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Home My WebLink AboutHoward Miller - Form 460 - Termination StatementRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period 10/21/12 from 11/12/12 through 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 Q Sponsored 0 Small Contributor Committee 0 Political Party /Central Committee 3. Committee Information 4. ❑ Ballot Measure Committee Q Primarily Formed Q Controlled O Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1349058 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Howard Miller to Saratoga City Council 2012 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 OPTIONAL: FAX / E -MAIL ADDRESS COVER PAGE Date Stamp Date of election if applicabl Page 1 of 6 (Month, Day, Year) NOV 13 2012 g For Official Use Only 11/06/12 y 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ❑ Semi - annual Statement ❑ Special Odd -Year Report ® Termination Statement ❑ Supplemental Preelection ❑ Amendment (Explain below) Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Sandy Miller 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 Verification have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 11 -12 -12 _ A l . Executed on Date 11 -12 -12 Executed on Date Executed on Date By By By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on BY FPPC Form 460 (June/01) Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Toll -Free Helpline: 866/ASK-FPPC 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 Howard Miller OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Saratoga City Council 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? Q YES Q 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? C) YES Q NO COMM ITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 6. Ballot Measure Committee NAME OF BALLOTMEASURE COVER PAGE - PART 2 2 6 Page of BALLOT NO. OR LETTER JURISDICTION 0 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 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 8 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT Q OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD } SUPPORT {j,_{,1 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD �y SUPPORT (8 OPPOSE Attach continuation sheets if necessary FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Campaign Disclosure Statement Type or print in ink. To calculate Column B, add SUMMARY PAGE 24.90 81.69 6. Payments Made ........................ ............................... Schedule E, Line 4 $ Amounts may be rounded Statement covers period - Summary Page 7. Loans Made .............................. ............................... to whole dollars. the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if 0.00 10/21/12 -r60 24.90 81.69 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ from FORM 0.00 0.00 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 11/12/12 3 6 0.00 0.00 through Schedule C, Line 3 Page of SEE INSTRUCTIONS ON REVERSE 24.90 81.69 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ NAME OF FILER I.D. NUMBER Committee to Elect Howard Miller to Saratoqa City Council 2012 1349058 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR Running in Both the State Prima and 9 Primary (FROM ATTACHED SCHEDULES) TOTALTODATE 56.69 81.69 General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ $ - 5000.00 0.60 1/1 through 6/30 7/1 to Date 2. Loans Received ....................... ............................... Schedule e, Line 3 56.69 81.69 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ $ Received $ $ 0.00 0.00 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 21. Expenditures - 4943. 31 81.69 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED .• ....• •••••...••••••••...• Add Lines 3 +4 $ $ Expenditures Made To calculate Column B, add - 4943.31 24.90 81.69 6. Payments Made ........................ ............................... Schedule E, Line 4 $ $ 0.00 figures that should be subtracted from previous 0.00 0.00 7. Loans Made .............................. ............................... Schedule H, Line 3 the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if 0.00 24.90 81.69 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ $ 0.00 0.00 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 0.00 0.00 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 24.90 81.69 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 a 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 e, 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 $ 4968.21 To calculate Column B, add - 4943.31 amounts in Column A to the corresponding amounts 0.00 from Column B of your last report. Some amounts in Column A may be negative 24.90 0.00 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 0.00 0.00 any). 0.00 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) /J $ `Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Crhnr111 1In A Type or print in ink. SCHEDULE A VVl .-. Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period • 10/21/12 from � 11/12/12 4 6 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Committee to Elect Howard Miller to Saratoga City Council 2012 1349058 DATE FULL NAME STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , 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 I.D. NUMBER) CODE * (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 11/9/12 Howard A. Miller QcoM Engineer, Apple Inc 56.69 81.69 Saratoga, CA 95070 (]OTH (] PTY SCC ()IND (]COM O OTH a PTY SCC (]IND a COM a OTH a PTY SCC (:)IND (:)COM Q OTH Q PTY C) SCC C)IND (:)COM () OTH a PTY d SCC SUBTOTAL$ 56.69 Schedule A Summary Amount received this period — contributions of $100 or more. (Include all Schedule A subtotals.) ........ ............................... 2. Amount received this period — unitemized 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.) . $ 56.69 .... $ TOTAL $ 0.00 56.69 *Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY -Political Party SCC - Small Contributor Committee FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC SCHEDULE B - PART 1 ' YPV �m N Schedule B — Part 1 Amounts be may be rounded Statement covers period CALIFORNIA to whole dollars. Loans Received 10/21/12 4 6 ' • ' $ from 5000.00 11/12/12 5 6 through Page of SEE INSTRUCTIONS ON REVERSE (May be a negative number) NAME OF FILER I.D. NUMBER Committee to Elect Howard Miller to Saratoga City Council 2012 1349058 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE (b) AMOUNT (c) AMOUNT PAID OUTSTANDING BALANCE AT (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER COMMITTEE, 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 CONTRIBUTIONS TO DATE (IF NAME OF BUSINESS) PERIOD THIS PERIOD* PERIOD Howard Miller Engineering Manager, ® PAID CALENDAR YEAR 13485 Holiday Drive Apple Inc 4943.31 $ 0.00 S 5000.00 0.00 $ Saratoga, CA 95070 % RATE $ ®FORGIVEN .* PER ELECT �ry -O 11 5000.00 0.00 56.69 0.00 07/19/12 $ $ $ $ $ DATE DUE DATE INCURRED t® IND ® COM 0 OTH 0 PTY 0 SCC PAID CALENDAR YEAR FORGIVEN PER ELECTION ** RATE DATE DUE DATE INCURRED tC) IND I) COM C) OTH 0 PTY 0 SCC PAID CALENDARYEAR FORGIVEN PER ELECTION ** RATE DATE DUE I DATE INCURRED to IND ® COM 0 OTH ® PTY 0 SCC SUBTOTALS $ 0.00 $ 5000.00 $ 0.00 $ 0.00 Schedule B Summary 1. Loans received this period ................ ............................... (Total Column (b) plus unitemized loans 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. t Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee *Amounts forgiven or paid by another party also must be reported on Schedule A. '* If required. FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC (Enter (e)on Schedule E, Line 3) 0.00 $ 5000.00 $ - 5000.00 NET $ (May be a negative number) t Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee *Amounts forgiven or paid by another party also must be reported on Schedule A. '* If required. FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER Committee to Elect Howard Miller to Saratoga City Council 2012 Statement covers period 10/21/12 from through 11/12/12 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment SCHEDULEE 6 6 Page of I.D. NUMBER 1349058 CMP campaign paraphernalia /misc. MBR member communications RAID 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 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 0.00 Schedule E Summary 0.00 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ................................................................... ............................... $ 24.90 2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 0.00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ................................................ ............................... $ 24.90 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC