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Home My Public Portal AboutJacinto, Edwin - Form 460 - 09.29.11 COVERPAGE Recipient Committee Type or print in Ink. Date stamp . Campaign Statement . _ ' • Cover Page RIECEI (Government Code Sections 84200- 84216.5) Statemen� covers period Date of election if applicable: Page of from ^J ' (Month, Day, Year) SEP 2. 9 2011 For Official Use Only y,�al �� 1 ^ ,CI Y OF LYNWOOD SEE INSTRUCTIONS ON REVERSE through CLERKS OFFIC r 1. �ype of Recipient Committee: All committees - Complete Parts 1, 2, 3, and 4. 2. Type of Statement: ffceholder, Candidate Controlled Committee E] Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement O State Candidate Election Committee Committee ❑ Semi - annual Statement El Special Odd -Year Report O Recall O Controlled ❑ Termination Statement ❑ Supplemental Preelection (Also Complete Part S) O Sponsored Also file a Form 410 Termination) ) Statement - Attach Form 495 F-1 (mso Complete Parf6J General Purpose Committee ❑ Amendment (Explain below) Q Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also Complete Part 7) 3. Committee Information p. NuM g t 2 2�, Treasurer(s) //COOMMIT�TE�E /NrA1M�.E (OR CANDIDATE'S NAME IF N �CrOMMITTEE)L /� NAME I�AS� �.� / �'\J tl Q 4__,o IL l'X- V.L''j� MAILING ADO 7 S �.0 '�7 (/� ��'- / l7 (/ STREET ADDRESS (NO P.O. BOXY ` l/N G,�,� ,,{ r� 1 r.IT�� L_ r' _ ' STATE ZIP COD AREA CODE /PHONE CITY - QT ZIP ( CODE —7 AREA C �E /P N� NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS (IF DIFFERENT) AND SSTRE OR P.O. BOX /r / � I MAILING ADDRESS CIT STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS O TIONAL: AX / E IL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledgfthin�forma 'on nt 1 Bret ^ id i attached s edules is true and complete. I certify under penalty of perjury under the lavP of the State of California that the foregoing is true and correct. Executed on , l By �W Signature r rorA si tantTreas er Executed on By pDaattEa Signature ofContr ing Otrksindder. Eidate. Stau, Me s ent or Respons,We Otuxar of Sponsor J Executed on BY Data Signature of Controlling ONQw0wCar idate, State Measure Pmponwt Executed on By pate SignaNreaCAntreOing Otficetwldeq Candidate, State Measure PmponeW FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/276 -3772) State of California Type or print in ink. COVERPAGE -PART2 Recipient Committee CAUFORNIA Campaign Statement FORM ' • Cover Page — Part 2 Page of 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OF ICEHOLDER OR CANDIDATT, NAME OF BALLOTMEASURE OFFIC SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑ SUPPORT V,/C, Z ^^, `, -, ❑ OPPOSE RESIDENTIAL /BUSINESS 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. COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7 . Primarily Formed Candidate /Officeholder Committee List names of 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 El SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [ YES ❑ NO ❑ OPPOSE ❑ COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) State of California Campaign Disclosure Statement Type or print in Ink. SUMMARYPAGE Amounts may be rounded Statement covers period - Summary Page to Whole dollars. J ' from SEE INSTRUCTIONS ON REVERSE through "7"r Page of NAME OF FILE I.D. NUMBER Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISFERI -0 CALENDARYEAR Running n Both the State Prima and (FROMATTACHEDSCNED ) TOTPLTODATE 9 Primary General Elections 1. Monetary Contributions ............ ............................... Schedule A, line 3 $ $ 1/1 through 6/30 711 to Date 2. Loans Received ....................... ............................... Schedule s, Line 3 / 20. Contributions f 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines l + z $ $ Received $ A $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED .... ....... .... ............ Add Lines 3+4 $ $ Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................ ............................... Schedule E, Line 4 $ $ Candidates 7. Loans Made .............................. ............................... Schedule H, Linea 22. Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add lines 6 +7 $ $ (it Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 (mm /dd /yy) 11. TOTAL EXPEN DITU RES MADE .......... ................ ...... Add Lines 8 +9 +10 $ $ $ Current Cash Statement $ 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ To calculate Column B, add 13. Cash Receipts .................... ............................... Column A, Line 3 above amounts in Column A to the corresponding amounts 'Amounts in this section maybe different from amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 from Column B of your last reported in Column B. 15. Cash Payments ................... ............................... column A, Line a above report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being fled 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts f Lines z, 7, ands (it y) 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772)