Roland Velasco - Form 460 - 2016/09/25 - 2016/10/22Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
Type or print in ink.
Statement covers period
from 7/1/2016
SEE INSTRUCTIONS ON REVERSE
I through 10/22/2016
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
m Primarily Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
Q Political Party/Central Committee
(Also Complete Part 7)
3. Committee Information I.D. NUMBER
1383384
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Roland Velasco for Mayor 2016
STREET ADDRESS (NO P.O. BOX)
9720 Bunting Court
CITY STATE ZIP CODE AREA CODE /PHONE
Gilroy Ca 95020 408 710 -8508
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
Date of election if app/
(Month, Day, Year)
11/8/2016
2. Type of Statement:
COVER PAGE
Date Stamp
OCT 2 Q 2016 1590 7 of L.&
J For Official Use Only
V Preelection Statement
❑ Semi - annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Joan M. Lewils
MAILING ADDRESS
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
8130 Oak Court
CITY STATE ZIP CODE AREA CODE /PHONE
Gilroy CA 95020 408 842 -8698
NAME OF ASSISTANT TREASURER. IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
roland @rolandvelasco.co joaniemiewis @charter.knet
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to
Executed on -- /lam - a 3 —Al7 By
h ate
Executed on ` / y ^ Z�
By
Date
Executed on
Date
Executed on
Date
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
Signature of Confroihng Olfioetrolder, Carxlidate, State Measure Proponent
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
State of California
Type or print in ink. COVER PAGE - PART 2
Recipient Committee
Campaign Statement O CALIFORNIA RM ' • 1
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Roland Velasco
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Mayor
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
9720 Bunting Court Gilroy, Ca 95020
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
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION
Page A of / 4,
❑ 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.
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets if necessary
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
Roland Velasco
Mayor
❑ 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
FPPC Form 460 (January/05)
FPPC Totl-Free Helpline: 866/ASK-FPPC (8661275 -3772)
State of California
Campaign Disclosure Statement
Type or print in ink.
SUMMARY PAGE
Summary Page
Amounts may be rounded
to whole dollars.
Statement covers period =
CALIFORNIA
1
•
from
9/25/2016
FORM
through
10/22/2016
Page -3 of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
b
I.D. NUMBER
1383384
Contributions Received
Column A
Column B
Calendar Year Summary for Candidates
TOTALTHISPERIOD
(FROMATTACHED SCHEDULES)
CALENDAR YEAR
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions ............ ...............................
Schedule A, Line 3
95.00
$ 115 $
54789.00
2. Loans Received ....................... ...............................
schedule e, Lane 3
O
1000.00
1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 + 2
$ 11595.00 $
55789.00
20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ...............................
schedule C, Line 3
0
0
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ..... • ...• ................AddLines3
+4
$ 11595.00 $
55789.00
Made $ $
Expenditures Made
6. Payments Made ......... ...............................
7. Loans Made ............... ...............................
8. SUBTOTAL CASH PAYMENTS .................
9. Accrued Expenses (Unpaid Bills) ............
10. Nonmonetary Adjustment ........................
11. TOTAL EXPENDITURES MADE ................
.... Schedule E, Line 4 $
.... Schedule H, Line 3
........ Add Lines 6 + 7 $
........ Schedule F, Line 3
....... Schedule C, Line 3
..... Add Lines 8 + 9 + 10 $
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.
22309.60 $
22309.60 $
22309.60 $
28433.51
11595.00
22309.60
17718.41
17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ I
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ......... ............................... See instructions on reverse $
19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $
1000.00
38070.09
38070.09
38070.09
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column B of your last
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 filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
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 be rounded
dollars.
Statement covers period
CALIFORNIA
to whole
A60
from 9/25/2016
FORM
through 10/22/2016
Page �. of
SEE INSTRUCTIONS ON REVERSE
_4
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016
1383384
DATE
EET A RALSAND ZIP O
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(IF COMMITTEE, I.D.NUMB
CODE *
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
BIND
9/26/2016
Toniann Filice- Schultz
BOTH
600.00
600.00
Retired
Aromas Ca 95004
❑ PTY
❑ SCC
❑IND
Ruckstahl, LLC
❑COM
9/26/2016
® OTH
500.00
500.00
San Jose, Ca 95150
❑ PTY
❑ SCC
❑ IND
Arcadia Development Co
❑COM
9/26/2016
® OTH
500.00
500.00
San Jose, Ca 95150
❑ PTY
❑ ScC
®IND
Bruno Filice
❑COM
Retired
9/28/2016
❑ OTH
400.00
400.00
San Jose, Ca 95125
❑ PTY
❑ SCC
Zanker Road Resource Management, LTD
❑IND
❑COM
9/28/2016
W1 OTH
250.00
750.00
San Jose, Ca 95112
❑ PTY
❑ ScC
SUBTOTAL$ 2250.00
Schedule A Summary
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 $
'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 A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
9/25/2016
• • '
from
•
through 10/22/2016
page _r of
NAME OF FILER
I.D. NUMBER
1383384
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(IF COMMITfEE ,ALSO ENTER I.D.NUMBER)
CODE*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
❑IND
Brookfield Ambrosia LLC
❑COD
10/1/2016
®OTH
250.00
500.00
Danville, Ca 94526
❑ PTY
❑ SCC
Edwin & Delia Diaz
®IND
❑❑COOIM
Retired
10/3/2016
250.00
250.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Salvatore J Bozzo
®❑COD
Retired
10/3/2016
E] OTH
25.00
25.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Marc Rauser
m❑COD
Nonprofit Manager
10/3/2016
[:]OTH
200.00
200.00
San Martin, Ca 95046
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 725.00
*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 (8661275 -3772)
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.)
