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)