The URL can be used to link to this page

Home My WebLink AboutHaubert Form 460 01-01-2016 through 06-30-2016_RedactedRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from 01/01/2016 through 06/30/2016 1. Type of Recipient Committee: All committees —Complete Parts 1, 2, 3, and 4. Fx] Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (A /so Complete Part 5) Q Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee Q Political Party /Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I I.D. NUMBER 1363526 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) DAVID HAUBERT FOR MAYOR 2016 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 under penalty of perjury underr the aws of the State of California that the foregoing is true and cc Executed on y /''" By Date Executed on i By Date Signat Executed on Date Executed on Date www.netfile.com Date of election if applicable: (Month, Day, Year) 11/08/2016 COVER PAGE Date Stamp JUL 2 9 2015 Page I of 16 For Official Use Only CITY OF DUBUN 'MANAGER'S OFFS 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement 0 Semi - annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER DAVID BAUER MAILING ADDRESS 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 attached schedules is true and complete. I certify By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, Stale 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 DAVID HAUBERT OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Mayor: DUBLIN RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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 DAVID HAUBERT FOR CITY COUNCIL 2016 1346083 NAME OF TREASURER CONTROLLED COMMITTEE? DAVID BAUER X❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE www.netfile.com COVER PAGE - PART 2 IPage 2 of 18 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT ❑ SUPPORT 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.gov Campaign Disclosure Statement SUMMARYPAGE Amounts may be rounded Statement covers period CALIFORNIA Summary Page to whole dollars. 460 from 01/01/2016 FORM i SEE INSTRUCTIONS ON REVERSE through 06/30/2016 I Page 3 of 18 NAME OF FILER 6. Payments Made ........................ ............................... I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1,616.75 $ 1,616.75 7. Loans Made .............................. ............................... Schedule H, Line 3 1363526 0.00 8. SUBTOTAL CASH PAYMENTS ..... ............................... Column A $ Column B Calendar Year Summary for Candidates Contributions Received 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 TOTALTHIS PERIOD 0.00 CALENDARYEAR Running in Both the State Primary and 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line (FROM ATTACHED SCHEDULES) TOTALTO DATE 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 +s +10 $ 1,616.75 $ 6,616.75 General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line a $ 13,244.00 $ 13,244.00 1/1 through 6/30 7/1 to Date 2. Loans Received ....................... ............................... schedule B, Line 3 0.00 5, 000.00 3. SUBTOTALCASH CONTRIBUTIONS Add Lines I +2 $ 13,244.00 $ 18,244.00 20. Contributions ......................... Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 13,244.00 $ 18,244.00 Made $ $ Expenditures Made 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 1,616.75 $ 1,616.75 7. Loans Made .............................. ............................... Schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 +7 $ 1, 616.75 $ 1,616.75 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 0.00 5,000.00 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 0.00 0.00 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 +s +10 $ 1,616.75 $ 6,616.75 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. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ 2,338.87 13,244.00 50.00 1,616.75 14,016.12 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 0.00 19. Outstanding Debts ......................... Add Line 2 +Line s in Column B above $ 10, 000.00 www.netfile.com 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 -eported in Column B. FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule A SCHEDULE A Monetary ntributions Received Amounts may rounaea �/ to dollars. lars. Statement covers period CALIFORNIA whole 4 6 ' from 01/01/2016 FORM through 06/30/2016 Page 4 of 18 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE RS ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR EET A CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION COMMITTEE, SAND (IF I.D. NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 03/28/2016 RAMESHU IMMADI MIND CONSULTANT 500.00 500.00 G2016 $500.00 ❑COM SELF - RAMESHU IMMADI ❑ OTH ❑ PTY ❑SCC 03/30/2016 MARK TRISKA ]]IND 100.00 100.00 G2016 $100.00 ❑ COM ❑ OTH ❑ PTY ❑ SCC 04/08/2016 CALIF. APARTMENT ASSOC. PAC (ID# 745208) ❑IND 500.00 500.00 G2016 $500.00 ❑COM ❑ OTH ❑ PTY ❑ SCC 04/11/2016 JIANG HAIMING ❑IND PRIES. 500.00 500.00 G2016 $500.00 ❑COM AEROSOL GAS ❑ OTH ❑ PTY ❑ SCC 04 T1 1/2016 ❑IND NOT EMPLOYED 500.00 500.00 G2016 $500.00 ❑COM N/A ❑ OTH ❑ PTY ❑ SCC Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule subtotals.) ............. ............................... 2. Amount received this period — unitemized monetary contributions of less than $100 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...... www.netfile.com SUBTOTAL$ 2,100.00 $ 12,499.00 $ 745.00 ......... TOTAL $ 13, 244.00 *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 A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. A ' from 01/01/2016 FORM through 06/30/2016 Page 5 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE S FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR EET A AND ZIP DE O CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 05/04/2016 GREGORY FINKELSON N❑IND PRES. 300.00 300.00 G2016 $300.00 ❑COM AMERICAN CORPORATE [_]OTH SERVICES ❑ PTY ❑ SCC 05/10/2016 BEL CONSTRUCTION LLC ❑IND 200.00 200.00 G2016 $200.00 ❑ COM E] OTH ❑ PTY ❑ SCC 05/10/2016 CORNERSTONE REALTORS IN. ❑IND 500.00 500.00 G2016 $500.00 ❑ COM 0 OTH ❑ PTY ❑ SCC 05/10/2016 FACTORY DIRECT FLOOR ❑IND 100.00 100.00 G2016 $100.00 ❑COM 0 OTH ❑ PTY ❑SCC 05 10 2016 MICHAEL GOOSEFF ❑IND MANAGER 100.00 100.00 G2016 $100.00 ❑COM UNITED PARCEL SVC. ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 1,200.00 *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 www.neifile.com FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/276 -3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded statement covers period----] CALIFORNIA to whole dollars. ' from 01/01/2016 ' through 06/30/2016 Page 6 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE EET A DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 05/10/2016 VANESSA KWONG ❑IND NOT EMPLOYED 100.00 100.00 G2016 $100.00 ❑COM N/A ❑ OTH ❑ PTY ❑SCC 05/10/2016 AN OORJ I X]IND EXECUTIVE 500.00 500.00 G2016 $500.00 ❑COM E- INFOTEK ❑OTH ❑ PTY []SCC 05/10/2016 JIDONG SHI ®IND EXECUTIVE 200.00 200.00 G2016 $200.00 ❑COM MICRODOSE TECHNOLOGIES ❑ OTH ❑ PTY ❑SCC 05/10/2016 SMARTMONEY LLC ❑IND 150.00 150.00 G2016 $150.00 ❑COM X❑ OTH ❑ PTY ❑ SCC 05/10/2016 SPICES INC. ❑IND 250.00 250.00 G2016 $250.00 ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 1,200.00 *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 www.netfile.com FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period _ towholedollars. ' from 01/01/2016 • ' through 06/30/2016 page 7 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE ADDRESS AND ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR A CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (EET IT ALSO LD.N CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFSELF- EMPLOYED, ENTER NAME PERIOD (SAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 05/10/2016 SPICY KING ❑IND 500.00 500.00 G2016 $500.00 ❑ COM X❑ OTH ❑ PTY ❑SCC 05/10/2016 ❑IND 500.00 500.00 G2016 $500.00 ❑ COM KI OTH ❑ PTY ❑ SCC 05/10/2016 ERIC ZHANG X❑IND EXECUTIVE 500.00 500.00 G2016 $500.00 ❑COM GLOBAL BUSINESS ❑ OTH COMMUNICATIONS ❑ PTY ❑SCC 05/10/2016 LIHUA ZHANG ❑IND NOT EMPLOYED 100.00 100.00 G2016 $100.00 ❑COM N/A ❑ OTH ❑ PTY ❑ SCC 05 10 2016 YUJIE ZHU X❑IND NOT EMPLOYED 100.00 100.00 G2016 100.00 N/A ❑COM ❑ OTH ❑ PTY ❑ SCC `Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity; PTY — Political Party SCC — Small Contributor Committee SUBTOTAL$ 1,700.00 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov www.netfiie.com Schedule A (Continuation Sheet) SCHEDULE (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. I ' from 01/01/2016 • " through 06/30/2016 page 8 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR EET A RS AND ZI CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO .D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 05/10/2016 X❑IND NOT EMPLOYED 250.00 250.00 G2016 $250.00 ❑COM N/A ❑ OTH ❑ PTY ❑SCC 05/12/2016 RAMEZ BAHU x❑IND REALTOR 250.00 250.00 G2016 $250.00 ❑COM CORNERSTONE REALTORS ❑OTH ❑ PTY ❑ SCC 05/13/2016 HOGE FENTON JONES & APPEL INC. ❑IND 100.00 100.00 G2016 $100.00 ❑COM fl OTH ❑ PTY ❑SCC 05/13/2016 INT'L ASSOC. OF FIREFIGHTERS, LOCAL 55 PAC ❑IND 500.00 500.00 G2016 $500.00 ID 892160 x❑COM ❑OTH ❑ PTY ❑ SCC 05 13 2016 YI WEI X❑IND MANAGER 200.00 200.00 G2016 $200.00 ❑COM AEROSOL GAS ❑ OTH ❑ PTY ❑SCC 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity; PTY— Political Party SCC — Small Contributor Committee SUBTOTAL$ 1,300.00 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov www.netfiie.com Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period to whole dollars. / 1 from 01/01/2016 FORM through 05/30/2016 Page 9 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE EET A DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RS AND ZI CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION (IF COMMITTEE, ALSO I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/06/2016 ❑IND 100.00 100.00 G2016 $100.00 ❑ COM x❑ OTH ❑ PTY ❑SCC 06/06/2016 ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN ❑IND 500.00 500.00 G2016 $500.00 CALIF. CHAPTER PAC (ID# 901313) x❑COM ❑ OTH PTY ❑ SCC 06/06/2016 JAMEEL BATSHON ❑IND OWNER 250.00 250.00 G2016 $250.00 ❑COM HOSANA PROPERTIES ❑ OTH ❑ PTY ❑SCC 06/06/2016 X❑iND OWNER 200.00 200.00 G2016 $200.00 ❑COM SPAN CORE INC. []OTH ❑ PTY ❑ SCC 06 06 2016 X❑IND OWNER 150.00 150.00 G2016 150.00 ❑COM EMERALD KINGS ❑ OTH ❑ PTY ❑SCC SUBTOTAL$ 11200.00 '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 www.neifile.com FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppe.ca.gov Schedule A (Continuation Sheet) SCHEDULEA (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. I ' from 01/01/2016 • through 06/30/2016 page 10 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE FULL NAME STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/06/2016 VARMA KAKARLAPUDI ❑IND CONSULTANT 101.00 101.00 G2016 $101.00 ❑COM VARMA KAKARLAPUDI ❑OTH ❑ PTY ❑SCC 06/06/2016 CHANDRASEKHAR KRISHNAGIRI VIIND MANAGER 200.00 200.00 G2016 $200.00 ❑COM APTTUS CORP ❑ OTH ❑ PTY ❑SCC 06/06/2016 ERIC KWOK BIND PRES. 100.00 100.00 G2016 $100.00 ❑COM AXELSYS TECHNOLOGY ❑OTH ❑ PTY ❑SCC 06/06/2016 X❑IND EXECUTIVE 100.00 100.00 G2016 $100.00 ❑COM FISERV ❑ OTH ❑ PTY ❑ SCC 06 7o 6 2016 SITYAM SUBRAMANIAN ❑IND PHYSICIAN 250.00 250.00 G2016 250.00 ❑COM BUTTER GOULD ❑ OTH ❑ PTY ❑ SCC *Contributor Codes IND — Individual COM— Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC — Small Contributor Committee www.netfile.com SUBTOTAL$ 751.00 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (8661275 -3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • _ towholedollars. from 01/01/2016 • ' through 06/30/2016 page 11 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE AND ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR EET A S CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO .D.N CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. i - DEC. 31) (IF REQUIRED) OF BUSINESS) 06/06/2016 LIANG YANG X❑IND DEVELOPER 500.00 500.00 G2016 $500.00 ❑COM SUGAR CRM ❑ OTH ❑ PTY ❑SCC 06/15/2016 AMP PRINTING INC. ❑IND 500.00 500.00 G2016 $500.00 ❑COM OTH ❑ PTY ❑SCC 06/15/2016 HOT CRAB ❑IND 300.00 300.00 G2016 $300.00 ❑COM RIOTH ❑ PTY ❑ SCC 06/15/2016 WALTER LUPEIKA BIND CPA 99.00 198.00 G2016 $198.00 ❑COM SELF - WALTER LUPEIKA ❑ OTH ❑ PTY ❑ SCC 06 15 2016 WALTER LUPEIKA RIND CPA 99.00 198.00 G2016 $198.00 ❑COM SELF - WALTER LUPEIKA ❑ OTH ❑ PTY ❑SCC SUBTOTAL$ 1,998.00 *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 www,netfile.corn Schedule A (Continuation Sheet) SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. ' from 01/01/2016 ' through 06/30/2016 Page 12 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 DATE ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR EET A CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED COMMITTEE, ALSOND (IF .D.N CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IFSELF- EMPLOYED. ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/15/2016 NOTHING BUNDT CAKES ❑IND 250.00 250.00 G2016 $250.00 ❑COM X❑ OTH ❑ PTY ❑SCC 06/16/2016 ZEN, ATTORNEY AT LAW ❑IND 250.00 250.00 G2016 $500.00 ❑COM FxI OTH ❑ PTY ❑ SCC 06/17/2016 GORDON GALVAN ❑IND CONSULTANT 250.00 250.00 G2016 $250.00 ❑COM GALVAN & ASSOC. ❑ OTH ❑ PTY ❑ SCC 06/25/2016 PEAK IP SOLUTIONS LLC ❑IND 100.00 100.00 G2016 $100.00 ❑ COM ff] OTH ❑ PTY ❑ SCC 06 72 5 2016 ROCKIN JUMP INC. ❑IND 500.00 500.00 G2016 $500.00 ❑COM Fx] OTH ❑ PTY ❑SCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC —Small Contributor Committee www.netfile.com SUBTOTAL$ 1,350.00 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. ' " from 01/01/2016 through 06/30/2016 Page 13 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 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 (IFSELF- EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 06/30/2016 ]IND DIRECTOR 200.00 200.00 G2016 $200.00 ❑COM W.N. FOODS ❑ OTH ❑ PTY ❑SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 200.00 *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 www.netfile.com FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov RYy. P� -IN 11MR-0 91-12 i Schedule B — Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. CALIFORNIA • 1 from 01/01/2016 • SEE INSTRUCTIONS ON REVERSE I through 06/30/2016 Page 14 of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER , (a OUTSTANDING (b) AMOUNT (c) AID AR (d) OUTSTANDING (e) INTEREST (r) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN FORGI BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE. ALSO. ENTER I.D. NUMBER) NAME OF BUSINESS D PERIOD * THIS PERIOD D PERIOD LOAN TO DATE DAVID HAUBERT THE CANDIDATE ❑ PAID CALENDARYEAR $ 0.00 $ 5,000.00 % $ 5,000.00 $ 0.00 ❑ FORGIVEN PER ELECTION— RATE $ 5,000.00 $ 0.00 $ 0.00 5 0.00 11/10/2015 $G2016 5,000.00 DATEDUE DATE INCURRED t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR. ❑ FORGIVEN PER ELECTION ** RATE 5 S 5 5 5 DATE DUE DATE INCURRED tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION*'' RATE 5 5 5 5 5 DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0.00$ 0.00$ 5,000.00$ 0.00 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.) 3. 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. www.netfile.com ....... $ (Enter (e) on Schedule E, Line 3) 0.00 0.00 NET $ 0.00 (May be a negative number) 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 Statement covers period Payments Made Amounts may be rounded Y to whole dollars. from 01/01/2016 SEE INSTRUCTIONS ON REVERSE NAME OF FILER DAVID HAUBERT FOR MAYOR 2016 through 06/30/2016 I page 15 of 18 I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment 1363526 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 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 (IFCOMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID DAVID BAUER PRO 475.00 2150 RIVER PLAZA DR., #150 SACRAMENTO, CA 95833 DUBLIN ROTARY CVC 300.00 5900 SIGNAL HILL DR. DUBLIN, CA 94568 ROWELL RANCH RODEO CVC 500.00 21728 EDEN CANYON RD. CASTRO VALLEY, CA 94522 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,275.00 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.) .................. www.netfile.com ............ $ .......... I. $ ............ $ TOTAL $ 1,475.00 141.75 0.00 1,616.75 FPPC Form 460 (Jan /2016) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) www.fppc.ca.gov Schedule E SCHEDULE E (CONT.) (Continuation Sheet) Amounts may be rounded Statement covers period .1 Payments Made to whole dollars. from 01/01/2016 h SEE INSTRUCTIONS ON REVERSE through 06/30/2016 P 16 age of 18 NAME OF FILER I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 1363526 CODES: If one of the following codes accurately describes the payment, CMP campaign paraphernalia /misc. MBR CNS campaign consultants MTG CTB contribution (explain nonmonetary)* OFC CVC civic donations PET FIL candidate filing /ballot fees PHO FND fundraising events POL IND independent expenditure supporting /opposing others (explain)* POs LEG legal defense PRO LIT campaign literature and mailings PRT you may enter the code. Otherwise, member communications RAD meetings and appearances RFD office expenses SAL petition circulating TEL phone banks TRC polling and survey research TRS postage, delivery and messenger services TSF professional services (legal, accounting) VOT print ads WEB describe the payment. 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.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID MERCY AND GRACE MINISTRIES 4047 FIRST ST. #206 LIVERMORE, CA 94551 CVC 200.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 200.00 FPPC Form 460 (Jan /2016) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) www.netfile.com www.fppc.ca.gov NAME AND ADDRESS OF CREDITOR CODE OR ( OUTSTAA NDING ( AMOUNTIN CURRED SCHEDULEF Schedule F Accrued Expenses (Unpaid Bills) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Amounts may be rounded to whole dollars. Statement covers period from 01/01/2016 CALIFORNIA •' I 6 ' SEE INSTRUCTIONS ON REVERSE BALANCE AT CLOSE through 06/30/2016 17 18 Page of NAME OF FILER (ALSO REPORT ON E) OF THIS PERIOD POTOMAC RESEARCH AND CONSULTING, LLC I.D. NUMBER DAVID HAUBERT FOR MAYOR 2016 0.00 0.00 5,000.00 1363526 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CUP 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 ND 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 CREDITOR CODE OR ( OUTSTAA NDING ( AMOUNTIN CURRED (c) AMOUNT PAID ( OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD POTOMAC RESEARCH AND CONSULTING, LLC CNS 5,000.00 0.00 0.00 5,000.00 10531 RUTLEDGE ST. PARKER CO 90134, * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 5, 000.00$ 0.00 $ 0. OQ$ 5, 000.00 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ....................... 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) , 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) ........................................................... ............................... ............. INCURRED TOTALS $ ...... PAID TOTALS $ 0.00 0.00 .. ............................... NET $ 0.00 May be a negative number FPPC Form 460 (Jan /2016) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) www.netfile.com www.fppc.ca.gov ;�M=mr -i .R(..I-IFnI n F I Miscellaneous Increases to Cash Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 01/01/2016 through 06/30/2016 page 18 _ F--I- NAME OF FILER DAVID HAUBERT FOR MAYOR 2016 I.D. NUMBER 1363526 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. Schedule I Summary 1. Itemized increases to cash this period ................................................................. ............................... 2. Unitemized increases to cash of under $100 this period ...................................... ............................... 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ......... 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ..................................................................................... ............................... www.netfile.com SUBTOTAL$ $ 0.00 $ 50.00 $ 0.00 TOTAL $ 50.00 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov