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Home My Public Portal AboutHernandez, Edwin - Form 460 - 10.19.11 - 1st Preelection Statement - AmendmentRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200 -84216 5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 7 // through / - Z t/ // Date of election if applicable: (Month, Day, Year) Date Stamp ECEIV OCT 19 2011 I (- 0' - // CITY OF LY 1 Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. �... Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall O Controlled (aso COmplere Parts) O Sponsored (Also Cbe dote Part 61 ❑ General Purpose Committee O Sponsored Q Small Contributor Committee 0 Political Party /Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I I D MMII ILL NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Co A4Ati -4e c 4-o z /c in k moo; A) Nkrwjw4z- STREET ADDRESS (NO PO BOX) 3 / z- -2_ F_ d ti ✓ CITY STATE ZIP CODE AREA CODE /PHONE k,y N /u r?0 d C — _ 9 oz 6-a- 3 i v - 7/ 3• / °'Zdr— MAILING ADDRESS (IF DIFFERENT) NO AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE N '1 "A At C/a z. caw J 7 i J e l ra• , L. e_e y, OPTIONAL FAX / E -MAIL ADDRESS Treasurer(s) Eae�o _ X% >L4 rN J( / Z Z il�- C06A3 i'nr d/ x ✓ C n �yn sc v rid .L — 96 ZdZ 7, 1:5 - CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE 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 �/ t// �/ B Date Signa or As s nt Tre surer Executed on 07,4 /� 77�' / / By Date Signature of Controlling Officeholder, Candidate, State MeasureP ponent or Responsible afroerof Sponsor Executed on D By DeeSignaNre of COnVglmg Offirehdtler, Candidate, State Measure PmpaneM Executed on By Data Signature afCOnVdling OthcehoMer, Candidate, State Measure PmponeM FPPC Form 460 (January/05) FPPC Toll -Free Helpllne: 866 /ASK -FPPC (8661275 -3772) State of California 2. Type of Statement: — ' 0 Preelection Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) Amendment (Explain below) PAGE �— of 7 =or Official Use Only IJ ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 Recipient Committee Type or print in ink. COVERPAGE -PART2 Campaign Statement CALIFO 460 � � Cover Page — Part 2 Page _ of 7 5. Officeholder or Candidate Controlled Committee NAME OF OFFI HOLDER OR CANDIDATE Aj /4 Ad OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) r V ( e , Ac'e-StJf 4-, — 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION ❑ SUPPORT ❑ OPPOSE RESIDENTIAL /BUSINESS ADDRESS (NO AND STREET) CITY STATE ZIP 3 ( 2-2- Identify the controlling officeholder, candidate, or state measure proponent, if any. G 4V A if �r`�`SLT7I�� Q Z �� NAME OF OFFCEHOLDER, 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 JID.NUMBER NAME OF TREASURER CONTROLLED COMMITTEES ❑ YES ❑ NO STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEENAME I.D NUMBER NAME OF TREASURER CONTROLLED COMMMEE9 ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary 7 Primarily Formed Cand idatelOffice holder Committee List names of 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 FPPC Form 460 (January/OS) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) State of California Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7 - / 7/ Expenditure Limit Summary for State Candidates Expenditures Made 6. Payments Made Schedule E, Line 4 through 2 1/'- e of SEE INSTRUCTIONS ON REVERSE Add Lines 6 +7 9. Accrued Expenses (Unpaid Bills) Schedule F, Linea 10. Nonmonetary Adjustment Schedule C, Linea 11 TOTAL EXPENDITURES MADE NAME OF FILER LI NUMBER /s 8 SOP2l Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHISPERIOD (FROMATTACHED SCHEDULES) CALENDARYEAR TOTALTODATE Running in Both the State Primary and Contributions 7� 7d0 General Elections 1 Monetary Schedule A, Line 3 $ $ // 7 ,Z— c I1'7 Z 111 through 6/30 7/1 to Date 2. Loans Received Schedule B, Line 3- [_J 3. SU BTOTAL CASH CONTRI B UTIONS Add Lines l +2 $ 'JAY7J $ /ZQa 20. Contributions Received $ $ 4. Nonmonetary Contributions Schedule C, line _ `-�_ �- 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 +4 $ $ ZC77J Made $ $ Expenditures Made 6. Payments Made Schedule E, Line 4 7 Loans Made Schedule H, Linea 8. SUBTOTAL CASH PAYMENTS Add Lines 6 +7 9. Accrued Expenses (Unpaid Bills) Schedule F, Linea 10. Nonmonetary Adjustment Schedule C, Linea 11 TOTAL EXPENDITURES MADE .Add Lines 8 +9 +10 $ 736.z 736. zs $ 736- as $ 73( zs Current Cash Statement 9) 12, Beginning Cash Balance Previous Summary Page, Line 16 $ 13. Cash Receipts Column A, Line 3 above If �a 14. Miscellaneous Increases to Cash Schedule 1, Line 15. Cash Payments Column A, Line 8 above 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Lme 15 $ If this is a termination statement, Line 16 must be zero. 17 LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ L Cash Equivalents and Outstanding Debts 18. Cash Equivalents See mstmchons on reverse $ 19. Outstanding Debts Add Line 2+ Line 9 in Column B above $ - To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts In Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (If any). 22. Cumulative Expenditures Made` (If Subjectto Voluntary Expenditure Limit) Date of Election Total to Date (mmldd /yy) SUMMARYPAGE Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January105) FPPC Toll -Free Helpline: 866 /ASK•FPPC (8661276 -3772) Schedule A Type or print in ink. SCHEDULE A Monetar Contributions Rived Amounts may be rounded ry ons ece to whole dollars. Statement covers period _ I ' from 7 � — � � a through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER o ^4 Nr 'Wit G "tIr -t/ '? #�-1rA.5. 'j d �Z G %f �i�tsu / D. NUMBER ) 3 "/ /S3e DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR OF COMMITTEE, use ENrERI D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * QFSELF- EMPLOYED, ENTER NAME PERIOD (JAN.1 -DEC 31) (IF REQUIRED) CF BUSINESS) A 1 U ❑IND ❑COM r� afoad cn•9dz6Z El SCC ]IND COM El l b ` c4 A t/ I o ,3 j `/ 1-t; I r %- El PTY dAi vrAAr� a cam_ / 0 - 0 ft �mvdv ❑ SCC ❑IND 3 / `�c�f h'(L �l d'•r• / ❑ P TH PTY tr.t -M-Z C. • 90 Z ❑SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 7� Schedule A Summary 'Contributor Codes 1 Amount received this period— itemized monetary contributions. IND - Individual (Include all Schedule A subtotals.) $ 70D COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) 2. Amount received this period — unitemized monetary contributions of less than $100 $ PTY - Political Party 3. Total monetary contributions received this period. SCC -Small Contributor Committee G (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ v 'v FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SCHEDULES -PART1 , .... Schedule B — Part 1 r ,..... ... Amounts "" - may be rounded ` Statement covers period P CALIF 1 Loans Received to whole dollars. FO through J- y % Page of 7 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER C0d1 -G-4 e Aa / ,` ,- �4,�✓�v ; f" f�-�s r i� l 3 '�/ s 3 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING BALANCE (b) AMOUNT (�) AMOUNT PAID (al OUTSTANDING BALANCEAT (el INTEREST (7) ORIGINAL (g) CUMULATIVE OF LENDER (IF COMMITTEE, ALSOENiERI D. NUMBER) (IF SELF- EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS TO NAMEOFBUSINESS) PERIOD THIS PERIOD PERIOD PERIOD LOAN DATE r `/i ly�tl gi •2� E] PAID �^ CALENDARYEAR $ 8! v, s s_ l70 ) I Wdrel aII�' 7 \� nn �7 / a RATE 3 ` _ [] FORGIVEN PERELECTION" t DATE DUE DATE INCURRED IND [:I DOM ❑ OTH [:j PTV E] SCC A1J� (/ PAID CALENDARYEAR 8 $ w g $ E] FORGIVEN PER ELECTION" RATE $ $ $ $ S DATE DUE DATE INCURRED t❑ IND ❑ DOM ❑ OTH [I PTY ❑ SCC PAID CALENDAR YEAR $ $ o E $ L] FORGIVEN PER ELECTION RATE f[] IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ $ DATE DUE DATE INCURRED s� - t/ _" SUBTOTALS $ i ~7 JS$ q $ Suz $ , � Y Schedule B Summary 1 Loans received this period (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1 ) 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. (Enter (e)on Sohedde E, Line 3) $ ` 70ZS , NET $ T S 9 -- 7 L S (May be a negative number) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) S Schedule D SCHEDULED bummary OT tX enaltureS Type or print in ink. p Statement covers period Amounts may be rounded Supporting /Opposing Other to Whole dollars, CALIFO � O 4 6 0 1 Candidates, Measures and Committees from p7 (� _ 7/7 ^// SEE INSTRUCTIONS ON REVERSE through / Page of NAME OF FILER I.D. NUMBER DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, ORCOMMITTEE (IF REQUIRED) PERIOD (JAN.1 -DEC. at) (IF REQUIRQUIR ED) Cam_ 1 Monetary !' i' t n ASV i A — —1 cc "s Fey- .SC. ��' Contribution ❑ Nonmonetary f 6D~r[� z�� Contribution I C" G rt S ❑ Independent '50 J V 1p-S upport ❑ Oppose Expenditure r Monetary P -f) r l one - C on tribu tion - ( h�,l.dyD t r ❑ Nonmonetary gZ�LtCD 0> c- Z // Contribution ❑ Independent 7 • ��b • / �J Lo ZS 10--su pport ❑ Oppose Expenditure ❑ Monetary - Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ n Schedule D Summary $1/e �/ 1 Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) $ � lrs 2. Unitemized contributions and independent expenditures made this period of under $100 $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $ Yd a s FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661276.3772) Schedule E Type or print In ink. Statement covers period • . Payments Made Amounts may be rounded to dollars. - 7- / —// J ' 0 • whole from through IP SEE INSTRUCTIONS ON REVERSE of NA ME OF FILER UMBER �C L ;)J 4ni A"J ok Gi - �tS / 3 a il X 30 CODES. If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia /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 fling /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 M 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 UT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER to. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID I' li A prr ;�j4 -c,- * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 1 Itemized payments made this period. (Include all Schedule E subtotals.) $ S 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 payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ Z sta FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)