HomeMy WebLinkAboutFitzsimmons -1st pre-election 460Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 7/l/2020
through 9/19/2020
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4.
Z officeholder, Candidate Controlled Committee
U State Candidate Election Committee
O Recall
(Also Complete Pal 5)
❑ Ueneral Purpose Committee
Sponsored
O Small Contributor Committee
O Political Party/Central Committee
3. Committee Information
Fitzsimmons for Saratoga Council 2020
❑ Primarily Formed Ballot Measure
Committee
8 Controlled
Sponsored
(Also Cwplete Part 6)
❑ Primarily Formed Candidate/
Officeholder Committee
(Aso Canptae Part n
I.D. NUMBER - r
O Alt
cl ts,' IY)t
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 CODEIPHONE
Saratoga
CA
95070
OPTIONAL: FAX / E-MAILADDRESS
COVER PAGE
RECEIVED
Date of election if applica e: 7 r t 'r1 r P e 1 of 7
(Month, Day, Year) S L P 2 4 2 f For Official Use Only
11/3/2020 GITY OF SARATO A
2. Type of Statement:
0 Preelection Statement ❑ Quarterly Statement
❑ Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Kathleen Fitzsimmons
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
Saratoga CA 95070
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
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 knowledg the information contained herein and in the attached schedules is true and complete. I
certify under penalty of pp/e/ ury un er the laws of the State of California that the
Sponsor
Executed on BY
Date Signature of Controlling Officeholder, Candidate, Stale Measure Proponent
Executed on By
Dale 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
Colleen "Kookie" Fitzsimmons
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Saratoga City Council
RESI DENTIAUBUSI NESS ADDRESS (NO.ANDSTREET) 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 AREACODE/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 AREACODE/PHONE
COVER PAGE - PART 2
Page 2 of 7
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
officeholders) 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
I 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 SUMMARY PAGE
to whole dollars. Statement covers period
from
Summary Page 7/1/2020 ONI'm
SEE INSTRUCTIONS ON REVERSE
through 9/19/2020
Page 3 of 7
NAME OF FILER
I.D. NUMBER
Fitzsimmons for Saratoga Council 2020
�i�plx wltron In Qa�eSS
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTAL THIS PERIOD
CALENDAR YEAR
(FROM ATTACHED SCHEDULES)
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions...................................................
schedule A, Line 3
$ 605.00
$ 605.00
5I00.00
5100.00
1/t through s/3o 7/t to Date
2. Loans Received................................................................
Schedule B, Line 3
570500
5705.00
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines t +2
$ .
$
Received $ $
4. Nonmonetary Contributions ............................................
schedule C, Line 3
0
0
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED................................Add
Lines 3+4
$ 5705.00
$ 5705.00
Made $ $
Expenditures Made
6. Payments Made................................................................ Schedule E, Line 4 $ 5560.00
7. Loans Made... ....................................................... ............ schedule H Line 3 0
8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 617 $ 5560.00
9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0
10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0
11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 5560.00
Current Cash Statement
12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 0
13. Cash Receipts........................................................... Column A, Line 3 above 5705.00
14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 0
15, Cash Payments......................................................... Column A, Line 8above 5560.00
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 145.00
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED, ............................... Schedule B, Part 2 $ 0
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ See instructions on reverse $
19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column B above $ 5100.00
$ 5560.00
0
$ 5560.00
0
0
$ 5560.00
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
(mmlddlyy)
$
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 A Amounts may be rounded SCHEDULE A
rowno(eoonars'
Monetary Contributions Received
Statement covers period
CALIFORNIA 460
from 7/1/2020
-
through 9/19/2020
Page 4 of 7
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
c�,pll�hti"t tr ��
FULL NAME, STREETADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
CONTRIBUTOR
CODE "
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF-EMPLOYED. ENTER NAME
PERIOD
(JAN.1-DEC. 31)
(IF REQUIRED)
® IND❑
8/26/2020
Steve Schirle
COM
Chief Councel
100.00
100.00
100.00
❑ OTH
PG&E
San Francisco, CA 94127
❑ PTY
❑ SCC
m IND
8/29/2020
Adrianna Cohen
El
n/a
100.00
100.00
100.00
❑ OTH
New York, NY 10028
❑ PTY
❑ SCC
® IND
9/8/2020
Cheriel Jensen
❑ COM
n/a
200.00
200.00
200.00
❑ OTH
Saratoga, CA 95070
❑ PTY
❑ SCC
® IND
9/18/2020
Ann Marie Burger
❑ COM
n/a
200.00
200.00
200.00
❑ OTH
San Jose, CaA95110
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$
Schedule A Summary
1. Amount received this period — itemized monetary contributions. 600.00
(Include all Schedule A subtotals.)............................................................... .......................................... $
2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 5'00
3. Total monetary contributions received this period. 605.00
(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)
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
SCHEDULE B - PART 1
hnwuma o—y uc...u. ,.
Schedule B — Part 1 to who Is dollars.
Statement covers period
CALIFORNIA
Loans Received
from 7/l/2020
FORM
through 9/19/2020
page 5 of 7
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Fitzsimmons for Saratoga Council 2020
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
°
OUTSTANDING
BALANCE
AMOUNT
RECEIVED THIS
c
AMOUNT PAID
OR FORGIVEN
OUTSTANDING
BALANCE AT
e
INTEREST
PAID THIS
ORIGINAL
AMOUNT OF
B
CUMULATIVE
CONTRIBUTIONS
OF LENDER
(IF SELF-EMPLOYED, ENTER
BEGINNING THIS
PERIOD
THIS PERIOD-
CLOSE OF THIS
PERIOD
LOAN
TO DATE
(IF COMMITTEOFLSO ENTER I.O. NUMBER)
NAME OF BUSINESS)
PERIOD
PERIOD
❑ PAID
CALENDAR YEAR
Colleen "Kookie" Fitzsimmons
Health Science Specialist
E
E 100.00
E 100.00
f 100.00
❑ FORGIVEN
PER ELECTION'*
Veterans Affairs
RATE
Saratoga, CA 95070
0
100.00
a
a
E
8/26/2020
f
s
DATE DUE
DATE INCURRED
t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
PAID
CALENDAR YEAR
Colleen "Kookie" Fitzsimmons
Health Science Specialist
y
f 5000.00
v
f 5000.00
E 5100.00
❑ FORGIVEN
PER ELECTION"
Veterans Affairs
EI--
RATE
Saratoga, CA 95070
0
E
f
9/19/2020
f
t® IND El COM El OTH El PTY El SCC
b
DUE
DATE INCURRED
PAID
El PAID
CALENDAR YEAR
E
E
%
E
f
❑ FORGIVEN
PER ELECTION "
RATE
E
E
E
E
f
DATE DUE
DATE INCURRED
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
SUBTOTALS $ 5100.00 $ $ 5100.00 $
Schedule B Summary
$ 5100.00
1. Loans received this period.............................................................................................................
(Total Column (b) plus unitemized loans of less than $100.) o
2. Loans paid or forgiven this period.........................................................................................................$
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.) 5100.00
3. Net change this period. (Subtract Line 2 from Line 1.).............................................................. NET $
Enter the net here and on the Summary Page, Column A, Line 2.
(May be a negative number)
`Amounts forgiven or paid by another party also must be reported on Schedule A.
" If required.
(Enter (a) 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
SCHEDULE E
Amounts may be rounded
Schedule E to whole dollars. Statement covers period CALIFORNIA 460
Payments Made from 7/1/2020 FORM
SEE INSTRUCTIONS ON REVERSE through 9/19/2020 Page 6 of 7
NAME OF FILER I.D. NUMBER
lit 6� +I
Fitzsimmons for Saratoga Council 2020 r^ V i
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalia/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/ballol 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 supportingtopposing 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 (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Colleen Fitzsimmons I FIL filing fees 13885.00
WIX.com WEB I website development 354.00
Tel Aviv, Israel
Victory Store I CMP yard signs I 1035.00
5200 30th Street SW, Davenport, IA 52802
. Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 5274.00
Schedule E Summary
5560.00
1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $
2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 0
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 0
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 5560.00
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule E
(Continuation Sheet)
Payments Made
Amounts may be rounded
to whole dollars.
from
tement covers
7/l/2020
SCHEDULE E (CONT)
through 9/19/2020
page 7 of 7
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D.,pNUMBER
RT\ 11G � trYl 1h VOU
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
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
IND independent expenditure supporting/opposing others (explain)`
POS postage, delivery and messenger services
TSF transfer between committees of the same candidatelsponsor
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
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Registrar of Voters
voter data file
129.00
1555 Berger Drive, Building 2, San Jose, CA 95112
Vistaprint
LIT
advertising cards
39.00
275 Wyman Street, Waltham, MA 02451
Office Depot
LIT
flyers
59.00
15166 Los Gatos, Blvd., Los Gatos, CA 95032
Saratoga Post Office
campaign PO Box
59.00
19630 Allendale Ave, Saratoga, CA 95070
Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 286.00
FPPC Form 460 (Jan 2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov