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Home My Public Portal AboutPerez, Francisco - Form 460 - 01.26.12 - 2nd Semi-Annual Statement Recipient Committee COVER PAGE Type or print in ink. Campaign Statement Date Stam p Cover Page G+ (Government Code Sections 84200 - 84216.5) V Statement covers period Date of election if applicable: from 10/23/2011 (Month, Day, Year) • JAN 2 6 2012 Page 1 of ic For Official Use Only SEE INSTRUCTIONS ON REVERSE through 12/31/2011 11/08/2011 ITY OF LYNWO D 1, Type of Recipient Committee: All Committees _ Complete Parts 1, 2, 3, and 4. 2. Type of Statement:• X❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ® Preelection Statement E Quarterly Statement • State Candidate Election Committee Committee • Recall 0 Controlled E] Semi-annual Statement ❑ Special Odd -Year Report (Arco Camplele Pad s) 0 Sponsored ❑ Terminatio t a t me Termination ❑ Supplemental Preelection (W So Complete Perth) ( Also F ) Statement - Attach Form 495 L] General Purpose Committee ❑ Amendment (Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party /Central Committee (Also Complete Pan 7) 3. Committee Information I.D. NUMBER Treasurer(s) 1341542 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEEI NAME OF TREASURER PEREZ FOR CITY TREASURER 20I1 - DAVID L. GOULD MAILING ADDRESS 3700 WILSHIRE BLVD. SUITE 1050B STREET ADDRESS (NO P.O. DO %). CITY STATE ZIP CODE AREA CODE /PHONE - 3700 WILSHIRE BLVD, SUITE 10508 LOS ANGELES, CA 90010 213- 989 -9992 PITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY LOS ANGELES, CA 90010 213- 489 -4792 MTCHPT,TF MOORT: RANnFRC MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS 3700 WILSHIRE BLVD. SUITE 1050B CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS LOS S N....c CA 90010 OPTIONAL: FAX / E -MAIL ADDRESS 213 - 489 -4818 dlqould@davidgouldcompany.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 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 U l — Z- 4 tz By /..r� Data / aigna�f u..,arddorAddrtareMasuds Executed on J ( _ 2 L( ,— \ 'Z By Dale Sgnature Controrng1JB older, Candidate, State Measure Proponentor Responsible Officerofsponsor Executed an By Date SgnaWmotC ntr gORrxfWder.Car date. State Measure Proponent Executed on B Date sgnaWreol ConW1in, Ofritehdder, CaMdate.5tate Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (66612753772) www.net/ile.com State of California Recipient Committee Type or print in ink. COVERPAGE -PART2 Campaign Statement CALIFORNIA -460' Cover Page — Part 2 Page z 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. OR LETTER JURISDICTION SUPPORT Local Treasurer City of Lynwood ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 10756 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: Listany 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 behaff of your candidacy. COMMITTEE NAME I.D.NUMBER NAME OFTREASURER CONTROLLED COMMITTEE? 7 • Primarily Formed Candidate /Officeholder Committee List names of ❑ YES NO officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODEIPHONE 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 ❑ SUPPORT ❑ OPPOSE NAME OFTREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES ❑ NO ❑ SUPPORT COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) E] OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 660 (January/06) FPPC Toll -Free Helpline: 866 1ASK -FPPC (6661275 -3772) State of California www.neffile.com Campaign Disclosure Statement T or print in ink. SUMMARYPAGE eriod Amounts may be rounded Statement covers Summary Page to whole dollars. p • ' FOR from 10/23/2011 SEE INSTRUCTIONS ON REVERSE through 12/31/2011 Page 3 Of 6 NAME OF FILER I.D. NUMBER PEREZ FOR CITY TREASURER 2011 1341542 Colurri Column B Calendar Year Summa for Candidates Contributions Received TOTAITHISPERK)D CAENDARVEAR Summar (rROMATTACHEDSCHEWLES) TOTA-TODATE Running in Both the State Primary and General Elections 1. Monetary Contributions ............ ............................... Schedule A, Linea $ 75400 $ 3,850.00 2. Loans Received ....................... ............................... Schedule e, Line 3 0.00 2,553.17 111 through 6 130 711 to Date 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines 1 +Z $ 75.00 $ 6,403.17 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule c, Linea 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ___........._........... Add Lines3 +a $ 75.00 $ 6,403417 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ... ......4444 ................. . 4.4 Schedule E. Lines $ 0.00 $ 6,328417 Candidates 7. Loans M_ ade .............................. ............................... Schedule H, Line 3 0.00 0.00 22. Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS ............... 4.4_ .............. 44 Add Lines6 +7 $ 0.00 $ 6,326.17 In subjectto vowotary expenditure Lime) 9. Accrued Expenses (Unpaid Bills ) 4_ ....................... Schedule F Line 3 250.00 800.00 Date of Election Total to Date 10. Nonmonetary Adjustment .. ............ 4............. 4_44_...... Schedule c, Line 3 - 0.00 0.00 (mm /ddtyy) 11. TOTAL EXPENDITURES MADE ... 44_ .............4.......4... Add Lines 8 +9 +10 $ 250000 $ 7,128.17 _�� $ Current Cash Statement �_� $ -12. Beginning Cash Balance_ ..................... Previous Summary Page, Line 16 $ 0.00 To calculate Column B, add 13. Cash Receipts .................... ....4.44..................4.... Column A, Line 3 above 75. 00 amounts in Column A to the 14. Miscellaneous Incr6ases to Cash ........................... Schedule 1, Line 4 0.00 corresponding amounts Amounts in this section may be different from amounts from Column B of your last reported in Column B. 15 . Cash Payments ....... ........':... ................ .............. Column A, Line 8 above 0.00 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE.......... Add Lines 12 +13 +14, then subtract Line 15 $ 75.00 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 e, Pad 2 $ 0.00 for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if any). 18. Cash Equivalents ......... ........4444................... See instructions on reverse $ 0.00 19. Outstanding Debts ......................... Add Line 2+One 9 in Column 8 above $ 3,353.17 FPPC Form 460(January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) www.nettile.com Schedule A Type or print in ink. SCHEDULE A Monetary Contributions Received Amounts may r Statement covers period to whole doolf larr s. s. from 10/23/2011 • - SEE INSTRUCTIONS ON REVERSE thrclugh 12/31/2011 Page 4 of 6 NAME OF FILER - PEREZ FOR CITY TREASURER 2011 - 1351542 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I. D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE CODE i (IF SELF - EMPLOYED. ENTER NAME. PERIOD OFEUSINESS) - (JAN. 1 -DEC. 31) (IF REQUIRED) 10/23/2011 RG Landscape Design, Incorporation ❑IND 75.00 150.00 P 11 150.00 ❑COM P.O. Sox 34699 x❑OTH Los Angeles, CA 90034 ❑ PTY " ❑ SCC ❑IND ❑ COM ❑ OTH 0 PTY ❑ SCC ❑ IND ❑ COM O OTH ❑ PTY ❑SCC ❑IND ❑COM 00TH ❑ PTY ❑SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑SCC SUBTOTAL 75 00� Schedule A Summary 'Contributor Codes 1. Amount received this period- itemized monetary contributions. IND- Individual (Include all Schedule Asubtotals.) .............. 75.00 COM RecipientCommittee ......................................................... ............................... (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 Summary Page, Column A, Line 1.) ....................... TOTAL $ 75100 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) www.netfile.com Schedule B —Part 1 Type or print in ink. SCHEDULEB -PART1 Amounts may be rounded Statement covers period Loans Received to whole dollars. CALIFORNIA I ' - from 10/23/201'_ •' SEE INSTRUCTIONS ON REVERSE - thrdngh 12/31/2011 Page 5 of 6 • NAME OF FILER I.D. NUMBER PEREZ FOR CITY TREASURER 2011 1341542 tar FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING )b) I`I Ial (0 00 (g) OF LENDER OCCUPATION AND EMPLOYER BALANCE AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE rsEtr- EmaLOYED,ENrEP RECEIVED THIS BALANCEAT (IF COMMITTEE. use ENreRLD.NUmeERI P BEGINNING THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS NAME OF BUSINESS) ERIOD PERIOD THIS PERIOD' pER D PERIOD LOAN TO DATE Francisco J. Perez ❑ PAID CALENDAR YEAR 107S6 San Jose Ave. 0.00 1,000.00 2,0130.00 5 g D$ % 5 $ 2,553.1 Lynwood, CA 90262 L) FORGIVEN RATE PER ELECTION" 1,000.00 0.00 0.00 all 2,553.17 E g o. as $ 09/12/2011 t® IND El COM ❑ OTH ❑ PTY ❑ SCC DATE DUE 5 DATE INCURRED $ Francisco J. POYCZ ❑PAID CALENDAR YEAR 10756 San Jose Ave. $ 0.00 $ 553.17 0% 6 5 553.17 E 2 Lynwood, CA 90262 FORGIVEN RATE ❑ PER ELECTION" 553.17 0.00 0.00 0 00 P11 3,553.17 $ $ E 10/18/2011 t® IND ❑ COM ❑ OTH ❑ PTV ❑ SCC DATE DUE $ DATE INCURRED $ 1 ❑ PAID CALENDAR YEAR $ 5 04 % E 5 RATE FORGIVEN ❑ PER ELECTION" E E 5 f❑ IND ❑ COM ❑ OTH [I PTY ❑ $CC 5 DATE WE E DATE INCURRED SUBTOTALS $ 0.00 $ 0.00 $ 2,553.17 $ 0.00 Schedule B Summary ' E "' ef(e)on •) SNheduIe E, Llne 3) 1. Loans received this period ..................................................................................... ............................... $ o _ 00 (Total Column (b) plus unitemized loans of less than $100.) tcontdbutor Codes 2. Loans paid or forgiven this period ................................................................... ........ ........................ IND — Individual ......$ o. DO 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 period. Subtract Line 2 from Line 1. 13.00 SCC — Small Contributor Committee 9 P ( ) .... ............................... ............................ NET $ 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 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) www.netfile.com Schedule F Type or print in ink. SCHEDULEF Amounts may be rounded Statement over period • - I • ' Accrued Expenses (Unpaid Bills) to whole dollars. from 1.0/23/2013 • Z 11 SEE INSTRUCTIONS ON REVERSE through 12131/2011 Page 6 of 6 NAME OF FILER D. NUMBER ` PERE2 FOR CITY TREASURER 2011 1341542 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 RAID 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 t.v. 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 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 LFr Campaign literature and mailings PRT print ads WEB information technology costs (internet, a -maii) NAME AND ADDRESS OF CREDITOR CODE OR (a) (b) (c) (d) (IF COMMITTEE, ALSO ENTER I. D. NUMBER) DESCRIPTION OF PAYMENT OUTSTANDING AMOUNT INCURRED AMOUNTPAID OUTSTANDING BALANCE BEGINNING THIS PERIOD THISPERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD David L. Gould Company PRO 400.00 0.00 0.00 400.00 3700 Wilshire Blvd., SCe.10s0 -B Los Angeles, -CA 90010 David L. Gould Company PRO 150.00 0.00 0.00 150.00 3700 Wilshire Blvd., Ste.1050 -B Los Angeles, CA 90010 David L. Gould Company PRO 0.00 250.00 0.00 250.00 3000 Wilshire 01Vd., Sta.loso -B Los Angeles, CA 90010 Payments that are contributions or independent expenditures must also be summarized on schedule D. SUBTOTALS $ 550.00 $ 250.00 $ 0.00$ 600.00 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 $ 250.00 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. P P P Y P ) .. .................. ........:.... PAID TOTALS $ 0.00 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.) ................................................................................................................. ............................... NET $ e 250.00 Ma y be a ne abva number FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) www.netfile.com