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HomeMy Public PortalAboutForm 460 Preelection Statement 2Cl Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from April 22, 2018 through May 19, 2018 I- Type of Recipient Committee: All Committees — Complete karts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also CorrqWe Pad 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information Partners for a Safe Claremont 0 Primarily Formed Ballot Measure Committee ® Controlled 0 Sponsored (also Car we Part 0 ❑ Primarily Formed Candidate/ Officeholder Committee Wso cm#918 Part rJ NO COMMITTEE) I.D. NUMBER 1403060 STREETADDRESS (NO P.O. BOX) 2058 N Mills Ave Suite 430 CITY STATE ZIP CODE AREACODOPHONE Claremont CA 91711 909 575-1456 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O BOX CITY STATE ZIP CODE AREACODEIPHONE OPTIONAL. FAX l E-MAIL ADDRESS COVER PAGE EGEwh I Al-IFORNIA i, FORM Date of election if applicable: MAY 2 3 2018 Page 1 of 15 (Month, Day, Year) CffY CLERK For Oficial Use Only June 5, 2018 M OF CLAREM0 : T 2. Type of Statement: Preelection Statement ❑ Quarterly Statement ❑ semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER William Buehler MAILING ADDRESS 304 E Miramar Ave CITY STATE ZIP CODE AREACODFJPHONE Claremont CA 91711 909 262-9922 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRE;� `: CITY STATE ZIP CODE AREACODElPHONE OPTIONAL. FAX E-MAILADDRESS 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 correct. _ Executed on April 23, 2018 Dale Executed on Date Executed an Date Executed on Date By curer & By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Respons'ble Officer of Sponsor By Signature of Controlling Officeholder Candidate. State Measure Proponent By Signature of Controlling Ofteholder, Candidate, Stale Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.Rov (866/275-3772) Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Partners for a Safe Claremont OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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. GUMMI I I tt WAML I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I D NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NOPO BOX) CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE - PART 2 Page 2 of 15 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Safe Claremont BALLOT NO. OR LETTER JURISDICTION 0 SUPPORT SC I Claremont ❑ 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 Candidate/Officeholder Committee Listnamesof officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELP ❑ SUPPORT ❑ OPPOSE Attach continuation sheets If necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE . Statement covers period , Summary Page to whole dollars� from April 22, 2018 - Expenditures Made 6. Payments Made .................. .......... through May 19, 2018 Page 3 of 15 SEE INSTRUCTIONS ON REVERSE 0 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ 15268.37 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0 NAME OF FILER schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE......................................Add Lines 8+ s+ 10 $ ID NUMBER Partners for a Safe Claremont 2582.02 amounts in Column A may 16. ENDING. CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 1403060 Contributions Received be negative figures that Column A TOTAL THIS PERIOD Column B Calendar Year Summary for Candidates should be subtracted from previous period amounts_ If (FROM ATTACHEDSCHEDULES) CALENDAR YEAR TOTAL TODATE Running in Both the State Primary and 17. LOAN GUARANTEES RECEIVED .................. ... Schedule B Part 2 $ 0 General Elections 1. Monetary Contributions ................................................... Schedule a, rave 3 99 $ 11874. $ 31134.99 Cash Equivalents and Outstanding Debts 18. Cash Equivalents .. .................-- ...................... see instructions on reverse $ 0 0 iti through 6130 711 to Dale 2. Loans Received................................................................ Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 11874.99 $ $ 31134.99 20. Contributions Received $ $ 4. Nonmoneta Contributions ................... ry ......................... Schedule C, lane 3 4861.24 4861.24 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ................................... Add Lines 3+4 $ 16736.23 $ _ 35996.23 Made $ $ Expenditures Made 6. Payments Made .................. .......... Schedule E. Line 4 $ 15268.37 7. Loans Made ................... ....... Schedule H. Line 3 0 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ 15268.37 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE......................................Add Lines 8+ s+ 10 $ 15268.37 $ 28559.41 0 $ 28559.41 0 $ 0 28559.41 Current Cash Statement 12. Beginning Cash Balance ................""""'". Previous summary Page, Line 16 s 5969.12 To calculate Column B, 13. Cash Receipts ...... Column A, Line 3 above 11874.99 add amounts in Column 14. Miscellaneous Increases to Cash .................................. schedule r, Line 4 6.28 A to the corresponding amounts from Column e 15. Cash Payments Column A, Line 8 above 15268.37 of your last report. Some 2582.02 amounts in Column A may 16. ENDING. CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ be negative figures that If this is a termination statement, Line 16 must be zero. should be subtracted from previous period amounts_ If this is the first report being 17. LOAN GUARANTEES RECEIVED .................. ... Schedule B Part 2 $ 0 riled for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 18. Cash Equivalents .. .................-- ...................... see instructions on reverse $ 0 any)_ 19. Outstanding Debts ...... ............. 3........... Add Line 2 +Line 9 in Column a above $ 0 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made, (It subject to Voluntary Expenditure Limit) Date of Election Total to Date (mmfddfyy) I / $ Amounts in this section may be different from amounts reported in Column B. FPPG Form 460 (Jan/2016) FPPG Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A to whole dollars. Monetary Contributions Received Statement covers period April 22, 2018 . from through May 19, 2018 Page 4 of 15 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 DATE FULL NAME, STREETADDRESS AND 21P CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN.1 -DEC. 31) (1F- REQUIRED) OF BUSINESS) ❑ IND See Attached ❑ coM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCG ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 11874.99 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, Column A, Line 1.)......................TOTAL $ 8650.00 3224.99 11874.99 '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 FPPC Form 460 (1an/2026) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fnnr ra anv -FPPC Form 460, 5-19-2018 O T 1,5 LAST NAME FIRST NAME ADDRESS CITY ZIP OCCUPATION EMPLOYER CHECK DATE DEPOSIT DATE f Haynes Hai & Carolyn 577 E Sebastopol Street Claremont 91711 _AMOUNT $100.00 Retired 03-12-2018 _ e04-24-2018 J Kovach Linda 916 Glenville Drive Claremont 91711 $250.00 Retired 0420-2018 04-242018 j Keith Jim 337 Marygrove Road Claremont 91711 $200.00 Retired 0425-2018 0426-2018 Leano Winfred 1570 N Town Ave Claremont 91711 $250.00 Attorney Jed Leano 0425-2018 04-26-2018 Henderson Butch 525 Harrison Ave Claremont 91711 $250.00 Retired 04-23-2018 04-27-2018 Horowitz Larry & Marcia 1657 Finecrott Drive Claremont 91711 $250.00 Proffessor Western University 04-26-2018 0427-2018 Stark Jennifer 242 Eagle Grove Ave Claremont 91711 $200.00 Yoga Instructor Pomona College 0426-2018 0427-2018 j Ferry Marylou 3831 Hollins Ave Claremont 91711 $100.00 Communications Pomona College 0428-2018 0430-2018 Lombardo Catherine 269 W Bonita Ave Claremont 91711 $500.00 Attorney Attorney at Law, Inc 0427-2018 0430-2018 % Rosenthal Michael & Karen 1100 Oxford Ave Claremont 91711 $100.00 Retired 0429-2018. 0430-2018 ' Blaine Brad & Mary Anne 904 Harrison Ave Claremont 91711 $1,000.00 Retired 04-26-2018, - 05.01-2018 f Fallon John & Joan 680 W Winthrop Ave Claremont 91711 $250.00 Retired 0426-2018 , 05-01-2018 f McGaha Michael & Agnes 424 Harrison Ave Claremont 91711 $250.00 Retired_ 0425-2018 05-01-2018 / McGrath Lori & Thomas 437 Julliard Drive Claremont 91711 $100.00 Retired 04-26-2018 i 05.01-2018 j Morgan Ann & Steve 251&N Mountain Ave Claremont 91711 $100.00 Retired 04-25-2018 05-01-2018 / Washington Linda 3602 -Kellett Street Claremont 91711 $250.00 Home Maker 04-28-2018, 05-03-2018 / Gerecke t Marian & August 333 S Villanova Drive Claremont 91711 $500.00 Retired x 05-01-20181 05.07-2018 Kamer A. George 1731;N towns Ave Claremont 91711 $100.00 Retired x 0430-2018t.- 05-07-2018 j Ceniceros Blair 650 Harrison Ave Claremont 91711 $250.00 R@tired 05-02-2018! _ 05-08.2018 ' Masten Betty 428 Champlain Drive Claremont 91711 $100.00 Retired 05-04-2018 i� a 05.08-2018 O Sanders Towing 344 W Arrow Hwy San Dimas 91773 $500.00 05-08-2018 05-09-2018 a Claremont Village Expansion 701 N Brand Blvd #810 Glendale 91203 $350.00 05-07-2018 05.11-2018 D Claremont Village Inn 701 N Brand Blvd #810 Glendale 91203 $150.00 05-07-2018 05-11-2018 Gottuso Mario & Robin 1400 Niagara Ave Claremont 91711 $250.00 Realtor C-21 Peak 05-07-2018 05-14-2018 f Gottuso Mario & Robin 1400 Niagara Ave Claremont 91711 $150.00 Realtor C-21 Peak 05-08-2018 05-142018 Herrera Consuelo 2366 Bonnie Brae Claremont 91711 $100.00 Retired 05-06-2018 05-14-2018 Napolin Alex & Jenna 462 Baughman Ave Claremont 91711 $250.00 Attorney Self 05-11-2018 05-142018 Nasmyth Peter 434 W Arrow Hwy Claremont 91711 $250.00 Attomey Self 05-11-2018 05-14-2018 Pearson Susan 2461 N San Jacinto Court Claremont 91711 $100.00 Business Owner Self 05-10-2018 05-14-2018 Ramos Tony 873 Atlanta Court Claremont 91711 $500.00 Retired 05-11-2018 05-14-2018 ' Rugeley Barbara 1436 Mural Drive Claremont 91711 $200.00 Retired Credit Card 05-142018 Scaff Marilee 627 Leyden Lane Claremont 91711 $100.00 Retired 05-10-2018 05-14-2018 f Su Kelvin 663 W Winthrop Ave Claremont 91711 $250.00 Retired 05-08-2018 05-14-2018 Cooper Paul 2274 Grand Ave Claremont 91711 $300.00 Retired 05-15-2018 05-17-2018 r Durian Barbara 1705 Bridgeport Ave Claremont 91711 $10000 Retired 05-12-2018 05-17-2018 5/22/2018 SCHEDULE B - PART 1 Schedule — Part I to whole dollars. Statement covers period Individual Loans Received April 22, 2018 a . - • (other than PTY or SCC) from - Other (e.g., business entity) Page 6 of 15 SEE INSTRUCTIONS ON REVERSE through May 19, 2018 NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 FULL NAME. STREETAb0RE55 AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING9 INTEREST ORIGINAL CUMULATIVE11) OF LENDER OF COMMITTEE. ALSO ENTER I.D. NUMBER) IIF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME of BUSINESS) PERIOD THIS PERIOD' PERIOD PERIOD LOAN TO DATE ❑ PAID CALENDAR YEAR None s s x 11 ❑FORGIVEN RATERATEs PER ELECTION" t ❑ IND 11 Com ElOTH 11 PTY ❑ sCC S S $ S DATE INCURRED S DATE DUE ❑ PAID CALENDAR YEAR $ S © FORGIVEN RATE PER ELECTION" S S S S DATE DUE tS ❑ IND C] COM ❑ OTH [I PTY [I SCC DATE INCURRED ❑ PAID CALENDAR YEAR S S x S f ❑ FORGIVEN RATE PER ELECTION' t ❑ IND ❑ COM [10TH ❑ PTY ❑ SCC $ S $- $ DATE INCURRED $ DATE DUE SUBTOTALS $ 0$ 0 $ 0 $ 0 Schedule B Summary 1. Loans received this period ..................................................... (Total Column (b) plus unitemized loans of less than $100.) ................................................$ n 2. Loans paid or forgiven this period.........................................................................................................$ _ n (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 $ n Enter the net here and on the Summary Page, Column A, Line 2. IWybean"awenun"r) `Amounts forgiven or paid by another party also must be reported on Schedule A. - If required. ten,er tel an Schedule E. Lina 7) tContributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) 0TH - Other (e.g., business entity) PTY - Political Parry SCC - Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 2 Schedule B — Part 2 Amounts may ne rounQeo Statement covers period . to whole dollars. e Loan Guarantors April 22, 2018 • ' from page 7 of 15 through May 19, 2018 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 FULL NAME, STREET ADDRESS AND ZIP CODE OF GUARANTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER LOAN AMOUNT GUARANTEED CUMULATIVE BALANCE OUTSTANDING (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED. OF U51 ESSR THIS PERIOD TO DATE TO DATE LENDER CALENDAR YEAR ❑ IND None ❑ coM S DATE ❑ OTH PER ELECTION (IF REQUIRED) ❑ PTY ❑ scC s CALENDAR YEAR ❑ IND LENDER ❑ cOM s ❑ OTH PER ELECTION DATE (IF REQUIRED) ❑ PTY ❑ SCC s CALENDAR YEAR ❑ IND LENDER ❑ COM S ❑ OTH PER ELECTION DATE (IF REQUIRED) ❑ PTY ❑ SCC s LENDER CALENDAR YEAR C] IND ❑ COM s ❑ OTH DATE ELECTION IIF REQUIRED) (IF ❑ PTY ❑ SCC s Enter on SUBTOTAL $ 0 '%MWry Page, Lina 17 only. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded SCHFnU[ F C Nonmonetary Contributions Received W "`IIUIW "U114` . Statement covers period • � a 1 from April 22, 2018 • - Page 8 of 15 through _ May 19, 2018 SEE INSTRUCTIONS ON REVERSE NAME Or EL I.D. NUMBER Partners for a Safe Claremont 1403060 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF IF AN INDIVIDUAL. ENTER OF AMOUNTI CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR CODE* OCCUPATION AND EMPLOYER IIF SELF-EMPLOYED. ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) (IF REQUIRED) ❑ IND 4/29/18 Double Tree by Hilton ❑ CoM Kick-off party 4861.24 4861,24 4861.24 Claremont, California 430TH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ Sc ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ C0M ❑ OTH ❑ PTY ❑ SCG Attach additional information on appropriately labeled continuation Sheets- SUBTOTALS 4861.24 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtatals.)..................................................... ................................................................. 2. Amount received this period — Lin item !zed nonmonetary contributions of less than $100 ..................................$ 4861.24 0 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 $ 4861.24 '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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees == wcT01 Jr "MMIR nN REVERSE NAME OF FILER Partners for a Safe Claremont Amounts may be rounded to whole dollars. DATE I NAME OF CANDIDATE, OFFICE. AND MEASURE NUMB OROOR COMM TT AND UIRISDICT ON, I TYPE OF PAYMENT I Diff ES EOu EDN ❑ Monetary None Contribution ❑ Nonmonetary Contribution �] Independent ❑ support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SCHEDULE D Statement covers pertoa CALIFORNIA 46 from April 22, 2018 _ • RM through May 19, 2018 Page 9 of 15 I.D. NUMBER 1403060 CUMULATIVE TO DATE PER ELECTION AMOUNT THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) SUBTOTAL $ 0 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) .........••••.......•..• $ 0 2. Unitemized contributions and independent expenditures made this period of under $100 ................ .....................••• $ 0 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL.. $ 0 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made ON REVERSE Partners for a Safe Claremont Amounts may be rounded to whole dollars. Statement covers period from April 22, 2018 through May 19, 2018 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. �14I.1901A4 4 CALIFIRLAIAI • 1;. - Page 10 of 15 I.D. NUMBER 1403060 CMP campaign paraphemalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' QFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL Is. or cable airtime and production costs FIL candidate filing/ballot fees PMO phone banks TRC 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)' 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 IIF COMMITTEE, ALSO ENTER I.O. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Direct Connection LIT Printing 8. Literature 4212,21 Claremont Courier PRT Print Ads 1359.50 USPS POS Stamps 1391.00 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 6962.71 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. $ 14995.48 2. Unitemized payments made this period of under $100 ........................ _... $ 272.89 ............................................................................................... ............. 3. Total Interest paid this period on loans. Enter amount from Schedule E, Part 1, Column e $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................ TOTAL $ 15268.37 FPPC Form 460 (?an/2016) FPPC Advice: advice@fppc.ra.gov (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE Partners for a Safe Claremont Amounts may be rounded to whole dollars. Statement covers period from April 22, 2018 through May 19, 2018 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalialmisc. CNS campaign consultants CTB contribution (explain nonmonelary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporlinglopposing others (explain)* LEG legal defense LIT campaign literature and mailings SCHEDULE E (CONT) CALIFORNIAs • FORM Page 11 of 15 I.D. NUMBER 1403060 MBR member communications RAD radio airtime and production costs MTG meetings and appearances RFD returned contributions OFC office expenses SAL campaign workers' salaries PET petition circulating TEL t.v. or cable airtime and production costs PHO phone banks TRC candidate travel, lodging, and meals POL polling and survey research TRS staff/spouse travel, lodging, and meals POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor PRO professional services (legal, accounting) VOT voter registration PRT print ads WEB information technology costs (internal, e-mail) NAME AND ADDRESS OF PAYEE QF COMMITTEE, ALSO ENTER I D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Linda Kovach CMp Reimbursement for Printing and Copies 361.05 Master Sign Printing Works CMP CMP Signs and Stakes Printing and Copies 1772.44 284.70 Veridyne Design CMP Printing 542.03 Veridyne Industries LIT Printing and Mailing 5072.55 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 8082,77 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Schedule F Accrued Expenses (Unpaid Bills) SEE ME OF FILER Partners for a Safe Claremont Amounts may be rounded to whole dollars. Statement covers period from April 22, 2018 through May 19, 2018 SCHEDULE F Page 12 of 15 I.D. NUMBER 1403060 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD SAL returned contributions campaign workers' salaries CTB contribution (explain nonmonetary)' OFC PET office expenses petition circulating TEL Lv. or cable airtime and production costs CVC civic donations PHO phone banks TRC candidate travel, lodging, and meals FIL candidate filing/ballot fees POL polling and survey research TRS staff/spouse travel, lodging, and meals FND IND fundraising events independent expenditure supportinglopposing 