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Home My Public Portal AboutForm 460 (Oct 1 - Oct 18, 2014)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print In ink. Statement covers period from October 1, 2014 SEE INSTRUCTIONS ON REVERSE I through October 18, 2014 1. Type of Recipient Committee: Jul commil6aea - complete Pana 1, 2, 3, amt 4. ❑ Officeholder, Candidate Controlled Committee 0 Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (AW C -00M Pad 67 O Sponsored pi-c-OwePart") ❑ General Purpose Committee Q Sponsored 0 Small Cwftutor Committee Q Politica] Party/Central Committee 3. Committee information Claremont FLOW ❑ Primarily Formed Candidate/ Officeholder Committee (WCePeer n I.D. NUMBER 1369230 STREET ADDRESS (NO P.O. BOX) 2058 N. Mills Ave #637 CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909 450-8363 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS COVER PAGE ECME OCT 2 0 2014 Page 1 of 15 Date of election if appNcabl®: , (Month, Day, Year) CITY CLERK For Offidel Use Only November 4, 2014 1W OF CLAREMON 2 Type of Statement: ® Preelection Statement ❑ Quarterly Statement ❑ Semi-ennuai Statement ❑ Specie] Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) T)I+ mumr(s) NAME OF TREASURER William Buehler MAILING ADDRESS 304 E. Miramar Ave CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909 262-9922 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. 1 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. . . A r' f Exea,ted an October 18, 2014 By Dale Exaa,ted on October 18, 2014 By Dab Executed an Dift By d smle Executed on By Dab sly , candaare, sla6e FPPC Form 480 (JmluaryADS) FPPC Toll -Free Helpline: SWASK-FPPC (SMM5-3772) State of calNomia Type or print In Ink. COVER PAGE - PA" 2 Recipient Committee Campaign Statement FORM Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE N/A OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: use any committees rmt Included In this statement that are controlled by you or are prlmadly formed to receive corrMbudons or make wgwdlturss on behalf of your eandidwy. N/A NAME OF TREASURER COMMITTEEADDRESS I.D. NUMBER P.O. BOX) ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMIITEEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Page 2 of 15 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Water Bond BALLOT NO. OR LETTER JURISDICTION is SUPPORT W Claremont, CA ❑ OPE 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 ust names of otrlceho/der(s) or candldaWs) for which this corrrmAtee /s pNmarlly tbrmed NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT WA ❑ 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 H necessary FPPC Form 460 (January/05) FPPC Toll -Free Halpline: 066/ASK-FPPC (86812753772) State of Callfomle Campaign Disclosure Statement SummaryPage Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period from October 1, 2014 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE through October 18, 2014 pogo 3 Of 15 NAME OF FILER I.D. NUMBER Claremont FLOW 1369230 Column A Column B Calendar Year Summary for Candidates Contributions Received TOT&THISPEFOOD CALENW Running in Both the State Prima and 9 Primary (Fhwh�+ATTAc*osca 0JLEs> TOTKToONE General Elections. 1. Monetary Contributions ........................................... Schedule A, Una 3 $ 577800 $ 29,623.00 1/1 through 8130 711 to Date 2. Loans Received ............................................... I...... Sdredule 8, Una 3 ....................... 9. SUBTOTALCASH CONTRIBUTIONS Add $ 5778.00 $ 29,623.00 20• Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Una 3 919.68 952.38 21. Expenditures5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Unes 3+4 $ 6,697.68 $ 30,575.38 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ....................................................... Schedule E, Una 4 $ 7,131.50 $ 14,191.69 Candidates 7. Loans Made............................................................. schedule H, Una 3 Cumulative 8. SUBTOTAL CASH PAYMENTS Add Unas8+7 $ 7,131.50 $ 14,191.69 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... schedule C, Una 3 952.38 952.38 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ................................ Add Unes 8 + 9 + 10 $ 8,083.88 $ 15,144.07 $ ---�--� $ Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Una 16 ....................... $ 16,784.81 To calculate Column B, add 13. Cash Receipts................................................... Column A, Una 3 above 5778.00 amounts in Column A to the corresponding amounts 'Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash ..... :..................... Schedule 1, Una 4 from Column B of your last reported In Column B. 7,131.50 report. Some amounts in 15. Cash Payments .................................................. Column A. Una s above Column A may be negative 16. ENDING CASH BALANCE .......... Add Unes 12 + 13 + 14, n►en subbed Una 15 $ 15.431.31 figures that should be subtracted from previous If this is a term/nation statement, Una 16 must be zero. period amounts. If this Is the first report being filed ., 17. LOAN GUARANTEES RECEIVED ....... Schedule 8, Part 2 $ for this calendar year, ordy carry over the amounts from aany) urhes 2, 7, and 9 (ii Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See tnsnucoons on reverse $ 19. Outstanding Debts ......................... Add Lkie 2 + Una 9 in Column 8 above $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 666/ASK-FPPC (66612783772) Sclhadtila A Type or print in Ink. SCHEDULE A Monetary Contributions Received Amounts may rounded lars. to whole dollars. Statement covers period s � October 1 2014 � e from e October 18, 2014 4 15 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Claremont FLOW 1369230 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONI RIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED OFCO�r ,ALMENTERIA.NUMBER) CODE * pFSElf-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF SLONEW) See Attached 1 page list OIND ❑COM OOTH ❑my ❑SCC ❑IND ❑COM OOTH ❑ PTY ❑SCC ❑IND ❑COM OOTH ❑pw ❑SCC ❑IND 000M 00TH 0 PTY ❑SCC []IND ❑COM OOTH ❑ PTY ❑SCC SUBTOTAL$ 8 z Schedule A Summary 1. Amount received this period — itemized monetary contributions. (include all Schedule A subtotals.)........................................................................................................ $ 5,778.00 2. Amount received this period — unitemized monetary contributions of less than 100 $ 919.68 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ 6,697.68 *Contributor Codes IND — Individual COM — Redplent 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: 8661ASK-FPPC (8661275.3772) s o i 15 rrvnvrnn. Brown vvv. a.ar Barbara vvv wanvrv)�ry 1821 Hanover Road vn.. v...v. .. ...CA, Claremont 917r.. .. 11 Retired ... �,..._ $ ......�...... 100.00 ..,.�,..,.,,.,.-,_.,:.........:,......_...__...,..,. 09/23/14 /h1� Claremont CA Aigozer Sharon 449 W 12th Street Claremont CA 91711 Retired $ 100.00 09/23/14 $ Fukada Robert & Laura 525 Mayflower Road Claremont CA 91711 Retired $ 100.00 09/23/14 IOAW14 Prout Randy & Rhonda 830 W. Highpoint Drive Claremont CA 91711 State Farm Agent State Farm $ 100.00 09/29/14 Kovach Linda 916 Glenville Drive Claremont CA 91711 Retired $ 100.00 08/13/14 Haynes Carolyn 577 Sebastopol Streert Claremont CA 91711 Retired $ 100.00 10/07/14 O'Brien Muriel P.O.Box 943 Claremont CA 91711 Retired $ 100.00 10/07/14 Durian Barbara 1705 Bridgeport Ave Claremont CA 91711 Retired $ 100.00 10/10/14 Nicholson Dennis & Sue 2772 Via Sinaloa Claremont CA 91711 Retired $ 200.00 10/03/14 Howland John & Naomi 1356 Via Zurits Street Claremont CA 91711 Lawyer Buxbaum & Chakm $ 200.00 10/10/14 Auerbach Roger 1105 N. College Ave Claremont CA 91711 Consultant Auerbach Consultin $ 200.00 10/16/14 Willoughby Todd & Pam 1056 E. Lamonette St Claremont CA 91711 Consultant Willoughby Consult $ 200.00 10/16/14 Neluber John 641 Indian Hill Blvd Claremont CA 91711 CEO Trinity Youth Sury v $ 250.00 09/23/14 TeBeau Zorn 1009 Butte Street Claremont CA 91711 Appraiser TeBeau Apraising $ 250.00 10/17/14 Gerecke, Jr Bob & Katie 333 S. Villanova Drive Claremont CA 91711 Retired $ 500.00 09/29/14 Claremont Star Dev LP Gerecke, Jr August & Marian Fowler Ray & Barbara Forney John Moving California Forward 11-1305T?3 555 W. Foothill Blvd Claremont CA 91711 Doubletree Hotel $ 500.00 10110/14 6-r# 333 S. vilanova Drive Claremont CA 91711 Retired $500 10/10/14 /wJ 272 W. Seventh St Claremont CA 91711 Retired $ 500.00 10/16/14 ltvD 644 W. 8th Street Claremont CA 91711 Retired $ 1,000.00 IOAW14 /ti'J 3700 Wilshire Blvd, Suite Los Angele CA 90010 Ballot Measure Cor $ 1,000.00 10/07/14 'L'oM SCHEDULE a - PART 1 Schedule B —Part 1 '"`" ' Amounts may be rounded Statement covers period i CALIFORNIA 1 Loans Received to whole dollars. October 1, 2014 e • RM from October 18, 2014 8 15 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Claremont FLOW 1389230 FULL NAME. STREET ADDRESS AND ZIP CODE OF LENDER IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTS ANDING BALANCE AMpUNT RECEIVED THIS Ic) AMOUNTPAID OR FORGIVEN MIG BALANCEAT INTEREST PAID THi3 ORIGINAL AMOUNT OF CUMULATIVE CONTRIBUTIONS (IF COMMITTEE, ALSO@nERLD.NLWBER) QFSELF-BpyEpR NAME�g EN BEGINNING THIS MOD PERIOD THIS PERIOD* CLOSE OF THIS PERIOD LOAN TO DATE NONE ❑ PAID CALE+DARYEAR ❑ FORGIVEN RATE PER ELECTION" s s s a s DATE DUE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENOARYEAR ❑ FORGIVEN RATE PERELECTION" s s s s a DATE DUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CAIFNDARYEAR ❑ FORGIVEN RATE PERELECTION' s s s a s DATEDUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATEINCURrWED SueTOTALS $ $ $ $. Schedule B Summary 1. Loans reoelved this period .................................. $ 0 .................................................................................. (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period......................................................................................................... $ 0 (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 $ 0 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. juinwte,u" SdW*F, LNe3) tConbibutor Codes IND— Indhridual 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 Toil -Free Helpline: 8661ASK-FPPC (8661275.3772) SCHEDULE B - PART 2 Schedule B - Part 2 Type or print In Ink. statement covers perlod71��DNU!MBER!7 Amounts may be rounded Loan Guarantors to whole dollars. October 1, 2014SEE from October 18, 2014NAME INSTRUCTIONS ON REVERSEthrough OF FILER Claremont FLOW 1369230 FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER LOAN AMOUNT GUARANTEED CUMULATIVE BALANCE OUTSTANDING ZIP CODE OF GUARANTOR OFCOMMUTEE.ALSO EWER LD.NUMBER) CODE (IF�D� .E NAME OF BUSINESS THIS PERIOD TO DATE TO DATE NONE ❑IND LENDER CALENDARYEAR [3Com = DATE ❑ OTH PER ELEDTfON (IF REQUIRED) ❑ PTY ❑Scc = CALENDARYEAR []IND LENDER ❑COM = ❑ OTH PER ELECTION OF REQUIRED) DATE ❑ PTY []SCC $ [:]IND LENDER CALENDARYEAR [:]Com _ PER ELECTION ❑0TH OF REQUIRED) DATE ❑ PTY ❑ SCC = CALENDARYEAR ❑ IND LENDER ❑COM = DATE ❑ OTH PER ELECTION OF REQUIRED) ❑ PTY []SCC _ SUBTOTALS s''W P °°, t x y 3 Lina 17 a* FPPC Form 460 (January/05) FPPC Toll -Free Helpline: SWASK-FPPC (86=75-3772) Schedule C Type or print In Ink. SCHEDULE C wmounin may oe rounoea NOtlmonetary Contributions Received towhole"lars. statement covers stateperiod CALIFORNIA October 1, 2014 FORM • from 8 15 October 18, 2014 SEE INSTRUCTIONS ON REVERSE through Paw of NAME OF FILER I.D. NUMBER Claremont FLOW 1369230 DATE FULL NAME, STREET ADDRESS AND CO �g�OR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR OF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OF SELF-EMPLOYED, ENTER NAME OF BUSINESS) GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) (IF REQUIRED) John Fomey OIND Retired Banners 10/16/14 644 W. 8th Street, 91711 � 196.20 228.90 [:][3Com ❑ pn' []SCC Claremont Outrage []IND Signs 10/16/14 c/o Bemie Bemstein, CPA 723.48 723.48 740 N. Garay Ave, 91767 QOTN 00TH ®SCC ❑IND ❑00M ❑OTH []PTY []SCC ❑IND [3Com poTH ❑ PTY ❑Scc Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 919.68 R3 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (include all Schedule C subtotals.)..................................................................................................................... $ 919.68 2. Amount received this period — unitemized nonmonetary contributions of fess than $100 .................................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ 919.68 *Contributor 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 480 (January/05) FPPC Toll -Free Helpline: SWASK-FPPC (888/2753772) Schedule D Summary of Expenditures Type or print in ink. Statement covers period ' Supporting/OpposingOther Amounts may be rounded to whore dollars. October 1, 2014 • • -S t Candidates, Measures and Committees from October 18, 2014 9 15 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Claremont FLOW 1369230 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE A MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQuiRED) PERIOD (JMI.1-DEC. 31) (IFREWRED) ORRLETTE NONE ❑ Monetary Contribution ❑ Nonmonetary Contribution [] Independent ❑ support ❑ Opp Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ independent ❑ support ❑ Oppose Expenditure ❑ Monetary Contribution [I NonmorIetary Contribution ❑ Independent ❑ support ❑ Oppose Expenditure SUBTOTALS" fs� z �Y Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.)......................................................... $ 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 $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: SWASK+PPC (8661275-3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Claremont FLOW type or print In Ink Amounts may be rounded to whole dollars. Statement covers period from October 1, 2014 through October 18, 2014 I Page 10 CODES: If one of the following odes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1369230 Of 15 CW campaign paraphemalia/misc. WAR member communications RAD radio airtime and production costs CNS campaign consultants W G meetings and appearances RFD returned contributions CTS contribution (explain nonmonateryr OFC office expenses SAL campaign workers' salaries CVC civic donations FET petition circulating IS t.v or cable airtime and production coats 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 IND Independent expenditure supportingfopposing 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 OF COMMMM AMENTMr,D.NUMOp) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Thelma Herrera 787 Merrett Drive CMP 439.00 Pasadena, CA 91104 Printing Works 681 E. Foothill Blvd LIT 4,941.75 Pomona, CA 91767 Master Sign 1846 B West 11th Street CMP 150.00 Upland, CA 91786 " Payments that are contributions or Independent expenditures must also be summarized on Schedule D. Schedule E Summary SUBTOTAL $ Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ ............................. $ 8.09 7,131.50 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.) ........................... ............ $ 0 TOTAL $ 7,139.59 FPPC Form 480 (January/05) FPPC Toll -Free Helpline: S66/ASK-FPPC (8661275-3772) NAME AND ADDRESS OF PAYEE OF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Claremont Courier 1420 N. Claremont Blvd, Suite 205B Claremont, CA 91711 SCHEDULE E (CONT.) Schedule E 1,536.00 k. Type or print in Ink Staeementcoversperiod (Continuation Sheet) Amo 20,-401- - � • � Payments Made �°'"''°'ed°"�'� fromOctober 1, 2o1a • October 18, 2014 11 15 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Claremont FLOW 1369230 CODES: If one of the following odes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CHP campaign paraphemaliaimisc. MBR membercommunications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetery)" OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL tv. or cable airtime and production costa FB. candidate filingradlot fees PHO phone banks TRC candidate travel, kxfging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure suppor inglopposing 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 campalan literature and mailings PRT print ads WEB Information technology costs (Internet, a -mall) NAME AND ADDRESS OF PAYEE OF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Claremont Courier 1420 N. Claremont Blvd, Suite 205B Claremont, CA 91711 PRT 1,536.00 Ink & Toner Outler 323 N. Mountain Ave Upland, CA 91786 OFC 64.75 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,600.75 FPPC Form 460 (January/05) FPPC Toil -Free Helpline: 6661ASK-FP1PC (866/275.3772) SCHEDULE F Schedule F TypArnouunft rmay eIn ounded "t CO periode!12 Accrued Expenses (Unpaid Bills) to wholedolla s. fromOctober 1, 2014 • -through October 18, 2014 P 15 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Claremont FLOW 1369230 CODES: If one of the following odes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphemalla/misc. NW member communications RAD radio airtime and production costs CNS campaign consultants NRG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetaryr CPC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL ty. or cable airtime and production costs FIL candidate filinglballot 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 ND independent expenditure supporting/opposing others (explain)" POS postage, delivery and messenger services TSF transfer between committees of the some candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB Information technology costa (Internet, e-mail) NAME AND ADDRESS OF CREDITOR OF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD OLSO R02ORT ON a) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD NONE • Paymsrris that are comrltwtlons or Independent expenditures must also be SUBTOTALS $ $ $ $ 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 $ 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 ac=ed expenses under $100.) ................................. PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)................................................................................................................................................ NET $ WO be e FPPC Form 460 (January/OS) FPPC Toll -Free Helpline: 866/ASK-FPPC (866J2764M) Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) Type or print In Ink. F — Amounts may be rounded �to whole dollars. rom October 1, 2014 through October 18, 2014 Page 13 of 15 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Claremont FLOW 1369230 NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes the payment, you may enter the Code. Otherwise, describe the payment. CNP 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 nonmonstaryr OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costa FIL candidate fifinglballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundralsing events POL polling and survey research TRS staff/spouse travel, lodging, and meals W independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candklaWsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LR campaign literature and mailings PRT print ads WEB information technology costs (Internet, a -mail) * Payments that are contributions or Independent expenditures must also be summarized on schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR OF COMMfREE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID NONE Attach additional information on appropriately labeled continuation sheets. TOTAL* $ ' Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 480 (January/OS) Independent contractor as reported on Schedule E. FPPC Toli-Free Helpline: 866/ASK-FPPC (86612753772) SCHEDULE H Schedule H Type or Print In Ink. Statement covers period , , * Amounts may be rounded October 1, 2014 • Loans Made to Others to whole dollars. fro from e through October 18, 2014 Page 14 of 15 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Claremont FLOW 1369230 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTS ANDING AMOUNT REPAYMENT OR M t� OUTSTANDING N) INTEREST ORIGINAL CUMULATIVE OF RECIPIENT OCCUPATION AND EMPLOYER ENTERPERIODLOAN (IF SELF-EMPLOYED.MEOBUSINESS) BEGINNING THIS LOANED THIS FORGIVENESS AT CLOSEBFETHIS RECEIVED AM OF (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) THIS PERM TLOANS O DATE NONE p PAID CALENDAR YEAR $ 11 % i s p FORGIVEN RAM PER ELECTION" i i i s i DATE DUE DATE INCURRED p PAID CALENDAR YEAR i i % i i p FORGIVEN WE PER ELECTION" i i i i i DATE DUE DATE INCURRED 'Loans that are contributions to another candidate or committee N� must also be summarized on Schedule D. Loans forgiven must SUBTOTALS $ S $ $ t' also be reported on Schedule E (Enter (9) on Schedulo I, Line 3) Schedule H Summary 1. Loans made this period................................................................................................................................................. $ (Total Column (b) plus unitemized loans of less than $100.) * If Required 2. Payments received on loans........................................................................................................................................... $ (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Suibt ad Line 2 from Line 1.).......................................................................................... NET $ Ww be a (Enter the net here and on the Summary Page, Column A, Line 7.) FPPC Form 460 (January/05) FPPC TolWree Helpline: 866/ASK-FPPC (8661275-3772) SL`HEbl1LE 1 W%rnw%AV,W I .7Pv- p........... - Miscellaneous Increases to Cash ''moor to Ing be roundW to whole dollaro. BEE INSTRUCTIONS ON REVERSE Statetmnt CO1em Wod October 1, 2014 flrom through October 18, 2014 • • ' F-4 Page 15of NAME OF FILER Claremont FLOW I.D. NUMBER 1369230 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE Also ENTER . NUM OF COMMME, AlR I.D.R) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH NONE Attach addNonal information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule I Summary 1. Itemized increases to cash this period........................................................................................................................ $ 2. Unitemized increases to cash of under $100 this period............................................................................................. $ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage Line 14 )........................................................................................................ TOTAL $ . ................... FPPC Form 40 (January/05) FPPC Toll -Free Helpline: SWASK-FPPC (SOWS -11M)