Amounts may be rounded
Statement covers period
-
to whole dollars.
October 21, 2012
'
- •
from
-DcLI},6,F 31, 2012
Page 4
SEE INSTRUCTIONS ON REVERSE
through
of
NAME OF FILER
I.D. NUMBER
Don Gage for Mayor 2012
1346217
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
E DE O
RALSAND ZIP
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVETO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
COMMITTEE, I.D. NUMBER)
CODE *
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
21ND
10/25/12
Michelle Rango
❑COM
Marketer.
100.00
100.00
131 Via Lucia
❑OTH
"Ctibte - = < ®v-
Alamo, Ca 94507
❑PTY
❑ Scc
❑ IND
10/25/12
CAA Tri- County
❑COM
Business
250,00
250.00
980 Ninth Street, Ste 200
20TH
Sacramento, Ca 95814
F-1 PTY
❑ Scc
❑ IND
10/25/12
Bonfante Nurseries, Inc
OCOM
Business
200.00
200.00
3675 Hecker Pass Hwy
2OTH
Gilroy, Ca 95020
El PTY
❑ SCC
21ND
10/25/12
Joel Goldsmith
❑COM
Retired
250.00
250.00
8321 Peppergrass Ct
❑OTH
Gilroy, Ca 95020
F-1 PTY
❑ SCC
Peter C Filice Exempt. Trust FBO Candace
❑IND
❑
Trust
25/12
7888 Wrent Ave Ste D143
TH
2 OTH
250.00
250.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
SUBTOTAL $ 1050.00}
Schedule A Summary *Contributor Codes
1. Amount received this period — itemized monetary contributions. IND — Individuai
(Include all Schedule A subtotals.) .................. ....... ............................... $
2500.00 COM — Recipient Committee
..... ...............................
• • � � � � (other than PTY or SCC)
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.) ......
....................... $
1 11
OTH — Other (e.g., business entity)
PTY— Political Party
SCC — Small Contributor Committee
...... TOTAL $ 2500.00
FPPC Form 460 (January/(
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -37'.
Schedule A (Continuation Sheet
Type or print in ink. SCHEDULER (CON
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
October 21, 2012
I '
FORM •
from
31, 2012
5
through'
page of� ..
NAME 0F FILER
I.D. NUMBER
Don Gage for Mayor 2012
1346217
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR TTEE, ALSO ENTER I.D. NUMBER)
(IF COMMI
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
CODE *
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
IND
David Li
VCOM
Self Employed- Physician
10/25/12
10185 Jean Ellen Ct
❑ OTH
'0C.— l•l M
250.00
250.00
Gilroy, Ca 95020
❑ PTY
leG1U1c� f
❑ SCC
William Reimal
®COD
Self Employed- Real
10/25/12
7551 Kentwood Ct
❑ OTH
Estate Broker
50.00
50.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Jim Mingus
®IND
E]
Self Employed - Mingus
10/25/12
7840 Westwood Dr
CO
Pest Control
100.00
100.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Joanne Cunningham
®IND
Retired
12
10(25/12
20 Corwin Dr
F]
100.00
100.00
Alamo, Ca 94507
❑ PTY
❑ SCC
Peter C Filice Exemption Trust FBO Craig
�COM
Trust
10/25/12
7888 Wren Ave Ste D143
VOTH
250.00
250.00
Gilroy, Ca 95020
171 PTY
[]SCC
'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
SUBTOTAL $ 750.001 }
FPPC Form 460 (January/0
FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -377
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (COP
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
October 21, 2012
I I
FORM
from
through �c' a'�31, 2012
Page 6
of
NAME OF FILER
I.D. NUMBER
Don Gage for Mayor 2012
1346217
DATE
E
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
COMMITTEE, ALSND I.D. NUMBER)
CODE *
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
®IND
Gloria P Millen
❑COM
Retired
10/25/12
18364 Oak Dr
L] OTH
250.00
250.00
Monte Sereno, Ca 95030
❑ PTY
❑ SCC
Richard Freedman
®IND
❑ COM
Real Estate - Intero
10/25/12
8675 Del Rey Court
❑OTHc�
100.00
100.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Brandt Bastow Trust
❑❑COD
Trust
10/25/12
7888 `/�/ren Ave, Ste D143
V1 OTH
100.00
100.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Greenwaste Recovery, Inc
❑ IND
COM
Business
10/25(12
1500 Berger Drive
0OTH
250.00
250.00
San Jose, Ca 95112
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY cr SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
SUBTOTAL $ 700.00
FPPC Form 460 (Januaryh
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866(275 -37'
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 21, 2012
through December 31,2012 page 7 of 8
I.D. NUMBER
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
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 AMOUNTPAID
Sanford Consulting, LLC Campaign Consultant
1492 Quail Walk Drive CNS 4000.00
Gilroy, Ca 95020
Sanford Consulting, LLC Design for Campaign Literature
LIT
1492 Quail Walk Drive 750.00
Gilroy, Ca 95020
First Class Mailing, Inc
10556 Cobie Road PMB 6485 LIT 3098.56
Auburn, Ca 95602
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 7848.56
Schedule E Summary
1. Itemized payments made this period. Include all Schedule E subtotals. ... ............................... $ 11688.56
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).) ........................... $ 0.00
....................
4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 11688.56
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule E
(Continuation Sheet)
Payments Made
SEE INSTRUCTIONS ON
NAME OF FILER
Don Gage for Mayor 2012
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULE E (CONT.)
Statement covers period CALIFORNIA I
from October 21, 2012 FORM
through December 31, 2% Page 8 of 8
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
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
FIL
civic donations
candidate filing /ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
TSF
staff /spouse travel, lodging, and meals
transfer between committees of the same candidate /sponsor
IUD
independent expenditure supporting /opposing others (explain)*
POS
postage, delivery and messenger services
1500.00
7351 Rosanna Street
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
WEB
voter registration
information technology costs (internet, e-mail)
i rr
cam nainn literature and mailinnS
PRT
print ads
300.00
13608 First Street
* o-ante that are contributions or independent expenditures must also be summarized on Schedule D.
SUBTOTAL $ 3840.00
FPPC Form 450 (.lanuarylub)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
NAME AND ADDRESS OF PAYEE
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Seledon, Vanni, Humphrey, & Kawafuchi
2000.00
7937 Hanna Street
PRO
Gilroy, Ca 95020
Vilma Pinheiro
Donation
40.00
Caravelle Travel
CBT
190 1st Street, Gilroy, Ca 95020
City of Gilroy
OFC
1500.00
7351 Rosanna Street
Gilroy, Ca 95020
Mama Mia's Restaurant
TRC
300.00
13608 First Street
Gilroy, CA 95020
* o-ante that are contributions or independent expenditures must also be summarized on Schedule D.
SUBTOTAL $ 3840.00
FPPC Form 450 (.lanuarylub)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)