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Don Gage - Form 460 - 2013/01/01 - 2013/06/30Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) fro m Type or print in ink. Statement covers period I Date of election if applicable: January 1, 2013 (Month, Day, Year) SEE INSTRUCTIONS ON REVERSE I through June 30, 2013 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) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee Q Political Party /Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1346217 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) 4. 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 November 6, 2012 COVER PAGE Date-Stamp CALIFORNIA • 1 .- t-y 3 IT `•'. Page 1 of 9 cFr ` For Official Use Only 2. Type of Statement: ❑ Preelection Statement Semi - annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 NAME OF TREASURER Sara Humphrey Nino MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX / E -MAIL ADDRESS STATE ZIP CODE AREA CODE /PHONE 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 Officerof Snontor 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 (866/276 -3772) State of California Recipient Committee Type or print in ink. COVERPAGE -PART2 Campaign Statement • - • 1 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, California 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) CITY STATE ZIP CODE AREA CODE /PHONE Page 2 of 9 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE 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 Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) State of California Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from __ January 1, 2013 SUMMARY PAGE Expenditures Made To calculate Column B, add 6. Payments Made ........................ ............................... through June 30, 2013 page 3 of 9 SEE INSTRUCTIONS ON REVERSE 0.00 8. SUBTOTALCASH PAYMENTS Add Lines 6 +7 $ 5628.36 $ 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 NAME OF FILER 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 0.00 11. TOTAL EXPENDITURES MADE . ............................... I.D. NUMBER Don Gage for Mayor 2012 any). 0.00 1346217 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR Running in Both the State Primary and (FROMATTACHED SCHEDULES) TOTALTO DATE General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 40 $ 2695. $ 2695.40 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 +2 2695.40 $ $ 2695.40 20. Contributions ......................... Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 2695.40 $ 2695.40 Made $ $ Expenditures Made To calculate Column B, add 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 5628.36 $ 7. Loans Made .............................. ............................... Schedule H, Line 3 0.00 8. SUBTOTALCASH PAYMENTS Add Lines 6 +7 $ 5628.36 $ 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 $ 5628.36 $ 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. 17. LOAN GUARANTEES RECEIVED ........................... Schedule e, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column 8 above $ 5628.36 0.00 5628.36 0.00 0.00 5628.36 11082.96 To calculate Column B, add 2695.40 amounts in Column A to the corresponding amounts from Column B of your last 141.36 5628.36 report. Some amounts in Column A may be negative 8291.36 figures that should be subtracted from previous period amounts. If this is the first report being filed 0.00 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if 0.00 any). 0.00 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 Monetary Contributions Received Amounts may ne rounaeo ry to whole dollars. Statement covers period CALIFORNIA ' from January, 1, 2013 - , June 30, 2013 4 9 SEE INSTRUCTIONS ON REVERSE through Page of 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 CUMULATIVETO 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) ❑IND 1/10/2013 Don Gage for Santa Clara Valley Water District IICOM $2,695.40 $2,695.40 771 4th Street, Gilroy, Ca 95020 E] OTH #1328064 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 2695.40 s . Schedule A Summary 1. Amount received this period — itemized monetary contributions. 2695.40 (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 2695.40 *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 D SCHEDULED Summary of txpenaltures Type or print in ink. Statement covers period Supporting/Opposing Other Amounts may be rounded - 4 • ' - to whole dollars. January 1, 2013 • Candidates, Measures and Committees from June 30, 2013 5 9 SEE INSTRUCTIONS ON REVERSE through 9 Page of 9 NAME OF FILER I.D. NUMBER Don Gage for Mayor 2012 1346217 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OR COMMITTEE Teresa Alvarado for Supervisor 2013 Monetary 5 -22 -13 1692 Story Road #200 Contribution 250.00 500.00 San Jose, CA 95122, FPPC# 1356267 ❑ Nonmonetary Contribution ❑ Independent ® Support ❑ Oppose Expenditure Teresa Alvarado for Supervisor 2013 m Monetary 6 -26 -13 Contribution 1692 Story Road #200 250.00 500.00 San Jose, CA 95122, FPPC# 1356267 ❑ Nonmonetary Contribution ❑ Independent ® Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 500.00 p_ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) .......................... ............................... $ 2. Unitemized contributions and independent expenditures made this period of under $100 ...................................................... ............................... $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ............ TOTAL $ 500.00 al 500.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -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. E Statement covers period from January 1, 2013 through June 30, 2013 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 6 of I.D. NUMBER 1346217 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 FIND 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 Lrf 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 I Bookkeeping and Accounting 7937 Hanna Street, Gilroy, Ca 95020 PRO 1000.00 Alviso Santa Program Donation PO Box 1012 CVC 200.00 Alviso, Ca 95002 Gilroy Police Department Donation 7301 Hanna Street CVC 1000.00 Gilroy, CA 95020 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2200.00 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. $ 5251.47 2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 376.89 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 $ 5628.36 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) Schedule E CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Mt. Madonna YMCA SCHEDULE E (CONT.) (Continuation Sheet) Type or print in ink Amounts may be rounded Statement covers period ' ' Payments Made Morgan Hill, Ca 95037 to wh ole dollars. from January 1, 2013 • FPage Donation through June 30, 2013 7 of SEE INSTRUCTIONS ON REVERSE Gilroy, Ca 95020 Gilroy High School FFA NAME OF FILER Donation 750 W 10th Street CVC I.D. NUMBER Don Gage for Mayor 2012 Gilroy, Ca 95020 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 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 Mt. Madonna YMCA Donation 171 West Edmundson Ave. CVC 1000.00 Morgan Hill, Ca 95037 St. Josephs Donation 7950 Church St CVC 100.00 Gilroy, Ca 95020 Gilroy High School FFA Donation 750 W 10th Street CVC 250.00 Gilroy, Ca 95020 United States Post Office Stamps 100 4th Street POS 184.00 Gilroy, Ca 95020 Zapp -A -Form Note Cards 353 -E East Tenth Street PMB 814 OFC 303.06 Gilroy, Ca 95020 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1837.06 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule E SCHEDULE E (CONT.) Type or print in ink. (Continuation Sheet) Amounts may be rounded Statement covers period • ' , Payments Made to whole dollars. from January 1, 2013 • - through June 30, 2013 Page 8 of SEE INSTRUCTIONS ON REVERSE 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. 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 LIT camoaion literature and mailinqs PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Bay Area Printers New Printer 1460 Tully Rd, Ste 607 OFC 244.41 San Jose, Ca 95122 PromotionsNow Advertisement Magnets 1270 Glen Ave PRT 340.00 Moorestown, NJ 08057 Gilroy Chamber of Commerce Spice of Life Awards 7471 Monterey Street FND 130.00 Gilroy, Ca 95020 Teresa Alvarado for Supervisor 2013 Donation 1692 Story Road #200 CVC 500.00 San Jose, CA 95122 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1214.41 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) T... -- _ ...: .-L k*T91VdIlIIndl Miscellaneous Increases to Cash Amounts may-be-rounded Statement covers period • . to whole dollars. .January 1, 2013 ' • ' from through June 30, 2013 Page 9 of 9 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Don Gage for Mayor 2012 1346217 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH City of Gilroy Overpayment refund for C /E Nh -'0ArC' 2/20/13 7351 Rosanna Street 5-;h;Y7 17 4 :1 141.36 Gilroy, Ca 95020 Attach additional information on appropriately labeled continuation sheets. Schedule I Summary SUBTOTAL $ 141.36 1. Itemized increases to cash this period ......................................................................................... ............................... $ 141.36 2. Unitemized increases to cash of under $100 this period .............................................................. ............................... $ 0.00 3. Total of all interest received this period on loans made to others. Schedule H, Column (e).) ........ $ 0.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) .................... ............................... TOTAL $ 141.36 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)