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Home My Public Portal AboutForm 460 (July 1, 2006 - Jan 20, 2007) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink. Statement cover. period 7-1-2006 from SEE INSTRUCTIONS ON REVERSE 1-20-2007 through 1. Type of Recipient Committee: All eon.n;ttees - Complete Parts 1. 2, 3, and 4. ~ Officeholder, Candidate Controlled Committee 0 Primarily Formed Ballot Measure o State Candidate Election Committee Committee o Recall 0 Controlled {AJso Canplete Pen 5) 0 Sponsored (AJsoCanpleteParl6) o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee o Primarily Formed Candidatel ~hoiderConvnittee (AJsoCanpleteParl7) 1.0. NUMBER 1249955 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) 3. Committee Information Committee to Elect Jackie McHenry STREET ADDRESS (NO P.O. BOX) 2467 Wood Ct CITY Claremont STATE ZIP CODE CA 91711 AREA CODE/PHONE 9096215412 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE AREA CODE/PHONE liP CODE OPTIONAL: FAX I E-MAIL ADDRESS COVER PAGE RE~ED CALIFORNIA 460 FORM Date of election if applicable: (Month, Day, Year) JAN 2 4 2001 Page ----'--- of LL For Official Use Only 3-6-07 CI1Y CLERK Q1Y OF CLAREMONT 2. Type of Statement: Il(I Preelection statement o Semi-annual statement D Termination statement (Also file a Form 410 Termination) o Amendment (Explain below) o Quarterly statement o Special Odd-Year Report D Supplemental Preelection statement - Attach Form 495 Treasurer(s) NAME OF TREASURER William Stoner MAILING ADDRESS 2341 Oxford St CITY STATE ZIP CODE Claremont CA 91711 NAME OF ASSISTANT TREASURER, IF ANY David Wishart MAILING ADDRESS 524 Contra Costa Way CITY AREA CODEfPHONE 909 624 1051 STATE ZIP CODE A.REA CODE/PHONE 909 624 4867 Claremont OPTIONAL: FAX I E-MAIL ADDRESS CA 91711 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the IaVlfS of the State of California that the foregoing is true and correct. Executed on j-w-t> 7 . "'" j - J..o -' 07 """ By Executed on By Executed on By "'" Executed on By "'" istantTreasurer orResponsihleOOicerofSponsor Signatu'e ofConlrolting 0lf1OE!ho\def, GanQdate, State Measure Proponent Siglature of control8rg OITicehoIder, CaMidate, state Measure Proponert. FPPC Fonn 460 (JanuarylO61 FPPC ToIl-Free Helpline: 888/ASK..fPPC (886/275-37721 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 Jackie McHenry OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member, City of Claremont, CA RESIDENT1AUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 2467 Wood Ct Claremont CA 91711 Related Committees Not Included in this Statement: LIs. any <omml_ not Included In thIa s.tement that .,. conttolled by you or are ptfmarlly formed to receive contributions or make expendlturea on behalf of your c.ndldecy. COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED C0r&4fTfEE? DYES DNa COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE CCWIJIITTEE NAME l.D. NUMBER NAME OF TREASURER CONTROLLED COWJIIT1EE? DYES DNa STREET ADDRESS (NO P.O. BOX) COMMITTEE ADDRESS CITY S1J\TE ZIP CODE AREA CODE/PHONE 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 I DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Us' names 0' oIfIceholder(s) or candldata(s) for which this committee Is prlm8ll1y fonned. 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 (Januaryf051 FPPC Toll-Free Helpline: 8861ASK-FPPC (868/275-37721 State of California Campaign Disclosure Statement Summary Page see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Contributions Received 1. Monetary Contributions .......... ................................ Schedule A, Une3 2. Loans Received .................................................... Schedule B, Une 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Un.. I + 2 4. Nonmonetary Contributions .................................... Schedule C, Une 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... AddUn..3+ 4 Type or print In Ink. Amounts may be rounded to whole dollar.. Column A TOTAL THSPERIOD (FROM ATTAa-IED SCI-EIJJLES) $ (0, z..t{(, o /0, z-C{r... ."32. /0, (p 7'i! SUMMARY PAGE from through ColumnB CAlEN~RYEAR TOTAL TO DAJE $ Statement covers period CALIFORNIA 460 FORM $ $ $ 7-1-2006 1-20-2007 3 of 1q $ Page J.D. NUMBER 1249955 Calendar Year Summary for Candidates Running In Both the State Primary and General Elections 111 through 6/30 7/1 to Date 20. Contributions Received $ 21. Expenditures Made $ $ $ Expenditures Made 6. Payments Made ................ ...................................... Schadula E, Una 4 7. Loans Made ............................................................. Schedu/aH. Una 3 8. SUBTOTALCASHPAYMENTS .................................... Add Un.. 6 + 7 9. Accrued Expenses (Unpaid Bills) ...............................Sdledut.F, Un. 3 10. Nonmonetary Adjustment .......................................... Schf1dulaC, Una 3 11. TOTAL EXPENDITURES MADE ................................AddLln..8+ 9+ 10 $ If,,!S o wcrS- o o 1'6'1!> $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subfed to Voluntary ExpendJture LlmM) Date of Election (mmlddlyy) Total to Date $ $ $ ~~- $ $ Current Cash Statement 12. Beginning Cash Balance ....................... PreviousSummlJryPage,Una16 13. Cash Receipts ................................................... ColumnA, UflB3above 14. Miscellaneous Increases to Cash ........................... Sch&dulel. Une4 15. Cash Payments .................................................. ColumnA, Un" 8 above 16. ENDING CASH BAlANCE .......... AddUnas 12+ 13+ 14, thansubtractUne15 If this is a termination statement, Una 16 must be zero. $ /330 / OZ-'f (., o ( 8"'t > q&'8J 17. LOAN GUARANTEES RECEIVED ........................... Schodu/. e, Parl2 $ $ o Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ S"e instructions on revel'36' 19. Outstanding Debts ......................... AddUne2+Une9inColumnBabove $ $ o o To calculate Column S, 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). ~~- $ *Amounts in this section may be different from amounts reported in Column 8. FPPC Form 460 (JanuarylO5) FPPC Tol~Free Helpline: 8661ASK-FPPC (866I27s.:ln2) Schedule A Monetary Contributions Received see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE A CALIFORNIA 460 FORM Statement cover. period from 7-1-2006 through 1-20-2007 Page ~ of If I,D. NUMBER 1249955 DAlE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IFCOMMlTTEE,ALOOENTERI,O, Nl.MBER) CODE ... AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 . DEC. 31) PER ELECTION TO DAlE (IF REQUIRED) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SElF-EMPlOYED, ENTER Nll.ME OF BUSINESS) Leslie F Boring i!lIND 11-20-06 OCOM 582 Clarion PI OOTH Claremont 91711 OPTY OSCC Linda Kovach i!lIND 12-5-06 o COM 916 Glenville Dr OOTH Claremont 91711 OPTY oscc David Levering i!lIND 11-22-06 OCOM 334 W 7th St OOTH Claremont 91711 OPTY oscc Coye Management Co OIND 11-14-06 o COM 873 E Arrow Hy ~OTH Claremont 91711 OPTY OSCC Susan M Schenk i1IlND 11-12-06 845 N Indian Hill BI o COM OOTH CI;aremont 91711 OPTY oscc Retired 100 100 100 Retired 150 150 150 Retired 200 200 200 A Medical devices Co 100 100 100 Biology lab lecturer Scripps and Claremont Colleges 250 250 250 Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.) ........................................... SUBTOTAL $ f'A-G f) l./ -( () .......................................................$ 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 $ 800 I I G.C{(9 3PZ7 /0 Z'-/(,. "Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - other (e.g., business entity) PTY - PoI~ical Party SCC - Small Contributor Committee FPPC Form 480 (JanuaryI05) FPPC Toll-Free Helpline: 8861ASK-FPPC (866/275-3772) Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print In Ink. Amounts may be rounded to whole dollars. SCHEDULE A CALIFORNIA 460 FORM Statement cover. period from 7-1-2006 through 1-20-2007 !)'" of if Page I.D. NUMBER I z.t( "if S-S DAlE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, AlSO ENTER!.D. NLJ.1BERj CODE * AMOUNT RECEIVED THIS PERIOD IF AN INDIVIDUAL, ENlER OCCUPATION AND EMPLOYER (IF SELF-EMPlOYED, ENTERI'W.1E OFBUSNESS> CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 . DEC. 31) PER ElECnON TO DAlE (IF REQUIRED) William W Stoner, Jr \i'lIND 11-12-06 oeOM 2341 Oxford St OOTH Claremont, 91711 OPTY osee Julie Lannom \i'lIND 11-13-06 oeOM 4146 LaJunta OOTH Claremont 91711 OPTY osee Karl Benjamin \i'lIND 11-13-06 oeOM 675 W 8th St OOTH Claremont 91711 OPTY osee Joyce A Stoner Ii2lIND 11-13-06 oeOM 2341 Oxford St OOTH Claremont 91711 OPTY osee Richard G Hall Ii2lIND 11-15-06 1943 Judson Ct oeOM OOTH Claremont (1711 OPTY osee Self Employed InvestorlRetired 240 240 240 Health Aide Claremont School District 100 100 100 Retired Artist 250 250 250 Retired 240 240 240 Retired 250 250 250 SUBTOTAL$ 1080 I I Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Indude 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, ColumnA, Line 1.) ....................... TOTAL $ .Contributor Codes INO -Individual COM - Recipient Committee (other than PTY or See) OTH - Other (e,g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 480 (JanuaryI05) FPPC TolI-Free Helpline: 868/ASK-FPPC (8661275-3n2) Schedule A Monetary Contributions Received see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print In ink. Amounts may be rounded to whole dollar.. SCHEDULE A CALIFORNIA 460 FORM Statement covers period from 7-1-2006 through 3-20-2007 Page~ of 4- J.D. NUMBER 1249955 12-16-06 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DAlE (lFSELF-EMPlOYEO, ENTER ~E PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OfBUSlNES5J Retired 250 250 250 DAlE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IFCQMMITTEE,AlOOENTERI.D.NUMBER) CODe 11 12-13-06 12-22-06 12-19-06 12-27-06 Beverly Benjamin 675 W 8th St Claremont 91711 ~IND OCOM OOTH OPTY oscc ~IND o COM OOTH OPTY OSCC ~IND oeOM OOTH OPTY OSCC ~IND o COM OOTH OPTY OSCC i!lIND o COM OOTH OPTY OSCC Teacher DeVry Institute 250 250 250 Jon Hart 1046 Pomello Dr Claremont 91711 Bruce Mayclin 659 W Sage St Claremont 91711 Melvin Henlrt.j::,I/1.J 1 :lli9 'J 9aFl"'a~lh If z. 7 ~0i.(;A1J A-(,E Claremont 91711 Lawrence Woodruff 4060 Olive Knoll PI Claremont 91711 Account Executive Unisource Corp 250 250 250 Retired 125 125 125 Retired 250 250 250 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 $1 00 .... 3. Total monetary contributions received this period. (Add Unes 1 and 2. Enter hare and on the Summary Page, ColumnA, Une 1.) .............. SUBTOTAL $ 1125 I .................. $ ..........:............. $ .Contributor Codes INO -Individual COM - Recipient Committee (other than PTY orSCC) OTH - other (e.g., business entity) PTY - Political Party see - Small Contributor Committee ........ TOTAL $ FPPC Form 460 (JanuaryI05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A Monetary Contributions Received Type or print in ink. Amount. may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry SCHEDULE A from 7-1-2006 through 1-20-2007 Page~of / r; 1.0. NUMBER 1249955 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATlVE TO DATE PER ElECTION OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IFSELF-EMPLOYEO, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSI/lESS) Retired 250 250 250 DAle FULL NAME, STReET ADDRESS AND ZIP CODe OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IFCOMMITTEE,AlOOENTERWNUMBER) CODe .. 12-27-06 12-28-06 12-29-06 12-29-06 1-2-07 Margaret Woodruff 4060 Olive knoll PI Claremont 91711 i/'IIND o COM oaTH OPTY OSCC i/'IIND o COM oaTH OPTY OSCC Iii'lIND OCOM oaTH OPTY OSCC ii'!IND OCOM oaTH OPTY OSCC Iii'lIND o COM oaTH OPTY OSCC Retired 250 250 250 Bernie Uhlyarik 1285 Sheppard Way claremont 91711 Christian Schank 1949 Port Seabourne Newport Beach 92660 Earl Carter 1042 Fuller Dr Claremont 91711 Brian Bowcock 4700 ....11"'~a Cir fi-4.I~ CIY. LaVeme 91750 Lawyer Legal management Svcs 250 250 250 RetifEla l..AWyC(l.. SElF' fJAPwY'i1> 250 250 250 Retired 106.18 106.18 106.18 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, ColumnA, Line 1.) ...... SUBTOTALS 1106.18 I ................... $ ................... $ *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party see - Small Contributor Committee ................ TOTAL $ FPPC Form 480 (JanuaryI05) FPPC TolI-l'ree Helpline: 886/ASK-FPPC (866/275-3n2) Schedule A Monetary Contributions Received see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE A CALIFORNIA 460 FORM Statement cover. period from 7-1-2006 through 1-20-2007 Page -1L- of / '1 1.0. NUMBER 1249955 [>\TE RECEIVED AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR {JAN. 1 - DEC. 31) PER ElECTION TO DATE (IF REQUIRED) FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (lfCOMMlTTEE,ALOClENTERl.O. NWBER} CODE it IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IfSElF-EMPLOYEO. ENTER NAME Of BUSINESS) 1-9-07 150 1-9-07 1-7-07 1-7-07 1-7-07 Linda L Kovach 916 Glenville Dr Claremont 91711 Iii'IIND OCOM OOTH OPTY OSCC Iii'IIND OCOM OOTH OPTY oscc OIND o COM Iii'IOTH OPTY OSCC Iii'IIND o COM OOTH OPTY OSCC Iii'IIND o COM OOTH OPTY OSCC Retired 150 Miriam Chaffin 313W11 St Claremont 91711 TLA Urban Plannin9 620 Miramar Claremont 91711 Lillian lee 426 Willamette Claremont 91711 Rita Levine 991 Amador St Claremont 91711 Retired 100 100 Self Employed Individual 150 150 Retired 200 200 Consultant Mark Levine Associates 100 100 SUBTOTAL $ 700 I 1 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, ColumnA, Line 1.) ....................... TOTAL $ *Contributor Codes INO -Individual COM - Recipient Committee (other than PTY or See) OTH - other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 480 (JanuaryI05) FPPC TolI-Free Helpline: 886/ASK-FPPC (866/275-3772) Schedule A Monetary Contributions Received see INSTRUCTIONS ON REVERSE NAME OF FILER ~-n(Ld J~ /JIlt. Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE A CALIFORNIA 460 FORM Statement COYers period from 7-f-C.-OOf# through 1- '1.-0 -l<>o7 Page --3- of If' 1.0. NUMBER I Z-lf Q'1 J) DAlE RECEIVED CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) FUll NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR {IF COMMITTEE, ALOOENTER!.D. NUMBER) CODe .. IF AN INOIVIDUAl, ENTER OCCUPATION AND EMPLOYER OFSELF-EMPlOYEO. ENTER NAME OFBUSlJlESS) AMOUNT RECEIVED THIS PERIOD PER ElECTION TO DATE (IF REQUIRED) 1-7-07 108 1-7-07 1-7-07 1-7-07 1-7-07 Carol Merrylees 834 Lawrence Cir Claremont 91711 ii'lIND o COM OOTH OPTY OSCC ii'lIND o COM OOTH OPTY OSCC ii'lIND o COM OOTH OPTY OSCC ~IND OCOM OOTH OPTY OSCC i/lIND o COM OOTH OPTY OSCC Retired 108 Richard G Hall 1943 Judson Ct Claremont 91711 Lawrence Woodruff 4060 Olive Knoll Dr Claremont 91711 Howard S Fuller 725 Plymouth Rd Claremont 91711 Susan V Castagnetto 463 W 10 th St Claremont 91711 Retired 200 200 Retired 250 250 Retired 100 100 College Teacher Scripps College 100 100 Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.) ... .......................... SUBTOTAL$ 758 I ................$ *Contrtbutor Codes IND - Individual COM - Recipient Committee (other than PTY or See) OTH - other (e,g., business entity) PTY - Political Party SCC - Small Contributor Committee 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 $ FPPC Form 460 (JanuaryI05) FPPC TolI-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A Monetary Contributions Received see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE A CALIFORNIA 460 FORM Statement covers period from 7-1-2006 through 1-20-2007 Page~of /7 I.D. NUMBER 1249955 DATE RECEIVED AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (tFCOMMlTTEE,ALOOENTERI,D, NWBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (lFSELF-a1PlOYEO, ENTER flL4.ME OFBUSlNESS) 1-7-07 250 1-7-07 1-14-07 1-14-07 1-15-07 Mar9aret Woodrlluff 4060 Olive Knoll Dr Claremont 91711 i21tND o COM OOTH OPTY oscc i21IND OCOM OOTH OPTY oscc i21IND OCOM OOTH OPTY oscc ii'lIND o COM OOTH OPTY OSCC OIND OCOM ii'lOTH OPTY oscc Retired 250 Bruce L Mayclin 659 W Sage St Claremont 91711 Wendy Hampton 1244 Clemson Ave Claremont 91711 Leslie F Boring 582 Clarion PI Claremont 91711 Karl Benjamin Fine Arts 675 W 8th St Claremont 91711 Account Exec Unisource Corp 150 150 Administrative Assistant Avery-Dennison Co 100 100 Retired 100 100 Owner Fine Arts Company 250 250 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 $100 . 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, ColumnA, Line 1.) .............. SUBTOTAL$ 850 I ............... $ ..................... $ .Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or See) OTH - other (e.g., business entity) PTY - Political Party sce - Small Contributor Committee ........ TOTAL $ FPPC Form 460 (JanuaryI05) FPPC Toll-Free Helpline: Il86/ASK-FPPC (1l861275-3n2) Schedule B - Part 1 Loans Received Type or print in ink. Amou nts may be rounded ' to whole dollars. from SCHEDULE B - PART 1 Statement covers period 7-1-2006 see INSTRUCTIONS ON REVERSE NAME OF FILER through Committee to Elect Jackie McHenry 1-20-2007 CALIFORNIA 460 FORM Page 11 Offt I.D. NUMBER 1249955 1"1 AMOUNT RECEIVED THIS PERIOD Col CUMULATIVE CONTRIBUTIONS TO DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, AlSO ENTERLD. ~BER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPlOYED, ENTER NAME ClF BUSINESS} a OUTSTANDING BALANCE BEGINNING THIS (el AMOUNT PAID OR FORGIVEN THIS PERIOD" o PAID ("I OUTSTANDING BALANCEAT CLOSE OF THIS , NONE . o FORGIVEN to INO 0 COM OOTH 0 PlY 0 sCC DATE DUE CAlENDAR YEAR o PAID . o FORGIVEN to 'NO 0 COM 0 OTH 0 PTY 0 SCC DATE DUE CAlENDAR YEAR o PAID o FORGIVEN to 'NO 0 COM 0 OTH 0 PTY 0 SCC DATE DUE I 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$100 paid or forgiven.) (Indude loans paid by a third party that are also itemized on Schedule A.) ........ $ 3. Net change this period. (Subtract Line 2 from Line 1.).................. Enter the net here and on the Summary Page, Column A, Line 2. "H", NET $ (May be a negativa nvrnber) *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. (oj INTEREST PAID THIS PERiOD ,^>E ,^>E _% ,^>E $ (Erter(e)on ScteduleE,line3) o o o (~ ORIGINAL AMOUNT OF LOAN CAlENDAR YEAR % PER ELECTION*"" DATE INCURRED % PER ELECTION ** DATE INCURRED PER ELECTION- DATE INCURRED tContributor Codes IND -Individual COM - Recipient Committee (other than PTY or See) OTH - Other (e.g., business entity) PTY - Po'~lcal Party see - Small Contributor Committee FPPC Form 460 (JanuaryI05) FPPC ToII-Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule B - Part 2 Loan Guarantors Type or print In ink. Amounts may be rounded to whole dollars. Statement covers period 7-1-2006 from seE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry through 1-20-2007 SCHEDULEB-PART2 CALIFORNIA 460 FORM 12 of --1L Page l.O. NUMBER 1249955 FULL NAME, STREET ADDRESS AND ZIP CODe OF GUARANTOR (IFCOMMlnEE, ALSOENTER LD. MJMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAMEOFBUSlNESS) LOAN AMOUNT GUARANTEED THIS PERIOD CUMULATIVE IODATE BALANCE OlITSTANDING TO DATE CONTRIBUTOR CODE NONE DIND DeOM DOTH DPTY osee LENDER DATE CALENDAR YEAR PER ELECTION (IF REQUIRED) LENDER CALENDAR YEAR DIND DeoM DOTH DPTY osee DATE CALENDAR YEAR DIND DeoM DOTH DPTY osee LENDER DATE PER ELECTION (IF REQUIRED) PER aECTKJN (IF REQUIRED) DIND DeoM DOTH DPTY osee LENDER CALENDAR YEAR DATE PER ELECTION (IF REQUIRED) SUBTOTAL $ o Enteron Slll'1'YnaryPage, Line170rYi FPpe FOI'm 460 (JanuaryI05) FPpe Toll-Free Helpline: 866/ASK-FPPC (6861275-3n2) Schedule C Nonmonetary Contributions Received see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print In ink. Amounts may be rounded to whole dollars. SCHEDULE C Statement covers period from 7-1-2006 through 1-20-2007 CALIFORNIA 460 FORM AMOUNTI FAIR MARKET VALUE 148 157 305 305 127 432 Page 13 olk 1.0. NUMBER DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, AlSO ENTER 1.0_ NUMBER) CONTRIBUTOR CODE. 1249955 IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) DESCRIPTION OF GOODS OR SERVICES CUMULATIVE TO DATE CALENDAR YEAR (JAN 1.0EC31) PER ELECTION TO DATE (IF REQUIRED) 12-26-06 Henry McHenry McHenry Vineyards 330 11th St Davis, CA 95616 ~IND OCOM OOTH OPTY osee ii'lIND OCOM OOTH OPTY osec OIND OCOM OOTH OPTY osec OIND OCOM OOTH OPTY osec 12-26-06 Linda McHenry McHenry Vineyards 330 11th St Davis, CA 95616 Co-Owner McHenry Vineyards Co Co-Owner McHenry Vineyards Co 1 Case 2000Carnares Pinot Noir 1 Case 2002 Estate Pinot Noir 148 157 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this penod - itemized nonmonetary contnbutions. (Indudeall Schedule C subtotals.) ................. ............................. ...... $ .$ 2. Amount received this penod - unitemized nonmonetary contnbutions o/Iess than $100 3. Total nonmonetary contnbutions received this penod. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ............... ...... TOTAL $ .Contributor Codes IND-Individual COM - Recipient Committee (other than PTY or SCC) OTH - other (e.g., business entity) PTY - Political Party sce - Small Contrtbutor Committee FPPC Form 460 (JanuaryIOS) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule 0 Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees see lNSTRUCTlONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE D Statement covers period CALIFORNIA 460 FORM 7-1-2006 from through 1-20-2007 14 Ie Page of ~ 1.0. NUMBER 1249955 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITIEE AMOUNT THIS PERIOD NONE 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 Contnbution 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) I Schedule 0 Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) .... HHHHHH $ HHHHH.HH . $ o o o 2. Unitemized contributions and independent expenditures made this period of under $1 00 .. H. H. H H H H.. 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enteron the Summary Page.) .. H .H.H TOTAL S FPPC Form 460 (JanuarylO5) FPPC TolI-Free Helpline: 8661ASK-FPPC (8661275-3772) SEE INSTRUCTIONS ON REVERSE NAME OF FilER Committee to Elect Jackie McHenry through 1-20-2007 Pag 10 SCHEDULE E L1FORNIA 460 FORM 15 of / f e_ . NUMBER 49955 costs Is als he same candidate/sponsor met, e-mail) AMOUNT PAID 1476.18 312.00 56.88 AL$ 1845.06 $ 1845 $ Stl $ 0 $ 18f5 PC Form 460 (JaniJaryIOS) lISK.FPPC (8661275-3772) -- Schedule E Payments Made Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7-1-2006 CA 12 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. ~ campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions cm contribution (explain nonmonetary)* <:FC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL 1. v. or cable airtime and production FIL candidate filing/baUot fees A-O phone banks TRC candidate travel, lodging, and mea FNJ fundraising events PCt.. polling and survey research TRS staff/spouse travel, lodging, and me N) independent expenditure supporting/opposing others (explain). pas postage, delivery and messenger services TSF transfer between committees of t LEG legal defense PRO professional services (legal, accounting) VOT voter registration UT campaign literature and mailings PRT print ads WEB information technology costs (inte NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER W. NUMBER) CODE OR DESCRIPTION OF PAYMENT Master Sign Co 1846BW11thSt Upland, CA 91786 Campaign Signs 1-2-07 CMP Claremont Post Office 91711 POS Postage Stamps for 2 Mailings Longs Drugs Upland. CA 91786 MTG Sparkling Cider Beverage for Campaign Kickoff . Payments that are contributions or independent expenditures must also be summarized on Schedule O. SUBTOt Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............... ................ ..................... ............... ................... 2. Unitemized payments made this period ofunder$100 ..........f.(~!J.?c;...f.f..'f,.............. ....................................................... .................... 3. Total interest paid this period on loans. (Enteramounttrom 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 FP FPPC Tolf..Free Helpline: 8661. Schedule F Accrued Expenses (Unpaid Bills) SCHEDULE F Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 7-1-2006 CALIFORNIA 460 FORM !rom SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry CODES: If one of the following codes accurately describes the payment, you may enter the code. o.,p campaign paraphernalia/misc. MeR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)* Cf'C office expenses eve civic donations FEr petition circulating FIL candidate filing/ballot fees A-O phone banks FND fundraising events POL polling and survey research NJ independent expenditure supporting/opposing others (explain)* PC5 postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads through 1-20-2007 page~ of-LL 1.0. NUMBER 1249955 Otherwise, describe the payment. RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration VI.EB information technology costs (internet, e-mail) CODE OR (al (bl (el (dl NAME AND ADDRESS OF CREDITOR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, AlSO ENTER f,O. NUMBER) DESCRIPTION OF PAYMENT BAlANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD NONE * Payments that are COntributIOnS or Independent expenditures must also be summarized on Schedule D. SUBTOTALS $ $ $ $ Schedule F Summary 1. Total accrued expenses incurred this peJiod. (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 peJiod. (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.) ................. 3. Net change this peJiod. (Subtract Line 2 from Line 1. Enter the difference here and o on the Summary Page, Column A, Line 9.) .................................................................................... ....................... ................................... NET $ Maybeanegativenurrber o .... PAID TOTALS $ o FPPC Fo<m 460 (JanuarylO5) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772) 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. from Statement covers pertod 7-1-2006 CALIFORNIA 460 FORM SCHEDULE G see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry NAME OF AGENT OR INDEPENDENT CONTRACTOR through 1-20-2007 Page ~ of---1.L to. NUMBER 1249955 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. eM' campaign paraphernalia/misc. M3R member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions ClB contribution (explain nonmonetary)* a::c office expenses SAL campaign workers' salaries eve civic donations FEr petition circulating TB... tv. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals R'ID fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals r.D 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 FRr print ads V\.EB 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 I.D_ NUMBER) NONE Attach additional information on appropriately labeled continuation sheets. TOTAL' $ o . Do not transfer to any other schedule or to the Summary Page. This totsl may not &quai the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Form 460 (JanuaryI05) FPPC TolI-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. statement covers period 7-1-2006 from see INSTRUCTIONS ON REVERSE NAME OF FILER 1-20-2007 through Committee to Elect Jackie McHenry SCHEDULE H CALIFORNIA 460 FORM Page 18 Ol~ 1.0. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE OF RECIPIENT OF COMMITTEE, AlSO ENTER LD NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER {IF SELF-EMPLOYED, ENTER NAME Of BUSINESS) (.J OUTSTANDING BALANCE BEGINNING THIS PERIOD (o) INTEREST RECEIVED 1249955 tb) AMOUNT LOANED THIS PERIOD OUTST~DING BALANCE AT CLOSE OF THIS PERIOD (oj REPAYMENT OR FORGIVENESS THIS PERIOD'" (II ORIGINAL AMOUNT OF lOAN (01 CUMULATIVE LOANS TO DATE o PAID . o FORGIVEN -, "''' DATE DUE CAlENDAR YEAR o PAID -, "''' D FORGIVEN DATE DUE DATE INCURRED *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. o $ o $ o $ SUBTOTALS $ CALENDAR YEAR PER ELECTlON-- DATE INCURRED PER ELECTION- (Enter (e) on Schedule I, Line 3) o 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.) "'''''''''''''''''''' (Enter the net here and on the Summary Page, Column A, Line 7.) ....................NET $ (May bea negEll:r.e number) o I -'I Required I o o FPPC Form 460 (JanuaryI05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule I Miscellaneous Increases to Cash from 7-1-2006 1-20-2007 CALIFORNIA 460 FORM SCHEDULE I Type or print in ink. Amounts may be rounded to wholedollars. Statement covers period see INSTRUCTIONS ON REVERSE NAME OF FILER through Page 19 01-4- 1.0. NUMBER Committee to Elect Jackie McHenry 1249955 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER lD NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH NONE Attach additional infonnation on appropriateiy labeled continuation sheets. SUBTOTAL $ o 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 $ o o o o FPPC Form 460 (Januaryf05) FPPC TolI-Free Helpline: 8661ASK.FPPC (866/27S-3n2)