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Home My Public Portal AboutPerez, Francisco - Form 460 - 09.28.11 - 1st Semi-Annual Statement Recipient Committee COVERPAGE Type or print in ink. Date Stamp Campaign Statement RECEIV 0 Cover Page (Government Code Sections 84200- 84216.5) q) Statement covers period Dale of election if applicable:. SEP 2 $ - from 0 . 1/ 01 /2011 6 (Month, Day, Year) Page of CITY OF LYNW00 Far Official Use Only SEE INSTRUCTIONS ON REVERSE through 09/24/2011 11/08/2011 Y CLERKS OFFI E 1. Type of Recipient Committee: All Committees - Complete Pans 1, 2, 3, and 4. 2. Type of Statement: [K] Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ® Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Committee ❑ Semi - annual Statement ❑ Special Odd -Year Report Recall O Controlled ❑ Termination Statement S (Alan Complete Fart s) S onsored ❑ pp ementatPreelection P (Also a Form 410 Termination) Statement - Attach Form 495 (Also Complete Can 6) ❑ General Purpose Committee ❑ Amendment (Explain below) O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee 0 Political Party /Central Committee (Also complete Part 7) .. 3. Committee information I.D. NUMBER Treasurer(s) 341542 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER PEREZ FOR CITY TREASURER DAVID L. GOULD MAILING ADDRESS - 3700 WILSHIRE BLVD. SUITE 1050B - STREET ADDRESS (NO P.O. BOX) - CITY STATE ZiP CODE - AREA CODE /PHONE 3700 WILSHIRE BLVD. SUITE 1050B LOS ANGELES, CA 90010 213- 489 -4792 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER. IF ANY LOS ANGELES, CA -90010 213- 489 -4792 MT09RDTF MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS 3700 WILSHIRE BLVD. SUITE 10508 CITY - STATE ZIP CODE AREA CODEIPHONE CITY STATE ZIP CODE AREA CODE /PHONE LOS ANGELES. CA 90010 91q_agq -G"1gJ OPTIONAL: FAX 1 E -MAIL ADDRESS OPTIONAL: FAX 1 E -MAIL ADDRESS ' 213 - 489 -4818 dlgoulci vidgouldcompany.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 at chedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. - - Executed on 4 � 7 — %, By Pate - - Slgnoturdef Treasureror Assist reasurer - Executed on 9 ' 2¢— t f By gna oponenmr Responsible orroerotsponsor Date Si of Conlrolli axesdeq Candidate. Slate Measure Pr Executed on By out Signawre of Controlling Offioeholtler, Candtdata, State Measure Proponent Executed on By Date Sgnature of Controlling Officenoldee Candidate, State Measure Proponent FPPC Form 468 (January/05) - FPPC Toll -Free Helping: 866 /ASK -FPPC (8661275 -3772) State of California. www.netfile.com , Type or print in ink. COVERPAGE- PART2' Recipient Committee Campaign Statement CALIFORNIA I FORM 46 Cover Page — Part 2 Page 2 of 6 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Francisco S. Perez OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.ORLETTER JURISDICTION ❑' SUPPORT Local Treasurer _ ❑ OPPOSE City o£ Lynwood RESIDENTIAIIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 10956 San Jose Ave. Lynwood, CA 90262 - 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 COMMIT TEE? 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 STREET ADDRESS (NO P 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 COMMITTEENAME !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 - F1 YES ❑ NO - � - ❑ OPPOSE ' ❑ COMMITTEE ADDRESS STREET ADDRESS (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: 8661ASK -FPPC (8661275 -3772) State of California www- neSile.com Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Summa Page Amounts may be rounded Statement covers period - Summary g to whole dollars. I ' from 01/01/2011 •' SEE INSTRUCTIONS ON REVERSE through 09/24/2011 Page 3 of 6 NAME OF FILER I.D. NUMBER PEREZ FOR CITY TREASURER - 1341542 ColumnA Column B Calendar Year Summary for Candidates Contributions Received TDTALTHISPERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) ToTALTDDATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........... .._ ............................ Schedule A. Line 3 $ 3,195.00 S 3,175.00 2. Loans Received ... ... ................ .......................__._.. scnedule e. Linea 2,000.00 2,000.00 111 through 6130 711 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ........ ............ Add Lines 1 12 $ 5, 195. Do $ s, 195.00 20. Contributions Received S $ 4. Nonmonetary Contributions ................. ............ ...... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ....... .................... Add lines 3 l a $ 5,195.00 $ 5,195.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made .... ......................... ........... .......... .... Schedule E, Line 4 S 4,696.28 $ 4,696428 Candidates 7. Loans Made... ........... ........... .................... ......... Schedule H. Line 3 0.00 0.00 22. Cumulative Expenditures Made' 8. SUBTOTALCASH PAYMENTS ............... ........... .._...... Add Lines 617 $ 4,696.28 S 4,696.28 (lt Subject to Volunpry E Rpentlitury 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 0.00 0.00 (mm /dd /yy) 11. TOTAL EXPENDITURES MADE ...... ............ ._........... Addunes a. 9 +to $ 4,696.28 $ 4.696.28 � $ Current Cash Statement J $ 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 0 . 00 To calculate Column B, add 13. Cash Receipts ............ .............................. Column A, Line 3 above 5,195.00 amounts in Column A to the corresponding amounts 'Amounts in this section may be differenlfrom amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 0.00 from Column B of your last reported in Column B. 15. Cash Payments ................. .. ........ .._ ........ .......... Column A, Line &above 4,676.2 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add lines 12113+ 14, then subtract Line 15 $ 498.92 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 $ 0.00 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents ......... ............................... see instructions onreverse $ 0.00 19. Outstanding Debts ........................ Add Line 2+ Line gin Column B above $ 2,000.00 FPPC Form 460(January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) www.netfile.com Schedule A - Type or print in ink. - SCHEDULE A Monetar ontributions Received Amounts may be rounded Statement covers period ry to whole dollars. . - CALIFOR 2 ' • � from 01/01/201 -1 •- SEE INSTRUCTIONS ON REVERSE through 09/24/2011 Page 4 of 6 NAME OF FILER I.D. NUMBER PEREZ FOR CITY TREASURER 1341542 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR' IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER LO. NUMBER) CODE + OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED ENTER NAME PERIOD (,IAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 09/22/2011 Isidro Perez - ®IND Machinist 3,000.00 3,000.00 PI1 3,000.00 ❑COM 10756 San Jose Ave. ❑OTH Cytec Engineered ❑ PTY Materials Lynwood, CA 98262 ❑SCC - , 09/24/2011 Rr Landscapes Design Inc. ❑IND - 100.00 100.00 P 11 100.00 [_JCOM 5111 Stacy Se. ❑x OTH Hawthorne, CA 90250 L] PTY ❑SCC .. _ ❑IND ❑COM ❑OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑OTH ❑ PTY _ ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY - ❑SCC - SUBTOTAL$ 3, 100 00 Schedule A Summary *Contributor Codes 1, Amount received this period — Itemized monetary contributions IND- Individual (Include all Schedule A subtotals.) ......................................................... ..............................$ 3, 100.00 COM Recipient Committee (other than STY or SCC) 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 7 .00 OTH - Other (e.g., business entity) PTY - Political Party - 3. Total monetary contributions received this period. SCC - Small contributor committee (Add tines 1 and 2. Enter here and on the Summary Page, Column A, Line T) :.:............... TOTAL $ 3, 175. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK•FPPC (8661275 -3772) www.netfile.com Type or print in ink. SCHEDULER -PART1 Schedule B — Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. 4 from 01/01 /2011 •' Ll SEE INSTRUCTIONS ON REVERSE through 09/24/2011 Page 5 of 6 NAME OF FILER I.D. NUMBER PEREZ FOR CITY TREASURER 1341542 IF AN INDIVIDUAL, ENTER (b) W ldl let IN lgl FULL NAME, STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTANDING OF LENDER OCCUPATION AND EMPLOYER BALANCE AMOUNT PAID BALANCEAT INTEREST ORIGINAL CUMULATIVE (IFCOMMUTEE, LSO ENTER LO.NUMaER) OFSELF- EAPL0YED,ENrER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAMEOFRUSINESSI PERIOD PERIOD THIS PERIOD' PERIOD PERIOD LOAN TO DATE Francisco J. Perez ❑ PAID CALENDAR YEAR S 2,000.0 Candidate S 0.00 3 z, 000.00 0c % s z, 000.00 10'156 San Jose Ave. Lynwoo RATE CA 90262 FORGIVEN PREELECTION 0.00 2,000.00 0 0o "i 2,000.00 S s 3 - S 0.00 09/12/2011 $ t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR $ $ 0% % 8 $ ❑ FORGIVEN RATE PER ELECTION •' E S 3 E E ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR 3 3 0% % $ $ FORGIVEN RATE ❑ PER ELECTION" 3 3 E S S t❑ IND ❑ COM ❑ OTH p PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 2,000.00 $ 0.00 $ 2,000. oa $ MIX (E uleE, Schedule B Summary ScheGuleE,Ln ieJ, 1. Loans received this period ..................................................................................... ............................... $ 2.000.00 (Total Column (b) plus unitemized loans of less than $100.) tcontributor Codes IND — Individual 2. Loans paid or forgiven this period .......................................................................... ............................... $ 0,00 COM - RecipientCommittee (Total Column (c) plus 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 period. Subtract Line 2 from Line 1. 2.000000 SCC — Small Contributor Committee 9 P ( ) .... ............................... ............................NET $ Enter the net here and on the Summary Page, Column A, Line 2. ` may bed negative n"mbeo 'Amounts forgiven or paid by another parry also must be reported on Schedule A. If required. FPPC Form 460 (January105) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772) www.netfile.com Schedule E T or print in ink. SCHEDULEE Amounts may be rounded Statement covers period 7NUMBER I 1 Payments Made to whole dollars. ` - from 01/01/2011 S EE INSTRUCTIONS ON REVERSE through 09/24/2011- of 6 NAME OF FILER PEREZ FOR CITY TREASURER - CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia /mist. MBR member communications HAD 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 tM. or cable airtime and production costs FL candidate filing ballot fees PHO phone banks - TRC candidate travel, lodging, and meals FIND fundraising events ROL 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Pyramid PYess LIT 4,676.20 5037 W. Jefferson Blvd. ' Los Angeles, CA 9n016 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 4,676.28 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ...... ....._ .. ........................ ............ ............................... $ 4, 676.28 2. Unitemized payments made this period of under $100 .. ...........................:..: ................. $ 0.00 3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e). ................... $ 0.00 4. Total a ments made this eriod. (Add Lines 1, 2, and 3. Enter here and on the Summa Page, Column A, Line 6. P Y P Summary 9 ) ............................. TOTAL $ 4, 676.28 FPPC Form 460 (January/05) FPPC Toll- Free Helpline: 866 1ASK -FPPC (866 1275 -3772) www.neffile.com