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Home My Public Portal AboutForm 460 (Jan 21 - Feb 17, 2007) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print In Ink. Statement covers period 1-21-07 from SEE INSTRUCTIONS ON REVERSE 2-17-07 through 1. Type of Recipient Committee: All c..,..d_ - CompIeIe Pans I, 2, 3, and" ~ Officeholder, Candldlte Controlled Committee 0 Primarily Formed Ballot Measure o state Candldllla Election Conmttee Commillee o Recall 0 Controlled (Aooeanpl6htPwt$ 0 Sponsored (AlsoCcmplslePatt6.l o General Purpose Committee o Sponso~d o Small Contributor Conmttee o Political Party/Central Committee o PrimarUy Formed Candidatel Officeholder Committee (AIsoCompletePvrt7) 1.0. HUMBER 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 909621 5412 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E..MAIL ADDRESS . r ,- Date of election if applicable: (Month, Day. Year) FED 2 0 2JJi 3-6-07 CIlY CLERK CITY OF CLAREMONT' For OfficIal Use Only 2. Type of Statement: ~ Preelection statement o Seml-annual Statement o Tennination Statement (Also file a Form 410 Termination) o Amendment (Explain below) o Quarterly statement o Special Odd-Vear Repori o 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 CODE/PHONE 909 624 1051 AREA CODE/PHONE 909 624 4867 STATE ZIP CODE Claremont OPTIONAl: FAX f E-MAIL ADDRESS CA 91711 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of ITrf knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. By Executed on 2-18-07 00Ie ;;).- /9- D7 00Ie By Executed on Executed on By ignatlSer:JCCOrolli'l9cmcet1oldef,Candidate, Meal5UreProponer1:otResponsibleO'ficerctSponllOt SQ'lalueofCor1rolHngorrlCehok:ler, Carxlid<lle, State Meal:Uf:Pn:IpoI'enl Dot. Executed on By 00Ie $ignirtl..e ~Cor1roIlrgOlficeholder, Candidate, State Measu'eProponenl FPPC Form 460 CJanuarylOfli) FPPC ToIl-f'ree Helpline: II6IASK-fPPC (818/276-3772) State of C.llfomia Type or print In Ink. COVER PAGE - PART 2 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 RESIOENTlAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 2467 Wood Ct Claremont CA 91711 Related Committees Not Included In this Statement: U...nycomml"'" not Included In rIrIe ..tam.., ther aN conltolted by )IOU or are ptfmarlly formed to receive cOIItdbufloM or meke upend"",.. on behalf of your candkMcy. COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COWoAITTEE? DYES DNO STREET ADDRESS (NO P.O. BOX) COMMITTEE ADDRESS CITY STATE ZIP CODE AREA CODElPHONE COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROlLED COMMITTEE? DYES DNO STREET ADDRESS (NO P.O. BOX) COt.NITTEE ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BAllOT NO. OR LETTER JURISDICTION D SUPPORT D OPPOSE klentify the controlling officeholder, candidate. or state mea.ure proponent, if any. NAME OF OfFICEHOLDER. CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HelD I DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee U.,n...... 0' omceholder(s) or csndldate(s) for which this committee I. p1fm8l11y fotmed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HElD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE Attach continuation sheets If necessary FPPC Fonn 480 (January/OS) FPPC Toll-Free Helpline: 8861ASK..fPPC (8661275-3772) state of CaUfomia Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FilER Committee to Elect Jackie McHenry Contributions Received 1. Monetary Contributions ........................................... Schedul.^ Une3 $ 2. Loans Received ...................................................... Schedule B. Une 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... AddUne.' + 2 $ 4. Nonmonetary Contributions .................................... Schedule C, Une3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Line. 3 + 4 $ Type or print In ink. Amou nts may be rounded to whole dollar.. ~ SUMMARY PAGE 1-21-07 from through CoI....nA CoIumnB TOTAl THSPERlOO CALENOARYEAR (fRCfAATTAO-EOSCI-EDU.ES) TOTAL TOQ6,TE 51> S- 3 $ I ~S-qq 0 0 5bS" 3 $ In'q~ 5"07- 934 01S-S- $ I~ 03 Statement cover. period CALIFORNIA 460 FORr~ 2-17-07 3 01 J.!/..- Page 1.0. NUMBER 1249955 Calendar Year Summary for Candidates Running In Both the Stale Primary and General Elections 1/1 through 6130 7/1 to Oate 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedul. E. Une 4 $ 7. Loans Made ............................................................. Schedu/eH, Une 3 8. SUBTOTAL CASH PAYMENTS .................................... AddU..." + 7 $ 9. A=ued Expenses (Unpaid Bills) ...............................Schedul.F, Un.' 10. Nonmonetary Adjustment .......................................... Schedul. c. Une3 11. TOTALEXPENDITURESMADE................................AddUn..S+9+ '0 $ /C;-4tf o '''-4 Lf o o ,5""YL{ 3 1/ "39 o "5 if}'? o D 7A39 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made. (lfSUbJlldto VoIum.ryExpeodIlu... UmIl) Date of Election (mm1ddlyy) Total to Date $ $ $ ----1----1_ $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Une 16 $ 13. Cash Receipts .............,..................................... ColumnA, Une 3abow 14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4 15. Cash Payments .................................................. ColumnA, Une Sabow 16. ENDING CASH BALANCE .......... AddUnes12+ 13+ 14, thens.tbtrBcfUne 15 $ If this is a termination statement, Una 16 must be zero. 9{,,~/ .!?7c r3 o I5""Lft1 , 37"10 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 ........................... Schedul. e. P.rl2 $ o Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on fBV8rs8 $ 19. Outstanding Debts ...............,......... AddUne 2 + Une 9in ColumnB.9bow $ o o ----1----1_ $ .Amounts in this section may be different from amounts reported in ColufTYl B. FPPC Form 480 (JanuarylO5) FPPC Toll-Free Helpline: 868/ASK-FPPC (886127~n2) Schedule A Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. Statement cover. period CALIFORNIA 46 (,\ FORM U SEe INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry SCHEDULE A from 1-21-07 through 2-17-07 Page ----'1- of J.!:/- 1.0. NUMBER 1249955 DATE RECEIVED CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 . DEC. 31) FUll NAME, STReET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IFCQMMITTEE,AlSOENTERI.O.Nl...NBER) COOE .. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IFSELF-EMPlOYEO, ENTER~E ~8USl""" AMOUNT RECeNED THIS PERIOD PER ELECTION TO DATE (IF REQUIRED) 1-22-07 1-22-07 1-24-07 1-22-07 1-22-07 Virginia Sutton 2458 Mariposa Pomona, 91767 i!"IlND o COM OOTH OPTY OSCC i!"IlND o COM OOTH OPTY OSCC i!"IlND OCOM OOTH OPTY OSCC ii'!IND o COM OOTH OPTY OSCC i!"IlND o COM OOTH OPTY OSCC Retired 100 Retired Consultant 200 Roy Clounts 1050 Fuller Dr Claremont 91711 Bruce Mayclin 659 W sage St Claremont 91711 Genesis Health Care 2088 N Mills Ave #616 Claremont 91711 Eugene Siegrist 336 Teasdale Dr Claremont 91711 Account Exec Unisource Corp 100 250 Registered Nurse 250 Retired 250 SUBTOTAL $ 900 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 $1 00 ............................. $ 3. Total monetary contributions received this period. (Add lines 1 and2. Enter here and on the Summary Page, Column A, line 1.) ....................... TOTAL $ .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 1850 3803 5653 FPPC Form 460 (JanuaryI05) FPPC TolI-Free Helpline: 1166/ASK.FPPC (ll661275-3nZ) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER Committee to Elect Jackie McHenry -' SCHEDULE A (CONn CALIFORNIA 460 FORM Statement covers period 1-21-07 from through 2-17-07 Poge~Of Ii.