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Home My WebLink AboutKumar 2017 -460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE 1. Type of Recipient Committee: All Committees ® Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee Type or print In Ink. Statement covers period 7/1/2017 from 12/31/2017 through — Complete Parts 1, 2, 3, and 4. ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Pert e) Primarily Formed Candidate/ Officeholder Committee (Also Complete Pert 7) Date of election If appl (Month, Day, Year) COVER PAGE CALIFORNIA 460 FORM v fj 1 2018 OF SARATOGA Page 1 of For Official Use Only 2. Type of Statement: ❑ Preelection Statement ✓ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 3. Committee Information .D. NUMBER 1364692 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) KUMAR FOR COUNCIL 2014 STREET ADDRESS (NO P.O. BOX) CITY SARATOGA STATE ZIP CODE CA 95070 AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE SARATOGA CA 95070 OPTIONAL FAX / E-MAIL ADDRESS AREA CODEIPHONE Treasurer(s) NAME OF TREASURER Sunil Sabat MAILING ADDRESS CITY SARATOGA STATE ZIP CODE CA 95070 AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/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 knowledge 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 oCaliforp is that the foregoing is true and correct. Date 12oT7 )' 3 Executed on Executed on Executed an Executed on Deb Dab Dab By no re of Treasurer orAssleuntTreaturer Signature of Controlling Offi holder, Candidate. State Measure Proponent or Responsible Officer of Sponsor By By Signature of Controlling Officeholder. Candidete, State Measure Proponent By Signature of Controlling Officeho der. Candidate, Stab Measure Proponent FPPC Form 460 (January/05) FPPC Toil -Free Helpline; 888/ASK-FPPC (8881275.3772) State of California Recipient Committee Campaign Statement Cover Page — Part 2 Type or print In Ink. COVER PAGE - PART 2 CALIFORNIA w `+0 FORM �F V 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE RISHI KUMAR 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? ❑ 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? E YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 6. Primarily Formed Ballot Measure Committee Page 2 of 131 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 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 D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets /f necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 888/ASK-FPPC (868/275.3772) State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Amounts may be rounded to whole dollars. NAME OF FILER KUMAR FOR COUNCIL 2014 Statement overs period from /1/2017 through / 243 SUMMARY PAGE CALIFORNIA 460 FORM Contributions Received 1. Monetary Contributions Schedule A, Line 3 $ 2. Loans Received Schedule 8, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines l + 2 $ 4. Nonmonetary Contributions Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ Column A TOTALTHIS PERIOD (FROMATTACHED SCHEDULES) 9102 1000 10,102 879 10,981 $ $ Column B CALENDAR YEAR TOTALTODATE 9102 4000 10,102 879 10,981 Page 3 of I.D. NUMBER 1364692 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contributions Received $ 21. Expenditures Made $ 1/1 through 6/30 7/1 to Date Expenditures Made 6. Payments Made Schedule E, Line 4 $ 7. Loans Made Schedule H, 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 $ 751 0 751 0 0 751 $ 3801 0 $ 3801 0 $ 3801 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 /, Line 4 15. Cash Payments Column A, Line 8 above 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 10108 If this is a termination statement, Line 18 must be zero. 757 10102 0 751 17. LOAN GUARANTEES RECEIVED Schedule B, Pert 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2 + Line 9 in Column 8 above $ 0 4000 To calculate Column 8, 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 (11 any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) / / $ Total to Date 'Amounts in thls section may be different from amounts reported in Column 8. FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 888/ASK-FPPC (866(270-3772) Schedule A Type or print In Ink. 3 I) 2 J ICHEDULE A MonetaryContributions Received Amounts may ne rounaea to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 8L44 446 CALIFORNIA 460 FORM Tv through 1' - '-" ' 7 Page 4 of NAME OF FILER KUMAR FOR COUNCIL 2014 I.D. NUMBER 1364692 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I. D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12/19 MayuraAnjali Global Investment ❑IND 0 COM ❑ OTH E PTY ❑ SCC 1000 10/21/2017 Ratra ENterprises ❑IND la COM OTH El PTY ❑ s c c 2500 11/10/17 Sunil Ahuja Saratoga, CA BIND LICOKaiser E OTH ❑ PTY [ism Surgeon Permanante 1000 12/19 Yogesh Agrawal Saratoga CA 95070 It3IND ❑COM ❑ OTH ❑PTY ❑ SCC Hi -tech executive Nvidia 500 10/13/17 Raj Galivanche Saratoga CA 95070 t[QIND ❑COM ❑ OTH ❑PTY ❑ SCC Principal Engineer Intel 1001 SUBTOTAL$ Schedule A Summary 1. 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) OTH — Other (e.g., business entity) PTY— Political Party SCC —Small Contributor Committee FPPC Form 460 (January/08) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661278-3772) Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULEA (CONT.) Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period from --8t CALIFORNIA FORM 460 1.4i1 through Page 5 of NAME OF FILER KUMAR FOR COUNCIL 2014 I.D. NUMBER 1364692 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR OF COMMITTEE. ALSO ENTERIC). NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 10/13/17 Vipin Jain Saratoga, CA ®IND ❑coM ❑ OTH ❑ PTY ❑SCC CEO 6d bytes 1000 10/13/17 Jayant Somani Saratoga CA BIND ❑COM ❑ OTH ❑ PTY ❑ SCC VP, Intel 504 7/3/17 Wells Fargo Credit to account ❑IND ®COM 0 OTH 0 PTY 0 SCC 46 8/22/17 Mihir Meghani DIND ❑coM ❑ OTH 0 PTY ❑ SCC Emergency Medicine Kaiser Permanante 1001 12/3/17 Deepak Satya Cupertino CA ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC VP, Marketing aptiWiz 300 SUBTOTAL$ *Contributor Codes IND—Individual COM — Recipient Committee (other then PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC —Small Contributor Committee FPPC Form 460 (Jenuery/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2754772) z O U W J 0 w 0 O Q z ix 2 0o O 'Q 1MBER PER ELECTION TO DATE (IF REQUIRED) J L 4 0 a °) a CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) Statement covers period from 7/ I through 1 113 (l 1 ,_.. d..3. ‘...) L,..) '4' W -.y J J w 2 z IF AN INDIVIDUAL, ENTER AMOUNT OCCUPATION AND EMPLOYER RECEIVED THIS (IF SELF-EMPLOYED. ENTER NAME PERIOD OF BUSINESS) A 1^ \, v ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ Monetary Contributions Received to whole dollars. v - V CONTRIBUTOR CODE * 0 ?Uoo_w 00000 DOHH0 ?Uoacr MODEL DOHF0 0 ?UOacn ❑❑❑❑❑ DOI-FC ?UO ave 0■■❑❑ FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) t 1 1_, DATE RECEIVED (0 N 0 N N M C N v E > LL 00 U •u a 0 a a LL a 0) u j co 0) u ., 'O U a a LL "Contributor Codes =}U 0 O H H U 0 50 0 0. 4- 3 3 'Amounts forgiven or pald by another party also must be reported on Schedule A. 1 ** If required. J 2%9— S EDULEB-PART1 Schedule B— Part 1 Amounts may be rounded Loans Received to whole dollars. SEE INSTRUCTIONS ON REVERSE from through Statement covers period CALIFORNIA A 60 FORM �F -874tEvio— .....----- 1/31/2017 7 13 I Page of NAME OF FILER KUMAR FOR COUNCIL 2014 I.D. NUMBER 1364692 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER ID NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD (5) AMOUNT RECEIVED THIS PERIOD (s) AMOUNT PAID OR FORGIVEN THIS PERIOD* (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD (e) INTEREST PAID THIS PERIOD (1) ORIGINAL AMOUNT OF LOAN (g) CUMULATIVE CONTRIBUTIONS TO DATE Rishi Kumar, Saratoga CA 95070 I-10 ❑ IND ❑COM ❑ OTH ❑PTY ❑ SCC - SELF- 3000 S 1000 S ❑PAID s s 5 s CALENDAR YEAR 4000 s ❑ FORGIVEN S RATE 5 PER ELECTION*" 5 DATE DUE DATE INCURRED t IND ❑ COM ❑ OTH ❑ PTY ❑ SCC 5 5 ❑ PAID $ $ % $ CALENDAR YEAR $ ❑ FORGIVEN 5 RATE 5 PER ELECTION** $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY L SCC $ $ ❑ PAID S $ % $ CALENDAR YEAR 5 ❑ FORGIVEN 5 RATE 5 PER ELECTION "* $ DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ Schedule B Summary 1000 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.) 1000 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 no t,ve number) (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 (Jenuary/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612754772) Schedule C Type or print In Ink. -7/1/1 7 / 'SCWEDULE C MIIIOOIITJ may OB TOONOCO NonmonetaryContributionsReceived to whole dollars. SEE INSTRUCTIONS ON REVERSE Stal+:mq(Tt from through covers period 84-14261-6- CALIFORNIA 460 1/ (77 Page 8 of NAME OF FILER KUMAR FOR COUNCIL 2014 I.D. NUMBER 1364692 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER IO. NUMBER) CONTRIBUTOR CODE • IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) DESCRIPTION OF GOODS OR SERVICES AMOUNT/ FAIR MARKET VALUE CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 - DEC 31) PER ELECTION TO DATE (IF REQUIRED) 12/4/17 Rishi Yadav, ❑IND ❑COM EloTH ❑PTY ❑SCC CEO, INFOOBJECTS Saratoga, CA 95070 Bitcoin 879 171 IND ❑COM DOTH ❑ PTY ❑SCC LIND ❑COM ❑ OTH ❑ PTY ❑ SCC ❑IND ['COM 0OTH ❑ PTY DSCC Attach additional information on appropriately labeled continuation sheets. SUBTOTALS Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.) $ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) 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 (January/08 FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275.3772 Schedule D ' /4- 2--)I)/ SSU Summary of expenditures Type or print In Ink. Supporting/OpposingOther Amounts may be rounded to whole dollars. Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE StateMent covers period from W442014 CALIFORNIA A 6O FORM ei1 1/31/2017 through d 9 d� Page of NAME OF FILER KUMAR FOR COUNCIL 2014 I.D. NUMBER 1364692 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN.1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 12/2/17 Mike Honda Legal ON-LINE E Monetary Contribution o Nonmonetary Contribution ❑ Independent Expenditure 250 290 290 ❑ Support 0 Oppose ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent Expenditure ❑ Support ❑ Oppose i7 :0-7177Contribution ARS_..,".._. ❑ Monetary ❑ Nonmonetary Contribution o Independent Expenditure 0 Support 0 Oppose SUBTOTAL $ 250 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) $ 2. Unitemized contributions and independent expenditures made this period of under $100 $ 250 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $ FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2764772) 250 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Amounts may be rounded to whole dollars. 7/(//4-_(z�� ) CHEDUL E Statement covers period from (-8/11201'6-- through 1/31/2017 CALIFORNIA ACO FORM �'1 V NAME OF FILER KUMAR FOR COUNCIL 2014 Page 10 111 of I.D. NUMBER 1364692 CODES: CNP CNS CTB CVC AL FIS BSD LEG UT If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. campaign paraphemalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings MBR MTG OFC PET PHO POL POS PRO FRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.O. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID League of Women Voters 80 Secretary of State Annual fee to keep this account open 50 League of California Cities 100 * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 230 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 $ FPPC Form 480 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2754772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print In Ink. Amounts may be rounded to whole dollars. 771/ A -- l'zl?l SCHEDU E CONT.) Statement covers perlod from through 17341.421417 CALIFORNIA A 6O FORM �F KUMAR FOR COUNCIL 2014 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP CNS CTB CVC FlL FND t�D LEG UT campaign paraphemalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate Tiling/ballot fees fundraising events independent expenditure supporting/opposing others (explain)' legal defense campaign literature and mailings MBR MTG OFC FET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB Page of I.D. NUMBER 1364692 radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.O. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Amazon Stationary for Neighborhood Safety Watch 9 Paypal Fee Fee 9 Silicon Valley Asian Pacific Democratic Club Sponsorsing ad 250 League of Calfiornia Cities Registration 100 Wells Fargo Fee 3 * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpllne: 866/ASK-FPPC (8661276.3772)