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Home My WebLink AboutTom Fischer - Form 460 - 20170701 - 20171231Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1/17 through 12/31/17 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 0 Recall O Controlled (Also Complete Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored 0 Small Contributor Committee 0 Political Party /Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I I.D. NUMBER 1366034 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Tom Fischer for City Council 2018 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E -MAIL ADDRESS Date of election if appli (Month, Day, Year) : _ -. RECErvEO► _" A 10 2016 City CIERISS OM' 61lROY, CA� 2. Type of Statement: ❑ Preelection Statement ICJ Semi- annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE 1 of 5 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Tom Fischer MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS 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 Officer of Sponsor Executed on By Date Signature of Controlling eholder, Candidate, State Measure Proponent Executed on By Date 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 RESIDENTIAUBUSINESS 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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (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 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COVER PAGE - PART 2 a .1 Page 2 of 5 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 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 Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded to whole dollars. Summary Page Statement covers period from 7/1/17 SUMMARY PAGE Expenditures Made through 12/31/17 Page 3 of 5 SEE INSTRUCTIONS ON REVERSE 7. Loans Made ........................................ ............................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ........... ............................... Add Lines 6 + 7 $ NAME OF FILER $ 9. Accrued Expenses (Unpaid Bills) ........... ............................... Schedule F Line 3 I.D. NUMBER Tom Fischer 11. TOTAL EXPENDITURES MADE ......... ............................... Add Lines s + 9 + 10 1366034 Contributions Received $ 0.00 Column A TOTAL THIS Column B Calendar Year Summary for Candidates 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and 13. Cash Receipts Column A, Line 3 above 0.00 add amounts in Column General Elections 1. Monetary Contributions .................... ............................... schedule A, Linea $ 0.00 $ 14. Miscellaneous Increases to Cash ... ............................... Schedule /, Line 4 amounts from Column B 15. Cash Payments .......................... ............................... Column A, Line s above 1/1 through 6/30 7/1 to Date 2. Loans Received ................................. ............................... Schedule a, Line 3 amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 0.00 be negative figures that 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines I +2 $ $ If this is a termination statement, Line 16 must be zero. Received $ $ 4. Nonmonetary Contributions ............. ............................... Schedule C, Line 3 144.92 144.92 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........ ............................Add Lines 3 + 4 $ 0.00 $ 144.92 Made $ $ Expenditures Made 6. Payments Made ................................. ............................... Schedule E, Line 4 $ 00.00 $ 0.00 7. Loans Made ........................................ ............................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ........... ............................... Add Lines 6 + 7 $ 0.00 $ 9. Accrued Expenses (Unpaid Bills) ........... ............................... Schedule F Line 3 10. Nonmonetary Adjustment .......................... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ......... ............................... Add Lines s + 9 + 10 $ 0.00 $ 0.00 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 1100.06 To calculate Column B, 13. Cash Receipts Column A, Line 3 above 0.00 add amounts in Column A to the corresponding 14. Miscellaneous Increases to Cash ... ............................... Schedule /, Line 4 amounts from Column B 15. Cash Payments .......................... ............................... Column A, Line s above 0.00 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 1,100.06 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED . ............................... Schedule s, Part 2 $ filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 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 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 SCHEDULE B - PART 1 Schedule B — Part 1 le � to whole dollars. Statement covers period p Loans Received imm from 7/1/17 SEE INSTRUCTIONS ON REVERSE through 12/31/17 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 a OUTSTANDING AMOUNT (c) AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL 9 CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF - EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD PERIOD * THIS PERIOD PERIOD PERIOD LOAN TO DATE Tom Fischer Candidate ❑ PAID CALENDAR YEAR $ $ 1,000.00 °,° $ 7500.00 $ PER ELECTION" Gilroy, CA 95020 ❑ FORGIVEN RATE $ 1,000.00 $ $ $ 8/28/14 $ t ❑ IND COM OTH ❑ PTY ❑ SCC ❑ ❑ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION" DATE DUE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ $ 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 $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ......................... ............................... Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. .....$ ..........$ NET $ (May be a negative 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 i r Schedule C Amounts may be rounded -A-11— SCHEDULE C L.- ...L...1.. lV WIIVIG UV1101A. Nonmonetary Contributions Received Statement covers period p from 7/1/17 • ' SEE INSTRUCTIONS ON REVERSE through 12/31/17 Page 5 of 5 NAME OF FILER I.D. NUMBER Tom Fischer 1366034 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT /. CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) (IF REQUIRED) IND Aaron Fischer El COM Software Engineer Domain 7/18/17 Calyx Software Registration 144.92 144.92 San Jose, CA 95120 ❑ pN Services ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ,,5 Y� — uLt`:'Y` :M•3S'a •,�,.,.f- SUBTOTAL ..a,,.:Fn:> Attach additional information on appropriately labeled continuation sheets. µt 144.92 ;:.�,..r.:.,:::n :. �•.:•: i1` �>'+. �C,' i�r.;. i:.' � ;ii::.::::�3.:.>?.,�'.�'- ..:',v 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 $ 144.92 1 11 144.92 *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: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov