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HomeMy Public PortalAboutForm 460 (January 1 - October 19, 2019)COVER PAGE Recipient Committee Date Stamp Campaign StatementC� ® s Cover Page ` Statement covers period from January 1, 2019 SEE INSTRUCTIONS ON REVERSE I through October 11, 2019 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 ® Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee InformationI I.D. NUMBER 1421389 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) No on Measure CR STREET ADDRESS (NO P.O. BOX) 1495 Via Zurita St. CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 310-849-0168 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ E-MAIL ADDRESS Date of election if applicable (Month, Day, Year) November 5, 2019 OCT 2 3 2019 Page of _- For Official Use Only MY CLERK CITY OF CLAREW NT ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Aundr6Johnson MAILING ADDRESS 1686 Sumner Ave. CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 310-849-0168 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/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 ofperjuryunder the laws of the State of California that the foregoing is true and co t. Executed on L r 2t -0l 01 BY U,-- Date Si ature of Treasurer or Assistant Treasurer Executed on / U )LV/ By—— Date Sig ature trolling Offic r, Candidate, 'State ] Measure Proponent or Responsible Officer of Sponsor Executed on � +_ 1 la 0 I � By � M 1--�--PAW # A `�' v D to / I Si neture of Controlling Officeholder, Candidate, State Measure Proponent Executed on Date By FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fnnc_ca.Pnv 1 2. Type of Statement: 0 Preelection Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Aundr6Johnson MAILING ADDRESS 1686 Sumner Ave. CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 310-849-0168 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/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 ofperjuryunder the laws of the State of California that the foregoing is true and co t. Executed on L r 2t -0l 01 BY U,-- Date Si ature of Treasurer or Assistant Treasurer Executed on / U )LV/ By—— Date Sig ature trolling Offic r, Candidate, 'State ] Measure Proponent or Responsible Officer of Sponsor Executed on � +_ 1 la 0 I � By � M 1--�--PAW # A `�' v D to / I Si neture of Controlling Officeholder, Candidate, State Measure Proponent Executed on Date By FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fnnc_ca.Pnv Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL/BUSINESS 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.D. NUMBER NAME OF TREASURERI CONTROLLED COMMII TEE'? ❑ YES ❑ NO COMMITTEE ADDRESS STREE I ADDRESS (Nu F.U. BUX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURERI CONTROLLED GOMMI I IEE'? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Measure CR BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT CR I Claremont W1 OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD I 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 SUMMARY PAGE Summa Page to whole dollars. Statement covers period 3 ® ` January 1, 2019 from through October 21, 2019 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER No on Measure CR 1421389 Column A Column B Calendar Year Summary for Candidates Contributions Received (FROM TOTAL THIS PERIOD ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 3067 3067 1. Monetary Contributions................................................... schedule A, Line 3 $ $ 1/1 through 6/30 7/1 to Date 0 0 2. Loans Received................................................................ Schedule e, Line 3 3067 3067 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ Received $ $ 70 70 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 3137 3137 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3 + 4 $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ Schedule E, Line 4 $ 1618 $ 1618 Candidates 7. Loans Made....................................................................... Schedule H, Line 3 0 0 1618 1618 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ $ (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 960 960 Date of Election Total to Date 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 70 70 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 $ 2648 $ 2648 $ $ Current Cash Statements 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above 3067 add amounts in Column 0 A to the corresponding *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash .................................. Schedule /, Line 4 amounts from Column B reported in Column B. 15. Cash Payments......................................................... Column A, Line 8 above 1618 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 1449 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 a, Part 2 $ 0 filed for this calendar year, ................................ only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if o y)' 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line s in Column a above $ 960 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 dollars. Monetary Contributions Received Statement covers period © . January 1, 2019,.._ from ®- October A7'. 2019 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER No on Measure CR 1421389 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR [FAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Devan Anderson � IND El COM JCtI �S 300 300 10/8/2019 702 Via Santo Tomas ❑ OTH Claremont, CA 91711 ❑ PTY ❑ SCC Lowe ®IND .�Lr 10/14/2019 Donna 1495 Via Zurita St ❑ COM ❑ OTH 200 200 Claremont, CA 91711 ❑!PTY, pG�e)�� ❑ SCC rise-) ® IND 10/9/2019 James Belna ❑ COM Dep. District Attorney 100 100 1402 Lafayette Rd ❑ OTH Los Angeles County Claremont, CA 91711 ❑ PTY ❑ SCC W1 IND 9/21/2019 Brian Adams 417 SalisburyLane El COM ❑ OTH Owner Adams & Hart 120 120 Claremont, CA 91711 ❑ PTY Investigations Inc. ❑ SCC 10/12/2019 Michael Conkey (� a 1,{gi'1(►'z� +'1 �� 0 IND El COM ❑ OTH Controller Air -Tec 250 250 C j a ►ern ? CIA �! l 3-11 ❑❑ IPTY SUBTOTAL$ 970 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.)....... $ 2370 $ 697 TOTAL $ 3067 "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 ® . January 1, 2019 from J �"�, �, 0 through October q, 2019 Page of NAME OF FILER I.D. NUMBER No on Measure CR 1421389 DATE FULL NAME, STREETADDRESSAND 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) IND Jay Pocock® ❑ COM Owner 9/29/19 489 W 6th St ❑ OTH Superior Trailer Works 550 550 Claremont CA 91711 ❑ PTY ❑ SCC 9/29/19 Matthew Magilke; ® IND El COM ����� r 120 120 < 1 6� (( 5 i ❑ OTH ci aro-M L'�'lcj C/9 oscc MLKgnneti Ca1l� Martha Voegeli ® IND E❑ CO & Sr. Consultant, Principal 10/18/189 1424 Lafayette Rd Vice President 730 730 Claremont CA 91711 ❑ PTY Marts & Lundy ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 1400 '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 B - PART 1 Schedule B — Part 1 to whole dollars. Statement covers period Loans Received January 1, 2019 from October 11, 2019 SEE INSTRUCTIONS ON REVERSE through page of NAME OF FILER I.D. NUMBER No on Measure CR 1421389 FULL NAME, STREET ADDRESS AND ZIP CODE AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT (o) AMOUNT PAID OUTSTANDING e REST INTEREST ORIGINAL 9 CUMULATIVE OF LENDER OCIF CUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THISOR 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 CALENDAR YEAR ❑ FORGIVEN PER ELECTION** RATE DATE DUE DATE INCURRED T ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR $ $ % $ $ ❑ FORGIVEN PER ELECTION** RATE DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION** RATE DATE DUE DATE INCURRED T ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ $ $ $ Schedule B Summary 1. Loans received this period ................................................... (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ 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. (May be a negative number) 'Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. (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 C Amounts may be rounded SCHEDULE C "' WflVgW UV101J. Nonmonetary Contributions Received Statement covers period p { from January 1, 2019 through October 'I.q , 2019 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER No on Measure CR 1421389 DATE FULL NAME, STREETADDRESSAND CONTRIBUTOR IFAN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER (IF 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 ❑ 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 $ 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 $ 70 TOTAL $ 70 *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 SCHEDULE D Summary of Expenditures Amounts may be rounded Statement covers period41 to whole dollars Supporting/Opposing Other . from January 1, 2019 Candidates, Measures and Committees October Iq 2019 through page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER No on Measure CR 1421389 CUMULATIVE TO DATE PER ELECTION DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OR COMMITTEE ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 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 No on Measure CR SCHEDULE E Amounts may be rounded Statement covers period to whole dollars. from January 1, 2019 ®j® through October iq , 2019 Page of CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1421389 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 The Final Say Printing 2011 E. Gladstone St #B CMP 550 Glendora CA 917451 Just Yard Signs 4880 Al, Distribution Court CMP 708 Orlando FL 32822 228 Interactive 1600 Campus Rd CMP 170 Los Angeles CA 90041 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,428 Schedule E Summary 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 $ 1,428 190 0 1618 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FILER No on Measure CR Amounts may be rounded to whole dollars. SCHEDULE F Statement covers period I from January 1, 2019 , ® _0 through October j 2019 Page of I.D. NUMBER 1421389 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 SUBTOTALS $ 0 $ 960 $ 0 $ 960 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 960 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 0 accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................... PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 960 onthe Summary Page, Column A, Line 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 ( ( (c) ( NAME AND ADDRESS OF CREDITOR CODE OR OUTSTAA NDING AMOUNT INNCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD The Claremont Courier LIT 114 Olive St 0 230 0 230 Claremont CA 91711 Printing Works, Inc CMP 679 E Foothill Blvd 0 730 0 730 Pomona CA 91767 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0 $ 960 $ 0 $ 960 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 960 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 0 accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................... PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 960 onthe Summary Page, Column A, Line 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 SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period d ® ' k to whole dollars. January 1, 2019 Contractor (on Behalf of This Committee) from ry NAMEAND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) 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 October (q, 2019 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER No on Measure CR 1421389 NAME OF AGENT OR INDEPENDENT CONTRACTOR N/A 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. NAMEAND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) 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* from January 1, 2019 Y October 2019 SEE INSTRUCTIONS ON REVERSE , through Page of NAME OF FILER I.D. NUMBER No on Measure CR 1421389 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER (a) OUTSTANDING (b) AMOUNT (c) REPAYMENT OR (d) OUTSTANDING (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF RECIPIENT OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCEBALANCE BEGINNING THIS LOANED THIS FORGIVENESSRECEIVED AT CLOSE OF THIS AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD LOAN TO DATE ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION** RATE DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION** RATE 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 $ $ $ $ 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.) 3. Net change this period. (Subtract Line 2 from Line 1.) ..................... (Enter the net here and on the Summary Page, Column A, Line 7.) (Enter (e) on Schedule I, Line 3) �j ..If Required $ 0 NET $ 0 (May be a negative number) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Srthociii1p I 11— — A.A SCHEDULE I Miscellaneous Increases to Cash to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from January 1, 2019 through October ��., 2019 ® - Page of NAME OF FILER No on Measure CR I.D. NUMBER 1421389 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH 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 0 0 0 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov