Roland Velasco - Form 460 - 2016/11/02 - 2016/12/31Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
fro
Type or print in ink.
Statement covers period I Date of election if applicable:
11/02/2016 (Month, Day, Year)
m
SEE INSTRUCTIONS ON REVERSE I through 12/31/2016
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
O Recall Q Controlled
(Also Complete Part 5) O Sponsored
(Also Complete Part s)
❑ General Purpose Committee
Q Sponsored
Q Small Contributor Committee
Q Political Party /Central Committee
W] 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 STATE ZIP CODE AREA CODE /PHONE
COVER PAGE
Date Stamp CALIFORNIA
FORM 460
e of 9
For Official Use Only
11/8/2016
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 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 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 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
Date
Executed on i& Data
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 Forth 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275.3772)
State of California
Type or print in ink. COVERPAGE -PART2
Recipient Committee RNIA
Campaign Statement O CALIFORM 4 • 0
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
RESIDENTIAL/BUSINESS 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
Page 2' of 9
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 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 CODE/PHONE 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/06)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661276 -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 11/02/2016
SUMMARY PAGE
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
through
12/31/2016
Page 4 of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016
1383384
Contributions Received
Column
Column B
Calendar Year Summary for Candidates
TOTALTHISPERIOD
(FROM ATTACHED SCHEDULES)
CALENDAR YEAR
TOTALTODATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions ............ ...............................
schedule A, Line 3
$
63.50
$ 61102.50
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
$
63.50
$ 62102.50
20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ...............................
Schedule C, Line 3
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED
........................... Add Lines 3 +4
$
63.50
$ 62102.50
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made ........................ ...............................
Schedule E, Line 4
$
5075.76
$ 53488.49
Candidates
7. Loans Made .............................. ...............................
Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS ..... ...............................
Add Lines 6 + 7
$
5075.76
$ 53488.49
22• Cumulative Expenditures Made*
(if Subject to voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ........
....................... Schedule F Line 3
Date of Election Total to Date
10. Nonmonetary Adjustment ............. .............................
Schedule C, Line 3
(mm /dd /yy)
11. TOTAL EXPENDITURES MADE . ...............................
Add Lines s + 9 + 10
$
5075.76
$ 53488.49
$
$
Current Cash Statement
12. Beginning Cash Balance .......................
Previous Summary Page, Line 16
$
13625. 77
To calculate Column B, add
13. Cash Receipts .................... ...............................
Column A, Line 3 above
63.50
amounts in Column A to the
14. Miscellaneous Increases to Cash ...........................
schedule /, Line 4
corresponding amounts
from Column B of your last
*Amounts in this section may be different from amounts
reported in Column B.
15. Cash Payments ................... ...............................
Column A, Line s above
5075. 76
report. Some amounts in
Column A may be negative
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15
$
8613.51
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 e, Part 2
$
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
Cash E
Equivalents and Outstanding Debts
q 9
any).
18. Cash Equivalents ......... ...............................
See instructions on reverse
$
19. Outstanding Debts .........................
Add Line 2 +Line s in Column a above
$
1000.00
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule A
Type or print in ink.
SCHEDULE A
ramounts may De rounaea
Monetary Contributions Received
Statement covers period p
to whole dollars.
C
CALIFORNIA ,
1
from \6�\ �•bt �.
•
• -
through 1�►� 3'
Page Aj of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Roland Velasco for Mayor 2016
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIB UTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(IF COMMITEE,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
12/09/2016
Roland Velasco
EICOM
Refund from City of
63.50
63.50
9720 Bunting Court
W1 OTH
Gilroy from 2016
Gilroy, Ca 95020
❑ PTY
Campaign
❑SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 63.50
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.) ......
............. $
.................... $
63.50
........... TOTAL $ 63.50
*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 B - PART 1
Schedule B — Part 1 'ry -m, ry""b' ," "u...
Amounts may be rounded
Statement covers period
P
Loans Received to whole dollars.
11/02/2016
CALIFORNIA
•
from
FORM
12/31/2016
Page
SEE INSTRUCTIONS ON REVERSE
through
of
NAME OF FILER
I.D. NUMBER
_
20 1
1383384
l �l � 6
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTE
OCCUPATION AND EMPLOYER
a
OUTSTANDING
BALANCE
(b)
AMOUNT
(�)
AMOUNT PAID
(d)
OUTSTANDING
BALANCEAT
(e)
INTEREST
(
ORIGINAL
(g)
CUMULATIVE
OF LENDER
(IFCOMMITTEE, ALSO ENTER I.D. NUMBER)
(IFSELF- EMPLOYED, ENTER
BEGINNING THIS
RECEIVED THIS
PERIOD
OR FORGIVEN
CLOSE OF THIS
PAID THIS
PERIOD
AMOUNT OF
CONTRIBUTIONS
TO DATE
NAMEOF BUSINESS)
E IOD
THIS PERI00*
ERI
LOAN
Roland Velasco
District Aide Supervisor
❑ PAID
CALENDAR YEAR
9720 Bunting Court
Mike Wasserman
$
$ 1000.00
%
s 1000.00
$ 1000.00
❑FORGIVEN
PER ELECTION**
Gilroy, Ca 95020
RATE
$ 1000.00
$
$
$
2/16/201
$
tv IND El COM [:3 OTH [_1 PTY ❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION **
RATE
S
S
S
S
S
DATEDUE
DATE INCURRED
t ❑ IND El COM El OTH ❑PTY El SCC
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION **
RATE
f IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
s
s
s
S
a
DATE DUE
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. A SCHEDULEE
Amounts may Statement covers period
Payments Made to whole be rounded
dollars. from 11/02/2016 • • '
SEE INSTRUCTIONS ON REVERSE through 12/31/2016 page_ of
NAME OF FILER 1 I.D. NUMBER
1383384
v
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CtirP
campaign paraphernalialmisc.
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 filingiballot 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
LrT
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
Moxxy Marketing Revision to campaign Brochure
380 Main Street LIT Invoice 4497 40.00
Salinas, Ca 93901
Moxxy Marketing Design postcards
380 Main Street LIT Invoice 4498 975.00
Salinas, Ca 93901
Old City Hall Old City Hall Restaurant
7400 Monterey Street CMP Banquet/Election Night 500.00
Gilroy, Ca 95020
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1515.00
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................... ............................... $ Z475-7- Zr
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 $ 4rZI16 -v/
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772)
Schedule E
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Susan Mister
SCHEDULE E (CONT.)
(Continuation Sheet)
or print in ink.
Amounts may be rounded
Statement covers p
period
• ' '
,
Payments Made
to whole dollars.
from
11/02/2016
•
• '
Susan Mister
through
12/31/2016 h
Page of AL_
SEE INSTRUCTIONS ON REVERSE
CMP
91.83
—I--
NAME OF FILER l
Roland Velasco
I.D. NUMBER
Hall of Fame Lunch
9720 Bunting Court
MTG
1383384
CODES: If one of the following codes accurately
Ascribes the payment, you may enter the code. Otherwise, describe the payment.
CW campaign paraphemalia /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
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 (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE. ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Susan Mister
Printing Walk Flyers
9265 Braquet Lane
LIT
71.35
Gilroy, CA 95020
Susan Mister
Election Night Costs -Cake, Balloons, And Gift Card
9265 Braquet Lane
CMP
91.83
Gilroy Ca 95020
Roland Velasco
Hall of Fame Lunch
9720 Bunting Court
MTG
45.00
Gilroy Ca 95020
Roland Velasco
Gilroy Downtown Association Beer Crawl
9720 Bunting Court
CVC
40.00
Gilroy, Ca 95020
Roland Velasco
Printing Walk List
9720 Bunting Court
LIT
187.50
Gilroy, Ca 95020
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 435.68
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule E SCHEDULE E (CONT.)
Type or print in ink. d i
covers period
(Continuation Sheet) Amounts may be rounded Statement • ' 4 . 1
Payments Made to whole dollars. from 11/02/2016
pa a
SEE INSTRUCTIONS ON REVERSE through 12/31/2016 of g
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.
Clue
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
PEr
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
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 1.0. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Roland Velasco
Lumber for repair of signs
9720 Bunting Court
CMP
28.38
Gilroy, Ca 95020
Roland Velasco
Gilroy Recreation -Youth Scholarship Funraiser
9720 Bunting Court
CVC
90.27
Gilroy, Ca 95020
Roland Velasco
Name tags for election night
9720 Bunting Court
CMP
6.51
Gilroy, Ca 95020
Joan Lewis
Facebook and Google Campaign Activity
8130 Oak court
WEB
2742.30
Gilroy, Ca 95020
Joan Lewis
Ink for Printer
8130 Oak Court
OFC
63.06
Gilroy Ca 95020
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2930.52
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772)
Schedule E
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
David Ferry Photography
SCHEDULE E (CONT.)
(Continuation Sheet)
Type or print in ink.
Amounts may be rounded
Statement covers period
• _
J '
Payments Made
Gilroy, Ca 95020
to whole dollars .
from
11/02/2016
�
FPag,
Ink for Printer
9720 Bunting Court
through 12/31 /2016
of
SEE INSTRUCTIONS ON REVERSE
Gilroy, Ca 95020
Political Reform Division
NAME OF FILER
Annual Fee
1500 11th Street -Room 495
FIL
I.D. NUMBER
Roland Velasco for Mayor 2016
Sacramento, Ca 95814
ID #1383384
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
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
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
AMOUNT PAID
David Ferry Photography
Photography of Ceremony Coverage
PRO
Invoice #121916001
125.00
Gilroy, Ca 95020
Roland Velasco
Ink for Printer
9720 Bunting Court
OFC
19.56
Gilroy, Ca 95020
Political Reform Division
Annual Fee
1500 11th Street -Room 495
FIL
Local Campaign
50.00
Sacramento, Ca 95814
ID #1383384
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 194.56
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772)