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HomeMy Public PortalAboutForm 460 (September 22 - October 19, 2019)Recipient Committee Date -Stamp COVER PAGE Campaign Statement Cover Page © ,} SEE INSTRUCTIONS ON REVERSE Statement covers period from 09/22/2019 through 10/19/2019 1. Type of Recipient Committee: All committees -complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee O State Candidate Election Committee O Recall (Also Complete Pert 5) ❑ General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee 3. Committee Information ® Primarily Formed Ballot Measure Committee ® Controlled O Sponsored (Also Complete Pert 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Pad 7) E (OR CANDIDATE'S NAME IF NO COMMITTEE) I.D. NUMBER 1419897 Yes! For Claremont -- The Committee to Support Measure CR STREETADDRESS (NO P.O. BOX) 2058 N Mills Ave #425 CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 626-720-7798 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS YesForClaremont@gmail.com 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of certify under penalty of perjury under the laws of the State of California that the foregoing is true By Date of election if applicable: OCT 2 3 2019 Page 1 of 8 (Month, Day, Year) For Official Use Only MY CLERK 11/05/2019 C' TY OF CL!4REMON V 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 Simon Brown MAILING ADDRE SS 2058 N Mills Ave, #333 CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909-625-5350 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS the informal ined herein and in the attached schedules is true and complete. 1 c or 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 10/21/2019 Executed on Date Executed on Date Executed on Date Executed on Date By Date of election if applicable: OCT 2 3 2019 Page 1 of 8 (Month, Day, Year) For Official Use Only MY CLERK 11/05/2019 C' TY OF CL!4REMON V 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 Simon Brown MAILING ADDRE SS 2058 N Mills Ave, #333 CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 909-625-5350 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS the informal ined herein and in the attached schedules is true and complete. 1 c or 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 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Measure CR OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION CR I Claremont RESIDENTIAUBUSINESS 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. COMMITTEE NAME I I.D. NUMBER NAME OF TREASURER ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEJPHONE COMMITTEE NAME NAME OF TREASURER I.D. NUMBER ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 8 ® 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 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 to whole dollars. Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Yes! For Claremont -- The Committee to Support Measure CR Statement covers period from 09/22/2019 through SUMMARY PAGE 10/19/2019 Page 3 of 8 I.D. NUMBER 1419897 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) J $ 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 Column A Column B Contributions Received TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE 3094 9069 1. Monetary Contributions................................................... Schedule A, Line $ $ 0 0 2. Loans Received................................................................ Schedule B, Line 3 3094 9069 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ 46 1283 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 $ 3140 $ 10352 Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $$ 2619 7278 7. Loans Made....................................................................... Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7 $ 2619 $ 7278 9. Accrued Expenses (Unpaid Bilis).......................................... Schedule F Line 3 0 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 46 1283 11. TOTAL EXPENDITURES MADE ........................................ Add Lines s + 9 + 10 $ 2665 $ 8561 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 1316 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above 3094 add amounts in Column 0 A to the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 amounts from Column B 2619 of your last report. Some 15. Cash Payments......................................................... Column A, Line 8 above amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 1791 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 any). 18. Cash Equivalents ................................................ See instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 SUMMARY PAGE 10/19/2019 Page 3 of 8 I.D. NUMBER 1419897 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) J $ 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 to whole sonars. Monetary Contributions Received Statement covers period .�. "a from 09/22/2019 ® 4 8 10/19/2019 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Yes! For Claremont -- The Committee to Support Measure CR 1419897 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) V1 IND 9/22/19 Eugenia Elliott Eu g El COM retired $150 $150 982 Richmond Dr ❑ OTH Claremont, CA 91711 ❑ PTY ❑ SCC ® IND 9/22/19 Karen Rosenthal ❑ COM retired $250 $250 1100 Oxford Ave [I OTH Claremont, CA 91711 ❑ PTY ❑ SCC ® IND 9/24/19 William Baker ❑ COM retired $250 $250 488 W 6th St ❑ OTH Claremont, CA 91711 ❑ PTY ❑ SCC W1 IND Sandra Baldonado El COM retired $200 $200 9/25/19435 Yale Ave ❑ OTH Claremont, CA 91711 ❑ PTY ❑ SCC IND Bob Gerecke ❑ COM retired $250 $250 9/25/19 333 S Villanova Dr ❑ OTH Claremont, CA 91711 ❑ PTY ❑ SCC SUBTOTAL $ $1100 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 $ 2250 844 3094 '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 SCHEDULEA (CONT.) Monetary Contributions Received to whole dollars. Statement covers period from 09/22/2019 o .;.. •:•.�, .�,x through 10/19/2019 Page 5 of 8 NAME OF FILER I.D. NUMBER Yes! For Claremont -- The Committee to Support Measure CR 1419897 CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE CODE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) IND Zora Tebeau El COM Appraiser 9/26/19 1009 Butte St ❑OTH Zora Tebeau (self) $150 $150 Claremont, CA 91711 ❑ PTY El SCC 9/27/19 - — - ---. - John Roseman ® IND El COM retired $100 $100 680 W 11th St ❑ OTH Claremont, CA 91711 ❑ PTY ❑ SCC 9/27/19 Kelly Kane ® IND ❑ COM Senior SRE $100 $100 243 S Mills Ave ❑ OTH The Trade Desk Claremont, CA 91711 ❑ PTY ❑ SCC La IND 9129!19 Joan Bunte ❑COM retired $100 $100 326 De Paul Rd ❑ OTH Claremont, CA 91711 ❑ PTY ❑ SCC Corey Calaycay ® IND ❑Com Manager of Ticket Sales 1011/19 1555 W Baseline Rd El OTH Fair lex p $250 $250 Claremont, CA 91711 ❑ 0 T ❑ SCC SUBTOTAL$ $700 '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) Schedule A (Continuation Sheet) Monetary Contributions Received Amounts may be rounded SCHEDULE A (CONT.) to whole dollars. Statement covers period from 09/22/2019 "® "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 10/19/2019 Page 6 of 8 NAME OF FILER I.D. NUMBER Yes! For Claremont -- The Committee to Support Measure CR 1419897 CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE ENTER NUMBER) CODE RECEIVED (IF COMMITTEE, ALSO I.D. (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ® IND Valerie Martinez El COM Business Owner 10R/19 2687 San Angelo Dr [I OTH VMA Communications $250 $250 Claremont, CA 91711 El PTY ❑ SCC Margaret Mathies El COM retired 10/7/19 612 W 10th St ❑ OTH $100 $100 Claremont, CA 91711 ❑ PTY ❑ SCC Anthony Ramos ® IND ❑Com retired 10/9/19 873 AtlantaCt ❑ OTH $100 $100 Claremont, CA 91711 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ $450 "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 C Amounts may be rounded SCHEDULE C Nonmonetary Contributions Received co w1101e oouars. Statement covers period o _ h from 09/22/2019 Page 7 of 8 through 10/19/2019 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Yes! For Claremont -- The Committee to Support Measure CR 1419897 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR 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 COMMITTEE, NAME OF BUSINESS) (JAN 1 - DEC 31) J❑ IND Laura Roach Consultant food and drink for 10/6/19 310 W. Radcliffe Drive ❑ OTH Laura Roach (self) campaign event $27 $249 Claremont, CA 91711 ❑ 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 $ 27 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.).....................TOTAL $ 27 19 46 "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 SEE INSTRUCTIONS ON REVERSE Yes! For Claremont -- The Committee to Support Measure CR Amounts may be rounded to whole dollars. Statement covers period from 09/22/2019 through 10/19/2019 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE E Page 8 of 8 I.D. NUMBER 1419897 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 PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Printing Works 679 E Foothill Blvd LIT $132 Pomona, CA 91767 Whalen Bindery 515 W Allen Ave #3 LIT $2155 San Dimas, CA 91773 Vista Print 275 Wyman Street LIT $166 Waltham, MA 02451 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2453 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 2453 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 166 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 $ 2619 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov