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Home My WebLink AboutForm 460 Amended 1-1-11 to 6-30-11Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from January 1, 2011 through June 30, 2011 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 O Recall Q Controlled (A /so Complete Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also Complete Part 7) 3. Committee Information I I.D. NUMBER 1226215 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMIT Chuck Page for Saratoga City Council 2010 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX By 2. Type of Statement: CITY STATE ZIP CODE AREA CODE /PHONE Saratoga CA 95070 OPTIONAL: FAX / E -MAIL ADDRESS 4. Verification have used all reasonable diligence in preparing and reviewing this statement and to the best of my under penalty of perjury under the laws of the State of California that the foregoing is true and oWT,1 Executed on December 31, 2011 Date Executed on December 31, 2011 Date Executed on Date Executed on Date By By COVER PAGE Date Stamp 0 T M T 0 T T Date of election if applicable: FEB E 6 2012 L� Page ' of V (Month, Day, Year) For Official Use Only November 2, 2010 By m� 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi - annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ® Amendment (Explain below) Had amended my 2010 statements, corrected this to match the 12/31/2010 balance Treasurer(s) NAME OF TREASURER Chuck Page MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE Saratoga CA 95070 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS the information contained herein and in the attached schedules is true and complete. I certify or By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent pppC Form 460 (January/OS) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Type or print in ink. COVERPAGE -PART2 Recipient Committee CALIFORNIA Campaign Statement FORM 460 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. BOX) 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. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Page 2 of 6 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 candidates) 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 /ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. Statement covers period from . January 1, 2011 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE through June 30, 2011 Page 3 of 6 NAME OF FILER I.D. NUMBER Chuck Page for City Council 2010 1226215 AioD Column B Calendar Year Summary for Candidates Contributions Received TColumn g Primary Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTALTO DATE General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ 0.00 $ 0.00 - 3180.23 - 3180.23 1/1 through 6/30 7/1 to Date 2. Loans Received ....................... ............................... schedule e, Line 3 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ - 3180.23 $ - 3180.23 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ••••••• •••••............••• Add Lines 3 +4 $ - 3180.23 $ - 3180.23 Made $ $ Expenditures Made 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 82.48 $ 82.48 7. Loans Made .............................. ............................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 82.48 $ 82.48 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 $ 82.48 $ 82.48 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 13. Cash Receipts .................... ............................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15. Cash Payments ................... ............................... Column A, Line 8 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 B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line s in Column B above $ 5876.26 - 3180.23 230.00 82.48 2843.55 500.00 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* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) lJ $ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SCHEDULEB -PART1 Schedule B — Part 1 Amounts — may be rounded Statement covers period CALIFORNIA ' Loans Received to whole dollars. January 1, 2011 FORM from June 30, 2011 4 6 through page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Chuck Page for City Council 2010 1226215 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCC(FSELFOEMPLOYDED,ENTEOYER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OFT IS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAMEOFBUSID,EN ER PERIOD THIS PERIOD* p PERIOD LOAN TO DATE ® PAID CALENDARYEAR Chuck Page Salesman $ 3180.23 $ 500.00 0 500.00 $ 0.00 Republic Services ,° $ ❑ FORGIVEN PER ELECTION" Saratoga, CA 95070 RATE $ 3680.23 $ $ $ 8/5/2010 $ _ DATEDUE DATE INCURRED t IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION ** RATE $ $ $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PERELECTION** RATE DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ $ 3180.23 $ 500.00 $ (Enter (e) on Schedule B Summary Schedule E, Line 3) 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. 0.00 $ 3180.23 NET $ - 3180.23 (May be a negative number) 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 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Chuck Page for City Council 2010 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from January 1, 2011 through June 30, 2011 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 5 of 6 I.D. NUMBER 1226215 E CMP campaign paraphernalia /misc. MBR member communications RAI) 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 IND independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF7 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary SUBTOTAL $ 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 $ AMOUNT PAID 82.48 82.48 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SCHFDIILF I ................ YP�., I-- ... ...... Miscellaneous Increases to Cash Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. January 1, 2011 _ • from June 30, 2011 6 6 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Chuck Page for City Council 2010 1226215 DATE FULL NAMEAND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) City of Saratoga partial refund of filing fee - county determined 3/21/2010 13777 Fruitvale Ave that original fee was too high. 230.00 Saratoga, CA 95070 Attach additional information on appropriately labeled continuation sheets. Schedule I Summary 1. Itemized increases to cash this period .................................................................... ............................... 2. Unitemized increases to cash of under $100 this period ......................................... ............................... 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ............ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ........................................................................................ ............................... $ $ $ TOTAL $ SUBTOTAL $ 230.00 230.00 230.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)