{ 1:0. NUMBER 1249955 DAlE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (lFCOMMlTlEE.ALSOENTCRI,D. PUABER) CODE * AMOUNT RECEIVED THIS PERIOD PER ELECTION TO DATE (IF REQUIRED) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPlOYED, ENTER NAME OFBUSlIIESS) CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 1-22-07 250 Mary L Siegrist 336 Teasdale Dr Claremont 91711 i21IND OCOM oaTH OPTY OSCC i21IND OCOM oaTH OPTY OSCC i21IND OCOM oaTH OPTY OSCC i21IND OCOM oaTH OPTY OSCC i21IND OCOM oaTH OPTY OSCC 1-22-07 Halford Fairchild 2271 W 25th 5t Los Angeles CA 90016 1-28-07 Linda Callaway 2225 Brescia Ave Claremont 91711 2-11-07 'James Dorst 4142 Via Padova Claremont 91711 2-11-07 Ronald Hanson 2058 Mills Ave #212 Claremont 91711 Retired Professor, Pitzer College Claremont CA Teacher, Pomona Unified School District Owner, Padua Glass Ent 1032 Brooks Ave Ontario, Ca Industriallnfonnation Group, Sales 250 100 250 100 *Contributor Codes INO -lndMdual COM - Recipient Committee (other than PTY or See) OTH - other (e.g., business entity) PTY - Political Party see - small Contributor Committee SUBTOTALS 950 I FPPC Form 480 (JanuaryI05) FPPC Toll-Free Helpline: 866/ASK-FPPC (8681275-3n2) Schedule B - Part 1 Loans Received Type or print In Ink. Amou nts may be rounded to whole dollar.. 1-21-07 Statement cover. period from see INSTRUCTIONS ON REVERSE NAME OF FILER through 2-17-07 Committee to Elect Jackie McHenry SCHEDULE B - PART 1 CALIFORNIA 460 FORM Page ro of .J.!L 1.0. NUMBER 1249955 FULL NAME. STReET ADDRESS AND ZIP CODE OF LENDER {lFOJMMlTIEE,ALSOENTERI,D, N..UBERJ IF AN INOMDUAL, ENTER . (0) 1'1 OUTS :4NOtNG AMOUNT AMOUNT PAID OUTS DING OCCUPATION AND EMPLOYER BALANCE BALANCE AT (IF SElF-€MF'LOYEO, ENTER BEGINNING THIS RECEIVED THIS OR FORGtVEN CLOSE OF THIS NAME OF BUSINESS) PERIOD THIS PERIOD. o PAID . o FORGIVEN DATE DUE o PAlO . o FORGIVEN DATE DUE o PAlO . o FORGIVEN DATEOUE SUBTOTALS $ $ $ $ . INTEREST PAID THIS PERIOD NONE -, Rm to INO 0 COM 0 OTH 0 PTY 0 SCC -, RATE to INO 0 COM 0 OTH 0 PTY 0 SCC -, RATE to lNO 0 COM OOTH 0 PTY 0 SCC Schedule B Summary 1. Loans received this period ...... ......... ..................................... ...... ...... ...... ....... ...... ........ ................ ...,.... $ (Total Column (b) plus unitemized loans of less than $100.) (Erter(e)on SChecUeE, Li'le3) o 2. Loans paid or forgiven this period .... ......., .......... .....................,.... ..... ............. ...,.. .... (Total Column (c) plus loans under$100 paid orforgiven.) (Include loans paid by a third party that are also itemized on Sclhedule A.) ................. $ (J 3. Netclhange this period. (Subtract Line 2 from Line 1.) .......................... Enter the net here and on the Summary Page, Column A, Line 2. .0 (MaybeanegalMtn"mbef) .................. NET $ *Amounts forgiven or paid by another party also must be reported on Schedule A. .. If required. ~ ORIGINAL AMOUNT OF LOAN (. CUMULATIVE CONTRIBUTIONS lODATE CAlENDAR YEAR PERaECTlON- CATE INCURRED CAlENDAR YEAR PER ELECTION - DATE INCURRED CALENDAR YEAR . PER ElECTION- . DATE INCURRED tContributor Codes INO -lndMdual COM - Recipient Committee (other than PTY or SCC) OTH - other (e.g., business entity) PTY - Pol~ical Party SCC - Small Contributor Committee FPPC Form 460 (JanuaryI05) FPPC TolI-Free Helpline: 866/ASK-FPPC (866/275-3n2) .' Schedule B - Part 2 Loan Guarantors Type or print In Ink. Amount. may be rounded to whole dollars. SCHEDULE B - PART 2 from 1-21-07 CALIFORNIA 460 FORM Statement coyer. period SEE INSTRUCTIONS ON REVERSE NAME OF FilER Committee to Elect Jackie McHenry through 2-17-07 Page '7 oI1::L 1.0. NUMBER 1249955 FULL NAME, STREET ADDRESS AND ZIP CODE OF GUARANTOR (IF COMMITTEE, AlSOENTER I_D. NMBER) CONTRIBUTOR CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SElf-EMPlOYED, ENTER NAMEOFBUSI/Il: LOAN AMOUNT GUARANTEED THIS PERIOD CUMULATIVE TO DATE BAlANCE OUTSTANDING lOCATE NONE OIND OCOM OOTH OPTY OSCC LENDER CALENOAR YEAR OAT<' PER aeCTION (tFREClUlREO) CALE~ARYEAR OIND OCOM OOTH OPTY OSCC LENDER DIIT. PER ELECTION (IF REQUIRED) CALENDAR YEAR OIND OCOM OOTH OPTY OSCC LENDER OAT<' . PER ELECTION (IF REQUIRED) CALENOARYEAR OIND OCOM OOTH OPTY OSCC LENDER OAT<' PER ELECTION (IFREClUIREO) SUBTOTAL S o '-00 Sl.I1'ITllry Page, l.he17~_ FPPC Form 460 (JanuarylO5) FPPC TolI-Free Helpline: I166/ASK-FPPC (1166/275-3772) 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 from 1-21-07 through statement covers period CALIFORNIA 460 FORM 2-17-07 Page1- of /Y 1.0. NUMBER 1249955 DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER to. NJMBER) CONTRIBUTOR CODE . IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPlOYEO, ENTER K6.MEOFBUSlNESS) /-JI-07 (~~-4-....-.. . ~ K.e..V1 ~ Po(Jo'f- IbOO C~~ql?11 LA Pl'd&'! ~ ISC.~ Fv<>~ ~70 VI;" ~, ~I )..-11-07 AMOUNTI CUMULATIVE TO PER ELECTION DESCRIPTION OF FAIR MARKET DATE IODATE GOODS OR SERVICES VALUE CALENDAR YEAR (IF REQUIRED) (JAN 1 .DEC 31) It!u, ~ ;2.$'0 ~.So , C4~ SUBTOTAL S Schedule C Summary 1. Amount received this period - itemized nonmonetary contributions. (Indudeall Schedule C subtotals.) ....................................................................................... ............................. $ 2. Amount received this period - unitemized nonmonetary contributions ofless than $1 00 .................................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, ColumnA, Lines 4 and 10.) ...................... lOTAL $ OIND OCOM ~TH OPTY osec &!jIND OCOM OOTH OPTY osec OIND OCOM OOTH OPTY osee OIND OCOM OOTH OPTY osec Attach additional information on appropriately labeled continuation sheets. .:zs-o ..2 TO S-Oo !FOO ~ .Contributor Codes INO -Individual COM - Recipient Committee (other than PTY or see) OTH - other (e.g., business entity) PTY - Political Party see - Small Contributor Committee .5 0'2- FPPC Form 460 (JanuaryI05) FPPC Toll-free Helpline: 886/ASK-FPPC (8861275-3772) ~ Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees from 1-21-07 CALIFORNIA 460 FORM SCHEDULE 0 Type or print in Ink. Amounts may be rounded to whole dollars. Statement cover. period SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry through 2-17-07 Page --3-- 01 ~ to. NUMBER 1249955 o Support o Oppose TYPE OF PAYMENT DESCRIPTION (If REQUIRED) o Monetary Contribution o Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure SUBTOTAL $ AMOUNT THIS PERIOO CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1-DEC. 31) PER ELECTION TO DATE (IFREClUIRED) DAlE NAME OF CANDIDATE, OFFICE, AND rnSTRICT, OR MEASURE NUMBER OR lETTER AND JURISDICTION, OR COMMITTEE NONE o Support o Oppose o Support o Oppose Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ......................................................... $ Q 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ....... .... TOTAL $ () D 2. Unitemized contributions and independent expenditures made this period ofunder$1 00........................... ......................................................... $ FPPC Form 460 (JanuaryI05) FPPC Toll-Free Helpline: 886/ASK-FPPC (866/275-3772) Schedule E Payments Made Type or print In ink. Amounts may be rounded to whole dollare. - SCHElllA.EE 1-21-07 CALIFORNIA 460 FORM Statement cover. period from see INSTRUCTIONS ON REVERSE NAME Of FILER Committee to Elect Jackie McHenry through 2-17-07 pagek of~ 1.0. NUMBER 1249955 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, desaibe the payment. eM=' campaign paraphernllialmisc. M:R member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)- CFC office expenses SAL campaign workers' salaries eve civic donaUons PEr petition circulating 1B.. t.v. or cable airtime and production costs FIL candidate filing/ballot fees PI-O phone banks TRC candidate travel, lodging, and meals fK) fundraislng events PO... polling and survey research TRS stafflspouse travel, lodging, and meals N) independent expenditure supporting/opposing others (explain). pas postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration UT Campaign literature and mailings PRT print ads 'v\EB information technok>gy costs (internet, e-mail) NAME ANO ADDRESS OF PAYEE (IF<XlMMITTEe,~ENTER (,D. NlMlER) DESCRIPTION OF PAYMENT AMOUNT PAID CODE OR .fd2-i Ut1JJ 6 WO/l..tcs. r"g-/ t FvoTk'U (?t tPo~CA 7~7 PILI ~r/lJ6 WO~(C.S MS' f G" Foe:> r;-i (f fS.4-J ~CA '11,'-'7 CL-;\-IL€.i<.vV ,. Cou fl-lE"n. I t{ ~o ~ 0- ~ i)<.v-J ~ /111 c~~ brf)~ SODa (p O~.lD 1/~'(I-07 L.fT ;2/3/01 [II ('~ b~.o'e....,,-,,-> ~"l:>o 0 ~/(6/0 7 ppcr If ~~ ()k 64'1. ~-o .;2~. 00 * Payments that are contributions or Independent expenditures must al80 be summarized on Schedule D. SUBTOTAL$ I S-4 3 . 7 () Schedule E Summary 1. Itemized payments made this period. (Indude all Schedule E subtotals.) .............................................................................................................. $ 2. Unitemized payments made this period of under $100 ..... ........... ...... ...... ...... ....... ....... ..... ........ .... ........... ....... ....... .... .......... ........ ...... .................... $ 3. Total interest paid this period on loans. (Enteramounlfrom Schedule 8, 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 $ I S-4Y o o is-41.f FPPC Form 460 (JanuaryI05) FPPC Toll-Free Helpline: 8661ASK-FPPC (8681275-3772) SCHEDULE F Schedule F Accrued Expenses (Unpaid Bills) Type or print In Ink. AmountB may be rounded towholedollars. from statement covers period 1-21-07 CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE NAME OF FilER Committee to Elect Jackie McHenry through 2-17-07 page~ of~ 1.0. NUMBER 1249955 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Q.,f) campaign paraphernalia/rrilc. Il.eR member communications RAe radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions ClB contributipn (expllln nonmonetary)- a=c office expenses SAL campaign workers' salaries eve civic donations FEr petition circulating T8... tv. or cable airtime and production costs AL candidate filinglballot fees pt.O phone banks TRC candidate travel, lodging, and meals FN) fundraising events POL polling and survey research TRS stafflspouse travel, lodging, and meals N) IDdependent expenditure supporting/opposing others (explain). P03 postage, delivery and messenger services TSF transfer between cormlittees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VCT voter registration LIT campaign literature and maHings ffiT print ads VvEB information technology costs (internet, e-mail) CODE OR fa) fbl (el fd) NAME AND ADDRESS OF CREDITOR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING OF COMMITTEE, AlSO EM'ER 1.0. N..NBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON El OF THIS PERIOD NONE . Payments that are contributions or Independent expenditures must also be surnrrmlzed 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 un itemized payments on accrued expenses under $100.) .................................PAID TOTALS $ f) 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 Maybeaf1e9"livel'lUlTber FPPC Form 460 (JanuaryIllS) FPPC Totl-Free Helpline: 886/ASK-FPPC (886/275-3772) - . Schedule G Payments Made by an Agent or Independent Contractor (on Behalf ofThis Committee) from statement covers period 1-21-07 CALIFORNIA 460 FORM SCHEDULE G Type or print In Ink. Amounts may be rounded to whole dollars. SEe INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry NAME OF AGENT OR INDEPENDENT CONTRACTOR through 2-17-07 P"IleJl 01~ 1.0. NUMBER 1249955 COOES: If one of the following codes accurately desClibes the payment, you may enter the code. Otherwise, desClibe the payment. ~ campaign paraphemllialmisc. lWR member communications RAD radio airtime and production costs CNS campaign consultlntt MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* a:C office expenses SAL campaign workers' salaries eve ciVic donations R:T petition circulating ill tv. or cable airtime and production costs AL candidate filinglballot feet FHJ phone banks TRC candidate travel, lodging, and meals A\[) fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals N:> independent expenditure supporting/opposing others (explein)* pes postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor lEG legal defense PRO professional services (legal, accounting) VOT voter registration UT campaign literature end mailings PRT print ads 'IJ\E8 information technology costs (internet, e-mail) * Payments that arecontrlbutlonl or Independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, AlSO ENTER 1.0 NUM8ERj CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID NONE Attach additional information on appropriately labeled continuation sheets. TOTAL. $ o . 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 480 (JonuoryIUS) FPPC TolI-Free Helpline: 886/ASK-FPPC (866/275-3772) _J Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE H from 1-21-07 CALIFORNIA 460 FORM Schedule H Loans Made to Others* Statement covers period see INSTRUCTIONS ON REVERSE NAME Of FILER through 2-17-07 *Loans that are contributions to another candidate or committee must also be summarized on Schedule O. Loans forgiven must also be reported on Schedule E. . . o FORGIVEN DATE DUE o PAID . o FORGIVEN DATE DUE SUBTOTALS $ o $ 0 $ 0 $ -~ .". Page ---1l oI-1.:L 1.0. NUMBER 1249955 (Il co! ORIGINAL CUMUlATIVE AMOUNT OF LOANS lOAN TO DATE CAlENDAR YEAR PERB.ECTION** DATE INCURRED CAlENOAR YEAR PER B.ECTlON" DATE INCURRED 0 Committee to Elect Jackie McHenry FULL NAME. STREET ADDRESS AND ZIP CODE OF RECIPIENT (IF COMMITTEE, AlIO ENTER LQ NlJMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) OUTSt:!NDING BALANCE BEGINNING THIS ERIOa lbI AMOUNT LOANED THIS PERIOD (0) REPAYMENT OR FORGIVENESS THIS PERIOD- OUTS~DING BALANCE AT CLOSE OF THIS PERIOD (01 INTEREST RECEIVED NONE o PAID -~ ,.". (Erter (e) on Schedule I, Une 3) Schedule H Summary 1. Loans made this period.. ..................... .......... ................... ............ ....... ....... ...... ........... .......... ........ """.""." ........... ........ $ (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans ........................................................................................................................................... $ (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) ...,.............................................................................. ....... NET $ (Enter the net here and on the Summary Page, Column A, Line 7.) o I -If Required I o o (MaybelnegltNenumber) FPPC Form 460 (JanuaryI05) FPPC TolI-Free Helpline: 8861ASK-FPPC (866/275-3772) ., Schedule I Miscellaneous Increases to Cash Type or print In Ink. Amounts may be rounded towholedollars. SCHEDULE I lIIrough 1-21-07 2-17-07 CALIFORNIA 460 FORM statement covers period from SEE INSTRUCTIONS ON REVERSE NAME OF FILER Page~ oI--.l!L 1.0. NUMBER Committee to Elect Jackie McHenry 1249955 OATE RECErvED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, AlSO EHlER 1.0. N1MBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH NONE Attach addllionsl infonnat/on on appropriately labalBd continuation shests. SUBTOTAL $ o Schedule I Summary 1. Itemized increases to cash this period. ....................................................................................................................... $ 0 2. Unitemized increases to cash of under $100 this period. ............................................................................................ $ 3. Total of all interest received this period on loans made to others. {Schedule H, Column (e).) ................................. $ 4. Total miscellaneous increases to cash this period. (Add lines 1, 2, and 3. Enter here and on the Summary Page, line 14.) ........................................................................................................................... TOTAL $ 0 FPPC Form 460 (JanuarylO5) FPPC Tol~Free Helpline: lI66IASK-FPPC (8681271>37721