Don Gage - Form 460 - 2015/07/01 - 2015/12/31Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 134216.5)
SEE INSTRUCTIONS ON REVERSE
from
Type or print in ink.
Date Stamp
DEC 31 2015
Statement covers period Date of election If applicable
July 1, 2015 (Month, Day, Year)
through December 31, 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 compete 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
4. Verification
2. Type of Statement:
❑ Preelection Statement
Semi - annual Statement
® Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Sara Humphrey -Nino
COVER PAGE
of 6
For Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
MAILING ADDRESS
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY
OPTIONAL: FAX / E -MAIL ADDRESS
STATE ZIP CODE AREA CODE /PHONE
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 I� zell a 1� By �
Data
Executed on
Data
By
Signature oFConlydlirg Olficetrplder ,Candidate, State Measure Proponent
Executed on By
Gate Signature ofConhd6ngOficr ceder ,Carddate, State Measure Proponent FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866IASK -FPPC (866/276 -3772)
State of California
Recipient Committee
Campaign Statement
Cover Page — Part 2
S. Officeholder or Candidate Controlled Committee
Type or print in ink.
NAME OF OFFICEHOLDER OR CANDIDATE
Don Gage
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Mayor of Gilroy, California
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 fanned to receive
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEEADDRESS STREETADDRESS (NO RO. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
COVER PAGE -PART 2
Page 2 of 6
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
oficeholder(s) or candidates) 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/06)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
State of Califomia
Campaign Disclosure Statement
Summary Page
Type or print In Ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from July 1, 2015
SUMMARY PAGE
Expenditures Made
through
December 31, 2015
page 3 of 6
SEE INSTRUCTIONS ON REVERSE
7. Loans Made .............................. ............................... schedule H, Line 3
0.00
0.00
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7
$
NAME OF FILER
$ 2,812.38
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3
0.00
I.D. NUMBER
Don Gage for Mayor 2012
0.00
0.00
11. TOTAL EXPENDITURES MADE . ............................... Add lines 6 + 9 + 10
1346217
2,402.38
$ 2,812.38
ColumnA
Column B
Calendar Year Summary for Candidates
Contributions Received
12. Beginning Cash Balance ....................... Previous summary Page, Line 16
TOTALTHIS PERIOD
CALENDARYEAR
Running in Both the State Primary and
13. Cash Receipts ................................................... Column A, Line 3 above
(FROMATTACHEDSCHEDULES)
TOTALTODATE
General Elections
1. Monetary Contributions ....................... ....................
Schedule A, Line 3
607.70
$ $
607.70
from Column B of your last
0.00
0.00
111 through 6130 711 to Date
2. Loans Received ............................... .......................
schedule s, Line 3
$
0.00
figures that should be
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 + 2
$ 607.70 $
607.70
20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ...............................
Schedule C, Line 3
0.00
0.00
21 Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4
$ 607.70 $
607.70
Made $ $
0.00
Expenditures Made
6. Payments Made ........................ ............................... Schedule E, Line 4
$
2,402.38
$ 2,812.38
7. Loans Made .............................. ............................... schedule H, Line 3
0.00
0.00
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7
$
2,402.38
$ 2,812.38
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3
0.00
0.00
10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3
0.00
0.00
11. TOTAL EXPENDITURES MADE . ............................... Add lines 6 + 9 + 10
$
2,402.38
$ 2,812.38
Current Cash Statement
12. Beginning Cash Balance ....................... Previous summary Page, Line 16
$
1,794.68
To calculate Column B, add
13. Cash Receipts ................................................... Column A, Line 3 above
607.70
amounts in Column A to the
0.00
corresponding amounts
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4
from Column B of your last
15. Cash Payments ............................ ..................... Column A, Line 8 above
2,402.38
report. Some amounts in
Column A may be negative
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15
$
0.00
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 a, Pert 2
$
0.00
for this calendar year, only
carry over the amounts
any)' m Lines 2, �, and 9 (if
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ......... ............................... see instructions on reverse
$
0.00
19. Outstanding Debts ......................... Add Line 2 + Line 91n Column 8 above
$
0.00
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made"
(n Subject to Voluntary Expenditure Omit)
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/06)
FPPC Toll -Free Helptine: 8661ASK -FPPC (8661275 -3772)
SChottiIIP_ A Type or print In ink. SCHEDULE A
Monetary Contributions Received Amounts may be rounded
rj/ to whole dollars.
Statement covers period
—CALIFORNI
July 1, 2015
from
FORM, ®
December 31, 2015
4 6
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
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
(IF COMMI TEE, ALSO ENTER I.D. NUMBER)
CODE *
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
❑❑COnn
12/21/2015
City of Gilroy
607.70
607.70
7351 Rosanna Street
®OTH
Gilroy, CA 95020
❑ PTY
p SCC
❑IND
[3Com
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$��
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 $
607.70
ME
607.70
`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 1ASK -FPPC (866/275 -3772)
. a
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 July 1, 2015
through December 31, 20fi
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
Page 5 of 6
I.D. NUMBER
1346217
CNP
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
10
independent expenditure supporting /opposing others (explain)*
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
FRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Old City Hall Restaurant Donation
7400 Monterey Street CVC 100.00
Gilroy, CA 95020
The Salvation Army Donation
P.O. Box 1059 CVC 100.00
Gilroy, CA 95021
New Hope Community Church Donation
8886 Muraoka Dr. CVC 500.00
Gilroy, CA 95020
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 700.00
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) ........................ $ 2,355.45
............................................ ...............................
2. Unitemized payments made this period of under $100 46.93
3. Total interest paid this period on loans. (Enter amount from Schedule B Part 1 Column e $ 0.00
4. Total: a ments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 2,402.38
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 8661ASK -FPPC (8661275 -3772)
}Schedule E
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
SCHEDULE E (CONT.)
(Continuation Sheet
Type or print in Ink.
Amounts m
Statement covers period
I'
Payments Made
POS
to wholedol�arsnded
.CALIFORNIA
July 1, 2015 •' UUM
from
through December 31, 20j& 6 6
SEE INSTRUCTIONS ON REVERSE
Page of
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
PFK)
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
FRO
professional services (legal, accounting)
VOT voter registration
Lrr campaign literature and mailings
FRT
print ads
WEB information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
OF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
FFA Boosters
2322 Hoya Lane
Gilroy, Ca 95020
CVC
Donation
675.45
United States Postal Service
100 4th Street
Gilroy, CA 95020
POS
Postage
980.00
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,655.45
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772)