Roland Velasco - Form 460 - 2016/10/23 - 2016/11/01Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
SEE INSTRUCTIONS ON REVERSE
fro
Type or print in ink.
Statement covers period I Date of election if applicable
m
10/23/2016 (Month, Day, Year)
through
11/1/2016 I 11/8/2016
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Cc-nmittee
Q State Candidate Election Committee
Q Recall
(Also Complete Part 5)
❑ General Purpose Committee
Q Sponsored
Q Small Contributor Committee
Q Political Party /Central Committee
❑ Primarily Formed Ballot Measure
Committee
Q Controlled
Q Sponsored
(Also Compete Part 6)
® Primarily Formed Candidate/
Officeholder 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
OPTIONAL: FAX / E -MAIL ADDRESS
roland @rolandvelasco.co
STATE ZIP CODE AREA CODE /PHONE
COVER PAGE
Stamp
H04, '- .,. ge - of 9
` X016 O For Official Use Only
2. Type of Statement:
Preelection Statement
❑ Semi - annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
Joan M. Lewils
MAILING ADDRESS
8130 Oak Court
CITY
Gilroy
STATE
CA
ZIP CODE AREA CODE /PHONE
95020 408 842 -8698
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY
STATE
ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
joaniemlewis @charter. knet
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
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 CALIFORNIA • 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 ;l' of L
❑ 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
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
CITY STATE ZIP CODE AREA CODE/PHONE 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
frnm 10/23/2016
SUMMARY PAGE
Expenditures Made
6. Payments Made ........................ ...............................
Schedule E, Line 4 $
through
11/1/2016
Page 3L of 9
SEE INSTRUCTIONS ON REVERSE
9. Accrued Expenses (Unpaid Bills) ........ .......................
Schedule F Line 3
10. Nonmonetary Adjustment ........... ...............................
Schedule c, Line 3
11. TOTAL EXPENDITURES MADE ................................
Add Lines 8 +9 +to $
NAME OF FILER
I.D. NUMBER
1383384
Contributions Received
olulmn AoD
Colu�mn B
Calendar Year Summary for Candidates
To
(FROMATTACHED SCHEDULES)
TOTALTODATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions ............ ...............................
Schedule A, Line 3
$ 6250.00 $
61039.00
2. Loans Received ....................... ...............................
schedule e. Line 3
1000.00
1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 + 2
$ 6250.00 $
62039.00
20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ...............................
schedule C, Line 3
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED •..• ... ....................AddLines3
+4
$ 6250.00 $
62039.00
Made $ $
Expenditures Made
6. Payments Made ........................ ...............................
Schedule E, Line 4 $
7. Loans Made .............................. ...............................
Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS ..... ...............................
Add Lines 6 + 7 $
9. Accrued Expenses (Unpaid Bills) ........ .......................
Schedule F Line 3
10. Nonmonetary Adjustment ........... ...............................
Schedule c, Line 3
11. TOTAL EXPENDITURES MADE ................................
Add Lines 8 +9 +to $
Current Cash Statement
12. Beginning Cash Balance.. ..................... Previous summary Page, Line 16 $
13. Cash Receipts .................... ............................... Column A, Line 3above
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 Lime 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 $
10342.64 $ 48412.73
10342.64 $ 48412.73
10342.64 $ 48412.73
17718.41
6250.00
10342.64
13625.77
1000.00
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)
-/� $
I 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 (866/275 -3772)
Schedule A Type or print in ink. SCHEDULE A
Monetary Contributions Received Amounts may be rounded
ry on
Statement covers period
-
to whole dollars.
'
from 10/23/2016
- •
through 11/1/2016
9
Pa y of 9
Page
9
SEE INSTRUCTIONS ON REVERSE
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
( IFCOMM(TTEE, ALSO ENTER ID.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)
VI IND
10/24/2016
John Filice
❑COM
Manager Glen Loma
200.00
500.00
❑OTH
Corp.
Gilroy, Ca 95020
E] PTY
❑ SCC
MIND
10/24/2016
Rene T Coleman
❑COM
Teacher, Santa Clara
750.00
750.00
E] OTH
Unified School District
Santa Clara, Ca 95050
❑ PTY
❑ SCC
® IND
10/24/2016
David A Gillmor
❑COM
Real Estate, Gillmor
750.00
750.00
E] OTH
Associates
Santa Clara, Ca 95050
❑ PTY
❑ SCC
® IND
10/24/2016
David Profitt
❑COM
❑OOH
Retired
750.00
750.00
Los Altos, Ca 94024
❑ PTY
❑ SCC
Michelle Profitt
®IND
❑COM
Retired
10/24/2016
❑ OTH
750.00
750.00
Los Altos,Ca 94024
❑ PTY
❑ SCC
SUBTOTAL$ 3200.00 '
Schedule A Summary
Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.) ......................................................................... ............................... $ Za )• 00
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 $ Iaas7o. 06
'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
to whole dollars.
10/23/2016
CALIFORNIA • '
-
from
•
11/1/2016
S
through
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 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)
OIND
Charles T. Muinger, Jr.
Experimental physicist,
10/24/2016
❑OTH
Stanford Linear
500.00
500.00
Palo Alto, Ca 94301
❑ PTY
Accelerator
❑ SCC
Ron & Wendy Gong
W]IND
❑IoM
CPA CTC /MYCFO
10/24/2016
❑ OTH
500.00
500.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
Tim Filice
V❑IOM
Glen Loma Group
10/27/2016
[]OTH
Executive
200.00
200.00
Gilroy, California 95020
❑ PTY
❑ SCC
Trece Herder
❑]IND
Manager Cal Atlantic
10/27/2016
❑OTH
500.00
500.00
Fairfield, Ca 94534
❑ PTY
❑ SCC
B. Wayne Hughes, Jr.
®IND
❑COM
Board Member of Public
10/28/2016
Storage. Retired
g
750.00
750.00
Malibu, Ca 90265
E] PTY
❑ SCC
SUBTOTAL$ 2450.00
*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 1ASK -FPPC (8661275 -3772)
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars.
10/23/2016
- i 1
from
o
11/1/2016
9
through
Page of
NAME OF FILER
I.D. NUMBER
Roland Velasco For Mayor 2016
1383384
DATE
EET A
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
ZI DE O
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
COMMITTEE, ALSOND
(IF .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)
Ernest Fortino
OCOM
Owner Fortino Winery
11/1/2016
[]OTH
Retired
300.00
300.00
Gilroy, Ca 95020
❑ PTY
❑SCC
Al Pastor
®IND
Retired
11/1/2016
❑COM
❑ OTH
300.00
300.00
Gilroy, Ca 95020
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL $ 600.00
*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)
SCHEDULER -PART1
Schedule B — Part 1 Amounts may u
Amounts may be rounded
Statement covers period
_
Loans Received to whole dollars.
10/23/2016
' •
from
•
11/1/2016
7
SEE INSTRUCTIONS ON REVERSE
through
Page of
NAME OF FILER
I.D. NUMBER
Roland Velasco For Mayor 2016
1383384
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
BALANCE
(b)
AMOUNT
(c)
AMOUNT PAID
(d)
OUTSTANDING
(e)
INTEREST
t)
ORIGINAL
(g)
CUMULATIVE
OF LENDER
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF - EMPLOYED, ENTER
BEGINNING THIS
RECEIVED THIS
PERIOD
OR FORGIVEN
BALANCEAT
CLOSE C THIS
PAID THIS
PERIOD
AMOUNTOF
CONTRIBUTIONS
NAMEOFBUSINESS)
PERIOD
THIS PERIOD*
PERIOD
LOAN
TO DATE
Roland Velasco
District Aide Supervisor
❑ PAID
CALENDAR YEAR
9720 Bunting Court
Mike Wasserman
$
$ 1000.00
,
$ 1000.00
$ 1000.00
❑ FORGIVEN
PER ELECTION**
Gilroy, Ca 95020
RATE
$ 1000.00
$
$
$
2/16/201
$
t9 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATEDUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION*"
RATE
s
$
a
a
$
DATE DUE
DATE INCURRED
to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION*"
RATE
to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
$
$
$
$
$
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.) ................................ ............................... NET $
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.
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 Type or print in ink.
Payments Made Amounts may be rounded
y to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Roland Velasco For Mayor 2016
Statement covers period
from 10/23/2016
through 1111/2016 Page - of
I.D. NUMBER
1383384
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment
SCHEDLILEE
CNP
campaign paraphernalia /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
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. Mailer number 4 -R1 -4
3310 Woodward Avenue LIT Invoice 9714 2489.29
Santa Clara Ca 95054
Legacy Print, Inc Postage for #4 -R1-4
3310 Woodward Avenue POS Invoice 9714 -1 2828.15
Santa Clara Ca 95054
Legacy Print Inc Tri -fold brochure
3310 Woodward Avenue LIT Invoice 9836 431.74
Santa Clara, Ca 95054
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 5,749.18
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.) ....
$4�a`f
....... ............................... $
....... TOTAL $ 1a1 3 4 a,.
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
2131 Capital Avenue
Sacramento, Ca 95816
WEB
Transaction Fees
SCHEDULE E (CONT.)
(Continuation Sheet)
Type or print in ink.
Amounts may be rounded
Postcard ROL- 10,000 Print and Mailing
Invoice 9720
Statement covers period
CALIFORNIA
460
Payments Made
to whole dollars.
from
10/23/2016
•
11/1/2016 h
through
�
Page ` % of
SEE INSTRUCTIONS ON REVERSE
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
E fundraising
2131 Capital Avenue
Sacramento, Ca 95816
WEB
Transaction Fees
23.00
Legacy Print, Inc
3310 Woodward Avenue
Santa Clara, Ca 95054
LIT
Postcard ROL- 10,000 Print and Mailing
Invoice 9720
4570.46
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4593.46
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)