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Home My Public Portal AboutForm 460 (Jan 25 - Feb 21, 2013) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) (g(Q)(p)\f" Type or print in ink. Statement covers period 1-25-13 from SEE INSTRUCTIONS ON REVERSE 2-21-13 through 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. II2J Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also Complete Part 5) D Primarily Formed Ballot Measure Committee o Controlled o Sponsored (Also Complete Part 6) D General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee D Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1272663 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Corey Calayay 2013 STREET ADDRESS (NO P.O. BOX) 15550West Baseline Road CITY Claremont STATE CA ZIP CODE 91711 AREA CODE/PHONE (909) 593-5913 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS Date of election if applicable: (Month, Day, Year) FEB 2 J 2013 1<: CITY CLERK OF CLAREMONT For Official Use Only Page of 13 CI 3-5-13 2. Type of Statement: Ii2'I Preelection Statement D Semi-annual Statement D Termination Statement (Also file a Form 410 Termination) D Amendment (Explain below) D Quarterly Statement D Special Odd-Year Report D Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Robert W. Bowcock MAILING ADDRESS 405 North Indian Hill Boulevard CITY STATE Claremont CA NAME OF ASSISTANT TREASURER, IF ANY ZIP CODE 91711 AREA CODE/PHONE (909) 621-1266 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 info all n 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 a~ct. 2-21-13 ~O Executed on By Date Executed on 2-21-13 By Date Executed on By Date Executed on By Signature of Controlling Officeholder, Candidate. Slate Measure Proponent Date FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page - Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Corey Calaycay OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member, City of Claremont RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 1555 West Baseline Road Claremont, CA 91711 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 contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES o NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES o NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION D SUPPORT D 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 Ii2I SUPPORT Corey Calaycay City Council D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT o OPPOSE Attach continuation sheets if necessary FPPC Form 460 (January/OS) FPPC TolI.Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 Type or print in ink. Amounts may be rounded to whole dollars. SUMMARY PAGE from through Statement covers period CALIFORNIA 460 FORM 1-25-13 2-21-13 3 of 13 Page 1.0. NUMBER Contributions Received 1272663 1. Monetary Contributions ........................................... Schedule A. Line 3 2. Loans Received ...................................................... Schedule e. Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 4. Nonmonetary Contributions .................................... Schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) $ 1,747.00 0.00 1,747.00 0.00 1,747.00 Column B CALENDAR YEAR TOTAL TO DATE $ 6,293.00 0.00 6,293.00 0.00 6,293.00 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date $ $ $ $ 20. Contributions Received $ 21. Expenditures Made $ $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E. Line 4 7. Loans Made ............................................................. Schedule H. Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F. Line 3 10. Nonmonetary Adjustment .......................................... Schedule C. Line 3 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 2,874.63 0.00 2,874.63 0.00 0.00 2,874.63 $ 2,974.63 0.00 2,974.63 0.00 0.00 2,974.63 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) Total to Date $ $ $ $ ----.l----.l_ $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page. Line 16 $ 13. Cash Receipts ................................................... Column A. Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule I. Line 4 15. Cash Payments .................................................. Column A. Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ If this is a termination statement, Line 16 must be zero. 4,446.00 1,747.00 0.00 2,874.63 3,318.37 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B 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). 17. LOAN GUARANTEES RECEIVED ........................... Schedule e, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... AddLine2+Line9inColumnBabove $ 0.00 0.00 ----.l----.l_ $ . Amounts in this section may be different from amounts reported in Column B. . '< ; FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE * 1-29-13 Theodore & Linda Kovatch 916 Glenville Dr. Claremont, CA 91711 01ND OCOM OOTH OPTY OSCC iZIlND OCOM OOTH OPTY OSCC i21IND OCOM OOTH OPTY OSCC Ii?IIND OCOM OOTH OPTY OSCC ~IND OCOM OOTH OPTY OSCC 1-29-13 David Jacks 225 B Palomeres Pomona, CA 91767 1-29-13 Glen E. Noreen 1502 Webster Ave Claremont, CA 91711 1-29-13 Ivan Misner 545 College Commerce Way Upland, CA 91786 2-13-13 Lillian Lee 845 E. Bonita #132 Claremont, CA 91711 IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Retired Jack's Technology & Industriallnc, Ingenium Schools Paradigm Publishing Inc. Retired SUBTOTAL $ Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.) ......... ........... ................ ...... ................. ......... .......... .... ................ ...... $ 2. Amount received this period - unitemized monetary contributions of less than $100............................. $ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ SCHEDULE A from Statement covers period CALIFORNIA 460 FORM through AMOUNT RECEIVED THIS PERIOD 100.00 250.00 200.00 250.00 200.00 1,000.00 747.00 1,747.00 1-25-13 2-21-13 \ Page 4 of 13 I.D. NUMBER 1272663 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 100.00 350.00 250.00 250.00 200.00 200.00 250.00 250.00 200.00 200.00 .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 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule B - Part 1 Loans Received Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) IF AN INDI.VIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) a OUTSTANDING BALANCE BEGINNING THIS PERIOD (b) (c) AMOUNT AMOUNT PAID RECEIVED THIS OR FORGIVEN PERIOD THIS PERIOD' o PAID o FORGIVEN to IND 0 COM 0 OTH 0 PTY 0 SCC o PAID o FORGIVEN to IND 0 COM 0 OTH 0 PTY 0 SCC o PAID $ o FORGIVEN to IND 0 COM 0 OTH 0 PTY 0 SCC SUBTOTALS $ $ Schedule B Summary 1. Loans received this period .................................................................................................................... $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ......................................................................................................... $ (Total Column (c) plus loans under $1 00 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 $ 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. Statement covers perioij from 1-25-13 through 2-21-13 (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD (e) INTEREST PAID THIS PERIOD _% RATE DATE DUE _% RATE DATE DUE _% RATE DATE DUE $ $ (Enter (e) on Schedule E, Line 3) 0.00 SCHEDULE B - PART 1 CALIFORNIA 460 FORM 5 of 13 Page I.D. NUMBER 1272663 (f) ORIGINAL AMOUNT OF LOAN (g) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR PER ELECTION'" DATE INCURRED CALENDAR YEAR PER ELECTION .. DATE INCURRED CALENDAR YEAR PER ELECTION'" DATE INCURRED tContributor Codes 0.00 INO-Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party 0.00 SCC - Small Contributor Committee (May be a negative number) FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule B - Part 2 Loan Guarantors SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 FULL NAME, STREET ADDRESS AND ZIP CODE OF GUARANTOR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CONTRIBUTOR CODE OIND oeoM OOTH OPTY osee OIND oeoM OOTH OPTY osee OIND oeoM OOTH OPTY osee OIND oeoM OOTH OPTY osee Type or print in ink. Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS LOAN LENDER DATE LENDER DATE LENDER DATE LENDER DATE from Statement covers period SCHEDULE B - PART 2 through SUBTOTAL $ 1-25-13 2-21-13 AMOUNT GUARANTEED THIS PERIOD 0.00 CALIFORNIA 460 FORM Page~ of~ I.D. NUMBER . 1272663 CUMULATIVE TO DATE 1, BALANCE ~UTSTANDING TO DATE CALENDAR YEAR PER ELECTION (IF REQUIRED) CALENDAR YEAR PER ELECTION (IF REQUIRED) CALENDAR YEAR PER ELECTION (IF REQUIRED) CALENDAR YEAR PER ELECTION (IF REQUIRED) Enter on Summary Page, Line 17 only. FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 Type or print in ink. Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) IF AN INDIVIDUAL, ENTER CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF CODE * (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES NAME OF BUSINESS) OIND oeoM OOTH OPTY osee OIND oeoM OOTH OPTY osee OIND oeOM OOTH OPTY osee OIND oeOM OOTH OPTY osee Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this period - itemized nonmonetary contributions. (Include all Schedule C subtotals.) ..................................................................................................................... $ 2. Amount received this period - unitemized nonmonetary contributions of less 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 $ Statement covers period from 1-25-13 through AMOUNTI FAIR MARKET VALUE 2-21-13 0.00 0.00 0.00 SCHEDULE C CALIFORNIA 460 FORM Page~ of~ 1.0. NUMBER 1272663 CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 - DEC 31) PER ELECTION TO DATE (IF REQUIRED) '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 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule 0 Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE D Support D Oppose D Support D Oppose D Support D Oppose Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE D Statement covers period CALIFORNIA 460 FORM from 1-25-13 through 2-21-13 page~ of~ I.D. NUMBER 1272663 TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) D Monetary Contribution D Nonmonetary Contribution D Independent Expenditure D Monetary Contribution D Nonmonetary Contribution D Independent Expenditure D Monetary Contribution D Nonmonetary Contribution D Independent Expenditure SUBTOTAL $ CUMULATIVE TO DATE CALENDAR YEAR (JAN, 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) AMOUNT THIS PERIOD 0.00 Schedule 0 Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ......................................................... $ 0.00 0.00 2. Unitemized contributions and independent expenditures made this period of under $1 00 ..................................................................................... $ 0.00 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/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) from 1-25-13 CALIFORNIA 460 FORM SCHEDULE E Schedule E Payments Made Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 through 2-21-13 Page ~ of 13 1.0. NUMBER 1272663 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 0v1P 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 nonmonetary)> OFC 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 PHO phone banks lRe candidate travel, lodging, and meals FND fundraising events POL polling and survey research lRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* pas postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VaT 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 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID United States Post Office Postage POS 1,235.31 L.A. County Registrar of Voters Mailing Addresses LIT 132.00 Coastal Value Publications Mailers LIT 1,507.32 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,874.63 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ 2. Un itemized payments made this period of under $1 00 .......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule S, 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 $ 2,874.63 0.00 0.00 2,874.63 FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule F Accrued Expenses (Unpaid Bills) SCHEDULE F Type or print in ink. Amounts may be rounded to whole dollars. CALIFORNIA 460 FORM from Statement covers period 1-25-13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 through 2-21-13 Page~ of~ I.D. NUMBER 1272663 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. a,.p 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 nonmonetary)' OFC 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 PHO phone banks TRC candidate travel, lodging, and meals FND fund raising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)' pas postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VaT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD , Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS $ $ $ $ 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 accrued expenses under $100.) .................................PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $ 0.00 0.00 0.00 May be a negative number FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) CALIFORNIA 460 FORM SCHEDULE G Type or print in ink. Amounts may be rounded to whole dollars. from Statement covers period 1-25-13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 NAME OF AGENT OR INDEPENDENT CONTRACTOR through 2-21-13 Page~ of~ I.D. NUMBER 1272663 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CfvP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTE contribution (explain nonmonetary)> OFC office expenses SAL campaign workers' salaries CVC civic donations PEr petition circulating TEL t.v. 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 !NO independent expenditure supporting/opposing others (explain)* pas postage. delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal. accounting) VaT voter registration UT campaign literature and mailings PRT print ads WEB information technology costs (internet. e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) , Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 0.00 > Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule H Loans Made to Others* Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay 2013 FULL NAME, STREET ADDRESS AND ZIP CODE OF RECIPIENT (IF COMMITTEE. ALSO ENTER I.D. NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) (0) OUTSTANDING BALANCE BEGINNING THIS PERIOD (b) AMOUNT LOANED THIS PERIOD *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. SUBTOTALS $ from Statement covers period 1-25-13 through (e) REPAYMENT OR FORGIVENESS THIS PERIOD' OUTST~~D1NG BALANCE AT CLOSE OF THIS PERIOD o PAID o FORGIVEN DATE DUE o PAID $ o FORGIVEN DATE DUE $ $ Schedule H Summary 1. Loans made this period .................................................................................................................................................. $ (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans ........................................................................................................................................... $ (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) .......................................................................................... NET $ (Enter the net here and on the Summary Page, Column A, Line 7.) 2-21-13 (eJ INTEREST RECEIVED _% RATE -% RATE $ (Enter (e) on Schedule I. line 3) (May be a negative number) SCHEDULE H CALIFORNIA 460 FORM Page 12 I.D.NUMBER 1272663 (I) ORIGINAL AMOUNT OF LOAN DATE INCURRED DATE INCURRED of 13 (g) CUMULATIVE LOANS TO DATE CALENDAR YEAR PER ELECTION" CALENDAR YEAR 1 $ PER ELECTION" "If Required FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) 0.00 0.00 0.00 Schedule I Miscellaneous Increases to Cash Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 1-25-13 CALIFORNIA 460 FORM SCHEDULE I SEE INSTRUCTIONS ON REVERSE NAME OF FILER through 2-21-13 Page~ of~ I.D. NUMBER Committee to Elect Corey Calaycay 2013 1272663 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 0.00 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 Summary Page, Line 14.) ........................................................................................................................... TOTAL $ 0.00 0.00 0.00 0.00 FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)