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Home My Public Portal AboutForm 460 (Oct 18 - Dec 31, 2015) Amendment i EI FEB 0 3 2016 CITY CLERK CITY OF CLARE ",®NT Recipient Committee - COVER PAGE Type or print in ink. Date Stamp '!' , ' Campaign Statement ,,CALIFORNIA Cover Page Fo12Mt° 460". (Government Code Sections 84200-84216 5) - Statement covers period Date of election if applicable: Page 1 of 3 from October 18,2015 (Month, Day,Year) For Official Use Only SEE INSTRUCTIONS ON REVERSE through December 31,2015 November 3,2015 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 ❑ Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee ❑ Semi-annual StatementS ort 0 Recall 0 Controlled 0 Termination Statement ❑ pecial Odd-Year Rep reelecoon (Aiae Complete Pan S) 0 Sponsored (Also file a Form 410 Termination) ❑ Statement-At Supplemental a h Form 495 (Also Complete Pea 6) ❑ General Purpose Committee 7 Amendment(Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ i failed to include Nonmonetary Ajustments,line 10,column B. 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Arco Complete Fax 7) I3. Committee Information D NUMBER Treasurer(s) 1378055 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER William Buehler Yes on Public Safety MAILING ADDRESS 304 E.Miramar Ave STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE 2058 N.Mills Ave#645 Claremont CA 91711 909 262-9922 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY Claremont CA 91711 . 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 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 February 3,2016 i//�/ //J/y/� Date By Signature ott> surer 6r ffitISlän`Treasurer Executed on By Date Signature of Controlling Officenolder,Candidate,Slate Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder,Candidate,State Measure Proponent Executed on By Date Signature of Controlling Officeholder,Canddate,State Measure Proponent FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) State of California Type or print in ink. COVER PAGE-PART 2 Recipient Committee Campaign Statement CALIFORNIA E4.6" CoverPage—Part2 ,�.FÕRM oä' Page 2 of 3 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE N/A Public Safety bond OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ®SUPPORT PS Claremont.CA O OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP 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 • 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 I.D.NUMBER - N/A 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 COMMITTEE ADDRESS STREET ADDRESS(NO PO.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT N/A ❑OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 5 SUPPORT ❑OPPOSE COMMITTEE NAME I.D.NUMBER - .- NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT 5 OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES ❑ NO ❑SUPPORT ❑OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO PO.BOX) • CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) State of California w Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE SummaryPage Amounts may be rounded Statement covers period 4a0 to whole dollars. CALIFORNIA VNVN from October 18,2015 1" FORM. December 31,2015 3 3 SEE INSTRUCTIONS ON REVERSE through Page of - NAME OF FILER I.D.NUMBER Yes On Public Safety 1378055 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTAL TO DATE 1029.00 15294.98 General Elections 1. Monetary Contributions Schedule A.Line 3 $ $ 1/1 through 6/30 7/1 to Date 2. Loans Received Schedule B,Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1•2 $ $ 15294.98 20. Contributions Received $ $ . 4. Nonmonetary Contributions Schedule C,Line 3 499.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ 1029.00 $ 15793.98 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made Schedule e.Line 4 $ 3578.92 $ 12476.02 Candidates 7. Loans Made Schedule H,Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ 3578.92 $ 12476.02 22.Cumulative Expenditures Made' lit Subject to Voluntary Expenditure Limit) 9. Accrued Expenses(Unpaid Bills) Schedule F Line 3 Date of Election Tõtal to Date 10.Nonmonetary Adjustment Schedule C,Line 3 499.00 (rnm/dd/yy) 11.TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ 3578.92 $ 12975.02 / / $ Current Cash Statement i i $ 12.Beginning Cash Balance Previous Summary Page,Line 16 $ 5385.23 To calculate Column B,add 13.Cash Receipts Column A,Line 3 above 1029.00 amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14.Miscellaneous Increases to Cash Schedule I,Line 4 from Column B of your last reported in Column B. 15.Cash Payments • Column A.Linea above 3578.92 eport. Some amounts in Column A may be negative 16.ENDING CASH BALANCE Add Lines 12•13.14,then subtract Line 15 $ 2835.31 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 $ for this calendar year,only . carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2,7,and 9 pr any). 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2+Line 9 in Column 8 above $ FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)