Monetary GontributionS Received Amounts may be rounded
Statement covers period
to whole dollars.
9/25/2016
e 4 t
- •
from
FP
through 10/22/2016
/0 of _L!�
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016
1383384
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(IF COMMITfEE ,ALSO ENTER I.D.NUMBER)
CODE *
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
®IND
Ermelindo Puente
❑ COM
Retired
10/5/2016
E] OTH
100.00
100.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Vanni Properties, Inc
❑IND
10/5/2016
❑COM
® OTH
100.00
100.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Erwin Boggs
V
❑IOM
Retired
10/5/2016
❑OTH
100.00
100.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Craig Filice
VICOM
Self- employed Glen
10/6/2016
❑OTH
Loma
300.00
300.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Jeffery & Candace Bastow
6flIND
❑
Retired
10/5/2016
❑ OTH
300.00
300.00
Salt Lake City, Ut 84121
❑ PTY
❑ SCC
SUBTOTAL$ 900.00
'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 A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
9/25/2016
'
- •
from
through 10/22/2016
Page — of
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016
1383384
DATE
ZIP
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(E COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
W]IND
Amanda R Gollott
❑IoM
Self employed
10/5/2016
❑OTH
Bookkeeper
200.00
200.00
Livermore Ca 94550 -7335
❑ PTY
❑ SCC
California Real Estate Political Action
❑IND
10/6/2016
Committee
®oTH
750.00
750.00
Los Angeles, Ca 90020
❑ PTY
At
8`i0►as.
❑SCC
GiIPAC
❑ IND
10/8/2016
❑IoM
V] OTH
750.00
750.00
Gilroy, Ca 95020
❑ PTY
3 V-7-3 X 7
❑ SCC
Kevin Cunningham
V] IND
❑IoM
Real Estate Cornish &
10/13/2016
❑ OTH
Care Y
250.00
250.00
Orinda, Ca 94563
❑ PTY
❑SCC
Shirley Willard
❑OIND
Self employed S W
10/13/2016
❑OTH
Properties
100.00
100.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
SUBTOTAL$ 2050.00
*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 (8661275 -3772)
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONY.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
-
to whole dollars.
9/25/2016
'
from
through 10/22/2016
Page �_ of �-
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016
1383384
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(IF COMMITfEE ,ALSO ENTER I.D.NUMBER)
CODE *
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
❑IND
Green Education Foundation Inc
❑IOM
10/13/2016
®OTH
750.00
750.00
San Jose, Ca 95118 -0000
❑ PTY
❑ SCC
CalAtlantic Group,lnc
❑IND
10/14/2016
❑COM
W] OTH
250.00
250.00
Pleasanton Ca 94588
❑ PTY
❑ SCC
California Apartment Association
❑IND
❑COM
10/14/2016
W] OTH
500.00
500.00
Sacramento, Ca 95814
❑ PTY
❑ SCC
P. Turcotle
®IND
❑COM
Retired
10/15/2016
❑OTH
50.00
50.00
Gilroy Ca 95020
❑ PTY
❑ SCC
Karen Aitken Bernosky
®IND
❑COM
Self employed Aitken
10/15/2016
OTH
❑❑
Landsca a
p
100.00
100.00
Gilroy, Ca 95020
PTY
❑ SCC
SUBTOTAL $ 1650.00
*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 (8661275 -3772)
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.)
Monetary GontributionS Received Amounts may be rounded
Statement covers period
to whole dollars.
9/25/2016
CALIFORNIA J , '
-
from
•
through 10/22/2016
Page 9 of
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016
1383384
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
DE O
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(�FCOMMIDRE,ALSANDZI I.D.N
CODE *
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
W]IND
Eric Howard
Business Relation Mgr.
10/15/2016
❑OTH
Gilroy Chamber
500.00
500.00
Prunedale, Ca 93907
❑ PTY
❑SCC
Lanny & Liz Brown
®IND
❑IoM
Police Academy Director
10/15/2016
Santa Rosa Jr. College
g
300.00
300.00
Gilroy, Ca 95020
E] PTY
❑ SCC
Elect Daniel Harney Gilroy City Council
E]IND
Political Data Inc.
10/17/2016
❑OTH
payment for half cost of
950.00
950.00
Gilroy, Ca 95020 FPPC #1386442
❑ PTY
software for campaign.
❑ SCC
Arcadia Development Co
❑IND
❑COM
10/17/2016
m OTH
250.00
750.00
San Jose, Ca 95150
❑ PTY
❑ SCC
Arcadia Homes, Inc
❑IND ❑COM
10/17/2016
VOTH
750.00
750.00
San Jose Ca 95150
❑ PTY
❑ SCC
SUBTOTAL$ 2750.00
*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 (8661275 -3772)
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
• ,
9/25/2016
from
• - •
through 10/22/2016
Page /d of //P
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016
1383384
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(IF COMMITTEE ,ALSO ENTER I.D.NUMBER)
CODE*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
RobinsonItMoretti, Inc
❑IND
10/18/2016
❑COM
®OTH
500.00
500.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Barry Marshall
®IND
Retired
10/18/2016
� off
20.00
20.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Lincoln Club of Northern California Pac
❑IND
❑COM
10/20/2016
FPPC 820082
® OTH
750.00
750.00
Sacramento, Ca 95814
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL $ 1270.00
"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 (8661275 -3772)
SCHEDULEB -PART1
Schedule B — Part 1 ""- ' ' ma e ,' ""
Amounts y "" be - ro" unded
Statement covers period
_
Loans Received to whole dollars.
9/25/2016
from
®�
through 10/22/2016
page u-
�L
SEE INSTRUCTIONS ON REVERSE
of
NAME OF FILER
I.D. NUMBER
1383384
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
AMOUNT
(N
AMOUNT AID
OUTSTANDING
e
INTEREST
ORIGINAL
8
CUMULATIVE
OF LENDER
(IF SELF-EMPLOYED, ENTER
BALANCE
BEGINNING THIS
RECEIVED THIS
OR FORGIVEN
BALANCEAT
CLOSE OF THIS
PAID THIS
AMOUNT OF
CONTRIBUTIONS
(IFCOMMITTEE, ALSO ENTER I.D. NUMBER)
NAMEOFBUSINESS)
PERIOD
PERIOD
THIS PERIOD*
PERIOD
PERIOD
LOAN
TO DATE
Roland Velasc0
District Aide Supervisor
❑ PAID
CALENDAR YEAR
9720 Bunting Court
Mike Wasserman
$
$ 1000.00
$ 1000.00
$ 1000.00
❑ FORGIVEN
PERELECTION-
Gilroy, Ca 95020
RATE
$ 1000.00
$
$
$
2/16/201
$
t� IND E] COM E] OTH ❑PTY ❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
$
$
%
$
$
❑ FORGIVEN
PER ELECTION *"
RATE
DATE DUE
DATE INCURRED
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
❑ PAID
CALENDAR YEAR
$
$
%
S
$
❑ FORGIVEN
PER ELECTION*'
RATE
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
I
$
$
s
s
$
DATEDUE
DATE INCURRED
SUBTOTALS $
Schedule B Summary
1. Loans received this period ........................................... ...............................
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period ................................ ...............................
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) ..............................
Enter the net here and on the Summary Page, Column A, Line 2.
*Amounts forgiven or paid by another party also must be reported on Schedule A.
** If required.
...... $
............................. $
............. NET $
1000.00
(May be a negative number)
(Enter (e) on
Schedule E, Line 3)
tContributor 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 (8661275 -3772)
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULEE
Statement covers period CALIFORNIA
from 9/25/2016 FORM 46'.
through 10/22/2016 Page I of y6
I.D.NUMBER
1383384
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment
CfvP
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
RL
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 (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR
DESCRIPTION OF PAYMENT
AMOUNTPAID
Legacy Print, Inc Paid by Check
3310 Woodward Avenue POS 2828.15
Santa Clara, Ca 95020
Legacy Print, Inc. Stickers for Gilroy Dispatch Newspaper
3310 Woodward Avenue LIT 389.33
Santa Clara, Ca 95054
Life Media Group, LLC Morgan Hill /Gilroy Life Newspaper Ad
16360 Monterey Road Duite 246 PRT 960.00
Morgan Hill, Ca 95037
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 4177.48
Schedule E Summary
1. Itemized payments made this period. Include all Schedule E subtotals. 22309.60
2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ................................................ ............................... $
4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summa Page, Column A, Line 6. 22309.60
P Y P ( Summary 9 ) ............................. TOTAL $
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
Schedule E SCHEDULE E (CONTI
Type or print in ink.
(Continuation Sheet) Amounts may be rounded Statement covers period .
Payments Made to whole dollars. from I • '
9/25/2016 •
Of
SEE INSTRUCTIONS ON REVERSE through 10/22/2016 Page/ �
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016 1383384
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CW
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 (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Legacy Print, Inc.
Lawn Signs and Stakes
3310 Woodward Avenue
CMP
Paid by Check
758.53
Santa Clara, Ca 95054
Legacy Print, Inc
Postage for second mailing
3310 Woodward Avenue
POS
Paid by Check
2828.15
Santa Clara, Ca 95054
E fundraising
Transaction fees
2131 Capital Avenue
WEB
9.50
Sacramento Ca 95816
Moxxy Marketing
Design and Production for Postcards
380 Main Street
LIT
650.00
Salinas, Ca 93901
Moxxy Marketing
Gilroy Life Ad Design
380 Main Street
LIT
75.00
Salinas, Ca 93901
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4321.18
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule E
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
E fundraising
Transaction fees
SCHEDULE E (CONT.)
(Continuation Sheet)
Type or print in ink.
Amounts may be rounded
Statement covers period
'
CALIFORNIA
Payments Made
to whole dollars.
Legacy Print, Inc
from
9!25/2016
•
• '
3310 Woodward Avenue
LIT
409.99
through
10/22/2016
Page- "Y of
SEE INSTRUCTIONS ON REVERSE
Staples
Postage stamps
8840 San Ysidro Avenue
g
NAME OF FILER
65.80
Gilroy, Ca 95020
I.D. NUMBER
Roland Velasco for Mayor 2016
Office Supplies
8840 San Ysidro Avenue
1383384
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CW 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
VVEB
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
E fundraising
Transaction fees
2131 Capital Avenue
WEB
5.00
Sacramento Ca 95816
Legacy Print, Inc
Tri -fold Brochure
3310 Woodward Avenue
LIT
409.99
Santa Clara, Ca 95054
Staples
Postage stamps
8840 San Ysidro Avenue
POS
65.80
Gilroy, Ca 95020
Staples
Office Supplies
8840 San Ysidro Avenue
OFC
5.43
Gilroy, Ca 95020
Legacy Print, Inc
Postcard and Mailing Color, 2 sides
3310 Woodward Avenue
LIT
ZNdbic� 9�4te
2489.29
Santa Clara, Ca 95054
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule E
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Legacy Print, Inc.
V2R2 Postcard and Mailing Color, 2 side
SCHEDULE E (CONT.)
(Continuation Sheet)
Type or print in ink.
Amounts may be rounded
Invoice #9701
Statement covers period
CALIFORNIA '
Payments Made
to whole dollars.
Citi Bank Visa
from
9/25/2016
• - •
P.O. Box 6004
WEB
2801.55
10/22/2016
through
Page iS of %lo
SEE INSTRUCTIONS ON REVERSE
E Fundraising
Transaction Fees
2131 Capital Avenue
NAME OF FILER
11.75
Sacramento Ca 95816
I.D. NUMBER
Roland Velasco for Mayor 2016
Legacy Print, Inc.
Postage for Mailer #3 Invoice 9709 -1
1383384
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CW campaign paraphemalia /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
W 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
Legacy Print, Inc.
V2R2 Postcard and Mailing Color, 2 side
3310 Woodward Avenue
LIT
Invoice #9701
2489.29
Santa Clara, Ca 95054
Citi Bank Visa
Facebook web site
P.O. Box 6004
WEB
2801.55
Sioux Falls, SD 57117 -6004
E Fundraising
Transaction Fees
2131 Capital Avenue
WEB
11.75
Sacramento Ca 95816
Legacy Print, Inc.
Postage for Mailer #3 Invoice 9709 -1
3310 Woodward Avenue
POS
2828.15
Santa Clara, Ca 95054
Legacy Print Inc
Mailer #3 14pt C2S Invoice 9709
3310 Woodward Avenue
LIT
2489.29
Santa Clara Ca 95054
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 10620.03
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772)
Schedule E
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
E Fundraisling
2131 Capital Avenue
Sacramento Ca 95816
WEB
Transaction Fees
SCHEDULE E (CONT.)
(Continuation Sheet)
Type or print in ink.
Amounts may be rounded
One Giving Tree
Statement covers period
CALIFORNIA
460
Payments Made
to whole dollars.
from
9/25/2016
•
through
10/22/2016
Page /6 of��
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I. D. NUMBER
1383384
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CW 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 (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
E Fundraisling
2131 Capital Avenue
Sacramento Ca 95816
WEB
Transaction Fees
15.40
Gilroy Foundation
60 Fourth Street #208
Gilroy, Ca 95020
CVC
One Giving Tree
200.00
* Payments thatare contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 215.40
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)