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Don Gage - Form 460 - 2015/01/01 - 2015/06/30Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 84216.5) SEE INSTRUCTIONS ON REVERSE COVER PAGE Type or print in ink. (IDW te Stamp CALIFORNIA I 1 k 10 O_ Statement covers period Date of election if applicab 2 015 age 1 of 4 from January 1, 2015 (Month, Day, Year) For Official Use Only through June 30, 2015 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 OPTIONAL: FAX / E -MAIL ADDRESS 2. Type of Statement: ❑ 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 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. T,� Executed on 7_6,-15 Date Executed on Data By By 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 (866/275 -3772) State of California Type or print in ink. COVER PAGE - PART 2 Recipient Committee CALIFORNIA Campaign Statement FORM 460 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 RESIDENTIALBUSINESS 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 4 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 I 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 Y - PCFoT 4rAY 60 (January/05) FPPC Toll -Free Helpline: 8661ASK -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, 2015 PAGE Expenditures Made 6. Payments !Made ....:................... ............................... Schedule E, Line 4 $ 410.00 7. Loans Made .............................. ............................... Schedule H, Line 3 0.00 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 410.00 9. Accrued Expenses (Unpaid Bills) .......... .....................Scheduler; Line 0.00 10: Nonmonetary Adjustment ........... ............................... Schedule C. Line 3 0.00 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ 410:00 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 2,204.68 13. Cash Receipts ................................................... Column A, Line 3 above 0.00 14. Miscellaneous Increases to Cash ........................... schedule r, Line 4 0.00 15. Cash Payments .................................................. Column A, Line 8 above 410.00 ......... .................... 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1'794'68 if this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Pert 2 $ _ 0.00 Cash, Equivalents and Outstanding Debts 0.00 18. Cash Equivalents ......... ............................... see instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in.Corumn B above $ 0.00 $ 410.00 0.00 $ 410.00 0.00 0.00 $ 410.00 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* in subject to voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) $ To calculate Column B, add through June 30, 2015 page 3 of 4_ _ SEE INSTRUCTIONS ON REVERSE from Column B of your last reported in Column B. report. Some amounts in Column A•may!be negative NAME OF FILER subtracted from previous period amounts. If this is I.D. NUMBER Don Gage for Mayor 2012 for this calendar year, only carry over the amounts 1346217 from,Lines 2, 7, and 9 (if Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDAR YEAR Running f7 In Both the State Primary and r (FROMATTACHED SCHEDULES) TOTALTODATE General, Elections 1. Monetary Contributions ............ ............................... schedule A, Line 3 $ 0.00 $ 0.00 0.00 0.00 1/1 through 6130 7!1 to Date 2. Loans Received ....................... ............................... schedule a, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ 0.00 $ 0.00 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule c, line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 0.00 $ 0.00 Made $ $ Expenditures Made 6. Payments !Made ....:................... ............................... Schedule E, Line 4 $ 410.00 7. Loans Made .............................. ............................... Schedule H, Line 3 0.00 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 410.00 9. Accrued Expenses (Unpaid Bills) .......... .....................Scheduler; Line 0.00 10: Nonmonetary Adjustment ........... ............................... Schedule C. Line 3 0.00 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ 410:00 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 2,204.68 13. Cash Receipts ................................................... Column A, Line 3 above 0.00 14. Miscellaneous Increases to Cash ........................... schedule r, Line 4 0.00 15. Cash Payments .................................................. Column A, Line 8 above 410.00 ......... .................... 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1'794'68 if this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Pert 2 $ _ 0.00 Cash, Equivalents and Outstanding Debts 0.00 18. Cash Equivalents ......... ............................... see instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in.Corumn B above $ 0.00 $ 410.00 0.00 $ 410.00 0.00 0.00 $ 410.00 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* in subject to voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) $ To calculate Column B, add amounts imColumn A to the corresponding amounts *Amounts in this section may be differentfrom amounts from Column B of your last reported in Column B. 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 tiled for this calendar year, only carry over the amounts from,Lines 2, 7, and 9 (if any). FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 888/ASK -FPPC (8861275-3772) Schedule E Type or print in Ink. Statement covers period Payments Made Amounts may be .rounded i to whole dollars. from January 1, 2015 SEE INSTRUCTIONS ON REVERSE NAME OF FILER Don Gage for Mayor 2012 through June 30, 2015 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 4 of 4 LD. 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 FND fundraising events POI_ polling and survey research TRS staff/spouse travel, lodging, and meals M 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 Mt. Madonna YMCA Donation 171 West Edmundson Ave. CVC 200.00 Morgan Hill, CA 95037 FFA Boosters Donation 2322 Hoya Lane CVC 100.00 Gilroy, CA 95020 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 300.00 Schedule E Summary 1:. Itemized payments made this period. (Include all Schedule E subtotals.) .. ... ............... $ 300.00 2. Unitemized payments made this period of under $100 $ 110.00 3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1 Column a ......_..... $ 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 $ 410.00 FPPC Form 480 (January/05) FPPC Toll -Free Helpline: 888 1ASK -FPPC (88812754772)