HomeMy Public PortalAboutHernandez, Edwin - Form 460 - Pre-election Amendment (09.25.11 - 10-23-11) - 10.22.12 Recipient Committee Type or print in ink. Date Stammp____E COVER PAGE
Campaign Statement F'R . 1
Cover Page �� RECEIVE
(Government Code Sections 84200-84216.5)
Statement covers period Date of election if applicable: Pagt of
1 (Month, Day,Year) OCT 2 2 2012 al Use Only
from
SEE INSTRUCTIONS ON REVERSE through +—� _1 / C1 Y OF LYNW002F
1. Type of Recipient Committee: All committees-complete Parts 1,2,3,and 4. 2. Type of Statement:
[Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure P4-Preelection Statement ❑ Quarterly Statement
0 State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report
0 Recall 0 Controlled
❑ Termination Statement ❑ Supplemental Preelection
(Also Complete Part S)
0 Sponsored JAlso_fiile a Form_410_Termination) Statement-Attach Form 495
F-1 General Complete Part 6)General Purpose Committee ❑ Amendment(Explain below)
0 Sponsored ❑ Primarily Formed Candidate/
0 Small Contributor Committee Officeholder Committee
0 Political Party/Central Committee (Also Complete Part 7)
3. Committee Information I.D. NUMBER G, (e? Treasurer(s)
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) 1 NAME OF TREASURER
��J/✓f/ �'f- 740 t'/� V' �G Y�J/R1 ",4 J..) C1'c''L
MAILING ADDRESS
STREET ADDRESS(NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
31,? cT
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
Z - 7/ am`
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 If ? t By j
D'aatte� � Signature of Treasurer or Assistant asurer
Executed on �+ / By
Date Signature of Controlling Officeholder,Candidate,State&990re Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent
Executed on By 4
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
State of California
Typo or print in ink. COVER PAGE - PART 2
Recipient Committee
Campaign Statement . O ' •
Cover Page — Part 2
Pago of
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF O OR CANDIDATE NAME OF BALLOT MEASURE
cl�tJ t� ��J
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT
C ❑OPPOSE
RESIDENTIALIBUSINESS ADDRESS (NO. AND ST EET) CITY STATE ZIP
p J C C( Identify the controlling officeholder, candidate, or state measure proponent, if any.
q NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
/ tTL6 L
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.
COMMITTEE NAME O. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE? 7 . Primarily Formed Candidate /Officeholder Committee List names of
officeholder(s) or candidate(s) for which this committee is primarily formed.
YES ❑ NO
COMMITTEEADDRESS STREET ADDRESS (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 OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑
❑ YES ❑ NO SUPPORT
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) C] OPPOSE
CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets if necessary
FPPC Form 460 (January/05)
FPPC TOILFroe Holpline: 8661ASK -FPPC (0661275 -3772)
State of California
Campaign Disclosure Statement Type or print In Ink. SUMMARY PAGE
Amounts may be rounded
Summary Page to whole dollars. Statement covers period
from / - ZS -//
M �/
SEE INSTRUCTIONS ON REVERSE through Ze3 Page . 3 of
NAME OF FILER I.D. NUMBER
ColumnA Column Calendar Year Summary for Candidates
Contributions Received TOTALTHISPE D aye roAtr
(FROMATTACMEDS(MEDOLES) 101uTOOATE Running in Both the State Primary and
�'Y General Elections
1. Monetary Contributions ............ ............................... Schedule A. Line 3 S c ( 5 fl) 7-3--7
III through 6130 711 to Date
2. Loans Received ....................... ............................... schedule e, Line 3 Z ,Z J S • '
0 z
N ' 9 d � S
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add ones 1 - 2 S —L!q s 20. Contributions
S Received 5 5
4. Nonmonetary Contributions ..... ............................... Schedule C, Linea )!;L 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED .................... Add Lines 3 -4 S —ISM S _ 3 � Made S S
Expenditures Made ( Expenditure Limit Summary for State
6. Payments Made ........................ ............................... Schedule E, Linea $ v ! s Z 3 9S' 25 Candidates
7. Loans Made .............................. ............................... Schedule H. Line l7'e• '19-
22. Cumulative Expenditures Mario•
8. SUBTOTALCASH PAYMENTS. .... ............................... Add Lines 6�7 S �S� 5 7 . (if subject ovolunury Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 7kp= Date of Election Total to Date
10. Nonmonetary Adjustment ........... ............................... Schedule c, Linea 72` lap-
(mmlddlyy)
11. TOTAL EXPENDITURES MADE ............ .................... Add Lines 8 -e -10 S /r S 9S•2.S — S
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 s 4 �J To calculate Column B. add
...................... Column A, Line 3 above .J y�y� t —d amounts in Column A to the
13. Cash Receipts ............................. / e'
corresponding amounts 'Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash ........................... Schedule r, Line a �_ from Column B of your last reported in Column B.
y p repon. Some amounts in
15. Cash Payments ................... ............................... Column A, Line a above 1 r 99 - Column A may be negative
16. ENDING CASH BALANCE .......... Add Lines 12. 13. 14, then subtract Line 15 S , ^ 7S 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 repon being filed
17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Pan 2 $ 7, Z S • iD for this calendar year, only
carry over the amounts
Cash Equivalents and Outstanding Debts /
from 2, 7, and 0 (f
18. Cash Equivalents ......... ............................... See OSMIC60113 on reverse s
19. Outstanding Debts ......................... add we 2 - Line gin Column Babove S Z. ZS - aiv FPPC Form 460 (Januaryf05)
FPPC Toll-Free Helpline: 866 1ASK.FPPC 18661275 -3772)
Schedule A Typo or print In Ink. SCHEDULE A
Monetar ontributions Received Amounts may be rounded Statement covers period
ry to whole dollars. L s / . •
from 9
S EE INSTRUCTIONS ON REVERSE through / _ / / Page J- of
NAME OF FILER . � I.D. NUMBER p�
c Z U lbw �J f�vr nJ a wj c('tn. FIB v/ G ai"G S� r Zp �� 1 3 s O
DATE NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER AMOUNT CUMULATNE TO DATE PER ELECTION
RECEIVED OFCOMMRTEE EMERLO.NUMBEP) CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDARVEAR TO DATE
QF SELF£MPLOYEO. ENFER NAME PERIOD (JAN. I - DEC. 31) (IF REQUIRED)
OF eUSNESS)
11 J J ✓ n if ❑IND
EICOM
sn AJ f�r` �'�- 1• tl .BOTH (/ v cJ
f(� ^/ ❑ PTY
N (J D•V r ,/ CA - �p r.17 ❑SCC
❑IND
1� (j L T-,Jt ❑COM
OL ,J d o Fti A ✓r J249TH
c � ❑PTV G, 5 6P�
/.- n11,TOa d, G^ / 0 U Z ❑SCC
II Y , r Jn fd -c,jv fug ❑
C 1
1�'� ) ZSG p{tvT�o4n °' Z' ElPTV al �� �U�
Pt,) .4, l c Cr- • �fo Z6 ❑scc I"i'c
S �� D � O
'
y/i w d i. IfW^l r• � � O ❑ COM / I UY e^
O ❑OTH
0' I I sG , El PTY
G-Os P L / ❑SCC PAL
Q OM QISTIf13 �B_�- �"`Q'r
L D S 4X W A tie_ ❑ OTH r L
M
El PTY S 1/il f1.�w1"•A. Z�
9 O Z C'1 ❑SCC
SUBTOTALS �
Schedule A Summary comdburor Codes
1. Amount received this period - itemized monetary contributions. (NO-Individual
(Include all Schedule Asubtotals.) S COM RecipientCommittee
......................................................................... ...............................
Q (ether than PTY or )
2. Amount received this period - unitemized monetary contributions of less than S100 ............................. $ 8 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 S / �-
FPPC Form 460 (January/08)
FPPC Tall -Froo Helplino: 8661ASK -FPPC (8661278.3772)
Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE (CONT.)
Monetary Contributions Received Amounts may be rounded statement covers period
to whole dollars. 9 - Z .s J 1 3 from �
through / d yU l Page S of
NAME OF FILER I.O. NUMBER
3
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN IND=L, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
OF C ADDR AND ERI COD O CODE OOCUPATIONAND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED OFSELFENPLOYEO,EN N E PERIOD (JAN. t - DEC. 3t) (IF REQUIRED)
OF BUSINESS)
.l ❑IND
CICOM
C] OTH
El PTY
L
[3Com C 4,rc4 ro
9 L/.3 l �'/71 n S n pPTY a'^'J
V I �.o� .� -.•� s3 9W 7 ❑SCC
L� y ❑IND
D A L ); 'd- �I / / � , G ,," � L ❑COM
6 7 Q- v' 4 %71 ❑OTH PTY 1/�v! ^ V�
�h /
EISCC
❑IND n � 1Ap'A
c}` 666 o r {rdy ❑COM �l—' Ar
� ❑ OT„
Ncuv p d I Gr - o z6 ❑SCC
❑IND
❑COM
❑ OTH
❑ PTY
❑SCC
SUBTOTAL$
'Contributor Codes
IND — Individual
COM— Reapient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party FPPC Form 660 (JanuarylOS)
SCC —Small Contributor Committee FPPC Toll -Froo Holpline: 8661ASK -FPPC (8661275 -3772)
Typo or print In Ink. SCHEDULER -PART1
Schedule B — Part 1 Amounts may be rounded Statement covers period
Loans Received to whole dollars. from FORM. 4 • 0
SEE INSTRUCTIONS ON REVERSE through I - L3 - �� Page of
NAME OF FILER I.D. NUMBER
IF AN INDIVIDUAL, ENTER (c) (b) W 1 let 1 (9)
FULL NAME, STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE
OF LENDER OCCn SDYF PLOYED EmER BEGIINNNI THIS RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNTOF CONTRIBUTIONS
(IFOOMMITI E.ALSOENTERI.D.NUMBER) NAMEOFeusNESS) PERIOD PERIOD THIS PERIOD CLOSE OF THIS PERIOD LOAN TO DATE
^ d C 11 PAID CALENDARYEAR
3 I � ,�,'
/_0_0 (!7, t % f �zzS , /z zs
W
FORGIVEN GATE PER EIECnON
f
i2l"IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED
E] PAID CALENDAR YEAR
S S _% S S
E] FORGIVEN RATE PER ELECTION ^
t t S S f
T❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED
I] PAID CALENDAR YEAR
E] FORGIVEN RATE PER ELECTION^
S S S f f
T[ IND O COM l] OTH O PTV Q SCC DATE DUE DATE INCURRED
SUBTOTALS $ �� $ $ I 'L $ —�---
(Enx(e)w
Schedule B Summary Smeate F e3)
1. Loans received this period ..................................................................................... ............................... S
(Total Column (b) plus unitemized loans of less than S100.) TContributor codes
--- -- IND — individual
2. Loans paid or forgiven this period .......................................................................... ............................... S 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. SCC -Small Contributor Conanittee
9 ( ) ................................ ............................... NET 5
Enter the net here and on the Summary Page, Column A, Line 2. M,y e..Repcvn we.p
'Amounts forgiven or paid by another parry also must be reported on Schedule A.
If required. FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772)
SCHEDULE
Schedule E Typo or print In ink. Statement covers period -
Amounts may be rounded I '
Payments Made to whole dollars. a
from
SEE INSTRUCTIONS ON REVERSE through 20 Page of
NAME OF FILER I.D. NUMBE
(,oNlrf' �f� i� ( ,.J / ^ ��ti� m �r{�' h'� ✓E✓ ?d /� l3
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CW campaign paraphernaliatmisc. M13R member communications RAD radio airtime and production costs
CNS campaign consultants MM meetings and appearances RFD returned contributions
CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries
CVC civic donations PET petition circulating TEL Lv. 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
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
LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
// QFfAMIdIifEE./.LSO ENTER to. NUUaExI / / CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
(Ir .✓/�Lj ll1S �y �i ra vs��'1 / ✓�- ��,�/ 5-5-a
�/ I a cirtT l C� l� 0 L LL IY
� ✓ FGO /v5 /`/ /rm ��A� f?/ ✓� G � � G 2 rO
tiy�oal 6,,. 9oz6v
n GA' 9
Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS
Schedule E Summary c
1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................... ...............................
2. Unitemized payments made this period of under S100 ............................................. ............................... ........................ ............................... S d�
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column ( e).) ...................................... ............................... ... S
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL S S
FPPC Form 460 (January/05)
FPPC Toll -Free Holpline: 8661ASK•FPPC (8661275 -3772)