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Home My WebLink AboutKAUSAR Form 460 01-2021 and terminationCOVER PAGI Recipient Committee Campaign Statement Cover Page 3EE INSTRUCTIONS ON REVERSE Statement covers period I Date of election if applicable: from 07-01-2020 (Month, Day, Year) through 12-31-2020 Date Stamp RECEIVED CITY OF SAI ATOG GALIFILI&IMA 4 • 1 .- Page 1 of 5 For Official Use Only 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement: 0 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement O State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd -Year Report O Recall O Controlled V Termination Statement (Also Complete Part 5) O Sponsored (Also file a Form 410 Termination) ❑ General Purpose Committee (Also Complete Part 6) ❑ Amendment (Explain below) O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D. NUMBER 1402171 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Anjali Kausar for Saratoga City Council 2018 STREET ADDRESS (NO P.O. BOX) 19731 Yuba CT 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 Treasurer(s) NAME OF TREASURER Sameer Kausar MAILING ADDRESS CA 95070 408-506-8125 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS anjali @anjalikausar.com L Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my certify under penalty of perjury under the laws of the State of California that the foregoin Executed on Jan 29, 2021 Date Executed on Jan 29, 2021 Date Executed on Date Executed on Date By By the information contained herein and in the attached schedules is true and complete. I or By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016 FPPC Advice: advice@fppc.ca.gov (866/275-3772 COVER PAGE - PART 2 Recipient Committee Campaign Statement Cover Page — Part 2 i. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Anjali Kausar OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Member, Saratoga City Council , 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 I CONTROLLED COMMITTEE? [-]YES ❑ NO ADDRESS STREETADDRESS 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 5 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 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 ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE 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.go 'ampaign Disclosure Statement Amounts may be rounded SUMMARY PAGI Mumma Page to whole dollars%. statement covers period . 07-01-2020 • - • from 12-31-2020 3 5 through Page of ;EE INSTRUCTIONS ON REVERSE TAME OF FILER I.D. NUMBER Anjali Kausar for Saratoga City Council 2018 1402171 Column A Column B Calendar Year Summary for Candidates r 'ontributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 0 0 Monetary Contributions................................................... Schedule A, Line 3 $ $ 1/1 through 6/30 711 to Date -1500 0 . '. Loans Received .................................................. ............. Schedule 8, Line 3 20. Contributions I. SUBTOTAL CASH CONTRIBUTIONS .......................... Add tines 1 + 2 $ O $ O Received $ $ Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures i. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3+4 $ -1500 $ 0 Made $ $ xpenditures Made Expenditure Limit Summary for State i. Payments Made................................................................ Schedule E Line 4 $ 2751 $ 2801 Candidates Loans Made....................................................................... Schedule H, Line 3 0 0 2751 2801 22. Cumulative Expenditures Made* I. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ $ (if Subject to Voluntary Expenditure Limit) 0 0 I. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 Date of Election Total to Date 0. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 0 (mm/dd/yy) 1. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 $ 2751 $ 2801 J� $ '.urrent Cash Statement 2. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 3. Cash Receipts........................................................... Column A, Line 3 above 4. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 5. Cash Payments......................................................... Column A, Line 8 above 6. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ If this is a termination statement, Line 16 must be zero. 7. LOAN GUARANTEES RECEIVED ................................ Schedule e, Part 2 $ ;ash Equivalents and Outstanding Debts 8. Cash Equivalents ................................................ See instructions on reverse $ 9. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 2751 To calculate Column B, add amounts in Column Ato 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). $ 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.ga SCHEDULE B - PART' ichedule B — Part 1 to whole dollars. ~ M Statement covers period CALIFORNIA Received 7/1/2020 FORM • _oans from 12/31 /2020 4 5 EE INSTRUCTIONS ON REVERSE through Page of AME OF FILER I.D. NUMBER Anjali Kausar for Saratoga City Council 2018 FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE AMOUNT (o) AMOUNT PAID OUTSTANDING BALANCE AT e INTEREST ORIGINAL CUMULATIVE OF LENDER (IF 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 CONTRIBUTION: TO DATE NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD Anjali Kausar CEO, Cupertino la PAID CALENDAR YEAR Chamber of $ 1500 $ 0 % $ 1500 $ ❑ FORGIVEN PER ELECTION*' Saratoga, Ca 95070 Commerce RATE $ 1500 $ $ $ 1 /2/18 $ 0 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ $ % $ $ ❑ FORGIVEN PER ELECTION* RATE DATE DUE DATE INCURRED ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR $ $ °k $ $ ❑ FORGIVEN RATE PER ELECTION* DATE DUE DATE INCURRED ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ $ 1500 $ $ —T ichedule B Summary Loans received this period................................................................................................. (Total Column (b) plus unitemized loans of less than $100.) Loans paid or forgiven this period............................................................... (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) Net change this period. (Subtract Line 2 from Line 1.) ............... Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. .$ 0 .................$ 1500 ........ NET $ -1500 (May be a negative number) (tnter(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/201E FPPC Advice: advice@fppc.ca.gov (866/275-3772 www.fppc.ca.go Schedule E payments Made ;EE INSTRUCTIONS ON REVERSE Anjali Kausar for Saratoga City Council 2018 Amounts may be rounded to whole dollars. Statement covers period from 01-01/2020 through 06-30-2020 :ODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE •- • 5 5 Page of ;MP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs :NS campaign consultants MTG meetings and appearances RFD returned contributions :TB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries :VC civic donations PET petition circulating TEL t.v. or cable airtime and production costs IL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals 'ND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals VD independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor .EG legal defense PRO professional services (legal, accounting) VOT voter registration IT 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) Anjali Kausar Loan pay off 1,500 Saratoga, CA CAIR I CVC 1 1 1251 Santa Clara, CA 95054 Payments that are contributions or independent expenditures must also be summarized on Schedule D. schedule E Summary Itemized payments made this period. (Include all Schedule E subtotals.) ..................................... '. Unitemized payments made this period of under$100...................................................................................................... 4. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)......................................... i. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.).... SUBTOTAL $ 2751 ................................ $ ................................ $ ................................ $ ....... TOTAL $ 2751 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772 www.fppc.ca.go,