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Home My WebLink AboutJan. -june 2011 Form 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period Date of election if applicable from January 1, 2011 (Month, Day, Year) through June 30, 2011 November 2, 2010 Date Stamp RECEIVED AUG 2 2011 C11 o �r ah A TOGA COVER PAGE Page 1 of 7 For Official Use Only 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 2. Type of Statement: ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Committee AREA CODE /PHONE Semi - annual Statement ❑ Special Odd -Year Report Q Recall Q Controlled MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX ❑ Termination Statement ❑ Supplemental Preelection (Also Complete Part 5) O Sponsored (Also file a Form 410 Termination) Statement - Attach Form 495 F-1 General Purpose Committee (Also Complete Part 6) Saratoga ❑ Amendment (Explain below) 95070 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 COMMITTEE) Chuck Page for City Council 2010 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Saratoga CA 95070 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE Saratoga CA 95070 OPTIONAL: FAX / E -MAIL ADDRESS 4. Verification 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 I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledg�tl�e 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 California that the foregoing is true and corrP , r 1 Executed on July 30, 2011 Date Executed on July 30, 2011 Date Executed on Date Executed on Date By By 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 (8661275 -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 RESIDENTIAUBUSINESS 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 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 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page 2 of 7 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 candidates) for which this committee is primarily formed. COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary 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 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -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 Expenditures Made 6. Payments Made ........................ ............................... Schedule e, Line 4 $ through June 30, 2011 Page 3 of 7 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 $ NAME OF FILER I.D. NUMBER Chuck Page for City Council 2010 1226215 ColumnA Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDAR YEAR g Primary Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTALTODATE General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ 449.00 $ 449.00 - 3180.23 1/1 through 6/30 7/1 to Date 2. Loans Received ....................... ............................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ - 2731.23 $ 449.00 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ - 2731.23 $ 449.00 Made $ $ Expenditures Made 6. Payments Made ........................ ............................... Schedule e, Line 4 $ 7. Loans Made .............................. ............................... Schedule rl, Line 3 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 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 $ 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. 82.48 $ 82.48 $ 82.48 $ 5427.26 - 2731.23 230.00 2926.03 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ I Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line gin Column B above $ 82.48 82.48 82.48 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) "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) SrhP[il lIP_ A Type or print in ink. SCHEDULE A -- —" Amounts may be rounded Monetary Contributions Received to Whole dollars. Statement covers period • - ' January 1, 2011 from June 30, 2011 4 71a through of SEE INSTRUCTIONS ON REVERSE NAME OF FILER ER Chuck Page for City Council 2010 1226215 DATE R ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR EET A 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 .D.N CODE * (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ❑IND [:]COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY []SCC ❑IND ❑ COM ❑ OTH ❑ PTY [:]SCC SUBTOTAL$ Schedule A Summary Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ......................................................................... ............................... $ 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. (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) 449 OTH — Other (e.g., business entity) PTY— Political Party 449 SCC —Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SCHEDULEB -PART1 type or pnm rn urn. Schedule B — Part 1 Amounts may be rounded Statement covers period - Loans Received to Whole dollars. January 1, 2011 from F June 30, 2011 7 through 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 a OUTST ANDING UNT AMOUNT O ( W ) AMOUNT PAID ld) OUTSTANDING (a) INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IFSELF- EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAMEOFBUSINESS) PERIOD PERIOD THIS PERIOD" PERIOD LOAN TO DATE Z PAID CALENDARYEAR Chuck Page Salesman Republic Services $ 3180.23 $ 0 0 % $ 3180.23 $ 0 ❑ FORGIVEN PER ELECTION`* Saratoga, CA 95070 RATE $ 3180.23 $ $ $ 8/5/2010 $ DATE DUE DATE INCURRED %Z IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION*" RATE DATE DUE DATE INCURRED tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION*` RATE DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC 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.) 3180.23 3. Net ( change this period. Subtract Line 2 from Line 1.) ............................................................... NET $ -3180,23 Enter the net here and on the Summary Page, Column A, Line 2. (May be negative number) *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. (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 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule E Type or print in ink. Amounts may be rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Chuck Page for City Council 2010 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 6 of 7 I.D. NUMBER 1226215 CIVP campaign paraphernalia /misc. MBR member communications RAID radio airtime and production costs CNS campaign consultants MfG 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 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 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 $ 82.48 82.48 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SCHEDULEI Miscellaneous Increases to Cash Amounts may be rounded Statement covers period CALIFORNIA 460 to whole dollars. January 1, 2011 • ' from June 30, 2011 7 7 through page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Chuck Page for City Council 2010 1226215 DATE FULL NAME AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) City of Saratoga refund of filing fee - county determined that 3/21/2011 13777 Fruitvale Ave original fee was too high 230.00 Saratoga, CA 95070 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 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 $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) 230.00 230.00