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Home My WebLink About01-01-2017 to 06-30-2017 Semi-Annual COVER PAGE Recipient Committee Date Stamp _ I • t Campaign Statement RECEIVED Cover Page Statement covers period Date of election if applicable: JUL 3 12017 Page 1 of 5 from 01/01/2017 (Month,Day,Year) For Official Use Only CITY OF DUBLIN SEE INSTRUCTIONS ON REVERSE thrOUgh 06/30/2017 CITY MANAGER'S OFFICE 1. Type of Recipient Committee: All committees-complete Parts 1,2,s,and 4. 2. Type of Statement: m Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee LZ Semi-annual Statement ❑ Special Odd-Year Report 0 Recall 0 Controlled ❑ Termination Statement (Also Complete Pert 5) 0 Sponsored (Also file a Form 410 Termination) (Also Complete Pert 6) ❑ General Purpose Committee ❑ Amendment(Explain below) • Sponsored ❑ Primarily Formed Candidate/ • Small Contributor Committee Officeholder Committee • Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D.NUMBER Treasurer(s) 1357076 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Abe Gupta for Dublin City Council 2014 Matthew Morrison MAILING ADDRESS STREETADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREACODE/PHONE CITY STATE ZIP CODE AREACODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/E-MAILADDRESS OPTIONAL: FAX/E-MAIL ADDRESS 925-269-2380/abegupta @gmail.com 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. certify under penalty of perjury under the laws of the State of California that the foregoing is Executed on \ 1 N-I BY Date Signature of Controlling Officeholder,Candidate,State Measure Proponent or Responsible Officer of Sponsor Executed on BY Date Signature of Controlling Officeholder,Candidate,State Measure Proponent Executed on BY Date - Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov COVER PAGE-PART 2 Recipient Committee CALIFORNIA Campaign Statement FORM ' • Cover Page — Part 2 Page 2 of 5 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Abe Gupta OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION PC, SUPPORT City Council Dublin OPPOSE RESIDENTIAUBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP Identify the controlling officeholder,candidate,or state measure proponent,if any. NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT 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 OFFICE SOUGHT OR HELD DISTRICT NO.If ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7• Primarily Formed Candidate/Officeholder Committee Listnamesof officeholder(s)or candidate(s)for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEE NAME I.D.NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD E:1 YES El NO E:1 SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE 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 Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers period CALIFORNIA Summary Page from 01/01/2017 FORM aa`A • through 06/30/2017 Page 3 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Abe Gupta for Dublin City Council 2014 1357076 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 0.00 1. Monetary Contributions................................................... schedule A,Line 3 $ 0.00 $ 0.00 0.00 1i1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule a,Line 3 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lines 1+2 $ 0.00 $ 0.00 Received $ $ 4. Nonmonetary Contributions............................................ schedule C,Line 3 50.00 0.00 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 $ 0.00 $ 0.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ Schedule E,Line 4 $ 0.00 $ 0.00 Candidates 7. Loans Made....................................................................... schedule H,Line 3 0.00 0.00 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS.......................................... Add Lines 6+7 $ 0.00 $ 0.00 (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses(Unpaid Bills)..........................................schedule F Line 3 0.00 0.00 Date of Election Total to Date 10. Nonmonetary Adjustment.........................................................schedule C,Line 3 50.00 0.00 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE........................................Add Lines s+9+10 $ 50.00 $ 0.00 $ Current Cash Statement $ 12. Beginning Cash Balance............................ Previous Summary Page,Line 16 $ 760.88 To calculate Column B, 13. Cash Receipts........................................................... Column A,Line 3 above 0.00 add amounts in Column 0.00 A to the corresponding *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash.................................. Schedule 1,Line 4 amounts from Column B reported in Column B. 15. Cash Payments......................................................... Column A,Line s above 0.00 of your last report. Some amounts in Column A may 16.ENDING CASH BALANCE ..................Add Lines 12+13+14,then subtract Line 15 $ 760.88 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 a,Part 2 $ 0.00 filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2,7,and 9(if any). 18. Cash Equivalents................................................ See instructions on reverse $ 0.00 19. Outstanding Debts.............................. Add Line 2+Line 9 in Column B above $ 5757.00 FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Amounts may be rounded SCHEDULE B-PART 1 Schedule B — Part 1 to whole dollars. Statement covers period _ Loans Received from 01/01/2017 . 1 SEE INSTRUCTIONS ON REVERSE through 06/30/2017 Page 4 of 5 NAME OF FILER I.D.NUMBER Abe Gupta for Dublin City Council 2014 1357076 FULL NAME,STREET ADDRESS AND ZIP CODE IFAN INDIVIDUAL,ENTER OUTSTANDING AMOUNT (c) OUTSTANDING INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER AMOUNT PAID OF LENDER BALANCE RECEIVED THIS BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS (IF SELF-EMPLOYED,ENTER BEGINNING THIS OR FORGIVEN* CLOSE OF THIS (IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE Abe Gupta Principal ❑ PAID CALENDAR YEAR 3329 Cydonia Court Anabe, Inc. $ $ 722.00 0.00 % $ 1000.00 $ 0.00 Dublin, CA 94568 ❑FORGIVEN RATE PER ELECTION- $ 722.00 $ 0.00 $ $ 416113 $ T10 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED Abe Gupta Principal ❑ PAID CALENDAR YEAR 3329 Cydonia Court Anabe, Inc. $ $ 35.00 0 00 % $ 35.00 $ 0.00 Dublin, CA 94568 ❑FORGIVEN PER ELECTION'* $ 35.00 $ 0.00 $ $ 7/29/13 $ to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED Abe Gupta Principal ❑PAID CALENDAR YEAR 3329 Cydonia Court Anabe, Inc. $ $ 5000.00 0.00 % $ 5000.00 $ 0.00 Dublin, CA 94568 ❑FORGIVEN RATE PER ELECTION** $ 5000.00 $ 0.00 $ $ 8/28/14 $ t m IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0.00 $ 0.00 $ 5757.00 $ (Enter(e)on Schedule B Summary Schedule E,Line 3) 1. Loans received this period....................................................................................................................$ 000 (Total Column (b) plus unitemized loans of less than $100.) tContributor Codes 2. Loans paid or forgiven this period.........................................................................................................$ n nn IND—Individual COM—Recipient Committee (Total Column (c) p lus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g.,business entity) PTY—Political Party 3. Net change this period. (Subtract Line 2 from Line 1.)..............................................................NET $ n nn SCC-Small Contributor Committee Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number) *Amounts forgiven or paid by another party also must be reported on Schedule A. FPPC Form 460(Jan/2016) **If required. FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded SCHEDULE C Nonmonetary Contributions Received to whole dollars. . _ , Statement covers period from 01/01/2017 • ' 0 SEE INSTRUCTIONS ON REVERSE through 06/30/2017 Page 5 of 5 NAME OF FILER I.D.NUMBER Abe Gupta for Dublin City Council 2014 1357076 ENTER DATE FULL NAME,STREETADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, DESCRIPTION OF AMOUNT! CUMULATIVE TO PER ELECTION DATE RECEIVED OCCUPATION AND EMPLOYER FAIR MARKET CALENDAR YEAR TO DATE ZIP CODE OF CONTRIBUTOR CODE* (IF SELF-EMPLOYED,ENTER GOODS OR SERVICES (IF COMMITTEE,ALSO ENTER I.D.NUMBER) VALUE (IF REQUIRED) NAME OF BUSINESS) (JAN 1-DEC 31) ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ Schedule C Summary "Contributor Codes 1. Amount received this period-itemized nonmonetary contributions. IND-Individual (Include all Schedule C subtotals.)......................................................................................................................$ 0.00 COM-Recipient Committee (other than PTY or SCC) 2. Amount received this period-unitemized nonmonetary contributions of less than $100..................................$ 50.00 OTH—Other(e.g.,business entity) PTY—Political Party 3. Total nonmonetary contributions received this period. SCC-Small Contributor committee Add Lines 1 and 2. Enter here and on the Summa Page, Column A, Lines 4 and 10. TOTAL $ 50.00 FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov RECEIVED or Drf�� JUL 3 12017 CM OF DUBLIN 9 I 8' C I7Y MANAGER'S OFFICE CITY OF DUBLIN DUBLIN MUNICIPAL CODE CHAPTER 2.28 et seq. (Ordinance No. 16-09) CAMPAIGN CONTRIBUTION LIMITATIONS Ordinance No. 16-09 limits campaign contributions with respect to an election to a total cumulative amount of$500 from any person. To ensure full compliance with this Ordinance, each candidate/office holder shall execute a declaration under penalty of perjury on a form provided by the City Clerk stating that such candidate/office holder did not receive any contribution or contributions totaling more than five hundred dollars ($500) from any person with respect to an election. This required declaration shall be filed with the City Clerk with each pre-election statement filed pursuant to State Law and with the semi-annual statements required to be filed pursuant to State Law. This form is filed with my: ❑ pre-election statement F] semi-annual statement and relates to the office of: ❑ Mayor ❑x Councilmember 1, Abe Gupta hereby certify under penalty of perjury that I understand the limitations discussed herein and further that I have complied with said limitations. 13�) (Date) (Signature) G:\Elections\Elections\FORMS\$500 I imit.DOC