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Home My WebLink AboutForm 460 7-1-11 to 12-31-11 (2)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE from Type or print in ink. Statement covers period I Date of election if applicable: July 1, 2011 (Month, Day, Year) through December 31, 2011 I November 2, 2010 1. Type of Recipient Committee: All committees — complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee Q State Candidate Election Committee Q Recall (Also Complete Part 5) ❑ General Purpose Committee 0 Sponsored Q Small Contributor Committee O Political Party /Central Committee ❑ Primarily Formed Ballot Measure Committee () Controlled (D Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I I.D. NUMBER 1226215 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Chuck Page for Saratoga City Council 2010 STREET ADDRESS (NO P.O. BOX) Date Stamp FEB 6 2012 ByQ�'craR !✓Uww 2. Type of Statement: ❑ Preelection Statement 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 ❑ Supplemental Preelection Statement -Attach Form 495 Treasurer(s) NAME OF TREASURER Chuck Page MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE Saratoga CA 95070 CITY STATE ZIP CCDE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY Saratoga CA 95070 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CCDE OPTIONAL: FAX / E -MAIL ADDRESS 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 know) 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 Californila that the foregoing is true aqa- celrr(,et. Executed on December 31, 2011 Date Executed on December 31, 2011 Date Executed on Date Executed on Date By By or By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Chuck Page OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Council Member, City of Saratoga, CA RESIDENTIAL /BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Saratoga CA 95070 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 STREETADDRESS (NO P.O. BOY) CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BO ;O CITY STATE ZIP CODE AREA CODE /PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page 2 of 5 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 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 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period • - 1 Summary Page to whole dollars. • ' July 1, 2011 from• December 31, 2011 page 3 of 5 through SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Chuck Page for Saratoga City Council 2010 1226215 ColumnA Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDAR YEAR Running n Both the State Prima and g Primary (FROMATTACHEDSCHEDULES) TOTALTO DATE General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ 0.00 $ 0.00 1/1 through 6/30 7/1 to Date - 500.00 - 3680.23 2. Loans Received ....................... ............................... Schedule s, Line 3 - 500.00 $ - 3680.23 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 $ - 500.00 $ - 3680.23 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 1262.51 $ 1344.99 Candidates 7. Loans Made .............................. ............................... Schedule H, Line 3 22. Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS .. ............................... Add Lines 6+ 7 $ 1262.51 $ 1344.99 (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 Date of Election Total to Date (mm /dd /yy) 10. Nonmonetary Adjustment ........... ............................... schedule C, Line 3 11. TOTAL EXPENDITURES MADE . ............................... Aad Lines 6 + s + 10 $ 1262.51 $ 1344.99 J $ -J $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 2843. 55 To calculate Column B, add 13. Cash Receipts .................... ............................... Column A, Line 3 above -500.00 amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash ........................... schedule I, Line 4 from Column B of your last reported in Column B. 1262. 51 report. Some amounts in 15. Cash Payments ................... ............................... column A, Line 8 above Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1581.04 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 any) Lines 2, 7, and 9 (if. Cash Equivalents and Outstanding Debt: 18. Cash Equivalents ......... ............................... See instr;ictions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column a above $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SCHEDULE B - PART 1 type or print In InK. Schedule B — Part 1 Amounts may be rounded Statement covers period i CALIFORNIA I ' Loans Received to whole dollars. July 1, 2011 .. • from December 31,206 Page 4 of 5 through SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER Chuck Page for Saratoga City Council 2010 1226215 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE AMOUNT (c) AMOUNTPAID OUTSTANDING BALANCEAT a INTEREST ORIGINAL (9) CUMULATIVE CONTRIBUTIONS OF LENDER ALSO ENTER I.D. NUMBER) (IF SELF- EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN CLOSE OF THIS PAID THIS PERIOD AMOUNT OF LOAN TO DATE (IFCOMMITTEE, NAME:OFBUSINESS) PERIOD D THIS PERIOD' pE Z PAID CALENDAR YEAR Chuck Page Mayor $ 500.00 $ 0.00 0 500.00 $ 0.00 City of Saratoga , $ ❑ FORGIVEN PER ELECTION"* Saratoga, CA 95070 RATE $ 500.00 $ $ $ 8/5/2010 $ DATE DUE DATE INCURRED t5Z IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION ** RATE DATE DUE DATE INCURRED to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION- RATE $ $ $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ $ 500.00 $ 0.00 $ 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. (Enter (e) on Schedule E, Line 3) $ 0.00 If tContributor Codes 500.00 ..................... NET $ - 500.00 (May be a negative number) 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 (January105) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Chuck Page for Saratoga City Council 2010 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from July 1, 2011 through December 31, 206 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 5 of 5 I.D. NUMBER 1226215 CMP campaign paraphernalia /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 ND 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) NAME AND ADDRESS OF PAYEE ( IFCOMMITrEE , ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Bell Tower Bistro Saratoga -Los Gatos Blvd Saratoga, CA 95070 FND mayoral inauguration fund raiser 1262.51 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary SUBTOTAL $ 1262.51 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 $ 1262.51 1262.51 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772)