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Home My WebLink AboutTom Fischer - Form 460 - 2016/07/01 - 2016/09/24Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1/16 through 9/24/16 1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall 0 Controlled (Nso carrplete Part 6) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party /Central Committee (Also Complete Part 1) 3. Committee Information I.D. NUMBER 1366034 Tom Fischer for City Council 2016 STREET ADDRESS (NO P.O. BOX) 745 Dawn Way CITY STATE ZIP CODE AREACODE/PHONE Gilroy CA 95020 408 - 847 -4716 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE /PHONE OPTIONAL FAX/ E -MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my certify under penalty of perjury under the laws of the State of California that the foregoing or By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan /2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 6. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Tom Fischer OFFICE SOUGHT ORHELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member, City of Gilroy RESID NTALIBUSINESSADDRESS (NO.ANDSTREET) CITY STATE ZIP 745 Dawn Way Gilroy, CA 95020 Related Committees Not Included In this Statement: List any committees not Included In'i thls statement drat are controlled by you: or are prlmedly formed to receive conblbudons or make expenditures on behalf of your candidacy. CITY STATE ZJP CODE AREA COD PHONE COMMITTEE NAME I I.D. NUMBER Col; ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2- of 13 6. Primarily Formed Ballot Measure Committee ME 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 DISTRICT NO. IF ANY 7. Primarily Formed Candidate /Officeholder Committee List names or otflceholder(s) or candidates) Ior which this committee ls; 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 irnecessery FPPC Form 460 (Jan /2016) FPPC Advice: advice@fppc.ce.pv (866/275 -3772) www.fppc.ca.gov Cam al n Disclosure Statement Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers period e 'Summery Page 7/1116 a ' ;s, �� from SEE INSTRUCTIONS WREVERSE through 9/24/16 page 3 or 43 NAME OF FILER LD. NUMBER Tom Fischer 1366034 Contributions Received 1. Monetary Contributions .................... ............................... Schedule A. Une3 2. Loans Received ................................. ............................... schedule B, Une 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Unes 1 +2 4. Nonmonetary Contributions ............. ............................... schedule C, Une 3 5. TOTAL CONTRIBUTIONS RECEIVED .............. .....................AddUnes3 +4 Expenditures Made 6. Payments Made ................................. ............................... Schedule E, Une 4 7. Loans Made ........................................ ............................... Schedule H, Une 9 8. SUBTOTAL CASH PAYMENTS ........... ............................... Add Unes a +7 9. Accrued Expenses.(Unpaid Bills) ................... .......................schedule F Une 3 10. Nonmonstary Adjustment .......................... ............................... Schedule C, Une 3 11. TOTAL EXPENDITURES MADE ......... ............................... Add ones 8 +9 + 10 Current Cash. Statement 12. Beginning Cash Balance ............................ Prev/ous summery Page, Une 16 13. Cash Receipts ........................................................... Column A, Une 3 above 14. Miscellaneous Increases to Cash ... ............................... Schedule 1, Une 4 15. Cash Payments .......................... ............................... Column A, Une 8 above 16. ENDING CASH BALANCE ..................Add ones 12 + 13+ 14, then Subtract Une 15 If this is a termination statement, Une 16 must be zero. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) $ 7,255:00 $ 7,255.00 144.92 $ 7399.92 Column B CALEHDARYEAR TOTAL TO DATE $ 7,255.00 $ 7,255.00 144.92 $ 7,399.92 $ 1.285.17 $ 1,335.17 $ 1285,17 $ 1,335.17 $ 1,285,17 $ 1,485.95 7,255.00 1,285.17 $ 7455.78 17. LOAN GUARANTEES RECEIVED . ............................... Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................. ............................... see insduodlons on reverse $ 19. Outstanding Debts .............................. Add Una 2 +Une a in Column.B above $ $ 1,335.17 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). Calendar Year Summary for Candidates Running In Both the State Primary and General Elections 1/1 through 8/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* IN sublect to Voluntary Emondibae Ume) 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 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866 /275 -3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statementcovers;perlod e from 7/1/16 through 9/24/18 Pees 4 of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER L0. NUMBER Tom Fischer 1366034 DATE FUEL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR C CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED LSO ENTER (IF COMMITTEE, A NUMBER) CODE * (IF SELF-EMPLOYED; ENTER NAME PERIOD (JAN.1- DEC. 31) (IF REQUIRED) OF BUSINESS) � IND 8/10/16 Carolyn To nett/ y g ❑ COM Retired 600.00 600.00 600.00 ❑ OTH Gilroy,CA 95020 ❑ PTY ❑ scc IND 8/11/16 g ers Constance Rogers El COM Retired 100.00 100.00 100.00 ❑ OTH Gilroy, CA 95020 ❑ PTY ❑ scc is IND 8/11'/18 Frances Olson ❑ CoM Retired 250.00 250.00 250.00 ❑ OTH Morgan Hill, CA 95037 ❑ PTY ❑ SCC ® IND 8/15/16 Gall Williams C1 COM Self Employed 750.00 750:00 750.00 Mesas OTH Williams Dental Labs Gilroy, CA 95020 ❑ PTY ❑ SCC 8!15/16 Jake Williams ® IND ❑ COM Self Employed 250.00 250.00 250.00 [-].OTH Williams Dental Labs Gilroy, CA 95020 ❑ PTY ❑ scc SUBTOTAL $ 1950.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ...................... .. ..............................$ 7,255.00 2. Amount received this period — unitemized monetary contributions of less than $100 ................. ......$ 0.00 3. Total monetary contributions received'this period. 7,255.00 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ......................TOTAL $ "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 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary Contributions Received to whoWdollars. Statement oovere period CALIFORNIA from 7/1/16 FORM through 9/24'/1:6 Page 5 of 13 NAME OF FILER I.D. NUMBER Tom Fischer 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OF SELFAMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Carol Wagner p IND Retired 8/29/16 [I OTH 750.00 750.00 750.00 Paso Robles, CA 93446 ❑ PTY ❑.SCC 8/29/16 B & S Construction ❑ IND 100.00 100.00 100.00 ®'Co Gilroy, CA 95020 ❑'PTY ❑ SCc John Filice ® IND ❑'CoM Self Employed 8/29/16 OTH Glen Loma Corp. 100.00 100.00 100.00 La, Selva, CA ❑ PTY ❑ SCC p IND 8/29/16 David Lima ❑,COM ❑.OTH Retired 250.00 250.00 250.00 Gilroy, CA 95020 ❑ PTY ❑ SCC Glen Bollenbacher ® IND El CoM Retired 8/29/16 [I OTH 500.00 500.00 500.00 Santa Clara, CA 95050 ❑ PTY ❑ SCC SUBTOTAL $ 1700.00 *Contributor Codes IND — Individual COM - Recipient'Committee (other than PTY or SCC) OTH — Other (e:g., business entity) PTY — Political Party SCC — Small Contributor Committe FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.w.gov (866/275 -3772) www.fppc.lca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period . - from 7/1/16 through 9/24/16. Page 6 of 13 NAME OF FILER t . NUMBER Tom Fischer '13066034 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR'YEAR PER ELECTION TO DATE RECEIVED ' (IF COMMITTEE, OF SELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1- DEC. 31) (IF REQUIRED) OF BUBINESM IND 912/16 Peter Burge p COM ❑ OTH Retired 80.00 80.00 80.00 Gilroy, CA 95020 ❑ PTY ❑ SCC 9/2116 Tim Filice ® IND CO O Executive Glen Loma Corp. 300.00 300.00 300.00 Gilroy; CA 95020 ❑ PTY ❑ SCc 9/2/16 Ruggeri- Jensen -Azar & Associates ❑ IND CTH 250.00 250.00 250.00 ® O Gilroy, CA 95020 ❑ PTY ❑scC V IND 9/4/16 Jim Fischer O OM Retired 500.00 500.00 500.00 Brentwood; CA 94513 ❑ PTY ❑ SCC 9/6/16 Christine Flaut IND ®,, ❑ COM Retired 50.00 50.00 50.00 ❑,OTH Gilroy, CA.95020 EI PTY ❑ SCC SUBTOTAL $ 1180.00 = *Contributor Codes IND — Individual COM — Recipient Committee (other than, PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committe FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary Contributions Received to whole,dollars. Statement covers period • ie' �' from 7/1/16 • through 9/24/16 Page 7 of 13 NAME OF FILER LD. NUMBER Tom Fischer 1366034 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR OF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF SELF - EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1- DEC. 31) (IF REQUIRED) ®IND IND Celia McCormack ❑ Teacher 917!16 ❑ OTH Gilroy Unified School 100.00 100:00 100.00 Gilroy, CA 95020 ❑.PTY District O SCC 9/8/16 David Peoples ® IND QCOM Self Employed 100.00 100.00 100.00 Garlic City ercantile ty Gilroy, CA 95020 p PTY ❑ SCC Tom and Fran Chadwick ®'IND ❑ coM Retired 9/10/16 ❑ OTH 125.00 125.00 125.00 Nipomo, CA 93444 ❑:PTY ❑ SCC Marian Yoder OIND Retired 9/15/16 o OTH 50.00 50.00 50.00 Gilroy, CA 95020 ❑PTY ❑ SCC Jim Kishimura ® IND Retired 9/16/16 ❑ OTH Gilroy, CA 95020 ❑ PTY ❑ SCC SUBTOTAL $ 475.00 *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 450 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. statement covers period e . • '� from 7/1/16 through 9 /24/16 Page B of 13 NAME OF FILER LD. N UW Tom Fischer 1366034 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE OF ' OF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1- DEC. 31) (IF REQUIRED) OF BUSINESS) ® IND Chad Bollenbacher l COM plumber 9/16/16 ❑ OTH Silicon Valley Mechanical 250.00 250.00 250.00 Morgan Hill, CA 95037 ❑ PTY ❑ SCC 9/16/16 Al Pinhelro m IND ❑ COM OTH Broker Pinheiro Insurance 100.00 100.00 100.00 Gilroy, CA 95020 p ❑ SCC Fred and Nancy Fischer 0IND El COM Retired 9/20/16 ❑ OTH 500.00 500.00 500.00 Aptos, CA 95003 ❑ PTY ❑ SICc ❑ IND California League of Conservation Voters R COM 9/21 /16 ❑ OTH 500.00 500.00 500.00 San Jose, CA 95109 ❑ PTY ❑ SCC Brookfield Norcal Builders Inc. ❑ IND ❑CoM 9/21/16 ® OTH 250:00 250.00 250.00 Danville, CA 94526 ❑ PTY ❑ SCC SUBTOTAL $ 1600.00 *Contributor Codes IND — Individual COM — Recipient Committee (other then PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan /2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary Contributions Received to Where dollars. Statement covers period from 7/1/16 q0f through 9/24/16 __ Pag113 NAME OF FILER I.D. NUMBER Tom Fischer 1366034 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR T DDEE, ENTER NUMBER) CONTRIBUTOR * IF'AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF ALSO I.D. CODE OF SELF- EMPLOYED; ENTER NAME PERIOD (JAN. 1- DEC. 31) (IF REQUIRED) OF BUSINESS) ® IND Kai Lai ❑ CO Retired 9/24/16 OTH ❑ OTH 100.00 100.00 100.00 Gilroy, CA 95020 ❑ PTY ❑ SCC 9/24/16 Arcadia Development Co. ❑ IND CO 250.00 250.00 250.00 ® San Jose, CA 95150. ❑ PTY ❑ SCC ❑ IND Cl COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 350.00 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 ()an /2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Sin—#& — ha r—ndaA SCHEDULEB -'PART 1 Schedule — Part 1 to whole dollars. Statement covers period • I e Loans Received 7/1/16 •I from • SEEINSTRUCTIONS ON REVERSE through 9/24/16 paw 10 of 13 NAME OF FILER I.D. NUMBER Tom Fischer 4 1366034 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE AMOUNT a AMOUNT PAID OUTSTANDING BALANCEAT INTEREST ORIGINAL CUMULATIVE OF LENDER (IF COMMITTEE, ALSO EWER I.D. NUMBER) OF BELF•EMPLOYED, ENTER NAME OF BUSINESS) EN BE THIS RECEIVED THIS PERIOD OR FORGIVEN THIS. PERIOD CLOSE OF THIS PAID THIS PERIOD AMOUNT OF LOAN CONTRIBUTIONS TO DATE PERIOD PERIOD Tom Fischer Candidate ❑ PAID CALENDAR YEAR 745 Dawn Way $ s� � % $ 7500.00 a Gilroy, CA 95020 ❑ FORGIVEN RATE PER ELECTION" a 11000.00 a 8128114 t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC a a DATE INCURRED a DATE DUE ❑ PAID CALENDAR YEAR PER ELECTION" ❑ FORGIVEN RATE a a a a a DATE DUE t ❑ IND ❑ COM ❑ OTH ❑PTY ❑SCC DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION" t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC a a a 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. (May be a nnatlw number) (Enter (e) on Schedule E, Une 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 (Jan /2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule C Amounts may be rounded SCHEDULE C Nonmonetary Contributions Received to whole dollars. Statement covers period from 7/1/16 , ' through 9/24/16 Page 41, of 13 SEE IN_ ST_ RUCTIONS ON REVERSE LD. NUMBER Tom Fischer 1366034 < DATE FULL NAME, , CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT! FAIR MARKET CUMULATIVE TO PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * - OF SELF•EMKOM, ENTER NAME OF BUSINESS) dOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1- DEC 31) (IF REQUIRED) JZ IND 7/18116 Aaron Fischer ❑ Software Engineer Domain 144.92 144.92 144.92 1187 Carla Ct. C3 OTH Caylz 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 $ 144.92 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals .) ........................ .................... . .............................. ..............................$ 144.92 2. Amount received this period — unitemized nonmonetary contributions of less than $100 .... ..............................$ 0.00 36 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 $ 144.92 *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!(Jan /2016) FPPC Advice: advlce@fppc.ca.gov,(966 /275 -3772) www.fppc.ca.gov Schedule E Amounts may be rounded statement covers period ll to whole dollars. Payments Made from 7/1/16 KZJ Tom Fischer through 9/24/16 I Page 12 of 13 1366034 CODES: If one of the following codes accurately describes the payment, you may enter the code. OthervAse, describe the payment. CMP campaign parephemalia/misc. MBR member communications RAD radio airtime and productlorrcosts CNS campaign consultants MTG meetings and appearances RFD returned contributions CTS contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salarles CVC civic donations PET petition circulating TEL W. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundralsing events POL polling and survey research TRS stalf/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 professlonal 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 (G COMMITTEE. ALSO ENTER I.C. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID City of Gilroy Ballot Statement Gilroy, CA 95020. 900.00 The Printing Spot Printing of envelopes 501 First St. 168.57 Gilroy, CA 95020 Staples Offoce Supplies 8840 San Ysidro Ave. 169.60 Gilroy, CA 95020 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1238.17 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................... ............................... $ 1285.17 . ............ ............... 2. Unitemized payments made this period of under $100 ........................... $ 0.00 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 $ 0.00 1285.87 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866 /275 -3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Wade SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. from 7/1/16 through 9/24/16 SCHEDULE E (CONT.) Page 13 of 13 Tom Fischer 1 1366034 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign parephemalia/misc. MBR member communications RAD redlo airtime and productlamcosts IONS campaign consultents MT(3, 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 some candidate /sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaigm 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 Staples 8840 San Ysidro Ave. Gilroy, CA 95020 Postage StampsBallot Statement 47.00' ` Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 47.00 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov