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Home My Public Portal AboutForm 460 (Sept 23 - Oct 20, 2018)Recipient Committee COVER PAGz • • . Statement I ,CAS"LIFO�RNIA :60" Cover Page FARM SEE INSTRUCTIONS ON REVERSE Statement covers period from 09/23/2018 through 10/20/2018 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. m Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (AAso Complete Pert 6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Aso Complete Part 7) 3. Committee Information I.D. NUMBER 140096: Jennifer Stark for Claremont City Council 2018 STREET ADDRESS (NO P.O. BOX) 242 Eagle Grove Avenue CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909-913-2580 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX 2058 N Mills Avenue, #425 CITY STATE ZIP CODE AREA CODE/PHONE Date of election if applicable: (Month, Day, Year) 11/06/2018 2. Type of Statement: OCT 2 5 2018 Page CITY CLERX ® Preelection Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) of 11 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Joe Hough MAILING ADDRESS 580 W. 8th Street CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909-625-3236 NAME OF ASSISTANT TREASURER, IF ANY Simon Brown MAILING ADDRESS 1420 N Claremont Blvd, Ste 204C CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909-541-0713 Claremont CA 91711 909-541-0713 OPTIONAL: FAX 1 E-MAIL ADDRESS OPTIONAL: FAX/ E-MAIL ADDRESS simon @claremontcraftales.com 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to th s f my certify under penalty of perj ry unde7rt e laws of the State of California that the foregoin is true.and Executed on CbJ By Date Executed on t By Dat g ture of Cont information contained herein and in the attached schedules is true and complete. I or Executed on By t ` Date Executed on By Signature of Controlling Officeholder, Candidate, State Measure Proponent Date 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 Jennifer Stark OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Claremont City Council RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 242 Eagle Grove Avenue 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? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (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 11 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ 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 Schedule e, Line 4 $ Amounts may be rounded 7. Loans Made....................................................................... SUMMARY PAGE Summa Page g 8. SUBTOTAL CASH PAYMENTS .......................................... to whole dollars. 4462.26 Statement covers period g 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE.. ..... 09/23/2018 4462.26 from through 10/20/2018 page 3 of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Jennifer Stark for Claremont City Council 2018 1400963 Contributions Received TOTAL Coluimn ADD Coluomn B Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 4178.00 21400.69 1. Monetary Contributions................................................... Schedule A, Linea $ $ 0 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule e, Line 3 4178.00 21400.69 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add tines 1 +2 $ $ Received $ $ 0 0 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+ 4 $ 4178.00 $ 21400.69 Made $ $ Expenditures Made 6. Payments Made................................................................ Schedule e, Line 4 $ 4462.26 7. Loans Made....................................................................... Schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+ 7 $ 4462.26 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+9+10 $ 4462.26 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 11467.38 13. Cash Receipts........................................................... Column A, Line 3 above 4178.00 14. Miscellaneous Increases to Cash... .... .......................... Schedule 1, Line 4 0 15. Cash Payments......................................................... Column A, Line 8above 4462.26 16. ENDING CASH BALANCE ..................Add tines 12 + 13 + 14, then subtract Line 15 $ 11183.12 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED... .... -- ....... Schedule B, Part 2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 $ 12532.68 0 $ 12532.68 0 0 $ 12532.68 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 cavy over the amounts from Lines 2, 7, and 9 (if any). 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) IJ $ *Amounts in this section may be different from amounts reported in Column B. 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 wnoie sonars. Statement covers period 09/23/2018 from through 10/20/2018 Page 4 of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Jennifer Stark for Claremont City Council 2018 1400963 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR [FAN 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) (IF REQUIRED) OF BUSINESS) JZI IND 9/23/18 Helaine Goldwater ElooH 100.00 100.00 2331 Coalinga Ct retired Claremont, CA 91711 ❑ PTY ❑ SCC ® IND 9/23/18 Parker Emerson ❑ COM owner 150.00 250.00 1084 Lake Forest Dr ❑ OTH Emerson Consulting Claremont, CA 91711 ❑ PTY Group ❑ SCC Z IND 9/23/18 Joseph Hough ❑ CoM retired 200.00 200.00 580 W 8th St ❑ OTH Claremont, CA 91711 ❑ PTY ❑ SCC Suzanne Keavney ® IND COM retired 9/23/18 890 E Harrison Ave, #T29❑ ❑ OTH 100.00 100.00 Pomona, CA 91767 ❑ PTY ❑ ScC Stephen Wade ® IND COM attorney 9/23/18❑ 350 W 4th Street 171 OTH Stephen Wade (self) 250.00 250.00 Claremont, CA 91711 ❑ PTY ❑ SCC SUBTOTAL $ 800.00 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.)......................TOTAL $ 3300.00 878.00 4178.00 *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) WWWJPPC.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) monetary contrinutionS Keceived to wnole aouars. Statement covers period from 09/23/2018=o r through 10/20/2018 page 5 of 11 NAME OF FILER I.D. NUMBER Jennifer Stark for Claremont City Council 2018 11400963 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR COMMITTEE, ALSO ENTER CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ® IND Robert Bowcock El COM consultant 9/23/18 1021 Belleville Court ❑ OTH Bowcock Consulting 250.00 250.00 Claremont, CA 91711 ❑ PTY (self) ❑ SCC Agnes McGaha ® IND El Com retired 9/27/18 424 Harrison Ave ❑ OTH 100.00 100.00 Claremont, CA 91711 ❑ PTY ❑ SCC Jennifer Anderson ® IND El COM graphic designer 9/28/18 109 W Oak Park Drive F-1 OTH Creativity Collaborative tY 100.00 100.00 Claremont, CA 91711 El PTY Inc. ❑ SCC V IND Richard Martinez ❑ COM retired 9/29/19 1961 Judson Ct ❑ OTH 100.00 100.00 Claremont, CA 91711 ❑ PTY ❑ SCC Susan Wait ® IND El COM retired 10/1/18 3113 Montana Lane El OTH 250.00 250.00 Claremont, CA 91711 ❑PTY ❑ SCC SUBTOTAL $ 800.00 *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 A (Continuation Sheet) Monetary Contributions Received Jennifer Stark for Claremont City Council 2018 Amounts may be rounded to whole dollars. statement covers peru from 09/23/2018 through 10/20/2018 • CALIFORNIA 460" I.D. NUMBER .y -•0•. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ® IND Naomi Sawelson El COM retired 10/3/18 505 California Drive D OTH 250.00 250.00 Claremont, CA 91711 D PTY D SCC Priva Junnar ® IND El COM Atheneum Director 10/5/18739 N College Ave ❑ OTH Claremont McKenna 100.00 100.00 Claremont, CA 91711 El PTY College ❑ SCC Jack Mills ® IND ❑ COM consultant 10/7/182560 King Way ❑ OTH Jack Mills Consulting 9 100.00 100.00 Claremont, CA 91711 El PTY (self) D SCC Eloise Cadman Q IND CO 100.00 unemployed 10/8/18 385 Taylor Dr 100.00 Claremont, CA 91711 ❑ PTY ❑ SCC Tony Ramos la IND retired 10/9/18 873 Atlanta ct ❑ OTH Claremont, CA 91711 D PTY ❑ SCC SUBTOTAL $ 650.00 *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 A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period = f from 09/23/2018 o through 10/20/2018 page 7 of 11 NAME OF FILER I.D. NUMBER Jennifer Stark for Claremont City Council 2018 11400963 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ® IND Gordon DesCombes F1 COM insurance broker 10/10/18 9 Havenhurst Dr ❑ OTH Alliant Insurance 250.00 250.00 Coto de Caza, CA 92679 ❑ PTY ❑ SCC Susan DesCombes ® IND ❑ COM unemployed 10/10/18 9 Havenhurst Dr ❑ OTH 250.00 250.00 Coto de Caza, CA 92679 ❑ PTY ❑ SCC Steven Bayer ® IND ❑COM self employed 10/11/18 518 ELMORE ST ❑ OTH Steven Ba er Y 100.00 100.00 Park Ridge, IL 60068 ❑ PTY ❑ SCC 10 IND John Neiuber El COM CEO 10/15/18 641 N Indian Hill Blvd ❑ OTH Trinity Youth Services 250.00 250.00 Claremont, CA 91711 ❑ PTY ❑ SCC Charles Allen ® IND ❑ COM retired 10/16/18 394 Blaisdell Dr ❑ OTH 100.00 100.00 Claremont, CA 91711 ❑ PTy ❑ SCC SUBTOTAL $ 950.00 '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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received Amounts may be rounded SCHEDULE A (CONT) to whole dollars. Statement covers period MI'my, 09/23/2018 *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 through 10/20/2018 Page 8 of 11 NAME OF FILER I.D. NUMBER Jennifer Stark for Claremont City Council 2018 1400963 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER LD. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ IND Democratic Club of Claremont El COM 10/20/18PO Box 1201 El OTH 100.00 100.00 Claremont, CA 91711 ID# 841491 ® PTY ❑ SCC ❑ IND ❑ COM ' ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 100.00 *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 E Payments Made Amounts may be rounded to whole dollars. Statement covers period from 09/23/2018 SCHEDULE E SEE INSTRUCTIONS ON REVERSE through 10/20/2018 Page 9 of 11 NAME OF FILER I.D. NUMBER Jennifer Stark for Claremont City Council 2018 1400963 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/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 (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Jamie Sutherland reimbursement for miscellaneous supplies for 4th of 4077 Olive Hill Dr July event 108.60 Claremont, CA 91711 Cheese Cave 325 Yale Ave FND 277,81 Claremont, CA 91711 Political Data Inc. 12501 Imperial Hwy # 200 POL 631.56 Norwalk, CA 90650 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary SUBTOTAL $ 1017.97 1. Itemized payments made this period. (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 $ 4173.90 288.36 0 4462.26 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Laura Roach SCHEDULE E (CONT) CONT. (Continuation Sheet) Amounts may be rounded to whole dollars. Statement covers period a , Payments Made from 09/23/2018 SEE INSTRUCTIONS ON REVERSE 681 E. Foothill Blvd through 10/20/2018 Page 10 of 11 NAME OF FILER JS Solutions I.D. NUMBER Jennifer Stark for Claremont City Council 2018 9700 Indiana Avenue CMP 1400963 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/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 (intemet, e-mail) NAME AND ADDRESS OFPAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) LD CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Laura Roach reimbursement for miscellaneous supplies for 310 W. Radcliffe Dr. canvassing events 113.82 Claremont, CA 91711 Printing Works 681 E. Foothill Blvd LIT 810.30 Pomona, CA 91767 JS Solutions 9700 Indiana Avenue CMP 1437.19 Riverside, CA 92503 Smart and Final 1028 N Mountain Ave CMP 102.60 Upland, CA 91786 Pizza N Such 273 W 2nd St TRS 130.02 Claremont, CA 91711 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2593.93 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule EASCHEDULE E (CONT.) mounts may be rounded Statement covers period (Continuation Sheet) to whole dollars. o L Payments Made from 09/23/2018 ® SEE INSTRUCTIONS ON REVERSE through 10/20/2018 Page 11 of 11 NAME OF FILER I.D. NUMBER Jennifer Stark for Claremont City Council 2018 1400963 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, CMP campaign paraphernalia/misc. MBR member communications RAD CNS campaign consultants MTG meetings and appearances RFD CTB contribution (explain nonmonetary)* OFC office expenses SAL CVC civic donations PET petition circulating TEL FIL candidate filing/ballot fees PHO phone banks TRC FND fundraising events POL polling and survey research TRS IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF LEG legal defense PRO professional services (legal, accounting) VOT LIT campaign literature and mailings PRT print ads WEB describe the payment. radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Claremont Courier 114 Olive St Claremont, CA 91711 PRT 562.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 562.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov