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Home My Public Portal AboutForm 460 (Feb 18 - June 30, 2007) 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 schedule'is true and complete. under penatty of perjury under the laws of the state of California that the foregoing is true and correct Executed on '1lt'l! 0 7 """ Exec"edon ~/ ;;l;;;(07 Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from 2-18-Q7 SEE INSTRUCTIONS ON REVERSE 6-30-07 through 1. Type of Recipient Committee: All ComnOtees - Complete P.... " 2, 3,.nd 4. 121 Officeholder, Candidate Controlled Committee 0 Primarily Formed Ballot Measure o State Candidate Election Committee Committee o Recall 0 Controlled (AJ$OCanp/efe~5) 0 Sponsored (AlsoCanplefrltPart6) o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee o Primarily Formed Candidate! Officeholder Committee (Al$OConp/etePa17) 3. Committee Information I.D. NUMBER 1249955 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Jackie McHenry STREET ADDRESS (NO P.O. BOX) 2467 Wood Ct CITY STATE ZIP CODE Claremont CA 91711 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX AREA CODE/PHONE CITY STATE AREA CODE/PHONE ZIP CODE OPTIONAL: FAX I E-MAIL ADDRESS By By Executed on By Sig"etu8otCortrolln;lOlrit'etlJlder,CanddIKe,StateM~Pmpclnert """ I Executed on By Sig1atueotConlrolirg~,Candid8te,StaleMeaSl.f8Proponert """ COVER PAGE Date of election if applicable: (Month, Day, Year) MAY 1 7 2rJI1 Page N of For Official Use Only 3-6-07 CITY ClERK CITY OF ClAREMONT 2. Type of Statement: o Preelection Statement o Semi-annual Statement ~ Termination Statement (Also file a Form 410 Termination) o Amendment (Explain below) o Quarterly statement o Special Odd-Year Report o Supplemental Preelection statement - Attach Form 495 Treasurer(s) NAME OF TREASURER William Stoner MAILING ADDRESS 2341 Oxford St CITY Claremont CA 91711 NAME OF ASSISTANT TREASURER, IF ANY David Wishart MAILING ADDRESS 524 Contra Costa Way CITY STATE STATE ZIP CODE AREA CODE/PHONE ZIP CODE AREA CODE/PHONE Claremont CA 91711 OPTIONAL: FAX I E.MAIL ADDRESS I corti1\' Measu-e F'rop:lnertorRe$pJnlible Ol"IicerotSponsor FPPC Fonn 480 (January/Oi) FPPC ToIl-Free Helpline: 8861ASK-FPPC t886/275-3n2) 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 RESIDENTlAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 2467 Wood Ct Claremont CA 91711 Related Committees Not Included in this Statement: Ua'any.omml..... not Included In this statement Ibat.t8 conlTolled by you or an primarily formed to receive contributions or ".ke expwtdltut8S on behalf of your candidacy. COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? OVES ONO STREET ADDRESS (NO P.O. BOX) COMMITTEE ADDRESS CITY STATE AREA CODE/PHONE ZIP CODE COWAITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? OVES ONO STREET ADDRESS (NO P.O. BOX) COMMITTEE ADDRESS CITY STATE AREA CODE/PHONE ZIP CODE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOTNQ. 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 ANV 7. Primarily Formed Candidate/OffIceholder Committee LhJln..... of otfIceholder(s) or candldate(s) for which this committee Is prlmlllfly 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 SOUGH; OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDtDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE Attach continuation sheets if necessary FPPC Form 480 (January/Ol) FPPC ToII-Free Helpline: 8881ASK-FPPC (8681271-3772) state of CaUfomill Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry SUMMARY PAGE from through Statement covers period CALIFORNIA 460 FORM 2-18-07 6-30-07 Page '3 of ~ 1.0. NUMBER Contributions Received 1249955 Column A ColumnS Calendar Year Summary for Candidates TOTAL THSPERlQO CALENl.)I..R YEAR Running in Both the Slate Primary and (FROM ATTACHED SCHEDU..ES) TOTAL TOOATE 4216 20115 General Elections $ 0 0 1/1 through 6130 7/1 to Date 4216 $ 20115 20. Contributions Received $ $ 499 1433 21. Expenditures 4715 $ 21548 Made $ $ 1. Monetary Contributions ............... Schedule A Une 3 $ 2. Loans Received ............... ..................... Schedule B. Une 3 3. SUBTOTAL CASH CONTRIBUTIONS nnnnnnn.n.nn.n Add Un.. '.2 $ 4. Nonmonetary Contributions ............. Schedule C, Une 3 5. TOTAL CONTRIBUTIONS RECEIVED ..n nm.n.nnnn.nnAddUn..3. 4 $ Expenditures Made 6. Payments Made .............................. .................... Schttdule E. Une 4 $ 7. Loans Made ......................................................... Schedule H, Une 3 8. SUBTOTALCASHPAYMENTS .......... ................... AddU...6.7 $ 9. Accrued Expenses (Unpaid Bills) ...............................Sch.duleF, Un. 3 10. Nonmonetary Adjustment .......................................... ScheduleC, Une3 11. TOTALEXPENDITURESMADE................................AddUn.... 9.,0 $ 18006 o 18006 o o 18006 Current Cash Statement 12. Beginning Cash Balance .................. .... Previous Summary Page, Une 16 $ 13. Cash Receipts .................................................... CoIumnA,Une3above 14. Miscellaneous Increases to Cash ........................... ScheduleJ, Une4 15. Cash Payments .................................................. ColumnA. Une 8 above 16. ENDING CASH BALANCE .......... Add Unes 12 + 13+ 14, rhen subtnlctUne 15 $ If this ;s a termination statem9flt, Una 16 mllSt be zero. 13790 4216 o 18006 o 17. LOAN GUARANTEES RECEIVED ........................... Sch.duI. 8, P.rl2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on mV8fSl11 $ 19. Outstanding Debts......................... AddUne2+Une9inCotumnBabow $ $ 21445 o 21445 o o 21445 $ $ o To calculate Column e, 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 cany over the amounts from Lines 2, 7, and 9 (if any). o o Expenditufe Limit Summary for Slate Candidates 22. Cumulative Expenditures Made. <"sut1ff1d to VotuntaryExpencllture LImit) Date of Election (mmlddJyy) Total to Date -----1-----1_ $ -----1-----1_ $ .Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (JanuarylO5) FPPC ToI~Free Helpline: 8661ASK-FPPC (8661276-3772) SCHEDULE A Schedule A Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. 2-18-07 SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Statement covers period CAliFORNIA 460 FORM from through 6-30-07 Cf o'~ Page 1.0. NUMBER 1249955 DAlE FUll NAME, STREET ADDRESS AND ZIP CODe OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IFCOMMlTTEE. AlSO ENTER to, NUMBER) CODE .. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IFSEl..F.et.llPLO'fEO.~NAME OFElUSlNESSl AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO OA TE (IF REaUIRED) 2-19-07 Lome Olfman 608 Rockford Or Claremont 91711 i!lIND OCOM OOTH OPTY OSCC i!lIND o COM OOTH OPTY OSCC i!lIND OCOM OOTH OPTY OSCC ~IND OCOM OOTH OPTY OSCC Ii!IIND o COM OOTH OPTY OSCC 2-19-07 Buzz K Loyd 4722 W Mission Blvd Ontario CA 91762 2-16-07 James S Bull 1648 N Mountain Ave Claremont 91711 2-19-07 Beverly Benjamin 675 W 8th St Claremont 91711 2-19-07 Jean Lipman-Blumen 1520 E Califomia Blvd Pasadena CA 91106 Professor, Claremont Graduate University 100 Businessman, Cal Spas Corp. 250 Retired 100 Retired 250 Professor, Claremont McKenna College 100 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, C61umn A, Line 1.) ....................... TOTAL $ Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.).. ................... .................... SUBTOTAL $ 800 I ............ $ .............. $ .Contributor Codes lNO -Individual COM - Recipient Committee (other than PT't' or SCC) OTH - Other (e.g., business entity) PTY - Political Party see - Small Contributor Committee FPPC Fonn 460 (JanuaryI05) FPPC TolI-FreeHelpline: 866IASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. ~mounts may be rounded towhote~lars. SCHEDULE A (COOT.) CALIFORNIA 460 FORM Statement covers period from 2-21-07 through 6-30-07 s l<-f Page of NAME OF FILER Committee to Elect Jackie McHenry 1.0. NUMBER 1249955 llA1E RECEIVED FUll NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR {IFCCtJlMlTTEE,ALSOENTERI.D_"'-IMBERl CODe .. CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 . DEC. 31) IF AN INDIVIDUAl, ENTER OCCUPATION AND EMPLOYER (IF S8..F-€MPlO'fEO. ENTER NAAlE OfBUSlP>ESS) AMOUNT RECEIVED THIS PERIOD PER ELECTION TO OA TE (IF REQUIRED) 3-6-07 C R Fer9uson 237 W 4th St CXlaremont 91711 ii'lIND OCOM OOTH OPTY OSCC ii'lIND OCOM OOTH OPTY OSCC ii'lIND o COM OOTH OPTY OSCC ii'lIND OCOM OOTH OPTY OSCC ii'lIND o COM OOTH OPTY OSCC 3-6-07 Colleen Stripling 537 occidental Claremont 91711 3-7-07 Linda Kovach 916 Glenville Dr Claremont 91711 3-7-07 Gwen Brown PO Box 580 Claremont 91711 3-7-07 Michael Hannon PO Box 580 Claremont 91711 Self Employed Attorney Retired Retired Exec Director Dogs for the Blind Bakersfield CA ,1;tt:i'I-'1"-'<7f <: ,. r <; - , ~ -L i ')-'<-<"J <-. , 200 100 100 250 250 "Contributor Codes INO-Individual COM - Recipient Corrrnittee (other than PTY or See) OTH - Other (d.g., business entity) PTY - Political Party see - Small Contributor Committee SUBTOTALS 900 I ! FPPC Form 460 (JanuaryI05) FPPC Toll-Free Hel~ine: 866/ASK-FPPC (8661275-3772) Schedule A Monetary Contributions Received Type or print in ink. Amounts 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 2-18-07 through 6-30-07 Page ~ of ----1i. LD. NUMBER 1249955 DAlE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (lfCOMMlTTEE. ALS) ENTERI.D. NlMBER} CODE . CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPlOYED. ENTER NAME OfBUSlNESS) AMOUNT RECEIVED THIS PERIOD PER ELECTION TO DATE (IF REQUIRED) 2-22-07 Ruthann Miller 988 Marymount Lane Claremont 91711 624-3102 ~IND o COM oaTH OPTY OSCC ~IND OCOM oaTH OPTY OSCC OIND OCOM oaTH OPTY OSCC OIND o COM OOTH OPTY OSCC OIND OCOM OOTH OPTY osec 2-19-07 Bernice Uhlyarik 1285 Shepherd Way Claremont 91711 Retired 100 Retired 250 SUBTOTAL$ 350 I Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.) ......... ..... .... ......... ...... ...... ....... ................... ...... ............ .......... ........... $ 2. Amount received this period-unitemized monetary contributions of less than $100............................. $ 3. Total monetary contributions received this Weriod. (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 see - Small Contributor Committee FPPC Form 480 (JanuaryI05) FPPC TolI..free Helpline: 866/ASK-FPPC (8681275-3n2) Schedule B - Part 1 Loans Received SEe INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print in ink. Amou nts may be rounded to whole dollars. SCHEDULE B - PART 1 Statement covers period from 2-18-07 CALIFORNIA 460 FORM through 6-30-07 P- ..., of -1!:L 1.0. NUMBER 1249955 In 'g) ORIGINAL CUMULATIVE AMOUNT OF CONTRIBUTIONS LOAN TO DATE CAlENDAR YEAR , PER ElECTION ** DATE INCURRED CALENDAR YEAR PER ELECTION'" DATE INCURRED CAlENDAR YEAR PER8.ECTOO** FULL NAME, STREET ADDRESS AND ZIP CODe OF LENDER (IF CONMIITEE, ALSO ENTER I.D. NUMBER) IF AN INDlVlOUAl. ENTER OCCUPATION AND EMPLOYER (lFSELFaAPLOYED. ENTER NAME OF BUSINESS) NONE to 'NO 0 COM OOTH 0 f'TY 0 see . OUTSTANDING BALANCE BEGINNING THIS 'b, AMOUNT RECEIVED THIS PERIOD , '<I AMOUNT PAID OR FORGIVEN THIS PERIOD .. o PAlO , o FORGIVEN '"' OUTSTANDING BAL.ANCEAT CLOSE OF THIS , DATE DUE ,., INTEREST PAID THIS PERIOD -, RAOE to INO 0 COM 0 OTH 0 f'TY 0 see . , o PAID , o FORGIVEN DATEOUE -, .." to INO 0 COM 0 OTH 0 f'TY 0 see o PAID , o FORGIVEN DATE DUE -, R^,' OATE INCURRED SUBTOTALS $ $ Schedule B Summary 1. Loans received this period ..... .... ...... ............ ............. ....... ..... ...... ....... ...... .......... .............. ... ......... ........ $ (Total Colum n (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period .................................................................. ....................................... $ (Total Column (c) plus loans under $1 00 paid or forgiven.) (I ndude loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............................................................... NET $ Enter the net here and on the Summary Page, Column A, Line 2. "'Amounts forgiven or paid by another party also must be reported on Schedule A. -If required. $ (May be I neglllM m.tmberl $ (Erter(e)on SchecUeE, Lr.e3) o o o tContributor Codes INO -lndMdual COM - Recipient Committee (other than PTY or Sce) OTH - Other (e.g., business entity) PTY - Political Party sec - Small Contributor Committee FPPC Form 460 (JanuaryI05) FPPC TolI-Free Helpline: 866/ASK-FPPC (6661215-3772) Schedule B - Part 2 Loan Guarantors Type or print in ink. Amounts may be rounded to whole dollars. from Statement covers period 2-18-07 SEe INSTRUCTIONS ON REVERSE NAME OF FILER through 6-30-07 Committee to Elect Jackie McHenry SCHEDULE B-PART2 CALIFORNIA 460 FORM Page --L of ~ to. NUMBER 1249955 FULL NAME, STREET ADDRESS AND ZIP CODE OF GUARANTOR (lFCOMMlTTEE, ALSOENTERI,O. /'UMBER) IF AN iNDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAMEOF6USIIlESS LOAN AMOUNT GUARANTEED THIS PERIOD CUMULATIVE TO DATE BALANCE OUTSTANDING TO DATE CONTRIBUTOR CODE NONE OIND o COM OOTH OPTY OSCC LENDER DATE CAlENDAR YEAR PER ELECTION (IF REOUJRED) OIND OCOM OOTH OPTY OSCC , LENDER CALENDAR YEAR DATE PER ELECTION (If REQUIRED) CALENDAR YEAR OIND o COM OOTH OPTY OSCC LENDER DATE PER ElECTION (IF REaUIRED) OIND OCOM OOTH OPTY OSCC LENDER CAlENDAR YEAR DATE PER ELECTION (IF REQUIRED) SUBTOTAL $ o _00 Sl.mITlilfY Page, t..re17crit'. FPPC Form 480 (JanuaryI05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE C CALIFORNIA 460 FORM Statement COYef1I period 2-18-07 !rom through 6-30-07 Page ~ ol---1J:L LQ. NUMBER 1249955 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, AlSO ENTER 10_ NUMBER) CONTRIBUTOR CODE * DESCRIPTION OF GOODS OR SERVICES IF AN INDMDUAl, ENTER OCCUPAnONAND EMPLOYER (IF SELF-EMPlOYED, ENTER NAME OF BUSINESS) CUMULATIVE TO DATE CALENDAR YEAR (JAN 1. DEe 31) PER ELECTION IODATE (IF REQUIRED) AMOUNTI FAIR MARKET VALUE 3-6-07 249.25 hvin G Henry Trust 452 W 8th St Claremont 91711 i!lINO OCOM OOTH OPTY osee OINO OCOM i!lOTH OPTY osee DlNO OCOM OOTH OPTY osee []IND' OCOM OOTH OPTY osee 3-6-07 Viva Madrid 225 Yale Ave, Ste B Claremont 91711 Trust administrator Beverages 249.25 Restaurant Food for Election Party 250. 250, SUBTOTAL $ Attach additional information on appropriately labeled continuation sheets. 499.25 Schedule C Summary 1. Amount received this period - itemized nonmonetary contributions. (Indude all Schedule C subtotals.) ..................................................................................................................... $ 2. Amount received this period - unitemized nonmonetary contributions of less than $100 .................................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 !'Ind 10.) ...................... TOTAL $ "Contributor Codes IND-lndMdual COM - Recipient Committee (other than PTY or SeC) OTH - other (e.g., business entity) PTY - Pol~ical Party see - Small Contributor Committee 499.25 o 499. FPPC Form 460 (JanuarylO5) FPPC Toll-Free Helpline: 888IASK-FPPC (866/275-3772) Schedule 0 Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE 0 from 2-18-07 CALIFORNIA 460 FORM I Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry through 6-30-07 Page~ Of~ 1.0. NUMBER 1249955 . 0 Support o Oppose TYPE OF PAYMENT DESCRIPTION {IF REQUIRED) 0 Monetary Conbibution 0 Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Conbibution 0 Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Contribution 0 Nonmonetary Conbibution 0 Independent Expenditure SUBTOTAL $ AMOUNT THIS PERIOD CUMULATIVE 10 DATE CALENDAR YEAR (JAN. l-OEC. 31) PER ELECTION mOATE (!F REQUIRED) [lATE NAME OF CANDIDATE, OFFICE. AND DISTRICT, OR MEASURE NUMBER OR lETTER AND JURISDICTION, OR COMMITTEE NONE o Support o Oppose . o Support o Oppose . I Schedule D Summary . . 1. Itemized cOntributions and independent expenditures made this perted. (Include all Schedule D subtotals.) ......................................................... $ 2. Unitemized contributions and independent expenditures made this perted ofunder$100 ..................................................................................... $ 3. Total contributions and independent expenditures made this pertod. (Add Lines 1 and 2. Do not enter on the Summary Page.) ............ TOTAL $. ! ! FPPC Form 460 (JanuaryIll5) FPPC TolI-Free Helpline: 8681ASK-FPPC (8661275-3772) o o o Schedule E Payments Made Type or print in ink. Amounts may be rounded to whole dollars. SCI-EIlUl.E E from 2-18-07 CALIFORNIA 460 FORM Statement covers period seE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry through 6-30-07 Page II 01 ---1.'::L 1.0. NUMBER 1249955 CODES: If one of the following codes accurately describes the payment, you may enter the code. CW campaign paraphernalia/misc. M3R member communications CNS campaign consultants MTG meetings and appearances ClB contribution (explain nonmonetary). a=c office expenses eve civic donations FEr petition circulating AL candidate filing/ballot fees PH::) phone banks A\D fund raising events PO... polling and survey research NJ independent expenditure supporting/opposing others (explain)- POS postage, delrvery and messenger services LEG legal defense PRO professional services (legal, accounting) UT campaign literature and mailings FRT print ads Otherwise, describe the payment. RAe radio airtime and production costs RFD returned contributions SAL campaign workef'3i' salaries lB... tv. or cable airtime and production costs 1RC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration V\EB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE {IF OOMMlTTEE, AlSO ENTER I.D. NUMBER) ceDE OR DESCRIPTION OF PAYMENT AMOUNT PAID Coastal Value Publications 2355 Foothill Blvd laVeme, CA 91750 Mailers- Printed and mailed LIT 3336.76 Salvation Army Pomona/Claremont 490 East Laveme St. Pomona, CA 91767 CVC 501 (C3) Recipient of Balance of Campaign Funds 101 Jean Hart 1046 Pamella Dr Claremont 91711 LIT Reimbursement for Printing Costs 92.01 * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 3529.77 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotaIS.i................:............................................................................................. $ 2. Unitemized payments made this period of under $1 00 ......... ....... ...... ................... .......... ........ ............. .......... ................... ........... ...... ...... .............. $ 3. Total interest paid this period on loans. (Enter amount from Schedule S, Part 1, Column (e).)............................................................................... $ 4. Total payments made this period. (Add Lines" 2, and 3. Enter here and on the Summary Page, ColumnA, Line 6.) ............................. TOTAL $ 18006 o o . 18006 FPPC Form 480 (JanuaryI05) FPPC Ton-Free Helpline: 888/ASK-FPPC (8661275-3772) Schedule E (Continuation Sheet) Payments Made Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE E (CONT) from 2-16-07 6-30-07 CALIFORNIA 460 FORM Statement covers period see INSTRUCTlONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry through P_ ----u.- of----L!:::L 1.0. NUMBER 1249955 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment OIP campaign paraphernalia/misc. ~ member communtcations RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RAJ returned contributions C1B contribution (explain nonmonetary). CFC office expenses SAL campaign workers' sa~ries eve civic donations FEr petition circulating 1R t.v. or cable airtime and production costs FlL candidate filinglballot fees PHJ phone banks TRC candidate travel, lodging, and meals FNJ fundraising events PClL polling and survey research TRS stafflspouse travel, lodging, and meals N) independent expenditure supporting/opposing others (explain)* PCS postage, delivery and messenger services TSF transfer between colTVT1ittees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration ur campaign literature and mailings PRT print ads Y\EB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) Coastal Valley Publications Flyers, Printed and Mailed 2355 Foothill Blvd LIT 13013.60 LaVerne, CA 91750 Claremont Courier Newspaper ads Claremont CA 91711 PRT 1462.50 . . . Payments that are contributions oJ independent expencUtures must also be summarized on Sehedule O. SUBTOTAL $ !14476 FPPC Form 480 (JanuarylO5) FPPC TolI-Free Helpline: 888/ASK-fPPC (8861275-3772) Schedule F Accrued Expenses (Unpaid Bills) Type or print in ink. Amounts may be rounded to whoie dollars. SCHEDULE F from Statement covers period 2-18-07 CALIFORNIA 460 FORM see INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry through 6-30-07 Page ~ of-1::L 1.0. NUMBER 1249955 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. o..F campaign paraphernalia/misc. M3R member communications RAe radio airtime and production costs CNS campaign consultants MTG meetings and appearances RfD returned contributions C1B contribution (explain nonmonetary}'" a=c office expenses SAL campaign workers' salaries eve civic donations R:T petition circulating 1E.. tv. or cable airtime and production costs AL candidate filinglbalk>t fees Ai:) phone banks TRC candidate travel, lodging, and meals FNJ fund raising events Pa... polling and survey research TRS staff/spouse travel, lodging, and meals N) independent expenditure supporting/opposing others (explain)* PCS postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration L1T campaign literature and mailings PRT print ads \o\EB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR (IF CClMMlTTEE, ALSO ENTER to. Nl.f.lBER) CODE OR DESCRIPTION OF PAYMENT la' OUTSTANDING BALANCE BEGINNING OF THIS PERIOD Cb' AMOUNT INCURRED THIS PERIOD Ie, AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) Cd' OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD NONE ... PayrMnts Uult are contributions or independent expendttures 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 un itemized payments on accrued expenses under $100.) ................................. PAID TOTALS $ 3. Net change this period. (Subtract Une 2 from Line 1. Enter the difference here and 0 on the Summary Page, Column 1'\, Line 9.) ................................................................................................................................................ NET $ - May bearegmr..enlJfl't)er FPPC Form 460 (JanuarylO5) FPPC ToIl-Free HelplIne: Il66IASK-FPPC (888J275-3n2) o o Schedule G Payments Made by an Agent or Independent Contractor (on Behalf ofThis Committee) Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE G from Statement covers period 2-18-07 CALIFORNIA 460 FORM SEE lNSTRUCllONS ON REVERSE NAME OF FILER Committee to Elect Jackie McHenry NAME OF AGENT OR INDEPENDENT CONTRACTOR through 6-30-07 page1!:1- of---.0L- 1.0. NUMBER 1249955 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CJ.oP campaign paraphernalia/misc. tvI3R member communications RAO radio airtime and production costs CNS campaign consultants MfG meetings and appearances RFO returned contributions era contribution (explain nonmonetary)'" a=c office expenses SAL campaign wor1<.ers' salaries eve civic donations FEr petition circulating T8.. tv. or cable airtime and production costs RL candidate filinglballot fees Pl-O phone banks TRC candidate travel, lodging, and meals FN) fundraising events PCL polling and SUlVey research TRS stafflspouse travel, lodging, and meals NJ independent expenditure supporting/opposing others (explain)* PC6 postage, delivery and messenger seMces TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registrabon UT campaign literature and maiUngs PRT 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 J.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 total may not eqUfJJ the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Fonn460 (JanuaryI05) FPPC TolI-Fnltl Helpline: 8681ASK-FPPC (lI86J275-37T2)