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Home My Public Portal AboutForm 460 (Jan 18 - Feb 14, 2009) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) COVER PAGE Type or print in ink. Date Stamp EC!ii!"""'~ . ~.' ~ . . . b..~ . CALIFORNIA 460 2001/02 FORM through 3/3/09 FEB ~ ~) CITY G ITV OF Page of 13 Statement covers period from 01/18/09 Date of election if applicable: (Month, Day, Year) SEE INSTRUCTIONS ON REVERSE 02/14/09 For Official Use Only 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. o Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also Complete Part 5) o Ballot Measure Committee o Primarily Formed o Controlled o Sponsored (Also Complete Part 6) 2. Type of Statement: iii Preelection Statement o Semi-annual Statement o Termination Statement o Amendment (Explain below) o Quarterly Statement o Special Odd-Year Report o Supplemental Preelection Statement - Attach Form 495 o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee iii Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information 1.0. NUMBER 1272663 Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Corey Calaycay CITY Claremont STATE ZIP CODE CA 91711 AREA CODE/PHONE (909) 593-5913 NAME OF TREASURER Robert W. Bowcock MAILING ADDRESS 1021 Belleville Court CITY Claremont NAME OF ASSISTANT TREASURER, IF ANY STATE CA ZIP CODE 91711 AREA CODE/PHONE (909) 621-1266 STREET ADDRESS (NO P.O. BOX) 1555 West Baseline Road 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 (909) 621-1196 / bbowcock@irmwater.com 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the certify under penalty of perjury under the laws of the State of California that the fore mg is true a 02/19/08 Executed on Date Executed on 02/19/08 Date Executed on Date Executed on Date By the' form tion contained herein and in the attached schedules is true and complete. By By By Signature of Controlling Officeholder, Candidate, Slate Measure Proponent FPPC Fonn 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC 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, City of Claremont RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 1555 West Baseline Road: Claremont, California 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? DYES o NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES ONO STREET ADDRESS (NO P.O. BOX) COMMITTEE ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE 6. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION COVER PAGE - PART 2 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 Committee List names of offlceholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE Corey Calaycay NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD iii SUPPORT o OPPOSE City Council OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE Attach continuation sheets if necessary FPPC Fonn 460 (June/Oi) FPPC Toll-Free Helpline: 866/ASK-FPPC Slale of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay Type or print in ink. Amounts may be rounded to whole dollars. SUMMARY PAGE from through Statement covers period CALIFORNIA 460 FORM 01/18/09 02/14/09 3 13 of Page 1.0. NUMBER Contributions Received 1272663 1. Monetary Contributions ........................................... Schedule A. Line 3 2. Loans Received ...................................................... Schedule B. 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) $ 2,248.00 0.00 2,248.00 0.00 2,248.00 Column B CALENDAR YEAR TOTAL TO DATE $ 6,805.99 0.00 6,805.99 0.00 6,805.99 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 $ 0.00 0.00 0.00 0.00 0.00 0.00 $ 0.00 0.00 0.00 0.00 0.00 0.00 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made. (If Subject to Voluntaoy Expenditure Limit) Date of Election Total to Date (mm/ddlyy) ~~- $ ~~- $ ~~- $ ~~- $ ~~- $ ~~- $ 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. $ $ $ $ 14,305.18 2,248.00 0.00 8.804.73 7,748.45 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 B. Parl2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 0.00 0.00 .Since January 1. 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK.FPPC Schedule A Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. 01/18/09 CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay SCHEDULE A from Statement covers period through 02/14/09 4 13 of Page 1.0. NUMBER AMOUNT RECEIVED THIS PERIOD $200.00 $250.00 $200.00 $250.00 $900.00 I 900.00 1,346.00 2,248.00 1272663 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE * CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) Retired Retired Retired Doctor California Healthy Marriages Coalition SUBTOTAL $ Schedule A Summary 1. Amount received this period - contributions of $1 00 or more. (Include all Schedule A subtotals.) ........................................................................................................ $ 2. Amount received this period - unitemized contributions ofless 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 $ $200.00 $150.00 $250.00 $250.00 01/19/09 Gene & Maija Hawkins 855 West Tenth Street Claremont, California 91711 K1IND OCOM OOTH OPTY OSCC IiIIND OCOM OOTH OPTY OSCC IKIIND OCOM OOTH OPTY OSCC IKIIND OCOM OOTH OPTY OSCC IKIIND OCOM OOTH OPTY OSCC 01/28/09 Betty Giannos 1832 Hanover Road Claremont, California 91711 02/02/09 Rodrigo & lona Miranda 355 Garnsey Avenue Bakersfield, California 91711 02/02/09 Edward & Ruth Santana-Grace 1574 Mural Drive Claremont, California 91711 $250.00 $250.00 'Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (June/01) FPPC TolI.Free Helpline: 866/ASK.FPPC Schedule B - Part 1 Loans Received Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE B - PART 1 from 01/18/09 CALIFORNIA 460 FORM Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER through 02/14/09 Page 1.0. NUMBER 5 of 13 Committee to Elect Corey Calaycay 1272663 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) a OUTSTANDING BALANCE BEGINNING THIS P I (b) (e) AMOUNT AMOUNT PAID RECEIVED THIS OR FORGIVEN PERIOD THIS PERIOD. o PAID (d) OUTSTANDING BALANCE AT CLOSE OF THIS RI (e) INTEREST PAID THIS PERIOD ( ) ORIGINAL AMOUNT OF LOAN (g) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR _% RATE o FORGIVEN PER ELECTION" to IND o COM o OTH o PTY o SCC o PAID o FORGIVEN to IND o COM o OTH o PTY o SCC o PAID o FORGIVEN to IND o COM o OTH OPTY o SCC SUBTOTALS $ $ DATE DUE DATE INCURRED CALENDAR YEAR _% RATE PER ELECTION .. DATE DUE DATE INCURRED CALENDAR YEAR _% RATE PER ELECTION" DATE DUE DATE INCURRED $ $ (Enler(e)on Schedule E, line 3) 0.00 .Amounts forgiven or paid by another party also must be 0.00 reported on Schedule A. .. If required. Schedule B Summary 1. Loans received this period.. ................... ............. .............................. ............;. ......... ..................... ........ $ (Total Column (b) plus un itemized loans less than $100.) 2. Loans paid or forgiven this period ......................................................................................................... $ (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 $ Enter the net here and on the Summary Page, Column A, Line 2. 0.00 (May be a negative number) t Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK.FPPC Schedule C Nonmonetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE C from 01/18/09 CALIFORNIA 460 FORM Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER through 02/14/09 6 13 Page_of_ 1.0. NUMBER Committee to Elect Corey Calaycay 1272663 DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) IF AN INDIVIDUAL, ENTER CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF CODE * (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES NAME OF BUSINESS) AMOUNTI FAIR MARKET VALUE CUMULATIVE TO DATE CALENDAR YEAR (JAN 1-DEC31) PER ELECTION TO DATE (IF REQUIRED) OIND o COM OOTH OPTY OSCC OIND OCOM OOTH OPTY OSCC OIND OCOM OOTH OPTY OSCC OIND DOOM OOTH OPTY OSCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this period - nonmonetary contributions of $1 00 or more. (Include all Schedule C subtotals.) ..................................................................................................................... $ 2. Amount received this period - unitemized nonmonetary contributions ofless 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 $ 0.00 0.00 .Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee 0.00 FPPC Form 460 (June/Oi) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule 0 Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay SCHEDULE D Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM 01/18/09 from through 02/14/09 page~ of~ I.D. NUMBER 1272663 DATE AMOUNT THIS PERIOD NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE o Support o Oppose o Support o Oppose o Support o Oppose TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) 0 Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure SUBTOTAL $ CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) Schedule 0 Summary 1. Contributions and independent expenditures made this period of$100 or more. (Include all Schedule D subtotals.) .............................................. $ 0.00 0.00 2. Unitemized contributions and independent expenditures made this period of under $100 ...................................................................................... $ 0.00 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enteron the Summary Page.) .............. TOTAL $ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule E Payments Made Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULEE from 01/18/09 CALIFORNIA 460 FORM Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER through 02/14/09 page~ of~ I.D. NUMBER Committee to Elect Corey Calaycay 1272663 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Ct.tP 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 filinglballot fees PI-O phone banks TRC candidate travel, lodging, and meals FND fundraising events POl polling and survey research TRS staff/spouse travel, lodging, and meals I\[) independent expenditure supporting/opposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID John Merrylees OFC Reimbursement CK# 1135 $239.42 Reimbursement CK# 1143 $128.64 $368.06 Claremont, California 91711 Jon Hart PRT Reimbursement CK# 1136 $173.64 Reimbursement CK# 1144 $216.99 $390.63 Claremont, California 91711 Linda Kovach FND Reimbursement CK# 1137 $522.02 Claremont, California 91711 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,280.71 Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) .................................................................................................. $ 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amountfrom 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 $ 8,804.73 0.00 0.00 8,804.73 FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule E (Continuation Sheet) Payments Made SCHEDULE E (CONT.) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period through 01/18/09 02/14/09 CALIFORNIA 460 FORM from SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay page~ of~ 1.0. 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 CTB contribution (explain nonmonetary)- OFC office expenses SAL campaign workers' salaries CVC civic donations FtT petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees A-IO phone banks TRC candidate travel, lodging, and meals FNJ fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals I\[) 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 (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Charles Seward 112 Harvard Avenue Claremont, California 91711 PRO CK# 1139 $850.00 CK# 1141 $950.00 CK# 1146 $1,500.00 $3,300.00 Vista Printing 1164 Monte Vista Avenue Upland, California 91786 PRT CK# 1140 $2,800.00 CK# 1142 $174.52 $2,974.52 Time Warner Cable Indian Hill Boulevard Claremont, California 91711 TEL CK#1145 $1,249.50 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 7,524.02 FPPC Form 460 (June/Oi) FPPC Toll-Free Helpline: 866/ASK-FPPC SCHEDULE F Schedule F Accrued Expenses (Unpaid Bills) Type or print in ink. Amounts may be rounded to whole dollars. from 01/18/09 02/14/09 CALIFORNIA 460 FORM Statement covers period through Page~ of~ SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay !.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. rvBR 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 FEr petition circulating TEL t.v. or cable airtime and production costs FIL candidate filinglballot fees PHO phone banks lRC candidate travel, lodging, and meals FND fundraising events POL 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 LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR (IF 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 (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE 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 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE G from 01/18/09 CALIFORNIA 460 FORM Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Corey Calaycay NAME OF AGENT OR INDEPENDENT CONTRACTOR through 02/14/09 page~ of~ 1.0. NUMBER 1272663 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. C1vP 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 FEr petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PH) phone banks 1RC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel. lodging, and meals IN[) 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) .. Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID 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 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule H Loans Made to Others* Type or print in ink. Amounts may be rounded to whole dollars. from Statement covers period 01/18/09 SEE INSTRUCTIONS ON REVERSE NAME OF FILER through Committee to Elect Corey Calaycay 02/14/09 SCHEDULE H CALIFORNIA 460 FORM 12 Page I.D. NUMBER 1272663 of 13 FULL NAME, STREET ADDRESS AND ZIP CODE OF RECIPIENT (IF COMMITTEE. ALSO ENTER 10. NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) (I) OUTSTANDING BALANCE BEGINNING THIS PERIOD OUTST~DING BALANCE AT CLOSE OF THIS PERIOD (b) AMOUNT LOANED THIS PERIOD (e) REPAYMENT OR FORGIVENESS THIS PERIOD* o PAID o FORGIVEN DATE DUE CALENDAR YEAR o PAID o FORGIVEN DATE DUE *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 $ $ $ Schedule H Summary 1. Loans made this period .......... ....... ................ .............. ..... ..... ...... ................... .............. ..... ....... ....................... ............... $ (Total Column (b) plus unitemized loans less than $100.) 2. Payments received on loans ........................................................................................................................................... $ (Total Column (c) plus unitemized payments 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.) (e) INTEREST RECEIVED _% RATE _% RATE $ (Enter (e) on Schedule I. Line 3) (May be a negative number) (f) ORIGINAL AMOUNT OF LOAN DATE INCURRED DATE INCURRED 0.00 0.00 0.00 (g) CUMULATIVE LOANS TO DATE CALENDAR YEAR PER ELECTION" PER ELECTION" **If Required FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC . . Schedule I Miscellaneous Increases to Cash Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE I SEE INSTRUCTIONS ON REVERSE NAME OF FILER through 01/18/09 02/14/09 CALIFORNIA 460 FORM Statement covers period from page~ of~ 1.0. NUMBER Committee to Elect Corey Calaycay 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. Increases to cash of $100 or more this period. .......................................................................................................... $ 2. Unitemized increases to cash 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 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC