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Home My Public Portal AboutForm 460 (Nov 28, 2008 - Jan 17, 2009) Recipient Committee Campaign Statement Cover Page (Government Code SectionS.84200-84216.5) Type or print In Ink. Statement covers period 11/28/2008 from SEE INSTRUCTIONS ON REVERSE 01/17/2009 through 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. hll Officeholder, Candidate Controlled Committee 0 Primarily Formed Ballot Measure o State Candidate Election Committee Committee o Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee o Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1313981 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) 3. Committee Information Bridget Healy for Council STREET ADDRESS (NO P.O. BOX) 124 Miramar Ave CITY STATE ZIP CODE Claremont CA 91711 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX AREA CODE/PHONE 909 445 9628 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 b f my knowled under penalty of pe~ury under the laws of the State of California that the foregoing is true nd co Executed on jlJ.W I S' {)()/J f By Dale I /-/8-09 Date COVER PAGE EC~fttE I CALIFORNIA 460 2001/02 FORM Date of election If applicable: (Month, Day, Year) JAN 2 U 2009 CITY CLERK ITV OF CLAREMONT For Official Use Only Page I of /~ 03/03/09 2. Type of Statement: hll Preelection Statement o Semi-annual Statement o Termination Statement (Also file a Form 410 Termination) o Amendment (Explain below) o Quarterly Statement o Special Odd-Year Report o Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER John Moylan MAILING ADDRESS 124 Miramar Ave CITY Claremont NAME OF ASSISTANT TREASURER, IF ANY STATE CA ZIP CODE 91711 AREA CODE/PHONE 909 445 9628 MAILING ADDRESS CITY JJMoylan@aol.com OPTIONAL: FAX / E-MAIL ADDRESS STATE ZIP CODE AREA CODE/PHONE the information contained herein and in the attached schedules is true and complete. I certify Executed on By Executed on By Date Executed on By Dale Proponent or Responsible 01Iicer of Sponsor Signature ofControlHng OIIicehoIder, Candidate, stete Measure Proponent Signature of Controlling OlIlceholder, CandIdate. Slate Measure Proponent FPPC Form 460 (January/OS) FPPC TolI..free Helpline: 8661ASK..fPPC (8661275-3772) 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 Bridget Healy OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Claremont City Council RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 640 Marshall Ct 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 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? o YES ONO STREET ADDRESS (NO P.O. BOX) COMMITTEE ADDRESS CITY ZIP CODE AREA CODElPHONE STATE COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? o YES ONO STREET ADDRESS (NO P.O. BOX) COMMITTEE ADDRESS CITY STATE AREA CODE/PHONE ZIP CODE COVER PAGE - PART 2 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION o SUPPORT o 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 offlceholder(s} or candidafe(s} for which this committee is primarily formed. 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 o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE Attach continuation sheets If necessary FPPC Form 460 (January/OS) FPPC ToII.f"ree Helpline: 866/ASK.f"PPC (866/275-3m) State of California Campaign Disclosure Statement Summary Page Type or print In Ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bridget Healy for Council SUMMARY PAGE from through Column A Column B TOTAl THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAl TO DATE 9186.00 $ 9186.00 1300.00 1300.00 10486.00 $ 10486.00 0.00 0.00 10486.00 $ 10486.00 Contributions Received 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 2. Loans Received ...................................................... Schedule B, Une 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ Statement covers period CALIFORNIA 460 FORM 11/28/2008 01/17/2009 Page ~ of ,:::; 1.0. NUMBER 1313981 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6130 7/1 to Date 20. Contributions Received $ 21. Expenditures Made $ $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Une 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 .......................................... ScheduleC, Line 3 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 3276.15 0.00 3276.15 100.03 0.00 3376.18 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 .................................................. ColumnA, 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. o 10486.00 0.00 3276.15 7209.85 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts......................... AddUne2+Line9inColumnBabove $ o 1400.03 $ 3276.15 0.00 3276.15 100.03 0.00 3376.18 $ $ o 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). 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 $ $ . Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866JASK-FPPC (866/275-3772) Schedule A Type or print In ink. A t b dd SCHEDULE A Monetary Contributions Received moun s may e roun e Statement covers period to whole dollars. CALIFORNIA 460 from 11/28/2008 FORM through 01/17/2009 pageL of /5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER 1.0. NUMBER Bridget Healy for Council 1313981 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, AlSO ENTER 1.0. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPlOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Otis Healy ~IND 11/28/08 o COM Retired $250.00 1028 Marine Dr OOTH Laguna Beach, CA 92651 OPTY oscc Paticia Petrie Lightfoot ~IND 12/2/08 o COM Retired $250.00 1028 Marine Dr OOTH Claremont, CA 91711 OPTY oscc Gary Riley !;ZIIND 12/2/08 o COM Teacher, Bonita Unified $250.00 3808 Newark Ct OOTH School District Claremont, CA 91711 OPTY oscc Paul Held lilllND 12/12/08 429 Willamette Ln o COM Attorney $250.00 OOTH Claremont, CA 91711 OPTY oscc Dexter and Mary Jane Merrill IilIIND 12/12/08 OCOM Retired 842 Hood Dr OOTH $100.00 Claremont, CA 91711 OPTY oscc SUBTOTAL $ 1,100.00 I 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 $ 6300.00 2886.00 .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 9186.00 FPPC Form 460 (January/05) FPPC TolI-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in Ink. Amounts may be rounded to whole dollars. Statement covers period 11/28/2008 CALIFORNIA 460 FORM NAME OF FILER Bridget Healy for Council SCHEDULE A (eONT.) from through 01/17/2009 --- ./ Page Q of / .~ I.D. NUMBER 1313981 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, AlSO ENTER 1.0. NUMBER) CODE * PER ELECTION TO DATE (IF REQUIRED) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) Sandra N Baldonado hlIlND o COM 12/12/08 435 Yale Ave OOTH Claremont, CA 91711 OPTY osee Georgeanne Andrus 'lIIND 12/20/08 o COM 231 W 10th St OOTH Claremont, CA 91711 OPTY oscc Helaine Goldwater 'lIIND o COM 12/20/08 2311 Coalinga Ct OOTH Claremont, CA 91711 OPTY osee Valerie Marinez IZIIND oeoM 12/20/08 293 Lamar Ave OOTH Claremont, CA 91711 OPTY osec Robin Gotteso IZIIND oeoM 12/26/08 1400 Niagra OOTH Claremont, CA 91711 OPTY osee Attorney $250.00 Retired $100.00 Interior Designer $100.00 Graphic Artist $250.00 Realtor, Century 21 $200.00 .Contributor Codes INO -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party see - Small Contributor Committee SUBTOTAL $ 900.00 I FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT.) . Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA 460 to whole dollars. from 11/28/2008 FORM ./ through 01/17/2009 Page 10 Of/~ NAME OF FILER 1.0. NUMBER Bridget Healy for Council 1313981 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) !;ZIIND President Westport Barry Hoveven oeoM $250.00 $250.00 12/26/08 17 Rockingham Dr OOTH Properties Newport Beach CA 92660 OPTY oscc Jody Billings IlIIND Investor 12/26/08 OCOM $100.00 $100.00 102 Emerald Bay OOTH Laguna Beach CA 92651 OPTY osec Anna & Joe Napoli IlIIND Alumni Event Coodinator, OCOM $100.00 $100.00 12/26/08 2436 Forbes OOTH Claremont McKenna Claremont CA 91711 OPTY College oscc Francine and Bill Baker IlIIND Attourny OCOM $250.00 $250.00 12/28/2008 488 W 6th St OOTH Claremont CA 91711 OPTY oscc Steve and Tina Collins IlIIND Restrurant Owner, Arby's OCOM $100.00 $100.00 12/31/2008 436 Bowling Green Dr OOTH Claremont CA 91711 OPTY oscc SUBTOTAL $ $800.00 I *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 TolI-Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM NAME OF FILER Bridget Healy for Council SCHEDULE A (CONT.) from 11/28/2008 through 01/17/2009 - off::::> Page 7 1.0. NUMBER 1313981 DATE RECEIVED PER ELECTION TO DATE (IF REQUIRED) FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 12/31/08 12/31/08 1/3/09 1/5/09 1/5/09 Annabelle and Don Killian 1070 Marine Drive Laguna Beach, CA 92651 !;ZIINO o COM OOTH OPTY OSCC IiZIINO OCOM OOTH OPTY OSCC IiZIINO o COM OOTH OPTY OSCC IZIINO o COM OOTH OPTY OSCC !;ZIINO o COM OOTH OPTY OSCC Retired $100.00 $100.00 Walter Klosterman 23911 Coral Way Dana Point, CA 92629 Diann Ring 816 Peninsula Ave Claremont, CA 91711 Joan Prescan 727 Alamosa Ave Claremont, CA 91711 AI Leiga 3790 Elmira Ave Claremont, CA 91711 Retired $200.00 $200.00 Retired $100.00 $100.00 Retired $100.00 $100.00 Retired $200.00 $200.00 .Contributor Codes INO -Individual COM - Recipient Committee (other than PTY or SCe) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee SUBTOTAL $ 700.00 I FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866127S-3n2) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print In Ink. Amounts may be rounded to whole dollars. SCHEDULE A (CONT.) CALIFORNIA 460 FORM Statement covers period 11/28/2008 from through 01/17/2009 Page 1f 1.0. NUMBER ....- ofJ~ NAME OF FILER Bridget Healy for Council 1313981 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, AlSO ENTER 1.0. NUMBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD PER ELECTION TO DATE (IF REQUIRED) CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 1/5/09 1/5/09 1/5/09 1/6/08 1/6/09 Kristin Hagstrom 539 Baughman Ave Claremont, CA 91711 !;l]IND o COM OOTH OPTY OSCC ~IND o COM OOTH OPTY OSCC ~IND o COM OOTH OPTY OSCC III IND OCOM OOTH OPTY OSCC III INO o COM OOTH OPTY OSCC $100.00 Retired $150.00 $150.00 William & Janice McCready 830 Stanislaus Ave Claremont, CA 91711 Owner Santana Tandem, Laverne CA $250.00 $250.00 Otis Healy 1028 Marine Drive Laguna Beach, CA Retired $250.00 $250.00 Susan and Matt Douglas 472 34th Street Manhattan Beach, CA 90266 Self $100.00 $100.00 Michael Stantly 8 Wharfside Dr Newport Coast, CA 92657 Real Estate, The Irvine Company $100.00 SUBTOTAL $ 850.00 r' .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 TolI-Free Helpline: 8661ASK-FPPC (866/275-3n2) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in Ink. Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM NAME OF FILER Bridget Healy for Council SCHEDULE A (CONT.) from 11/28/2008 through 01/17/2009 - of ,~ Page C} 1.0. NUMBER 1313981 DATE RECEIVED CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) FULL NAME, STREET ADDRESS AND ZIP CODe OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD PER ELECTION TO DATE (IF REQUIRED) 1/6/09 1/6/09 117/09 1/9/09 1/9/09 Gregory Shapton 1436 Mural Dr Claremont, CA 91711 IlIIND o COM OOTH OPTY OSCC IlIIND o COM OOTH OPTY OSCC IlIIND o COM OOTH OPTY OSCC IlIIND oeOM OOTH OPTY Dsec IlIIND o COM OOTH OPTY OSCC library Administrator, City of Pomona $200.00 $200.00 Retired $100.00 $100.00 Frank Hungerford 1559 Webster Ave Claremont, CA 91711 William H. Hurt 333 SHope St Los Angeles, CA 90071 Jeanne Kennedy PO Box 123 Claremont, CA 91711 Sharron Bentley PO Box 1927 Claremont, CA 91711 Chairman, Capital Strategy Research $250.00 $250.00 Retired $100.00 $100.00 Psychotherapist $150.00 $150.00 *Contributor Codes IND -lndMdual COM - Recipient Committee (other than PTY or SCe) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee SUBTOTAL $ 800.00 I> FPPC Form 460 (January/OS) FPPC TolI-Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print In Ink. Amounts may be rounded to whole dollars. NAME OF FILER Bridget Healy for Council SCHEDULE A (CONT.) Statement covers period CALIFORNIA 460 FORM from 11/28/2008 through 01/17/2009 ./ of/~ Page 10 1.0. NUMBER DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE * 1313981 IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SelF-EMPLOYED. ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 1/9/09 $150.00 Mona Sparks Johnson 351 Annapolis Ave Claremont, CA 91711 !;lIIND OCOM OOTH OPTY OSCC IiZIINO o COM OOTH OPTY OSCC IiZIINO o COM OOTH OPTY OSCC 'lIINO o COM OOTH DPTY OSCC IlIINO o COM OOTH OPTY OSCC 1/13/09 Frank & Betty Villani 5821 Cameo St Alta Lorna, CA 91701 1/13/09 John & Peggy Moylan 124 Miramar Ave Claremont, CA 91711 1/14/09 J Michael Fay 4085 Olive Hill Dr Claremont, CA 91711 1/16/09 o Michael Gray 101 Ocean Ave Santa Monica, CA 90402 Mental Health Advocate, County of Los Angeles Owner, Exclusive Tile and Marble Installations President, Delsen Testing Laboratories, Glendale CA Attorney Real Estate Developer Lambert Development $150.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $250.00 $250.00 *Contributor Codes INO -Individual COM - Recipient Committee (other than PTY or SCe) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee SUBTOTAL $ 700.00 I FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period 11/28/2008 CALIFORNIA 460 FORM NAME OF FILER Bridget Healy for Council SCHEDULE A (CONT.) from through 01/17/2009 of /:5 Page j / 1.0. NUMBER 1313981 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE * PER ELECTION TO DATE (IF REQUIRED) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 1/17/09 Michael & Victoria Shea 896 Syracuse Dr Claremont, CA 91711 IlIINO DCOM DOTH DPTY DSCC IilIINO DCOM DOTH DPTY DSCC DIND DCOM DOTH DPTY DSCC DINO DCOM DOTH DPTY DSCC DINO DCOM DOTH DPTY DSCC 1/17/09 Gary Soto 821 Trinity Lane Claremont, CA 91711 Archetect $200.00 $200.00 Consultant, Action Leasing Systems $250.00 $250.00 *Contributor Codes INO -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee SUBTOTAL $ 450.00 r< 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 Bridget Healy for Council Statement covers period from 11/28/2008 SCHEDULE B - PART 1 CALIFORNIA 460 FORM Page I Z-- 1.0. NUMBER -" of f.::::l- through 01/17/2009 1313981 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF.EMPlOYED, ENTER NAME OF BUSINESS) · (b) (e) (d) OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING BALANCE RECEIVED TH BALANCE AT BEGINNING THIS IS OR FORGIVEN CLOSE OF THIS PERIOD THIS PERIOD * o PAID (e) INTEREST PAID THIS PERIOD Bridget Healy MarshaU Ct Claremont, CA 91711 Retired $ o FORGIVEN o 1300.00 $ $ tlill INO 0 COM 0 OTH 0 PTY 0 SCC o PAID $ o FORGIVEN $ $ to IND 0 COM 0 OTH 0 PrY 0 SCC o PAID $ o FORGIVEN to INO 0 COM 0 OTH 0 PTY 0 SCC $ 01............. SUBTOTALS $ 1300.00 $ Schedule B Summary 1. Loans received this period................... .................. .......................... ........................... ....... ................... $ (Total Column (b) plus unitemized loans ofless 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. o $ 1300.00 ~% RATE 3/31/09 $ DATE DUE _% RATE $ ( ) ORIGINAL AMOUNT OF LOAN (g CUMULATIVE CONTRIBUTIONS TO DATE o DATE DUE CALENDAR YEAR 1300 PER ELECTION** 0 11/28/09 $ DATE INCURRED CALENDAR YEAR $ PER ELECTION ** DATE INCURRED CALENDAR YEAR _% RATE PER ELECTION** $ $ DATE INCURRED tContributor Codes o INO -Individual COM - Recipient Committee (other than PTY or SCe) OTH - Other (e.g., business entity) PTY - Political Party 1300.00 SCC - Small Contributor Committee (May be a negallve number) DATE DUE o $ 1300.00 $ (Enter Ie) on Schedule E, Line 3) 1300.00 FPPC Form 460 (January/OS) FPPC TolI-Free Helpline: 866/ASK-FPPC (866/275-3772) from 11/28/2008 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 Bridget Healy for Council through 01/17/2009 ,/ Page Jl.:L of ~ 1.0. NUMBER 1313981 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 0I,f) campaign paraphernalia/misc. M3R member communications RAe 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 F1L candidate filing/ballot fees PHO phone banks 1RC candidate travel, lodging, and meals FJID fundraising events POI.. polling and survey research TRS staff/spouse travel, lodging, and meals N:> 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) VOT 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 t.o. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Vilma Caldwell Sales For Signs 11557 Embree Dr CMP $1631.74 EI Monte, CA 91732 Claremont Print and Copy 108 Olive St LIT $693.84 Claremont, CA 91711 Paul Held Reimbursement for Postage 429 Willamette POS $546.00 Claremont, CA 91711 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS 2871.58 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .. ....... ..... ............ ......... ................................................................... '" ..... $ 2. Unitemized payments made this period of under $1 00 . ........................................................................................................................ ......... ........ $ 3. Total interest paid this period on loans. (Enter amountfrom 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, ColumnA, Line 6.) ............................. TOTAL $ 3221.58 54.57 o 3276.15 FPPC Fonn 460 (January/OS) FPPC ToIl-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E (Continuation Sheet) Payments Made Type or print In ink. Amounts may be rounded to whole dollars. SCHEDULE E (CONT.) from 11/28/2008 01/17/2009 CALIFORNIA 460 FORM Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bridget Healy for Council through pagelt- of 6- 1.0. NUMBER 1313981 CODes: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. o.P campaign paraphernalia/misc. M3R 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 lB. t.v. or cable airtime and production costs RL candidate filinglballot fees PHO phone banks TRC candidate travel, lodging, and meals FN) fund raising events POl. polling and survey research TRS staff/spouse travel, lodging, and meals II[) 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 PRr print ads VVEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Claremont Forum To Rent Claremont Forum for Campaign Kick-off 1 st Street FND event $150.00 Claremont, CA 91711 Claremont Quarterly Forfeited Deposit 2355 Foothill Blvd #552 PRT $200.00 La Verne, CA 91750 * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 350.00 FPPC Form 460 (January/OS) FPPC TolI..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 11/28/2008 SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bridget Healy for Council through 01/17/2009 ../ Page L:2..-. of ~ 1.0. NUMBER 1313981 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CI\.P campaign paraphernalia/misc. M:IR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RfD returned contributions em 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 AL candidate filing/ballot fees PHO phone banks 1RC candidate travel, lodging, and meals FND fundraising events POI.. polling and survey research TRS staff/spouse travel, lodging, and meals N) 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 UT campaign literature and mailings PRT print ads WEB information technOlogy costs (internet, e-mail) CODE OR (8) (b) (c) (d) NAME AND ADDRESS OF CREDITOR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER 1.0. 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 $ 100.03 May be a negative number FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772) 100.03 o