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Roland Velasco - Form 460 - 2017/07/01 - 2017/12/31Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period Date of election if applic '7//%2017 (Month, Day, Year) from through 12/31/2017 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure State Candidate Election Committee Committee Recall O Controlled (Also Complete Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also Complete Part 7) 3. Committee Information I 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 roland @rolandvelasco.co Dateitarnp RECC/�,� , D JAN 9 2018 CITYCCF �, G1LRpY OFFICE CA COVER PAGE e I of 6 For Official Use Only 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement [� Semi - annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Joan M. Lewis 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 joaniemlewis @charter.net 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 — k By 1 Dat or Responsible Officer of Sponsor Executed on Date Executed on Date 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 (8661275 -3772) State of California Type or print in ink. COVER PAGE - PART 2 Recipient Committee Campaign Statement 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 COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE CALIFORNIA- 460' FORM 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. 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 Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -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 6/30/2017 - SUMMARY PAGE 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 /, 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. 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 $ 125.00 $ 125.00 $ 125.00 $ 5282.14 125.00 5157.14 1000.00 56944.86 56944.86 56944.86 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) �JJ �JJ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772) 12/31/2017 Page of SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Roland Velasco for Mayor 2016 11383384 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTAL TODATE General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ $ 61102.50 1000.00 1/1 through 6/30 7/1 to Date 2. Loans Received ....................... ............................... Schedule e, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ $ 62102.50 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ $ 62102.50 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 /, 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. 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 $ 125.00 $ 125.00 $ 125.00 $ 5282.14 125.00 5157.14 1000.00 56944.86 56944.86 56944.86 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) �JJ �JJ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772) SCHEDULE B - PART 1 Schedule B — Part 1 Amounts �may b b e rounded Statement covers period _ Loans Received to whole dollars. 6/30/2017 � MA F _ from 12/31/2017 Page_ SEE INSTRUCTIONS ON REVERSE through 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 BALANCEAT (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTERI.D.NUMBER) NAMEOFBUSINESS) PERIOD PERIOD THIS PERIOD* 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 $ $ $ 2/16/16 $ IV IND ❑ COM ❑ 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 ❑ FORGIVEN PER ELECTION t* RATE DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ $ $ $•ys7 4 :.s. s =,y 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. (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 (May be a negative number) FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Roland Velasco for Mayor 2016 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 6/30/2017 through 12/31/2017 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page of I.D. NUMBER 1383384 SCHEDULE E CIVP 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 (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER LID. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Gilroy Chamber of Commerce Membership to Gilroy Charmber 7471 Monterey Street 125.00 Gilroy Ca 95020 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 125.00 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. _..._..._._ $ 125.00 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. ................. TOTAL $ 125.00 P Y P Summary 9 ) ............ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)