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Home My WebLink AboutTom Fischer - Form 460 - 20170101 - 20170630Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 1/1/17 through 6/30/17 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. m Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also CoMW@ Pat 5) 0 Sponsored (Also Coffplete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party /Central Committee (Also Corrplete Part 7) 3. Committee Information I.D. NUMBER 1366034 Tom Fischer for City Council 2018 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE Gilroy CA 95020 LING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/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 is tru am Executed on / - /1 a 17 By ✓. Executed on Date Executed on Date Executed on Date By COVER PAGE Date Stamp Date of election If applicable: jf� „ ,/ age 1 of 5 (Month, Day, Year), For Official Use Only �cT /fir 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement m Semi - annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Tom Fischer MAILINGADDRESS I STATE IP CODE AR COD N Gilroy CA 95020 NAME OF ASSISTANT TREASURER, IF ANY MAI ING DDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E-MAIL ADDRESS herein and in the attached schedules is true and complete. I or By Signature of Controlling Officeholder, Candidate, State Measure Proponent 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 5. 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 RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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. NAME OF TREASURER ID NUMBER ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME ID NUMBER STREETADDRESS (NO,P.O. BOX) ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE of 5 BALLOT NO. OR LETTER I JURISDICTION I ❑ SUPPORT ❑ OPPOSE IdentIN 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 ofticeholder(s)' or candidate(s) for which this committee /a 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 Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. Statement covers period from 1/1/17 SUMMARY PAGE Expenditures ,Made 6. Payments Made ................................ ............................... schedule t:, Line 4 $ 50.00 through 6/30/17 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 $ 50.00 NAME OF FILER I D. NUMBER Tom Fischer 1366034 Contributions Received TOTAL A THIS PERIOD Column B Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions .................. ............................... schedule A, Line 3 $ 0.00 $ 1/1 through 6/30 711 to Date 2. Loans Received ................................. ............................... schedule B, Line 3 0.00 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ............................. Add Lines 1 + 2 $ $ Received $ $ 4. Nonmonetary Contributions ............. ............................... schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ....... ............................Add Lines 3 +4 $ 0.00 $ Made $ $ Expenditures ,Made 6. Payments Made ................................ ............................... schedule t:, Line 4 $ 50.00 7. Loans Made ....................................... ............................... schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ......... ............................... Add Lines 6+ 7 $ 50.00 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 $ 50.00 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 1e $ 13. Cash Receipts ............................ ............................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ... ............................... schedule 1, Line 4 15. Cash Payments .......................... ............................... column A, Line s 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 A 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 $ 1150.06 0.00 50.00 1,100.06 $ 50.00 $ $ 50.00 To calculate Column B, add�amounls in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that shoul6be subtracted,from previous period amounts. If this Is the first reportibeing 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* (It Subject to voluntary Expenditure Limit) 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 (Jan /2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Arnnunfa rnav ha — unded SCHEDULE B - PART 1 5checiule 8 — Part 1 to w ..._' of ars. - -- to whole dollars. Statement covers period P � . �� O Loans Received 1/1/17 � from s SEE INSTRUCTIONS ON REVERSE through 6/30/17 Page 4 of 5 NAME OF FILER I.D. NUMBER Tom Fischer 1366034 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I D NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN BALANCE AT CLOPSEROOFDTHIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD THIS PERIOD' PERIOD LOAN TO DATE Tom Fischer Candidate ❑ PAID CALENDAR YEAR $ $ 1.000.00 % $ 7500.00 $ ❑ FORGIVEN PER ELECTION" Gilroy, CA 95020 RATE $ 1,000.00 a S S t ❑ IND ❑' COM E:1 OTH ❑ PTY ❑ SCC S DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR PER ELECTION~ ❑ FORGIVEN RATE t ❑ IND ❑ COM ❑ OTH ❑PTY ❑SCC S S S S S DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR S $ % i S ❑ FORGIVEN PER ELECTION" RATE t ❑ IND El COM El OTH [] PTY E] SCC S S $ S DATE INCURRED S DATE DUE SUBTOTALS $ $ $ $ Schedule B Summary 1. Loans received this period ...................................................................................... ..............................$ (Total Column (b) plus unitemized loans of less than $100.) Loanspaid or forgiven this period ........................................................................... ..............................$ (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. (SubtractiLine 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 nega0m 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 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule E Amounts may be rounded SCHEDULE E Statement covers period Schedule Made to is may be rounded • ° a e ,1 Payments from 1/1117 �' SEE INSTRUCTIONS ON REVERSE Tom Fischer CODES: If one of the following codes accurately describes the payment, you may enter the code. CMP campaign peraphemalla /misc. MBR member communlcations CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)• OFC office expenses CVC civic donations PET petition circulating FIL candidate filing /ballot fees PHO phone,banks FND fundralsing events POL polling and survey research IND Independent expenditure supporting /opposing others (explain)' POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I D NUMBER) Secretary of State 1500 11th St.'Rm. 495 Sacramento, CA 95814 CODE OR Annual Fee through 6/30/17 I Page 5 of 5 1366034 Otherwise, describe the payment. RAD radio airtime and production costs RFD returned contributions SAL campaign,workers' salaries TEL t.v, or cable,airtime and production, costs TRC candidate travel, lodging, and meals TRS staff /spouse travel, lodging, and meals TSF transfer between committees of the same candidate /sponsor VOT voter registration WEB Information technology costs (Internet, e-mail) DESCRIPTION OF PAYMENT I AMOUNT PAID 50.00 ' Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 50.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................. ............................... $ 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 $ 50.00 50.00 FPPC Form 460 (Jan /2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov