HomeMy WebLinkAboutTom Fischer - Form 460 - 2014/10/19 - 2014/10/28Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from 10/19/2014
through
10/28/2014
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)
O Sponsored
❑ General Purpose Committee
(At- Complete Part 6)
Q Sponsored
❑ Primarily Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
Q Political Party /Central Committee
(Also Complete Part 7)
3. Committee Information
I.o.^NUMBER
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
Y STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
Date Stamp
Date of election if applicable: ( ,01
{4
(Month, Day, Year) OCj\ �
iT( C1.E0K 10
11/04/2014 Ca1��r
2. Type of Statement:
® Preelection Statement
❑ Semi - annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
KeP1�7LCe7�
Page 1 of 5
For Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
Marie P Blankley
MAILING ADDRESS
2290 Coral Bell Ct.
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 correct.
Executed on 0 Aqllnz By
q i asurerYAss' antTrea surer
Executed on -�/ l By
Date sionature of Untroilft Officieliolder . candiddtal StafWeasure Proponent or Responsible Officer of Soonsor
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 (866/275 -3772)
State of California
Recipient Committee Type or print in Ink. COVERPAGE -PART 2
Campaign Statement CALIFORNIA
Cover Page — Part 2
S. Officeholder or Candidate Controlled Committee
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.
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 I CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Page 2 of 5
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I JURISDICTION I ❑ 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 Ust 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 Fonn 460 (January/06)
FPPC Toll -Free Helpline: 86WASK -FPPC (8661276 -1772)
State of Californla
Campaign Disclosure Statement Type or print in Ink
Summa Page Amounts may be rounded
r'j/ g to whole dollars.
Statement covers period
from 10/19/2014
SUMMARY PAGE
Expenditures Made
6. Payments Made ........................ ...............................
schedule E, Line 4 $ 0.00
through
10/28/2014
page 3 of 5
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 +10 $ 0.00
NAME OF FILER
I.D. NUMBER
Tom Fischer forlCity Council 2014
1366034
Contributions Received
Column A
Column B
Calendar Year Summary for Candidates
TOTALTHIS PERIOD
(FROMATTACHEDSCHEDULES)
CALENDAR YEAR
TOTALTO DATE
Running, in Both the State Primary and
General Elections
1. Monetary Contributions ............ ...............................
schedule A, Line 3
$ 2250.00 - $
11999.00
2. Loans Received ....................... ...............................
schedule e, Line 3
00
7500.- -
1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 +2
$ 2250.00 $
19499.00
20. Contributions
Received $ $
4. Nonmonetary Contribution ..... ...............................
s
schedule C, Line 3
50.05
21. Expenditures
5, TOTAL CONTRIBUTIONS RECEIVED ........................... Add u nes3 +4
2250.00
$ -- - - -- $
-- 19549.05
Made $ $
Expenditures Made
6. Payments Made ........................ ...............................
schedule E, Line 4 $ 0.00
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 +10 $ 0.00
Current Cash Statement
12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 5689.95
13. Cash Receipts ................................................... Column A, Line 3 above 2250:00
14. Miscellaneous Increases to Cash ........................... schedule 1, Line 4
15. Cash Payments ................... ............................... Column A, Line a above
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 7939:95
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES' RECEIVED ........................... schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ......... ............................... see instructions on reverse $
19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $
$ 11559.05
$ 11559.05
$
50.05
11609.10
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*
IN Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
n
I I -i $
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772)
Schedule A Type or print In Ink. SCHEDULE A
Moneta Contributions Received Amounts may be rounded
rY
- Statement covers period
CALIFORNIA
to whole dollars.
rD '
from 10/19/2014 FORM
10/28/2014 4 5
SEE INSTRUCTIONS ON REVERSE
through Page 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
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
pFCOMMnTEE;ALSNTERLD.NUMBER)
CODE*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
OF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
F IND
Yvonne I Fang g Liu
❑COM
Homemaker
250.00
250.00
10296 Virginia Swan PI.
❑OTH
Cupertino, CA 95014
❑ PTY
❑SCC
UJIND
10/20/14
Brent Wei -Teh Lee
❑COM
owner
250.00
250.00
24168 Congress Spring Rd.
❑OTH
Country Estates 4
Saratoga, CA 95070
❑ PTY
❑ SCC
®IND
10/20/14
Chester Spiering, Jr.
❑COM
owner
250.00
250.00
1235 Christobal Privada
❑OTH
Nor -Cal Land Entitlement
Mountain View, CA 94040
❑ PTY
❑SCC
®IND
- - -
10/24/14
Sophia Liu
807 Bounty Dr, Apt. 101
❑COM
❑OTH
Treasurer
Wanmei, Inc.
250.00
250:00
Foster City, CA 94404
E] PTY
pseC
Dennis Liu
®IND ❑COM
Owner
10/24/14
10377 Amistad Ct.
❑OTH
Wanmei, Inc:
250.00
250.00
Cupertino, CA 95014
❑ PTY
❑ SCC
- -
SUBTOTAL$ 125000
t .,
'I5G n p- e.a
C_
_
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include alUSchedule A subtotals.) ......................................................................... ............................... $
2. Amount received this period — unitemized monetary contributions of less than.$100 ............................. $
2250.00
3. Total monetary contributions received this period. 2250.00
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
*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
Schedule A (Continuation Sheet) Wpeor print In)nL SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
•
towholedollars.
10/19/2014
X00 w 1,
e •
from - -
10/28/2014
5 5
through
Page 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
OCCUPATIONAND:EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
QFCOMMnTEES SANDZII:D:NUMBER)
CODE *
OF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
6flEIIND
Hayes Shair
Manager
10/24/14
1150 Ripley St. Apt. 312
❑OTH
Wanmei, Inc.
250.00
250.00
Silver Spring, MD 20910
El PTY
❑SCC
Ruggeri- Jensen -Azar & Associates
❑IND
❑COM
10/27/14
8055 Camino Arroyo
®OTH
250:00
250.00
Gilroy, CA 95020
❑ PTY
❑SCC
Brookfield Norcal Builder Inc.
❑IND
10/27/14
500 La Gonda Way, Suite 100
®oTH
250.00
250.00
Danville, CA 94526
❑ PTY
❑ scc
Arcadia Companies, LLC
❑IND
❑COM
10/27/14
P:O: Box 5368
i,ZJATH
250.00
250.00
San Jose, CA 95150
❑PTY
❑ SCC
- - -
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 1000.00
21 ru
*Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH -Other (e.g., business entity)
PTY - Political Party
SCC - Smal[Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK -FPPC (8661275 -3772)