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HomeMy WebLinkAboutGoel Form 460 08-21-2016 through 12--31-16 redactedRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 8/21/2016 through 12/31/2015 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 Q Recall 0 Controlled (Also Cm*fe Part 6) O Sponsored ❑ General Purpose Committee (Alm Complete Pert 6) O Sponsored ❑ Primarily Formed Candidate/ • Small Contributor Committee Officeholder Committee • Political Party/Central Committee (AWOwWWOPerl7) 3. Committee Information I I.D. NUMBER A o7nn^ld GOEL FOR DUBLIN CITY COUNCIL 2016 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODEIPHONE COVER PAGE Date Stamp RECEIVED pp JAN 2 9 2016 page of x Date of election if applicable: (Month, Day, Year) For official Use Only CITY OF DUBLIN 11/2016 MANAGER'S OFFICE 2, Type of Statement: ❑ Preelection Statement ❑ quarterly Statement la 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 OFASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX /E- MAILADDRESS 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 of California that the foregoing Is true and Executed on 1/28/16 By Dale ur e Executed on 1/28/16 13Y S ro of ontr ate onent or r Responsible Officer of Sponsor Executed on By Date Signature of Controlling Offimholder, Candidate, State Measure Proponent Executed on By Data Signature of Controlling Officeholder, Candidate, Stela 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 RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: Listanycommittees not Included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of yourcandidacy. NAME OF TREASURER ADDRESS STREET ADDRESS (NO P.O. BOX) COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREACODEIPHONE COMMITTEE NAME I.D. NUMBER ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE - PART 2 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 DISTRICT NO. IF ANY 7. Primarily Formed Candidate /Officeholder Committee Listnamesof 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 Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to wnose dollars. Statement covers period , t 8/21/2016 from • • through 12/31/2015 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER LD. NUMBER Arun Goel 1379978 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITfEE S SENTER I.D. 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) OF BUSINESS) Bhavna Goel 0 IND Co Housewife 101 101 101 912/15 0 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ sCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC 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 101 COM — Recipient Committee (other than PTY or SCC) 0 OTH — Other (e.g., business entity) PTY — Political Party 101 SCC — Small Contributor Committee FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Statement covers period from 8/21/2015 through 12/31 /2015 • . , I , •' Page 4 of�.2_ NAME OF FILER I.D. NUMBER Arun Goel 1379978 CODES., If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign parephemalle /misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetaryr OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v, or cable airtime and production costs FIL candidate filingiballot 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 $ 24.06 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. 24.06 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).) .............................................. ............................... $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ 24.06 FPPC Form 460 (Jan /2016) FPPC Advice: advice@fppc.co.gov (866/275 -3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. Statement covers period from 8/21/2015 SUMMARY PAGE Expenditures Made through 12/31/2015 Page S of SEE INSTRUCTIONS ON REVERSE 7. Loans Made ........................................ I.............................. Schedule H Line 3 0 0 B. SUBTOTAL CASH PAYMENTS ........... ............................... Add Unes6 +7 $ NAME OF FILER $ 24.06 9. Accrued Expenses (Unpaid Bills ,. Schedule F, Line 3 0 I.D. NUMBER Arun Goel 0 0 11. TOTAL EXPENDITURES MADE ......... ............................... Add Unes a + 9 + 10 1379978 24.06 $ 24.06 Column A Column B Calendar Year Summary for Candidates Contributions Received 12. Beginning Cash Balance Previous Summary Page, Line 16 "" " """""""""""' TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Primary 13. Cash Receipts ........................................................... Column A, Line 3 above (FROM ATTACHED SCHEDULES) TOTAL TO DATE and 0 A to the corresponding 14. Miscellaneous Increases to Cash ... ............................... Schedule i Line 4 General Elections amounts from Column B 101 101 24.06 1. Monetary Contributions .................... ............................... Schedule A, Una3 $ $ 76.94 1/1 through 6/30 7/1 to Date 0 0 2. Loans Received ................................. ............................... schedule B, Line 3 this is the first report being 101 101 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ $ Received $ $ any)' 16. Cash Equivalents ................. ............................... See instructions on reverse 0 0 4. Nonmonetary Contributions ............. ............................... Schedule C, Una 3 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........ ............................Add Lines 3 +4 $ 101 $ 101 Made $ $ Expenditures Made 6. Payments Made ................................. ............................... Schedule E Una 4 $ 24.06 $ 24.06 7. Loans Made ........................................ I.............................. Schedule H Line 3 0 0 B. SUBTOTAL CASH PAYMENTS ........... ............................... Add Unes6 +7 $ 24.06 $ 24.06 9. Accrued Expenses (Unpaid Bills ,. Schedule F, Line 3 0 0 10. Nonmonetary Adjustment .......................... ............................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE ......... ............................... Add Unes a + 9 + 10 $ 24.06 $ 24.06 Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 "" " """""""""""' $ 0 To calculate Column B, 13. Cash Receipts ........................................................... Column A, Line 3 above 101 add amounts In Column 0 A to the corresponding 14. Miscellaneous Increases to Cash ... ............................... Schedule i Line 4 amounts from Column B 15. Cash Payments .......................... ............................... Column A, Una 8 above 24.06 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Unes 12+ 13 + 14, then subtract Una 15 $ 76.94 be negative figures that should be subtracted from If this Is a termination statement, Line 16 must be zero, 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 from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 0 any)' 16. Cash Equivalents ................. ............................... See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Una 9 in Column B above $ 0 Expenditure Limit Summary for State Candidates 22, Cumulative Expenditures Made* (a Subject to Voluntary Expendlture Limit) Date of Election Total to Date (mm /dd /yy) J 1 $ I $ *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