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Home My Public Portal AboutForm 460 Semi-AnnualRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE from Statement covers periodI Date of election if applicable July 1, 2018 (Month, Day, Year) through September 22, 2018 1. Type of Recipient Committee: All committees -Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information ® Primarily Formed Ballot Measure Committee ® Controlled 0 Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Partners for a Safe Claremont I.D. NUMBER 1403060 STREETADDRESS (NO P.O. BOX) 2058 N Mills Ave Suite 430 CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909 575-1456 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/ E-MAIL ADDRESS June 5, 2018 5 U0! pP.' SEP 2 6 2010 C#,ry CLE., '0Fr-, A , ( I 2. Type of Statement: ❑ Preelection Statement Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE 1 of For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER William Buehler MAILING ADDRESS 304 E Miramar Ave CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909 262-9922 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/ E-MAIL ADDRESS 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. , _,e � — �- Executed on September 26, 2018 Date Executed on Date Executed on Date Executed on Date By or Assistant treasurer By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 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) RESIDENTIAL/BUSINESSADDRESS (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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ 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? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) COVER PAGE - PART 2 Page 2 of /3 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Safe Claremont BALLOT NO. OR LETTER JURISDICTION ® SUPPORT SC 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 Listnames of 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 HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE 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 Summary Page to whole dollars. Statement covers period . July 1, 2018 a - from September 22, 2018 Page 3 of !-� SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 Contributions Received Column A TOTAL THIS PERIOD Column B CALENDAR YEAR Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 200.00 39740.61 1. Monetary Contributions................................................... schedule A, Line 3 $ $ 0 0 111 through 6/30 7/t to Date 2. Loans Received................................................................ schedule B, Line 3 200.00 39740.61 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ $ Received $ $ 0 5206.24 4. Nonmonetary Contributions ............................................ schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3+4 $ 200.00 $ 44946.85 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ schedule E, Line 4 $ 345.39 $ 38407.82 Candidates 7, Loans Made....................................................................... Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7 $ 345.39 $ 38407.82 22• Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 0 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 $ 345.39 $ 38407.82 $ $ Current Cash Statements 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 1485.12 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above 200.00 add amounts in Column 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 1.23 A to the corresponding amounts from Column B Amounts in this section may be different from amounts reported in Column B. 15. Cash Payments......................................................... Column A, Line 8 above 345.39 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 1340.96 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $ 0 filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 0 any). 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period July 1, 2018 from y September 22, 2018 4 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 DATE AD FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR S CONTRIBUTOR WAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED FET TEE SENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Randall W. Lewis IND CEO 08/31/18 3201 N. Mountain Ave. ❑coM ❑ OTH Lewis Mgmt. Corp. 200.00 200.00 Claremont, CA 91711 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 200.00`', , 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.)....... 200.00 Q ........TOTAL $ 200.00 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — 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 1 Schedule — Part 1 to whole dollars. Statement covers period Loans Received July 1, 2018 from through 22, 201E Pae 5 of 9 SEE INSTRUCTIONS ON REVERSE 9 NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER a OUTSTANDING AMOUNT (o) AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL g CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD " PERIOD PERIOD LOAN TO DATE ❑ PAID CALENDARYEAR None $ $ % $ $ ❑ FORGIVEN PER ELECTION - RATE DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR FORGIVEN E] FORGIVEN PER ELECTION" DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR FORGIVEN E:1 FORGIVEN PER ELECTION` $ $ $ $ $ DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0$ 0 $ 0 $ 0 Schedule B Summary 1. Loans received this period........................................................................................... (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period............................................................................................ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ................. Enter the net here and on the Summary Page, Column A, Line 2. "Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. ........$ $ ................................ NET $ (May be a negative number) (Enter (e) on Schedule E, Line 3) tContributor 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 B - PART 2 Schedule B — Part Z +mounts may ne rounaea Statement covers period to whole dollars. Loan Guarantors from July 1, 2018 0 through September 22, 201 F page 6 of / -3 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 FULL NAME, STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE BALANCE ZIP CODE OF GUARANTOR CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER THIS PERIOD TO DATE TO DATE NAME OF BUSINESS) CALENDAR YEAR NoneLENDER ❑IND ❑ COM $ DATE ❑ OTH PER ELECTION (IF REQUIRED) ❑ PTY ❑ SCC $ CALENDAR YEAR ❑ IND LENDER ❑ COM $ ❑ OTH PER ELECTION DATE (IF REQUIRED) ❑ PTY ❑ SCC $ CALENDAR YEAR ❑ IND LENDER ❑ COM $ DATE [:1 OTH PER ELECTION (IF REQUIRED) ❑ PTY ❑ SCC $ CALENDAR YEAR ❑ IND LENDER ❑ COM $ F-1OTHDATE PER ELECTION (IF REQUIRED) ❑ PTY ❑ SCC $ Enteron ?; a,.•• SUBTOTAL $ 0 Summary Page, Line 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 SCHEDULE C Nonmonetary Contributions Received io wnole uouars. Statement covers period from July 1, 2018 v through September 22, 201 t Page 7 of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF REQUIRED) (IF NAME OF BUSINESS) (JAN 1 - DEC 31) ❑ IND None ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 0 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include 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 and 10.)...... $ 0 $ 0 ..TOTAL $ 0 '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 SCHFDtJLF D ,jummary OT tX enanures Amounts may ne rounded Statement covers period Supporting/Opposing Other to whole dollars. Candidates, Measures and Committees from July 1, 2018 r through September 22, 201 f page 8 of 13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OR COMMITTEE ❑ 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 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 SEE INSTRUCTIONS ON REVERSE Partners for a Safe Claremont Amounts may be rounded to whole dollars. SCHEDULE E Statement covers period from July 1, 2018 through'eptember 22, 201 f Page 9 of /,3 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 returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. 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 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 345.39 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. 345.39 2. Unitemized payments made this period of under $100 ....................................... 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, 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 $ 349.39 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE Schedule F Amounts may be rounded to whole dollars. Statement covers period • o Accrued Expenses (Unpaid Bills) from July 1, 2018 through'eptember 22, 201 f 10 SEE INSTRUCTIONS ON REVERSE Page of 13 NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 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 returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. 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 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 CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT ( OUTSTAA NDING BALANCE BEGINNING OF THIS PERIOD ( AMOUNT INNCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) ( OUTSTAA NDING BALANCE AT CLOSE OF THIS PERIOD None ` Payments that are contributions or independent expenditures must also be SUBTOTALS $ summarized on Schedule D. 0 $ 0 $ 0 $ 0 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 N 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9. 0 9)................................................................................................................................................................................... NET $ May be a negative number FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) to whole dollars. Partners for a Safe Claremont NAME OF AGENT OR INDEPENDENT CONTRACTOR Statement covers peri from July 1, 2018 through'eptember 22, 2011 SCHEDULE G CALIFgRNlA ;,_` o, t .' FORM Ba a'Avv I.D.Page of NUMBER 4ICI■1 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 returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. 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 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 0 * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460 (Jan/2016) independent contractor as reported on Schedule E. FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE H Schedule H Amounts may be rounded Statement covers period _ * to whole dollars. Loans Made to Others Jul 1, 2018 y a from September 22, 201 t 12of 13 SEE INSTRUCTIONS ON REVERSE through Page NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 FULL NAME, STREETADDRESSAND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING (b) AMOUNT (e) REPAYMENT OR (d) OUTSTANDING (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF RECIPIENT (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED. ENTER BALANCE BEGINNING THIS LOANED THIS FORGIVENESS BALANCEAT CLOSE OF THIS RECEIVED AMOUNT OF LOANS NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD LOAN TO DATE ❑ PAID CALENDAR YEAR None $ $ q S $ ❑ FORGIVEN PER ELECTION** RATE $ 5 $ $ $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ $ q 5 $ FORGIVEN 1:1 FORGIVEN PER ELECTION** $ S $ 8 $ 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 $100.) (Enter (e) on Schedule I, Line 3) ........................................................................$ 0 **If Required .......................................................................$ 0 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 a negative number) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule I AmmintQ may ha r—inrlari SCHEDULE I Miscellaneous Increases to Cash to whole dollars. Statement covers period rl'I!• 0 from July 1, 2018 c' through'eptember 22, 2011 Page 13 13 SEE INSTRUCTIONS ON REVERSE of NAME OF FILER I.D. NUMBER Partners for a Safe Claremont 1403060 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH US Bank Bank Account Interest 23 Accounting Error 1.00 Attach additional information on appropriately labeled continuation sheets. Schedule I Summary 1. Itemized increases to cash this period............................................................................................ 2. Unitemized increases to cash of under $100 this period................................................................. 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....... 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.)............................................................................................................... ..... TOTAL $ SUBTOTAL $ 0 1.23 0 1.23 1.23 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov