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Home My WebLink AboutGoel Form 460 01-01-2016 through 06--30-16_RedactedRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 1/1/16 6 through /30/16 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. [� Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Pad 5) 0 Sponsored (Also Complete Pert 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Ako Complete PM 7) 3, Committee Information I.D. NUMBER 1379978 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO CON GOEL FOR DUBLIN CITY COUNCIL 2016 STREETADDRESS NO P.O. BOX CITY AND CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE OtMED Data of election if applicable: JUN 2 3 2016 Page —I of n (Month, Day, Year) CITY OF DUBLIN For Official Use Only CI T ,' MANAGER'S OFFICE 11/2016 2. Type of Statement: ❑ 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 Maryanne Tracy -Baker MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE S OPTIONAL: FAX/ E- MAILADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of erein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true Executed on 6/21/16 Date Executed on 6/21/16 Dale Executed on Dale Executed on By By By Signature or 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 Goel, Arun K. OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE) City Council Member RESIDENTIALIBUSINESS 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 fanned to receive contributions or make expenditures on behalf of your candidacy. NAME OF TREASURER I.D. NUMBER STREET ADDRESS (NO P.O. BOX) ❑ YES ❑ NO CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME NAME OF TREASURER I.D. NUMBER ❑ YES ❑ NO ADDRESS STREET ADDRESS (NO P.O. BOX) COVER PAGE - PART 2 Page 1 of a 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. IFANY 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 CITY STATE ZIP CODE AREACODE/PHONE I Attach continuation sheets ifnecessary FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov t Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summary Page to whole dollars, Statement covers period P . - 1/1/16 0 - from SEE INSTRUCTIONS ON REVERSE through 6/30/16 Page 3 of 0 NAME OF FILER I.D. NUMBER Arun Goel 1379978 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and 5550 5550 General Elections 1. Monetary Contributions .................... ....................:.......... Schedule A, Line 3 $ $ 2. Loans Received ........... ......;.,......... ,,., ..,..,,,,,,,,.,,,,,,,,,,,,,,,,, schedule B, Line 3 0 0 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CAS CONTRIBUTIONS., ............................ Add Lines 1 + 2 $ 5550 $ 5550 20. Contributions .Received $ $ 4. Nonmoneta Contributions ................... ry • ....................... Schedule C, Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........ ............................Add Lines 3 +4 $ 5550 $ 5550 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ................................. ............................... Schedule E, Line 4 $ 30 $ 30 Candidates 7. Loans Made . ............................... ............ Schedule H, Line 3 O 0 8. SUBTOTAL CASH PAYMENTS ........... ............................... Add Lines s + $ 30 $ 30 22. Cumulative Expenditures Made* (11 Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ................... .......................schedule F, Linea 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment .......................... ............................... Schedule C, Line 3 0 0 (mm /dd /yy) 11. TOTAL EXPENDITURES MADE ............................ ........... Add Lines 8 +9 +10 $ 30 $ 30 $ Current Cash Statement _�_� $ 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 76.94 To calculate Column B, 13. Cash Receipts ............................ ............................... Column A, Line 3 above 5550 add amounts in Column 14. Miscellaneous Increases to Cash ... ............................... Schedule 4 Line 4 0 A to the corresponding amounts from Column B *Amounts in this section may be different from amounts 15. Cash Payments ......................................................... . Column A, Line 8 above 30 of your last report. Some reported in Column B, 16. ENDING CASH BALANCE ...................Add Lines 12 + 13 + 14, then subtract Line 15 $ . 559694 amounts in Column A may be negative figures that If this is a termination statement, Line 16 must be zero. should be subtracted from previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED . ............................... schedule B, Part 2 $ 0 filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if 18. Cash Equivalents ................. ............................... see instructions on reverse $ 0 any). 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 FPPC Form 460 (Jan /2016) FPPC Advice: adviceCcbfppc.ca.gov (866/275 -3772) www.fppc.ca.gov A Amounts may be rounded SCHEDULE A to whole dollars. Monetary Contributions Received Statement covers period "s 1/1 from // through gSC'Llr, ofSEE 7NUMBER INSTRUCTIONS ON REVERSE NAME OF FILER Arun Goel DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR WAN 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) Ramakrishnan Mohan I] IND ❑ COM Staff Engineer 250 250 4/17/16 E] OTH Linkedln 250 ❑ PTY ❑ SCC Mukesh Idnani ® IND El COM Senior Consultant 200 200 200 4/17/16 F1 OTH VMWare ❑ PTY ❑ SCC Monica Shangle ® IND El COM Director Business 200 4/17/16 ❑ OTH Operations Blackrock Inc. 200 200 ❑ PTY ❑ SCC Jyotika Mehta [✓J IND CEO /Founder 200 4117/16 El COM ❑ OTH JMD Creations Inc 200 200 ❑ PTY ❑ SCC DMR Mana ement Consultants ❑ IND 225 4/17!16 El 225 225 W3 OTH ❑ PTY ❑ SCC SUBTOTAL$ 1075 Schedule A Summary 1. Amount received this period — itemized monetary contributions. 5550 (Include all Schedule A subtotals.) ........................................................................... ..............................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 0 3. Total monetary contributions received this period. 55517 *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 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ......................TOTAL $ 2 6 FPPC Farm 460 (Jan/ N ) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) Cwww.fppc.ra.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received �� w "�'� uouars' Statement covers period CALIFORNIA 1/1/16 4;�60' from • SEE INSTRUCTIONS ON REVERSE through 6/30/16 791 5 of f3 NAME OF FILER I.D. NUMBER Arun Goel 1379978 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR S CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE SA ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC, 31) (IF REQUIRED) OF BUSINESS) Shreela Goei W] IND None 4/17/16 ❑ coM 200 200 200 ❑ OTH ❑ PTY ❑ SCC Patrick Vu ® IND Partner 4/17/16 El COM OTH El OTH Silicon Transportation 100 100 ❑ PTY Consultants ❑ SCC Kanda Ra' ® IND El COM Consultant 4/17/16 El OTH DMR Management g 225 225 225 ❑ PTY Consultants ❑ SCC Scott Mittan Z IND Audit Supervisor 4/17/16 ❑ COM ❑ OTH Board of Equalization 200 200 200 ❑ PTY ❑ SCC Puran Moorjani W1 IND President 4/17/16 E- Infotek Solutions, Inc 500 500 500 ❑OTH ❑ PTY ❑ SCC SUBTOTAL$ 1225 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 $ 5550 I 5559 *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 Sr-harhilp A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole aonars• Statement covers period 1/1/16 from � through 6/30/16 Page �O of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Arun Goel 1379978 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ET AD S CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF TEE SAENTER I.D. NUMBER) CODE * (IF SELF- EMPLDYED,ENTER NAME PERIOD (JAN.1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Marian Francisco 91 IND CO None 100 4/17/16 El 100 100 ❑ PTY ❑ SCC Mahesh Puri ® IND None 4/17/16 El COM 500 500 500 ❑ OTH ❑ PTY ❑ SCC Yogesh Chugh 10 IND Managing Director 500 4/17/16 El S5 Advisory, Inc, 500 500 ❑ PTY ❑ SCC Purnima Moorjani Z IND Portfolio Management Lead 500 4/17/16 & CEO 500 500 El OTH ❑ Pte, Cosmo Cloud ❑ SCC 91 IND None 4/17/16 El CoM 200 200 200 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 1800 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 $ 5551 0 5551) '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.,a.gov RrherlulP A Amounts may be rounded SCHEDULE A to wnole aonars. Monetary Contributions Received Statement covers period IFO . 1/1/16 from . � ' • ' 6/30/16 7 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Arun Goel 1379978 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE ALSO ENTER ID NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED , . . CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) DF BUSINESS) Sousou Ventures, Inc. ❑ IND 4/17/16 El CO 500 500 500 ❑ PTY ❑ SCc Gautam Gulati [1 Pharmacy Purchase 250 4123/16 ❑OTH [j Kaiser 25U 25 D ❑ PTY ❑ SCC odd Katz ® IND co Chief Financial Officer 100 4/30/16 El Quest Integrity Group 100 100 ❑ PTY ❑ SCC Frazzano Real Estate, Inc. ❑ IND 5/8/16 El COM 500 500 500 W1 OTH ❑ PTY ❑ SCC Kiran Gulati Z IND Principal Medical Device 5/21/16 ❑COM Consultant - Lead Auditor 100 100 100 ❑ OTH ❑ PTY Kiran Gulati & Associates ❑ SCC SUBTOTAL $ 14517 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 $ 5551) 2 5550 '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 466 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule E Amounts may be rounded period SCHEDULE E y 7from ement covers • ' to whole dollars. � Payments Made yl/f b • - SEE INSTRUCTIONS ON REVERSE through (6126 b Page -- of 8 NAME OF FILER I.D. NUMBER Arun Goel 1 3'79 q 318 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 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 Lv, 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) ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 30 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................. ............................... $ 30 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 $ 30 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www ;fppc.ca.gov