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Home My Public Portal AboutForm 460 (Jan 23 - Feb 19, 2005) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink, Statement covers period from 01/23/05 SEE INSTRUCTIONS ON REVERSE 02/19/05 through 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. !XI Officeholder, Candidate Controlled Committee D Ballot Measure Committee 0 State Candidate Election Committee 0 Primarily Formed 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) D General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee D Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3 Committee Information I.O. NUMBER . 1273509 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Sam Pedroza STREET ADDRESS (NO P.O. BOX) 580 Cinderella Drive CITY Claremont STATE CA ZIP CODE 91711 AREA CODE/PHONE 909-621-0615 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Date of election if applicable: (Month, Day, Year) 03/08/05 2. Type of Statement: !XI D D 0 Preelection Statement Semi-annual Statement Termination Statement Amendment (Explain below) Treasurer(s) NAME OF TREASURER Brian Teuber MAILING ADDRESS 553 Redlands Avenue CITY Claremont NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX / E-MAIL ADDRESS Date Stamp RECEIVE COVER PAGE FEB 2 it 2005 Page 1 of II CITV CLERK CITY OF CLAREMONT For Official Use Only 0 Quarterly Statement D Special Odd-Year Report D Supplemental Preelection Statement - Attach Form 495 STATE CA AREA CODE/PHONE 909-482-1568 ZIP CODE 91711 STATE ZIP CODE AREA CODE/PHONE 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 laws of the State of California that the foregoing is true and c?~e~~ Executed on z./ 1.. '11,5 By r~ ~ "', Dr~ . Signature~surerlJAssista. n. t Treasurer Executed on ¿,..'~i:5 By ~IA.'\.. I' ~ A. cp\eV Date Signature of Controll6..Jf:œ'f¡older, Candi":Jate, State Measure I-'ro,¡,e;¡ °ðesponsib'e Officer of Sponsor Executed on By Date Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC State of California 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 Sam Pedroza OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City of Claremont - City Council RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 580 Cinderella Drive Claremont, CA 91711 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 0 YES 0 NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 0 YES 0 NO STREET ADDRESS (NO P.O. BOX) COMMITTEE ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CALIFORNIA 4 6 0 FORM Page 2 £ 1 of 6. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION 0 SUPPORT 0 OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE Attach continuation sheets if necessary FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Sam Pedroza Contributions Received 1. Monetary Contributions.......................... ........... ...... Schedule A, Line 3 2. Loans Received...................................................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS """""""""""'" Add Lines 1 + 2 4. Nonmonetary Contributions.. .................................. Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 7. Loans Made ............................................................. Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 13. Cash Receipts.. ........ ...... ................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4 15. Cash Payments. ........ ......................................... Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED """"""""""""'" Schedule 8, Part 2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents........... """""""""""""'" See instructions on reverse 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column 8 above Type or print in ink. Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) $ 3632.90 0.00 3632.90 390.04 4022.94 $ $ $ 5507.06 0.00 5507.06 -1886.81 0.00 3620.25 $ $ $ 5011.88 3632.90 0.00 5507.06 3137.72 $ $ 0.00 $ $ 0.00 6064.30 from through Column B CALENDAR YEAR TOTAL TO DATE $ 4507.90 5000.00 9507.90 390.04 9897.94 $ $ $ 6370.18 0.00 6370.18 1064.30 0.00 7434.48 $ $ 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). SUMMARY PAGE Statement covers period CALIFORNIA 460 FORM 01/23/05 02/19/05 3 of L ( Page J.D. NUMBER 1273509 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ 21. Expenditures Made $ $ $ Expenditure Limit Summary for State Candidates 22, Cumulative Expenditures Made* (If Subject to Voluntary Expenditure LImit) Date of Election Total to Date (mm/dd/yy) I I $ I I $ I I $ I I $ I I $ I I $ *Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule A Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Sam Pedroza FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 01/27/05 Vincent Antonino IKIIND Public Affairs OCOM 1269 Upton Place oaTH Los Angeles, CA 90041 OPTY Metropolitan Water oscc District 01/30/05 Joan Presecan IKJIND Teacher OCOM 727 Alamosa Drive oaTH Claremont, CA 91711 OPTY Retired oscc 02/01/05 Timothy Worley IKJIND Water Distirict Manager OCOM 2649 Sweetbriar Drive OOTH Claremont, CA 91711 OPTY Metropolitan Water oscc District 02/01/05 Alfonso Contreras IKJIND Supervisor OCOM 15219 E. Adams Drive OOTH Baldwin Park, CA OPTY Southern California oscc Edision 02/03/05 Bradley Free IKJIND Sports Writer OCOM 880 W. 10th Street oaTH Claremont, CA 91711 OPTY Daily Racing Form OSCC SUBTOTAL $ Schedule A Summary 1. Amount received this period - contributions of $1 00 or more. (Include all Schedule A subtotals.) ........................................................................................................ $ 2, Amount received this period - unitemized contributions 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 $ SCHEDULE A Statement covers period CALIFORNIA 4 6 0 FORM from 01/23/05 through 02/19/05 Page t of II I.D. NUMBER 1273509 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 250.00 250.00 250.00 100.00 1 00.00 100.00 100.00 100.00 100.00 200.00 200.00 200.00 1 00.00 100.00 100.00 750.00 2325,00 1307.90 ,. *Contributor Codes IND -Individual COM - Recipient Committee (other than pry or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee ~ 3632.90 '- FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC 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 Sam Pedroza DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * Fred Ackman IX] IND 02/05/05 DcOM 4077 Chaminade Court DoTH Claremont, CA 91711 DPTY Dsec [KJIND 02/05/05 Claralou Labarge DeoM 431 Lewis Court DoTH Claremont, CA 91711 DPTY Dsec 02/06/05 Donald Nellor [KJIND DcOM 2955 Maui Place OOTH Costa Mesa, CA 92626 OPTY osec Southwest Management Consultants DIND 02/1 0/05 DcOM 835 Mission Street [KJ OTH South Pasadena, CA 91030 DPTY oscc . [KJIND 02/10/05 . Thomas Ambrogi OCOM 737 Alden Road DoTH Claremont, CA 91711 OPTY oscc r *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee l .., ~ IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) Teacher Claremont Unified School District Attorney Self Employed .- wþtJ E Asst. Department Head County Sanitation Districts of Los Angeles County Minister Retired SUBTOTAL $ SCHEDULE A (CONT.) Statement covers period CALIFORNIA 460 FORM from 01/23/05 through 02/19/05 Page S- 1.0. NUMBER of 1/ 1273509 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 100.00 100.00 100.00 250.00 250.00 250.00 100.00 100.00 100.00 250.00 250.00 250.00 100.00 100.00 100.00 800.00 FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM NAME OF FILER Committee to Elect Sam Pedroza DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE * T alaee Corporation OIND 02/10/05 oeoM 213 N. Indian Hill Blvd IKI OTH Claremont, CA 91711 OPTY osee IKIIND 02/14/05 Wade Mathieson oeoM 1776 Bridgeport Avenue OOTH Claremont, CA 91711 OPTY osee Willard Hunter IKIIND 02/17/05 oeoM 627 Leyden OOTH Claremont, CA 91711 OPTY oscc Dan Arrighi IKIIND 02/19/05 oeoM 5702 Cloverly OOTH Temple City, CA 91780 OPTY osee Betty Salas IKIIND 02/01/05 OCOM 469 W. 11 th Street OOTH Claremont, CA 91711 OPTY osec ,. *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee .., \.. ~ SCHEDULE A (eONT.) from 01/23/05 through 02/19/05 of I' Page b I.D. NUMBER 1273509 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 100.00 100.00 100.00 Regional Director 250.00 250.00 250.00 Bed, Bath & Beyond Writer 250.00 250.00 250.00 Self Employed - None Water Resource Manager 100.00 100.00 100.00 San Gabriel Valley Water Company Preschool Teacher 75.00 75.00 75.00 Pending - Requested SUBTOTAL $ 775.00 FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule B - Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Sam Pedroza FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Sam Pedroza 580 Cinderella Drive Claremont, CA 91711 Environmental Planner County Sanitation Districts of Los Angeles County t rxJ IND 0 COM 0 OTH 0 PTY 0 SCC Sam Pedroza 580 Cinderella Drive Claremont, CA 91711 Environmental Planner County Sanitation Districts of Los Angeles County tfXI IND 0 COM 0 OTH 0 PTY 0 SCC to IND 0 COM 0 OTH 0 PTY 0 see Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 01/23/05 through 02/19/05 (d) (e) (a) (b) (c) OUTSTANDING INTEREST OUTSTANDING AMOUNT AMOUNT PAID BALANCE AT PAID THIS BALANCE RECEIVED THIS OR FORGIVEN CLOSE OF THIS PERIOD BEGINNING THIS PERIOD THIS PERIOD * PERIOD PERIOD 0 PAID $ 0 FORGIVEN $ 2500.00 $ 0.00 $ 0 PAID $ 0 FORGIVEN $ 2500.00 $ 0.00 $ 0 PAID $ 0 FORGIVEN $ $ $ SUBTOTALS $ 0.00 $ Schedule B Summary 1. Loans received this period .................................................................................................................... $ (Total Column (b) plus un itemized loans less than $100.) 2. Loans paid or forgiven this period ......................................................................................................... $ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............................................................... NET $ Enter the net here and on the Summary Page, Column A, Line 2. [ t Contributor Codes IND-Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other $ 2500.00 0 % RATE $ 0.00 DATE DUE $ 2500.00 0 % RATE $ 0.00 DATE DUE $ % RATE $ DATE DUE 0.00 $ 5000.00 $ (Enter (e) on Schedule E, Line 3) 0.00 SCHEDULE B - PART 1 CALIFORNIA 4 6 0 FORM Page 1 1.0. NUMBER of It 1273509 (f) ORIGINAL AMOUNT OF LOAN (9) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR $ 2500.00 2500.00 $ 01/07/05 PER ELECTION** 2500.00 $ DATE INCURRED CALENDAR YEAR $ 2500.00 $ 5000.00 PER ELECTION ** 01/15/05 5000.00 $ DATE INCURRED CALENDAR YEAR $ $ PER ELECTION ** $ DATE INCURRED 0.00 r -- * Amounts forgiven or paid by another party also must be 0.00 reported on Schedule A. ** If required. \.. .J 0.00 (May be a negative number) PTY - Political Party SCC - Small Contributor Committee J FPPC Form 460 (June/O1) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Sam Pedroza DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) 02/18/05 Integrated Resource Management 405 N. Indianhill Blvd. Claremont, CA 91711 02/18/05 Integrated Resource Management 405 N. Indianhill Blvd. Claremont, CA 91711 Type or print in ink. Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER CONTRIBUTOR OCCUPATION AND EMPLOYER CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) OIND oeOM ~OTH OPTY osee DIND DCOM [iJOTH DPTY Dsec OIND DCOM OaTH OPTY osee OIND oeOM OaTH OPTY osec Attach additional information on appropriately labeled continuation sheets. DESCRIPTION OF GOODS OR SERVICES Printing for Fundraiser Invitation Postage for Fundraiser Invitation SUBTOTAL $ Schedule C Summary 1. Amount received this period - nonmonetary contributions of $100 or more. (Include all Schedule C subtotals.) ...................... .................. ................................ """"""""" ........................... $ 2. Amount received this period - un itemized 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 and 10.) """"""""""" TOTAL $ Statement covers period from 01/23/05 through 02/19/05 AMOUNT! FAIR MARKET VALUE 62.50 185.00 247.50 247.50 142.54 390.04 SCHEDULE C CALIFORNIA 460 FORM Page g of L I 1.0. NUMBER 1273509 CUMULATIVE TO PER ELECTION DATE TO DATE CALENDAR YEAR (IF REQUIRED) (JAN 1 - DEC 31) 62.50 62.50 247.50 247.50 ~ *Contributor Codes IND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (June/01) FPPC TolI.Free Helpline: 866/ASK-FPPC Schedule E Payments Made from 01/23/05 CALIFORNIA 4 6 0 FORM SCHEDULE E Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER through 02/19/05 Page' of' I 1.0. NUMBER Committee to Elect Sam Pedroza 1273509 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 0vP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations ÆT petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks lRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research lRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Whalen Bindery & Mailing Services 535 W. Allen Avenue No. 16 San Dimas, CA 91773 P~S 244.86 Vilma Caldwell Signs 11557 Embree Drive EI Monte, CA 91732 Campaign Signs 2189.16 Typegallery Printers 20461 E. Valley Suite A Walnut, CA 91789 LIT 2706.25 * Payments that are contributions or independent expenditures must also be summarized on Schedule D, SUBTOTAL $ 5140.27 Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................................................................................""" $ 2. Unitemized payments made this period of under $100 ............................., ......... ...... ................. ............... .................. ............. ..... ....... ...... ............ $ 3. Total interest paid this period on loans. (Enter amount from 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, Column A, Line 6.) ............................. TOTAL $ 5430.07 76.99 0.00 5507.06 FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule E (Continuation Sheet) Payments Made Type or print in ink. Amounts may be rounded to whole dollars. . SCHEDULE E (CONT.) from 01/23/05 CALIFORNIA 460 FORM Statement covers period SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Sam Pedroza through 02/19/05 Page' 0 I.D. NUMBER of l ( 1273509 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. crvP campaign paraphernalia/misc. MBR member communications RAO radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFO returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations ÆT petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks mc candidate travel, lodging, and meals FND fundraising events POL polling and survey research ms staff/spouse travel, lodging, and meals INO independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Claremont Courier 111 S, College Avenue Claremont, CA 91711 PRT 289.80 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 289.80 FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC SCHEDULE F Schedule F Accrued Expenses (Unpaid Bills) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period through 01/23/05 02/19/05 CALIFORNIA 460 FORM from SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Sam Pedroza Page II of I t I.D. NUMBER 1273509 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. QvP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations Æf petition circulating TEL tv. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks mc candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* PaS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) - NAME AND ADDRESS OF CREDITOR (IF COMMIITEE, ALSO ENTER 1.0. NUMBER) (a) (b) (c) (d) CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD p~S 244.86 0.00 244.86 0.00 Whalen Bindery & Mailing Services 535 W. Allen Avenue San Dimas, CA 91773 Typegallery 20461 East Valley Boulevard Suite A Walnut, CA 91789 LIT 2706.25 0.00 2706.25 0.00 Claremont Courier 111 S, College Avenue Claremont, CA 91711 PRT 0.00 1014.30 0.00 1014.30 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS $ 2951.11 $ 1014.30 $ 2951 .11 $ 1014.30 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 Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) ............,....,.............................,........................................................................................"""" NET $ 1 064.30 2951.11 -1886.81 May be a negative number FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC