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HomeMy Public PortalAboutPerez, Francisco - Form 460 - 10.25.11 - 2nd Preelection StatementRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200 -84216 5) SEE INSTRUCTIONS ON REVERSE COVERPAGE Type or print In ink. Date Stamp CALIFORNIA ECEAV Statement covers period Date of election if applicable: OCT 2'5 2011 1 e (Month. Day, Year) Page of '_ _ from 09/25/201 through 10/22/2011 Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. X❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall O Controlled (Also Complete Pan 5) O Sponsored (Also Comoletepan6l ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee O Political Party /Central Committee 3. Committee Information COMMITTEE NAME (OR PEREZ FOR CITY TREASURER STREET ADDRESS (NO RO BOXI ❑ Primarily Formed Candidate/ Officeholder Committee (At. Complete Part 7) ID.NUMBER 3700 WILSHIRE. BLVD. SUITE 10508 CITY STATE ZIP CODE AREA CODE /PHONE LOS ANGELES, CA 90010 213 -489 -4792 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL FAX / 11/08/2011 �ITY OF LYNWOPD ^ TY CLERKS OF ICE 2. Type of Statement: ,©- Preelection Statement ❑ Quarterly Statement ❑ Semi - annual Statement ❑ Special Odd -Year Report El Termination Statement ❑ Supplemental Preelection (Also fie a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER DAVID L. GOULD MAILING ADDRESS 3700 WILSHIRE BLVD. SUITE 1050E CITY STATE ZIP CODE AREA CODE /PHONE LOS ANGELES, CA 90010 213 -489 -4792 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS 3700 WILSHIRE BLVD. SUITE 10508 CITY STATE ZIP CODE AREA CODE /PHONE LOS ANGELES, CA 90010 o>>_aa P_a7op OPTIONAL FAX / E -MAIL ADDRESS 213 -489 -4818 dlgouldsidavidgouldcompany.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 atte hedules 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. i U.I Executed on 1 r By Executed an x e 12r I r 1 ��✓ l i- Dale By SgnaWr Controlbng DR akl6Fdc, Candidate,state Measure Proponent or Reaponvbk Officer of sponsor Executed on By Data Signature of controlling OBicehdtler, Candidate. Slate Measure Proponent Executed on By Hate. Signature of Controlling Officeholder, Candidate, Slate Measure Proponent FPPC Form 460 (January/OS) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275-3772) State of California www.net/ile.com Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee Type or print in ink. NAME OF OFFICEHOLDER OR CANDIDATE Francisco J. Perez OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Local Treasurer City of Lynwood RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 10756 San Jose Ave Lynwood, CA 90262 Related Committees Not Included in this Statement: Listany committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. NAME OF TREASURER STREETADDRESS NUMBER ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME IID NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMIT TEEADDRESS STREET ADDRESS (NO PO. BOX) CITY STATE ZIP CODE AREA CODEIPHONE www.neffile.com 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVERPAGE -PART2 Page 2 of 8 BALLOT NO OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate /Officeholder 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 Attach continuation sheets if necessary FPPC Form 460 (January105) FPPC Toll -Free Helpline: 866 /ASK.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 09/25/2011 SUMMARYPAGE SEE INSTRUCTIONS ON REVERSE I through 10/22/2011 1 Page 3 of 8 NAME OF FILER I.D. NUMBER PEREZ FOR CITY TREASURER 1341542 Contributions Received Column A TOTnimISPERIOO (FROM ATfAC HED SOHEDULE5) 1. Monetary Contributions ........ ._.... ...................... Schedule A, Line 3 $ 600.00 S 2. Loans Received .. a ............ .. ..... a.... Schedule B. Line 3 $ 553.17 14 Miscellaneous Increases to Cash ... ......_ .... .. Schedule 1, Line 4 1 SUBTOTALCASH CONTRIBUTIONS ... ............. . Add Lines 1 +2 S 1, 153.17 1,651.89 4. Nonmonetary Contributions............ .............. Schedule Cr Line 3 $ 0 00 5. TOTAL CONTRIBUTIONS RECEIVED. ........_......... Add Lmes 3 +4 $ 1,153 17 10 Nonmonetary Adjustment ..................... ........... Schedule C, Line 3 Expenditures Made 17 12 Beginning Cash Balance .................. Previous Summary Page, Line 16 S 6. Payments Made .. ...................... .................... Schedule E Line4 $ 1,651.89 14 Miscellaneous Increases to Cash ... ......_ .... .. Schedule 1, Line 4 7. Loans Made ............ ............................... ...... Schedule H, Line 3 15 Cash Payments.... ............ . ..... .... __. .4..... Column A, Line B above 0.00 1,651.89 8 SUBTOTAL CASH PAYMENTS ....... ........................ Add Lines 5 +7 $ 1,651.89 9 Accrued Expenses (Unpaid Bills) ................... . ....Schedule F Line 3 $ 550 00 10 Nonmonetary Adjustment ..................... ........... Schedule C, Line 3 18 Cash Equivalents ............... ........_ .... .. See instructions on reverse 0 .00 11 TOTAL EXPENDITURES MADE ... .................. ...Add Lines 8 +9 +10 S 2.201 89 Current Cash Statement 17 12 Beginning Cash Balance .................. Previous Summary Page, Line 16 S 498 72 13. Cash Receipts ...... _ ... ...................... Column A, Line 3 above 00 1,153 17 14 Miscellaneous Increases to Cash ... ......_ .... .. Schedule 1, Line 4 550.00 0.00 15 Cash Payments.... ............ . ..... .... __. .4..... Column A, Line B above 1,651.89 16. ENDING CASH BALANCE.... . Add Lines 12 + 13 + 14, than subtract Line 15 $ 0 00 If this is a termination statement, Line 16 must be zero 17. LOAN GUARANTEES RECEIVED .............4...... Schedule e, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18 Cash Equivalents ............... ........_ .... .. See instructions on reverse $ 0 00 19. Outstanding Debts ... ........... Add Lme 2 +Lme 9m Column 8 above $ 3,103 17 www.netfile.com Column B CALENDAR \EAR TOTPLTODATE $ 3,775.00 2,$53.17 $ 6,328.17 0.00 S 6,328 17 $ 6,328.17 0 00 $ 6,328.17 550.00 0.00 S 6 878.17 To calculate Column B, add amounts In Column A to the corresponding amounts from Column 8 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6 130 711 to Oat( 20, Contributions Received $ $ 21 Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Matle' (if Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) $ 'Amounts In this section may be different from amounts 'eported in Column B FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule A Type or print in ink. SCHEDULE A wmounts may III returned Monetary Contributions Received Statement covers period I to whole dollars. ' from 09/25/2011 0 SEE INSTRUCTIONS ON REVERSE through 10/22/2011 Page 4 of S NAME OF FILER I.D NUMBER PEREZ FOR CITY TREASURER 1341552 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER AMOUNT CUMULATIVETO DATE PER ELECTION RECEIVED Or COMMITTEE , ALSO ENTER I D HUMBER) CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF - EMPLOYED. ENTER NAME PERIOD (JAN 1 -DEC 31) (IF REQUIRED) OFeuswBSSI 10/11/2011 Isrdro Perez FIND Machinist 600 00 3,600.00 P11 3,600 00 []COM 30756 San Jose Ave. ❑OTH Cytec Engineered Lynwood, CA 90:.6 ❑ PTY Materials []SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY El SCC ❑IND ❑ COM ❑ OTH ❑ PTY [:]SCC SUBTOTALS 600 on �,� ==. �.:...>_= -- m,: Schedule A Summary 'Contributor Codes 1. Amount received this period- Itemized monetary contributions. IND - Individual (Include all Schedule A subtotals.) .................................................................. ..............................$ 600.00 COM- Recipient Committee (other than PTY or SCC) 2. Amount received this period - unitemized monetary contributions of less than $100 ........................... $ 0.00 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 Summa Page, Column A, Line 1. 600.00 ( Y 9 ) ....................... TOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) www.netfile.com r ...... ... ...:...:..:..1 SCHEOULEB -PART1 acneaute tS — vart i Amounts may be rounded Statement covers period Loans Received to whole dollars. CAUFORNIA 1 from 09/25/2011 •' SEE INSTRUCTIONS ON REVERSE through 10/22/2011 Page 5 Of 8 NAME OF FILER I.D NUMBER PEREZ FOR CITY TREASURER 1341542 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING (b) AMOUNT IN gMOUNT PAID Itl) OUTSTANDING (e) INTEREST If) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (FOOMMITTEE.ALSO ENTE9I O, NUMBER) NAVEOFSUSINESSI PERIOD PERIOD THIS PERIOD" PERIOD PERIOD LOAN TO DATE Francisco J. Perez PAID CALENDAR YEAR 10756 San Jose Ave. 0.00 2,000.00 2,000.00 $ 0% % 5 $ 2, 553.P FORGIVEN PER ELECTION" Lynwood, CA 90262 RITE 2,000 00 5 0 00 $ 0 00 5 0 00 5 09112/2011 PIT z, 113 17 S t® IND 0 COM ❑ OTH ❑ PTY C] SCC DATE INCURRED DITE DUE Francisco J. Perez PAID CALENDAR YEAR 10756 San Jose Ave. 0 Do 5 553.17 3 0$ 553 17 5 2,553 v7 % 5 ❑ FORGIVEN PER ELECTION " Lynwood, CA 90262 RATE 0.00 S 553 17 E 0 $ .00 S 0 00 10/18/2011 Pu 2,55:.17 E t® IND ❑ CON [_1 OTH PTY D SCC DATE DUE DATE INCURRED PAID CALENDAR YEAR $ 3 0% % E 3 FORGIVEN PER ELECTION RITE tEl IND ❑ COM ❑ OTH ❑PTV ❑ SCC 5 5 5 5 E DATE DUE DATE INCURRED SUBTOTALS $ 553.17 $ 0 00 $ 2,553.17 Schedule B Summary 1. Loans received this period ............................................................................... ............................... $ 553 17 (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ..................................................................... ............................... $ 0.00 (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.) .............................. ............................... NET $ 553.17 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 If required FPPC Form 460 (January /05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Icmer lei on Schedule E, une 3) tContnbutor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g , business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER PEREZ FOR CITY TREASURER Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 09/25/2011 through 10/22/2011 Page 6 of 8 to NUMBER 1341542 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphernalia /misc. MBR member communications RAID radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTR contribution (explain nonmonetary)' DEC 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 RHO phone banks TRC candidate travel, lodging, and meals END 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 Lrr campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE Or COMMITTEE, ALSO ENTER I o NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Isaac Ga van CMP 250.00 2328 Wo;,a Ave/ Commerce, CA 90040 David L. Gould Company PRO 100.00 3700 Wilshire Blvd , SLe.1050 -E Los Angeles, CA 90010 David L. Gould Company PRO 100.00 3700 Wilshire Blvd , See 1050 -a Los Angeles, CA 90030 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 450.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .......................................................................... ............................... $ 1, 6471 34 2 Unitemized payments made this period of under $100 ........................................................................................................ ............................... $ 4.55 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 $ www.netfile.com 0.00 rs�ws1 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule E (Continuation Sheet) Payments Made PEREZ FOR CITY TREASURER Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 09/25/2011 through 10/22/2011 SCHEDULE E (CONT.) Page 7 of a ID NUMBER 1341542 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphernalia /mist. MBR member communications RAD radio airtime and production costs CNS Campaign consultants MTG meetings and appearances RFD returned contributions CTB Contribution (explain nonmonetary)' DEC office expenses SAL Campaign workers' salaries CVC civic donations PET petition circulating TEL Lv or Cable airtime and production costs FIL Candidate fling /ballot fees PHO phone banks TRC Candidate travel, lodging, and meals END fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals IND independent expenditure supportinglopposing 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 AMOUNT PAID Colby Poster Printing 1332 West 12th Plece Los Angeles, CA 90015 -2089 LIT 1,197.34 `Payments thatare contributions or independent expenditures mustalso be summarized on Schedule D. SUBTOTAL$ 1,197 34 FPPC Form 460 (January/05) FPPC Toll -Free Helpline- 866 1ASK -FPPC (8661275 -3772) www.netfile.com Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTI NAME OF FILER PEREZ FOR CITY TREASURER Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 09/25/2011 through 10/22/2011 SCHEDULEF Page B of B ID NUMBER 1341542 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. GMP campaign paraphernalia /mist. MBR member communications RAD radio airtime and production costs CNS campaign consultants MI meetings and appearances RFD returned contributions CTB contribution (explain nonmonelary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL I v. or cable airtime and production costs FIL candidate filing /ballot fees PHO phone banks TRC candidate travel, lodging, and meals FIND fundraising events POL 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 pnnt ads VVEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR CODE OR (a) OUTSTANDING (IN AMOUNTINCIOD (c) AMOUNT (d) OUTSTANDING pr coMmirieE ALSO ENTER I eumeERl DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (uSO REPORT ON E) OF THIS PERIOD Dnvnd L Gould Company PRO 0 00 400 00 0 00 400.00 3700 Wilshire Blvd., SLe.1050 -9 Los Angeles, CA 90010 David L Gould Company PRO 0.00 150.00 0 00 150 00 3700 Wilshire Blvd., Ste 1050 -B Los Angeles, CA 90010 Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0.00 $ 550.00 $ 0 00$ 550.00 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses Incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $ 100.) ............. ............................... INCURRED TOTALS $ 550 00 2 Total accrued expenses paid this period (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100. ) ........... ............. . ..... PAID TOTALS $ 0.00 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summa Page, Column A, Line 9. NET $ 550.00 Summary 9 ) .................................................................................................... ............................... . .. May be a negative number FPPC Form 460 (January/05) FPPC Toll -Free Helpllne: 866 /ASK -FPPC (8661275 -3772) www.netfile.com