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 WEB voter registration information technology costs (internet. e-mail) LIT campaign literature and mailings PRT print ads (a)(b) (c) (d) NAME AND ADDRESS OF CREDITOR IIF cOMMn-TEE.ALSO ENTER I D. NUMBER) CODE OR DESCRIPTION OF PAYMENT OUTSTANDING BALANCE BEGINNING AMOUNT INCURRED THIS PERIOD AMOUNT PAID THIS PERIOD OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD (MM REPORT ON E) OF THIS PERIOD None Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0 $ 0 $ 0 $ 0 summarized on Schedule D Schedule F Summary 1. Total accrued expenses incurred this period. (include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ..............................................INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................... PAID TOTALS $ 0 0 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here ana 0 on the Summary Page, Column A, Line 9.)................................................................................................................................................................................... NET $ May be a negative number FPPC Form 450 ()an/2016} FPPC Advice: advice@fppc.ca.gov (866/275-3772) Schedule G SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period . Contractor (on Behalf of This Committee) to whole dollars. from April 22, 2018 f . through May 19, 2018 Pae 13 of 15 g SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonelary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL Lv, or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supportinglopposing others (explain)' POS postage, delivdry and messenger services TSF transfer between committees of the same candidatelsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D, NAME AND ADDRESS OF PAYEE OR CREDITOR I CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE. ALSO ENTER I D. NUMBER) None Attach additional information on appropriately labeled continuation sheets. Do not transfer to any other schedule or to the Summary Page This total may not equal the amount pard to the agent or independent contractor as reported on Schedule E. TOTAL' $ 0 FPPC Form 460 (Jan/2016) FPPC Advice: advice ftpc.ca.gov (966/275-3772) www.fppc.ca.gov SCHEDULE H Schedulell Amounts may be rounded Statement covers period * to whole dollars. Loans Made to Others April 22, 2018 0 from May 19, 201$ 14 15 SEE INSTRUCTIONS ON REVERSE through pee of 9 NAME OF FILER I.O. NUMBER Partners for a Safe Claremont 1403060 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER ° OUTSTANDING (b) AMOUNTREPAYMENT {c) OR Id) OUTSTANDING 101 INTEREST to ORIGINAL {9) CUMULATIVE OF RECIPIENT I[F COMMITTEE, ALSO ENTER I.D. NUMBER) IIF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS LOANEp THIS PERIOD FORGIVENESS BALANCE AT CLOSE OF THIS RECEIVED AMOUNT OF LOANS NAME OF BUSINESS) PERIODPERIOU THIS PERIOD' LOAN TO DATE ❑ PAID CALENDARYEAR None s S % S- 1:1 ❑ FORGIVEN RATE PER ELECTION' S S S S S DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR S S S S ❑ FORGIVEN RATE PER ELECTION" S $ S S S 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. SUBTOTALS $ 0 $ 0 $ 0 $ 0 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 $100.) (Ener (e) on Schedule 1, Line 3) ...........................................................$ ..............................................................$ C 3. Net change this period. (Subtract Line 2 from Line 1.)............................................................................................NET $ 0 (Enter the net here and on the Summary Page, Column A, Line 7.) (May be neptrve number) ..If Required FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov . -hpirb llp_ I A....,....�� ...�., tis .......aea SCHEDULE 1 Miscellaneous Increases to Cash to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period A ril 22, 2018 from p through May 19, 2018 ' page 15 of 15 NAME OF FILER Partners for a Safe Claremont I.D. NUMBER 1403060 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE [IF CDMMIT4EE.ALSO ENTER 1.0. NUMBER] DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH None Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ Schedule I Summary 1. Itemized increases to cash this period..........................................................................................................$ D 2. Unitemized increases to cash of under $100 this period. $ 6.28 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 tines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.).............................................................................................................. ....................... $ ..... TOTAL $ D 6.28 0 FPPC Form 460 (]an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772)