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Home My WebLink AboutTom Fischer - Form 460 - 2014/07/01 - 2014/09/30Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 01/01/2014 through 09/30/2014 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) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee MAILING ADDRESS Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Pail 7) 3. Committee Information CITY I.D. NUMBER 1366034 4. COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Tom Fischer for City Council 2014 STREET ADDRESS (NO P.O. BOX) 745 Dawn Way CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 408 - 847 -4716 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE ONAL: FAX / E -MAIL ADDRESS COVER PAGE Date Stamp f� Date of election if applicable: DOT 2014 Page 1 of �16 (Month, Day, Year) COTY CLERKS 0 fiCE For Official Use Only GILROY, CA 11/04/2014 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 Marie P Blankley MAILING ADDRESS 2290 Coral Bell Court CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 408- 842 -4544 NAME OF ASSISTANT TREASURER, IF ANY Tom Fischer MAILING ADDRESS 745 Dawn Way CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 408 - 847 -4716 OPTIONAL: FAX / E -MAIL ADDRESS 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 c rrect. Executed on "J By /05.- Assistant reasurer Executed on ✓ / By Date Signature of Controlling OffioeflhWr, Candi er tate MeaslIfe, Proponent or Responsible Officer of Sponsor Executed on Date By Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Forth 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661276 -3772) State of California Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee Type or print in Ink. NAME OF OFFICEHOLDER OR CANDIDATE Tom Fischer OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member, City of Gilroy RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 745 Dawn Way 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? El 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 -PART2 IPage 2 of _L 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 candidates) 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 ❑ 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 Type or print In ink. Amounts may be rounded Summary Page to whole dollars. Statement covers period from 01/01/2014 SUMMARY PAGE Expenditures Made through 09 /30/2014 Page _ _3 of SEE INSTRUCTIONS ON REVERSE 7. Loans Made .............................. ............................... schedule H, Line 3 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ NAME OF FILER $ 11436.11 9. Accrued Expenses (Unpaid Bills) ............................... schedule F Line 3 I.D. NUMBER Tom Fischer for City Council 2014 50.05 50.05 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 +g +10 1366034 1148_6.16 $ 11486.16 Column A Column B Calendar Year Summary for Candidates Contributions Received 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 TOTALTHISPERIOD CALENDARYEAR TOTALTO Running in Both the State Prima and 9 Primary 13. Cash Receipts .................... ............................... Column A, Line 3 above (FROMATTACHED SCHEDULES) DATE General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 8149.00 $ $ 8149.00 from Column B of your last 7500.00 7500.00 1/1 through 6/30 711 to Date 2. Loans Received ....................... ............................... schedule B, Line 3 $ 4212.89 figures that should be 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add tines 1 +2 $ 15649.00 $ 15649.00 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... schedule c, Line 3 50.05 50.05 21 Expenditures the first report being filed 5. TOTAL CONTRIBUTIONS RECEIVED •••.•.• ..••.•••.••...••.••• Add Lines 3 +4 $ 15699.05 $ 15699.05 Made $ - - $ Equivalents and Outstanding Debts Cash E 9 Expenditures Made 6. Payments Made ........................ ............................... schedule E, Line 4 $ 11436.11 $ 11436.11 7. Loans Made .............................. ............................... schedule H, Line 3 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 11436.11 $ 11436.11 9. Accrued Expenses (Unpaid Bills) ............................... schedule F Line 3 - 10. Nonmonetary Adjustment ........... ............................... schedule C, Line 3 50.05 50.05 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 +g +10 $ 1148_6.16 $ 11486.16 Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 0 To calculate Column B, add 13. Cash Receipts .................... ............................... Column A, Line 3 above 15649.00 amounts in Column A to the corresponding amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 from Column B of your last 15. Cash Payments .............................. Column A, line s above 11436.11 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add lines 12 + 13 + 14, then subtract Line 15 $ 4212.89 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 Equivalents and Outstanding Debts Cash E 9 q any). 18. Cash Equivalents ......... ............................... see instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 +Line 9. in Column B above $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary F.xpendfture Llmit) 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/06) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule A Type or print in Ink. SCHEDULE A Amounts may. be rounded Monetary Contributions Received to whole dollars. Statement covers period ifrom 01'/01/2014 09/30/2014 4 r® SEE INSTRUCTIONS ON REVERSE through of NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED QFCOMMnTEE,ALSND.D.NUMBER) CODE* OF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) ®IND 3/24/14 Frances Olson Francs Olson ❑COM Retired 250.00 250.00 250.00 Court ❑ OTH Morgan Hill, CA 95037 ❑ PTY ❑ Scc WJIND 5/01/14 John Geer ❑COM Retired 250.00 250.00 250.00 2104 Carmelita Ave. ❑OTH Burlingame, CA 94010 ❑'PTY ❑SCC ®IND 6/02/14 Nancy Fischer ❑COM Veterinarian 250.00 250.00 250.00 1245 Cox Road E] OTH Princevalle Pet Hospital Aptos, CA 95003 El PTY ❑ ScC ®IND 6/13/14 Robert Clark ❑COM Dental Lab Tech 250.00 250:00 250.00 g350 Verbena Dr. ❑OTH Williams Dental Lab Gilroy, CA 95020 El PTY ❑SCC 6/13/14 Jakake Williams ❑ND WIND COM self - employed 250.00 250.00 250.00 Mesa Road ❑OTH Williams Dental Lab Gilroy, CA 95020 ❑ PTY ❑SCC SUBTOTAL$ 1250.00 4 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 receivedithis period. (Add Lines 1 and 2. Enter here and omthe Summary Page, Column A, Line 1.) ....................... TOTAL $ 8149.00 *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) lypeor print InInk. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA towholedoilars. 01/01/2014 FORM � 460 from through 09 /30/2014 Page 5 of 18 NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED pFCOMMfE,ALSND .D. NUMBER) CODE * OF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ZIND 6/13/14 Gail Williams 1000 Mesa Road ❑OTH self - employed Williams Dental Lab 250.00 250.00 250.00 Gilroy, CA 95020 ❑ PTY ❑ SCC 6/13/14 Susan Clark ®IND self- employed 250.00 250.00 250.00 1000 Mesa Road OATH Williams Dental Lab Gilroy, CA 95020 ❑ PTY ❑ SCC 6/13/14 Don Gage for Mayor 2012 IND ❑COM ®❑OTH 250.00 250.00 250.00 7937 Hanna St. Gilroy, CA 95020 ❑ PTY ❑ SCC 6/13/14 Vilma Pinheiro MIND ❑IoM self - employed 150.00 150.00 150.00 190 First St. ❑ OTH Pinheiro Insurance Gilroy, CA 95020 ❑ PTY ❑ SCC 6/13/14 Kai Lai WIND Retired 100.00 100.00 100.00 855 W. 8th Street ❑OTH Gilroy, CA 95020 ❑ PTY p SCC SUBTOTAL$ 1000.00- *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY —Political Parry SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661276 -3772) Schedule A (Continuation Sheet) TVpe or print In ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 01/01/2014 I �/, • - from ____ 09/30/2014 [Page 6 18 through of NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED QFCOMMITTEE,ALSNDI.D.NUMBER) CODE * (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) OEIIND 07/17/14 Elden Shreve Sheet Metal 250.00 250.00 250.00 1309 Laurelwood Road ❑OTH Hellwig Mech. Santa Clara, CA 95054 ❑ PTY ❑SCC 7/17/14 John Allen ®IND ❑COM Engineer 250.00 250.00 250.00 1530 The Alameda #300 Q OTH VAO Engineers g San Jose, CA 95112 ❑ PTY ❑ SCC 7/17/14 Carol Wagner IND ®IOM Retired 250.00 250.00 250.00 1126 Golf Place ❑OTH Paso Robles, CA 93446 ❑ PTY ❑ SCC 7/17/14 Richard Collins MIND ❑❑OTH Retired 250.00 250.00 250.00 8309 Muscat Ct. Redding, CA 96001 ❑ PTY ❑ SCC 7/17/14 Glen Bollenbacher MIND Plumber 250.00 250.00 250.00 1301 Laurelwood Road ❑OOH Hellwig Plumbing Co. Santa Clara, CA 95054 ❑ PTY ❑ SCC SUBTOTAL $ 1250.00 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Politicai 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 Contributions Received Amounts may be rounded Statementcoversperiod 'CALIFORNIA to whole dollars. 01/01/2014 • 1 from 09/30/2014 7 16 through Page of NAME OF FILER - - -- - I.D. NUMBER Tom Fischer for City Council 2014 1366034 DATE EET A DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RALSAND ZI CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, I.D.N CODE * (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 07!17/14 James Fischer EICOM Retired 250.00 250.00 250.00 3795 Ridgeview Ct. ❑OTH Morgan Hill, CA 95037 El PTY ❑SCC 7/17/14 Tom Chadwick WIND ❑❑CO Retired 100.00 100.00 100.00 496 Alegre Ave Nipomo, CA 93444 ❑ PTY ❑ SCC 7/17/14 Sidney Kaufmann W]IND Actuary 250.00 250.00 250.00 160 W. Santa Clara St. E]OTH Kaufmann & Goble San Jose, CA 95113 ❑ PTY ❑ SCC 7/17/14 Kaufmann & Goble Associates, Inc. ❑IND ®oTH 250.00 250.00 250.00 160 W. Santa Clara St., Ste 1550 San Jose, CA 95113 ❑ PTY ❑SCC 8/01/14 Steven Andrade OIND Retired 150.00 150.00 150.00 9007 El Matador Dr. ❑OTH Gilroy, CA 95020 ❑ PTY El SCC SUBTOTAL$ 1000.00 - '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 Contributions Received Amounts may be rounded Statement covers period CALIFO towholedollars. 01/01/2014 • 460 from _ 09/30/2014 8 18 through Page of NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 DATE ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED QFCOMMfDRESLSAND I.D.N CODE * OF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 08/01/14 Timothy Filice OIND self- employed 150.00 150.00 150.00 7888 Wren Ave, Ste D143 ❑OTH Glen Loma Corp Gilroy, CA 95020 El PTY ❑SCC 8/01/14 John Filice ®INN ❑COM self- employed 150.00 150.00 150.00 714 E. Bel Mar Dr. ❑ OTH Glen Loma Co rp Watsonville, CA 95076 ❑ PTY [J SCC 8/01/14 Fred Lico V]IND ❑COM Retired 150.00 150.00 150.00 Way 1416 Glen Ellen Wa ❑ OTH San Jose, CA 95125 ❑ PTY ❑SCC 8/06/14 Chad Bollenbacher MIND EICOM Plumber 250.00 250.00 250.00 2975 Holiday Ct. Hellwig Plumbing Morgan Hill, CA 95037 ❑ PTY ❑SCC 8/13/14 Barbara Fischer m❑COM Engineer 100.00 100.00 100.00 20305 Northglen Square ❑OOH Lockheed Martin Cupertino, CA 95014 ❑ PTY ❑SCC '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 SUBTOTAL$ aUU.UO I�k gi 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 Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 01/01/2014 • 460 from through 09/30/2014 Page 9 of /8 NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 DATE ADDRESS AND ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (EETA IT .D.N CODE * (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) OIND 08/21/14 Franklyn Lopes 4311 Gladys Ave. ooTH Retired 100.00 100.00 100:00 Santa Cruz, CA 95062 ❑ PTY ❑SCC 8/14/14 John Cianciolo ®IND Engineer 250.00 250.00 250.00 6011 Majorca Ct. opTH Synopsis San Jose, CA 95120 ❑ PTY ❑ SCC 8/14/14 Gina Lopez ®IND ❑COM Gina Lopez Insurance 250.00 250.00 250.00 140 Second St. ❑ OTH & Financial Services Gilroy, CA 95020 ❑ PTY ❑ SCC 8/14/14 Shawn Haugen MIND Owner 250.00 250.00 250.00 4133 Ross Park Dr. DOTH Just Tape Inc San Jose, CA 95118 ❑ PTY ❑ SCC 8/21/14 Eden Smith MIND ❑COM self - employed 100.00 100.00 100:00 1602 Ocean St. ❑ OTH Property manager p dY 9 Santa Cruz, CA 95060 ❑ PTY ❑ SCC SUBTOTAL$ 950.00 *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 (6661275 -3772) Schedule A (Continuation Sheet) Type or print in Ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNLA to whole dollars, 01/01/2014 FOR 460' from 09/30/2014 10 /8 - - - - -- - -- - - - -- through - -- Page of -- NAME OF FILER LD.NUMBER Tom Fischer for City Council 2014 1366034 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ADDRESS ZIPD.N DE O CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED QFCOMMfDRE CODE * QFSELFEMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 08/21/14 Carolyn Tognetti E]COM Retired 250.00 250.00 250.00 820 Carignane Dr. ❑OTH Gilroy, CA 95020 ❑ PTY ❑SCC 9/08/14 James Kishimura W]IND H Accountant 100.00 100.00 100.00 755 Dawn Way 0o Steven C Schrepfer, CPA Gilroy, CA 95020 ❑ PTY ❑ SCC 9/02/14 Princevalle Pet Hospital, Inc. ❑IND COD 250.00 250.00 -_ - 250.00 7995 Princevalle St, Ste 100 ®OTIi Gilroy, CA 95020 ❑ PTY ❑ SCC 9103/14 The James Group ❑IND ®OTH 250.00 250.00 250.00 2950 Soma Way Gilroy, CA 95020 ❑ PTY El SCC 8/13/14 Kelly Shaeffer PO Box 46 MIND ❑COM owner Kelly in California 250.00 250.00 250.00 ❑OTH Redwood Estates, CA 95044 ❑ PTY []SCC - - - -- - - - - -- SUBTOTAIL$ 1100.00; is WON `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/06) FPPC Toll -Free Helpline: 866 /ASK -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 CALIFORNIA to whole dollars. 01/01/2014 FORM • 1' from 09/30/2014 11 ��- through Page of NAME OF FILER I:D. NUMBER Tom Fischer for City Council 2014 1366034 DATE DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ZI CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED OFCOMMnTEE,ALSAND I.D.N CODE * QFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ❑IND 09/10/14 Committee to Elect Woodward 2012 ®❑OTIi 250.00 250.00 250.00 7241 Eagle Ridge Dr. Gilroy, CA 95020 ❑ PTY ❑SCC 9/24/14 California League of Conservative Voters IND ❑COM 100.00 100.00 100.00 PO Box 2079 ❑OTH San Jose, CA 95109 ❑ PTY ❑ SCC ❑IND - ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY - - - - ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY SCC SUBTOTAL$ 350:00 �} �s '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) Tvoe or print In Ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. 01/01/14 I • ' from 09/30!14 �C, through Page of NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 DATE ADDRESS ZIP FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (EET I.D.NUMBER) CODE * OF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) IND ®❑COD 06!05/14 Peter Burge Retired 75.00 75.00 75.00 735 Dawn Way ❑OTH Gilroy, CA 95020 ❑ PTY EI SCC 05/27/14 Constance Rogers E]COM Retired 50.00 50.00 50.00 7690 Santa Theresa Dr ❑OTH Gilroy, CA 95020 ❑ PTY ❑ SCC 08/02/14 Salvatore Bozzo W]IND ❑COM Retired 25.00 25.00 25.00 727 5th Street ❑ OTH Gilroy, CA 95020 ❑ PTY ❑ SCC 8/02/14 Daniel Likeness MIND ❑❑OTH Retired 50.00 50.00 50.00 3975 Glen Haven Rd. Soquel, CA 95073 ❑ PTY SCC 8/22/14 Brad Bannister MIND ❑❑CO Realtor 25.00 25.00 25.00 2425 Olea Ct. Coldwell Banker Gilroy, CA 95020 ❑ PTY p SCC a '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 SUBTOTAL $ 225.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULEA (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 01/01/14 FORM, 1 from 09/30/14 13 through Page of NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 DATE ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED -. OFCOMMIDRE,ALSAND I.D.N CODE * OF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ®❑COM 09/01/14 George Hinn Retired 50.00 50.00 50.00 750 Dawn Way ❑OTH Gilroy, CA 95020 ❑ PTY ❑SCC 09/03/14 Christine Flautt ®IND ❑COM Retired 50.00 50.00 50.00 5605 Mesa Rd. ❑ OTH Gilroy, CA 95020 ❑ PTY ❑ SCC 09/17/14 David Peoples ®COD GOTH Retired 99.00 99.00 99.00 1176 Hacienda Dr. Gilroy, CA 95020 ❑ PTY ❑ SCC 8/25/14 Marion Yoder MIND EICOM Retired 25.00 25.00 25.00 760 Dawn Way ❑OTH Gilroy, CA 95020 ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH El PTY ❑ SCC SUBTOTAL$ 224.00 - "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: 8661ASK -FPPC (8661275 -3772) SCHEDULEB -PART1 Schedule B —Part 1 rr "C �� "��" "' "'~ Amounts may be rounded statement covers period P � Loans Received to whole dollars. 01/01/2014 6 - • from !Page 09/30/2014 � of SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER , a OUTSTANDING (b) AMOUNT (c) AMOUNT PAID (d) OUTSTANDING a INTEREST f) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER OF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD O PERIOD LOAN TO DATE Tom Fischer Candidate ❑PAID CALENDARYEAR 745 Dawn Way $ $ 7.500.00 0 % $ 7500.00 $ 7500.00 ❑ FORGIVEN PERELECTION- Gilroy, CA 95020 RATE $ 7500.00 $ 08/28/14 $ 7500.00 $ $ DATE DUE DATE INCURRED tia IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR FORGIVEN PER ELECTION'* RATE DATE DUE DATEINCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PERELECTION** RATE DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 7500.00$ $ 7500.00 $ Schedule B Summary 1. Loans received this period ..................................................................................... ............................... $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid orforgiven,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.) 7500.00 3. Net period. (Subtract Line 2 from Line 1 this change . ................. ............................... NET $ 7500.00 P (Subtract Enter the net here and on the Summary Page, Column A, Line 2. (May beanegalive number) `Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. (Enter (e) on Schedde 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 C Type or print in ink SCHEDULE C Nonmoneta Contributions Received Amounts may of rounded rj/ to whole dollars. Statement covers pe_r1_o=i CALIFORNIA, 460' 01/01/14 FORM from 09/30/14 /14 18 through -- -- Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION DATE RECEIVED ZIP CODE OF CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE IF REQUIRED ( ) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) ®IND 07/17/14 Aaron Fischer ❑COM software engineer Domain 50.05 50.05 50.05 1187 Carla Ct. ❑OTH Calyx Software registration San Jose, CA 95120 ❑ PTY services ❑SCC ❑ IND ❑COM ❑ OTH PTY ❑ SCC ❑IND ❑COM OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.) ...................................................................................... ............................... $ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ..... ............................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ *Contributor Codes IND — Individual 50.05 COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) -- PTY — Political Party 50.05 SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Tom Fischer for City Council 2014 Type or print In ink Amounts may be rounded to whole dollars. Statement covers period from 01/01/2014 through 09/30/2014 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 16 of I.D. NUMBER 1366034 E CMP 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 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) The Printing Spot 501 First St. Gilroy, CA 95020 Staples 8840 San Ysidro Ave. Gilroy, CA 95020 City of Gilroy Gilroy, CA 95020 NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Printing of envelopes 192.49 Stationery, toner 121.72 Ballot statement 950.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1264.21 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ....................... $ 11225.11 2. Unitemized payments made this period of under $100 ... ............................... 211.00 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 $ 11436.11 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule E CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Articulate Solutions SCHEDULE E (CONT.) Statement covers period CALIFORNIA J •, !, Ty pe or print In ink. (Continuation Sheet) Amounts may be rounded Payments Made 4200.00 to whole dollars. from 01'/01'/2014 e' InfoPower Communications Placement of Ad in Gilroy Today through 09/30/2014 Page /7 of _ SEE INSTRUCTIONS ON REVERSE 250.00 Gilroy, CA 95020 NAME OF FILER Pacific Printing Coroplast signs and yard signs I.D. NUMBER Tom Fischer for City Council 2014 1604.07 San Jose, CA 95112 1366034 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 WG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations FEr 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 Articulate Solutions Web Design 65 Fifth Street Website, logo, print ad, postcards 4200.00 Gilroy, CA 95020 InfoPower Communications Placement of Ad in Gilroy Today 7446 Rosanna St 250.00 Gilroy, CA 95020 Pacific Printing Coroplast signs and yard signs 1002 South 2nd St. 1604.07 San Jose, CA 95112 PAR Global Resources, Inc. Print and mail voter postcard 2005 De La Cruz Blvd, #111 1587.00 Santa Clara, CA 95050 US Postmaster Postage for voter postcard 1963.00 Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 9604.07 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule E CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID SCHEDULE E (CONY.) Statementcovers period CALIFORNIA Type or print In ink. (Continuation Sheet) Amounts may be rounded Payments Made to whole dollars. from 01 /01 /2014 a • through 09/30/2014 Page 18 of /18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Tom Fischer for City Council 2014 1366034 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphemalialmisc. 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 WD 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 Lrr 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 Political Data, Inc. PO Box 59570 Norwalk, CA 90652 Mail file for City of Gilroy 250.00 The Home Depot 8850 San Ysidro Ave Gilroy, CA 95020 Posts and related materials for mounting signs 106.83 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 356.83 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)