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HomeMy Public PortalAboutForm 460 (Sept. 20 - Oct. 17, 2020)Recipient Committee Campaign Statement Cover Page Statement covers period from SEPTEMBER 20, 2020 SEE INSTRUCTIONS ON REVERSE I through OCTOBER 17, 2020 1. Type of Recipient Committee: All committees - Complete Farts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Compble Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored © Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also CompbtePad 7) 3. Committee Information I.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) ZACH COURSER FOR CLAREMONT CITY COUNCIL 2020 STREET ADDRESS (NO P.O. BOX) 1142 N CAMBRIDGE AV CITY STATE ZIP CODE AREA CODE/PHONE CLAREMONT CA 91711 617-901-8787 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ E-MAIL ADDRESS 4. Verification COVER PAGE N Date of election if applicable: OCT 2 12020 Page ( of 8 (Month, Day, Year) CITY CLERKFor Official Use Only NOVEMBER 3, 2020 C TY ®F CLAREMON 2. Type of Statement: m 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 LINDA A MOORE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CLAREMONT CA 91711 909-210-3704 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS 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 perjuryunder the laws of the State of California that the foregoin is tr nd correct. /f Executed on C " -I,i z a Z- By r (/ 9 DateSign ure of Trea urer(Assis nt I reasurer Executed on �O `� �o Z 0 By Date Signature of Controlling CV4Qeholaer, Candidate, Vdte MftsTre Proponent or Responsible Officer of Sponsor Executed on Date Executed on Date 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 ZACH COURSER OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CLAREMONT CITY COUNCIL RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 1142 N CAMBRIDGE AV CLAREMOI 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 S STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 8 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 Z SUPPORT ZACH COURSER CLAREMONT CITY CC ