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Gilroy Growing Smarter - Form 460 - 2016/09/25 - 2016/10/22Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 09/25/2016 through 10/22/2016 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee O Political Party /Central Committee 3. Committee Information ;OMMITTEE NAME (OR CANDIDATE'S NAME IF NO CO Gilroy Growing Smarter STREET ADDRESS (NO P.O. BOX) 7690 Santa Theresa Drive ® Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1383355 CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 650 - 575 -8285 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX 2335 Olea Court CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 650 - 575 -8285 OPTIONAL: FAX/ E -MAIL ADDRESS gilroygrowingsmarter @gmail.com COVER PAGE Date Stamp Date of election if applicab Oj OCT 7;�t6 Page 1 of 5 (Month, Day, Year) a., x U For Official Use Only 11 /08!2016 �s �aV 2. Type of Statement: W Preelection Statement ❑ Quarterly Statement ❑ Semi - annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER David J. Lima MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE Gilroy CA 95020 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 certify under penalty of perjury uunderr the laws of the State of California that the foregoing is true Executed on Date Executed on Date Executed on Date By herein and in the attached schedules is true and complete. I or By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate. State Measure Proponent FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) 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 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 COVEWPAGE -PART 2 Page 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Gilroy Urban Growth Boundary Initiative BALLOT NO. OR LETTER JURISDICTION SUPPORT H I Gilroy ❑ 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 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www ;fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. Statement covers period from 09/25/2016 SUMMARY PAGE Expenditures Made 6. Payments Made ................................. ............................... Schedule E, Line 4 $ 10/22/2016 3 5 SEE INSTRUCTIONS ON REVERSE Schedule H, Line 3 none 8. SUBTOTAL CASH PAYMENTS ........... ............................... through 19,716.09 Page - of ......Schedule F, Line 3 NAME OF FILER 10. Nonmonetary Adjustment .......................... ............................... Schedule C, Line 3 _ _ none I.D. NUMBER Gilroy Growing Smarter 19,716.09 1383355 Contributions Received Column A TOTAL THIS PERIOD Column B Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions .................... ............................... Schedule A, Line 3 4,045.00 $ $ 44,915.32 none 1/1 through 6/30 7/1 to Date 2. Loans Received ................................. ............................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. .add Lines 1 +2 4,045.00 $ $ 44,915.32 20. Contributions Received $ $ 4. Nonmonetary Contributions ............. ............................... Schedule C, Line 3 none 5,104.00 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........ ............................Add Lines 3 +4 $ 4,045.00 $ 44,915.32 Made $ $ Expenditures Made 6. Payments Made ................................. ............................... Schedule E, Line 4 $ 19,716.09 7. Loans Made ........................................ ............................... Schedule H, Line 3 none 8. SUBTOTAL CASH PAYMENTS ........... ............................... Add Lines 6 + 7 $ 19,716.09 9. Accrued Expenses (Unpaid Bills ......Schedule F, Line 3 none 10. Nonmonetary Adjustment .......................... ............................... Schedule C, Line 3 _ _ none 11. TOTAL EXPENDITURES MADE ......... ............................... Add Lines 6 + s + 10 $ 19,716.09 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 25,634.56 13. Cash Receipts ............................ ............................... Column A, Line 3 above 4,045.00 14. Miscellaneous Increases to Cash ... ............................... Schedule 1, Line 4 none 15. Cash Payments ., ....................... ............................... column A, Line a above 19,716.09 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 9,963.47 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED . ............................... Schedule B, Part 2 $ none Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................. ............................... See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 +Line gin Column B above $ none none $ 36,151.85 none $ 36,151.85 none 5,104.00 $ 41,255.85 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) IJ $ I $ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan /2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule A Amounts,may be rounded SCHEDULE A "' w ""'C °" "a"' Monetary Contributions Received Statement covers period ° a. 1. from 09/25/2016 ° - 10/22/2016 4 5 SEE INSTRUCTIONS ON REVERSE through Page of g NAME OF FILER I:D. NUMBER Gilroy Growing Smarter 1383355 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR [FAN 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) IND 10/08/2016 Andrew McCallum Gilroy CA 95020 El OTH Engineer $25.00 $25.00 Western Digital ❑ PTY ❑ SCC IND 10/18/2016 John Pappa Gilroy CA 95020 El COM [I OTH Software Engineer $20.00 $20.00 TransMed Systems, Inc ❑ PTY ❑ SCC ® IND 10/20/2016 David Collier Gilroy, 95020 ❑ COM El OTH Retired $2,000.00 $5,000.00 ❑ PTY ❑ SCC Carolyn Tognetti ® IND ❑ Conn Retired 10/20/2016 , Gilroy 95020 ❑ OTH $2,000.00 $6,397.00 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 4,045 00� P` -. 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 $ 4,045.00 none 4,045.00 "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 (1an/2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period from 09/25/2016 SEE INSTRUCTIONS ON REVERSE through 10/22/2016 Page 5 of 5 NAME OF FILER I.D. NUMBER Gilroy Growing Smarter 1383355 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. ULE E CMP campaign paraphernalia /mist. 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 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 Life Media Group, LLC 16360 Monterey Road, Suite 246, Morgan Hill, CA, 95037 PRT Pacific Printing Lawn Signs and Mailers 1445 Monterey Highway, San Jose, CA, 95110 New SV Media, Inc 64 W. 6th Street, Gilroy, CA, 95020 PRT * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................. ............................... $ 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 Summary Page, Column A, Line 6.) ........................... TOTAL $ $2,550.00 $15,933.63 $1,222.00 19, 705.63 10.46 none 19,716.09 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov