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HomeMy Public PortalAboutHernandez, Edwin - Form 460 - 09.29.11 - 1st Preelection Statement Recipient Committee COVER PAC' C Statement Type or print in Ink. GC Date S I V tamp e Covet Page' E e � I (Governrripnt Code Sections 84200.84216.5) Statement covers period Date of election if applicable: Page from 1 of 7 - / _ j (Month, Day, Year) SEP 2 9 2011 For Official Use Only / / SEE INSTRUCTIONS ON REVERSE through 1 7/ �/ �( J � / C. ITY OF LYNWOO Y CLERKS OFFI E 1. Type of Recipient Committee: All committees - template Pans 1, 2, 3, and 4. 2. T of Statement: . o TI Candidate Controlled Committee ❑ Primarily Formed Ballot Measure IJv Preelection Statement ❑ Quartedy Statement Q State Candidate Election Committee Committee ❑ Semi - annual Statement ❑ Special Odd -Year Report Q Recall Q Controlled ❑ Termination Statement E] Supplemental Preelection (Also COrnpere Part 5J 0 Sponsored (Also file a Form 410 Termination) .Statement - Attach Form 495 (Also Compete Pad 6) ❑ General Purpose Committee ❑ Amendment (Explain below) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Compere Pert y) 3. Committee Information D. NUMBER Treasurer(s) / Eew: tiw\1�ey COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER c µ w11 r iE. i e LI f &( n� 4k A.A dt.t ec�- C -1 31 2 E� C - d e 0 019d ACC MAILING ADDRESS )!O Ly,jv F t' j�'�(aroo� tin_ �10 7 /3 -i y 2a STREET ADDRESS (NO P.O. BOX) 3/a CITY T STATE ZIP CODE AREA CODE /PHONE :31 ZZ - 11) -1 CITY / STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE �f 4n A1P dcz. Cd o"'i �3 @ 6��s L ©r(• OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS 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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct Executed on �:) Z6, a fl BY Y ate /`,�Sign�eMeorT era ASSisbntTreasrxer Executed on �-� / 2� By -"� -- Oa[e SidneWnor COneoltine oltEelwltler, Ceridldete, stal ePrvponerrt or Respaoibb Ofimrot 6parsor Executed on Die By Slrptehteof ConftflgOB ¢ddder, Candibte, State Me ePropmert Executed on Dale By SignetureorCO Ilhg Olricdclder;Csndid % State Meatve Pmpo l FPPC Form 460 (Januaryl) FPPC Toll -Free Helpline: B68 /ASK -FPPC (8661176 -37r State of Califon' Type or print in ink. COVER PAGE-PI Recipient Committee CALIFO Campaign Statement F OR M • 1 Cover Page— Part 2 Page -I— of S. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION Foos', PPORT // ,,� POSE �yt � d i, y _ J f F" V! NYC b i RESIDENTIAL/BUSINESS ADDR SS (NO. AND STREET) CITY SLATE ZIP 3 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 r 'S ��� — =— _ 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 n ' I.D.NUMBER L oy /y"' " -1 ' z'# }+'K4.3r r rI CONTROLLED COMMITTEE? 7 • Primarily Formed Candidate /Officeholder Committee List names of NAME OF TREASURER _ officeholder(s) or candidate(s) for which this committee Is primarily formed. AN CCFi - z- ❑ YES ['�_�O COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT Q(_ " ❑ OPPOSE CITY STATE ZIP CODE AREA CODEIPHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD n1 djJ - _-i� 0- .S !G c - Y - "i J S ❑ SUPPORT 0 - tS ❑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] YES E] NO ❑ ❑ OPPOSE COMMITTEE ADDRESS S7REETADDRESS (NO P.O. BOX) _ CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets if necessary FPPC Form 460 (JanuarylO FPPC Toll -Free Helpline: 866IASK -FPPC (8661276 -371' State of Califonf Campaign Disclosure Statement Type or print In Ink. SUMMARYPAG Summ Page Amounts may be rounded Statement covers period CA LIFORNIA �ry g to whole dollars. � — / / a ' from c7 F OR M SEE INSTRUCTIONS ON REVERSE through L Page of NAME OF FILER / ' L I.D. NUMBER G(j��f•���T i L +v £, / Z��P.�:n; �f4-r%l)a.,JdE.�- �v,� .✓A.'dtd cr H�Smr�r ?iii 13 y/ s.� �-- Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENOARYFAR (FROMATTA WSCHEDULES) TOTALTOOATE Running in Both the State Primary and 1. Monetary Contributions ............ ............................... schedule A, Lines $ 7o $ General Elections 2. Loans Received ............. ............................... .......... Schedule B, Line 3 ' 5 - 0 J. 0 1 7 L 5. o a 1/1 through 6130 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines i +2 $ Z ©O • 09 $ ! 7 Z S • 0 0 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Linea 21. Expenditures DD O J S. e � 736. as 5. TOTAL CONTRIBUTIONS RECEIVED ....... .................... Add Lines 3 +4 $ 'Z .J $ 7 Z .- � b Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 73C. a 5 $ 3 6- > > Candidates 7. Loans Made .............................. ............................... Schedule H, line 3 SL tb2 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add lines s +7 $ $ 22. Cumulative Expenditures Made* (e sublo°t tovolunla,y Exp°omtum umh) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment ........... ............................... schedule C, Line 3 B'- (mnVddtyy) 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8.9 + 10 $ 7 3 (, . $ 7 3 C— 9 J $ Current Cash Statement K, I_J $ 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ /0 To calculate Column B, add 13. Cash Receipts .................... ............................... Column A, Line 3 above in Column A to the corresponding amounts *Amounts in this section may be 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 $ `b-- 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 filed 17. LOAN GUARANTEES RECEIVED .... ....................... Schedule B, Part 2 $ i9_ for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if � an 18. Cash Equivalents ......... ............................... see instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ $`— FPPC Form 460 (January/0 FPPC Toll -Free Helpllne: 8661ASK -FPPC (8661275 -377: ScheduleA Type or print in ink. SCHEDULE Monetary ontributions Received Amounts may be rounded Statement covers period rY to whole dollars. �7 e' • ' from '[ — / e SEE INSTRUCTIONS ON REVERSE through 7z Page / of / NAME OF FILER I.D. NUMBER GP�Ivt -¢�- .O r, Z cr DATE CONTRIBUTOR NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION RECEIVED OFCOMMITTEE. PLW ENrERi.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE OF SELF - EMPLOYED. ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF SU &NESS] _ ❑ IND a t)�d � (4 EIOTH r su tro 2 � Z ❑SCC k mwrze r ❑IND 6 (( fww 6 h I DOOM U/j rrrd ❑ oTH 0 3 7 N; /oGr 2.r�r A C ❑ PTY / , y �✓ Sd V� CCa- °cn44 ❑SCC o ❑IND ❑COM J L_1 0 of , 19 3 1r(fr rthr+ G� w t <;. rr oPTY cam,- 9oZ6 i, ❑SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑SCC SUBTOTAL$ 7 0 D Schedule A Summary * Contributor Codes 1. Amount received this period — itemized monetary IND - Individual (Include all Schedule A subtotals.) .......................................... ............................... $ �� COM- Recipient Committee "" (other than PTY or SCC) 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ OTH - Other (e.g., business entity) PTY - Political Party 3. Total monetary contributions received this period. SCC -Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ FPPC Form 460 (January/Q' FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661276 -377. ' Type or print In ink. SCHEDULEB -PART' Schedule B Part 1 Amounts may be rounded Statement covers period (_oans Received to whole dollars. _ I 7 NT fromq / �� SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. ctl J 0 FULL NAME, STREET ADDRESS AND 21P CODE IF AN INDIVIDUAL, ENTER (b) AMOUNT (PI OUTSTANDING e 9 OCCUPATION AND EMPLOYER AMOUNTPAID INTEREST ORIGINAL CUMULATIVE OF LENDER BALANCE RECEIVED THIS BALANCE AT PAID THIS AMOUNT OF CONTRIBUTION QFCOMMITTEE.ALSO ENTER LO.NUMaER) (IFSEF BEGINNING THIS PERIOD OR FORGIVEN CLOSE OF THIS PERIOD LOAN TO DATE too NAMEOFSUSINESSI THIS PERIOD ��� �� ❑ PAID CALE � 2 '(LS cT� r4 � �v� ✓/�1 $ $ $� bL % $ T 0 $ 3 ❑ FORGIVEN PER ELECTION' I�n1Waa�! G.�- 9 0 -t��L $ � O a $ .5� $ � t� • %�• Il s s t❑ IND ❑ COM ❑ OTH ❑ PTV ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDARYEAF 5 3 _% E $ ❑ FORGIVEN RATE PER ELECTION" $ E E E 5 t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATEDUE DATE INCURRED ❑ PAID CALENDARYEAF i $ _% E $ ❑ FORGIVEN RATE PER ELECTION" $ $ $ S E t❑ IND -❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ SCCC) O (EMer(e)an Schedule B Summary SOiedYe E,Une3) 1. Loans received this period ..................................................................................... ............................... $ 60-0 (Total Column (b) plus unitemized loans of less than $100.) tcontributor Codes IND — Individual 2. Loans paid or forgiven this period .......................................................................... ............................... $ COM - Recipient Committee (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 this period. Subtract Line 2 from Line 1. ................ ............................... NET $ S SCC —Small Contributor Committee 9 P ( Subtract •.... (MeYEee^eGaWervmber) Enter the net here and on the Summary Page, Column A, Line 2. 'Amounts forgiven or paid by another party also must be reported on Schedule A. If required. FPPC Form 460 (January101 FPPC Toll -Free Helpline: 866IASK -FPPC (8661275.377:: Schedule D of Ex penditures Type or print in Ink. SCHEDULE Summary P Statement covers period Sup Other Amounts may of rounded ++ CALIFORNIA 4 . 1 to whole dollars. from — 7 — � ` 1 � F OR M Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE through I !� Page --L-- of 'r' NAME OF FILER ,/� g B '/_ I.D. NUMBER CO � r�. C- £` l �' �G( f� `l wi rtla�.i ✓ Fo,r Ni�Tf -t r l�'=z� �':u r er�"2�9� . - '0 / J J rJ �+- DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE PER ELECTION MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) CALENDAR YEAR TO DATE OR COMMITTEE PERIOD (JAN.1 DEC. 3t) (IF REQUIRED) G CA4A4 i -r f f 1 -7 63-Monetary &C_e'v ed' ` .,. r ( Contribution it ❑ Nonmonetary T _ 1 - Contribution .50 ❑ Independent L3 Support ❑ Oppose Expenditure Gp rl,�.'�£ C kv kP>:'Cir�— f7 M^ netary v (( Contribution r"/+ -a'ry Q.A"f O $� Fcr jG'ea( ❑ Nonmonetary Contribution �pwf.0 red' /�. �/ ��10• J ❑ Independent Q. Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL b Schedule D Summary J t 1. Itemized contributions and independent expenditures made this period. Include all Schedule D subtotals. ........ ............................... $ 2. Unitemized contributions and independent expenditures made this period of under $100 ...................................................... ............................... $ mo o/ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ............ TOTAL $ �l 0 CO " ZS FPPC Form 460 (January/Oc FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -377:: SCHEDUIL Schedule E T or print in Ink. Statement . Amounts may be rounded covers period , Payments Made to whole dollars. — j .: • ' from SEE INSTRUCTIONS ON REVERSE through Page of / // . NAME OF FILER I.D. NUMBER 0i 13 4 11-5 v CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphemalia/misc. MBR member communications RAD 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 t.v. 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 PA independent expenditure supporting /opposing others (explain)" POS postage, delivery and messenger services TSF transfer between committees of the same candidate /spons LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads VIIEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE ffr IT - EE / ALSO EN I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID 3 50 Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTALS Schedule E Summary 2 SV 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................... ............................... $ 2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column ( e).) ................................................ ............................... $ 4. Total a ments made this period. Add Lines 1, 2, and 3. Enter here and on the Summa Page, Column A, Line 6. Z'S a P y P ( Summary 9 ) ............................. TOTAL $ FPPC Form 460 (January/CI: FPPC Toll -Free Helpline: 866/ASK -FPPC (8661275 -377': SCHEDULE Schedule H Type or print in ink. Statement covers period CALIF Loans Made to Others* Amounts may be rounded I J i t � to whole dollars. from ! �j F O R M SEE INSTRUCTIONS ON REVERSE through ? �` �/ Page u of NAME OF FILER / / I.D. NUMBER t 4 % f c 'Y �, c v7 (mow, A L) S 2 r C.; {rf 6 co (c 2,0 // (b) Ic) 411 lei 10 I91 FULL NAME, STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF RECIPIENT OCIF AN INDIVIDUAL, ENTER CUPATION AND EMPLOYER BALANCE LOANED THIS REPAYMENT OR BALANCE AT (IF COMMITTEE, ALSO ENTER D. NUMBER) (IF SELF - EMPLOYED, ENTER BEGINNING THIS FORGIVENESS CLOSE OF THIS RECEIVED AMOUNT OF LOANS ; _/ NAME OF BUSINESS) PER PERIOD THIS PERIOD* PERIOD LOAN TO DATE CIO A.A `I�r 4,�G�ry� ❑ PAID CALENDAR YEAF �CrLSO LL��S.i..3d �•v L✓,V :AFc7d i, {� f f _% f 3 R a /j`T� 'L . E] FORGIVEN I RATE PERELECTION* .} q $ Sab` /,� J (J34� 1 % GA • L �Z 6 E $ $ DATE DUE DATE INCURRED f El PAID CALENDAR YEAF f $ -% 3 $ D FORGIVEN MME PER ELECTION' $ 3 $ $ 3 DATE DUE DATE INCURRED "Loans that are contributions to another candidate committee �n� must also summarized Schedule D. Loans forgiven must SUBTOTALS $ (/ t/ $ $ $ also be reported on Schedulul e E. IEnler (e) on Schedule 1 Line 3) Schedule H Summary 1. Loans made this period ................................................................................................................... ............................... $ ��CIU (Total Column (b) plus unitemized loans of less than $100.) If Required Z�•, 2. Payments received on loans ............................................................................................................ ............................... $ (Total Column (c) plus unitemized payments of less than $100.) C3� 3. Net change this period. (Subtract Line 2 from Line 1.) ............................... ............................... ............................ NET $ (Me a a negati e n mee) (Enter the net here and on the Summary Page, Column A, Line 7.) FPPC Form 460 (Januaryl0: FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -377,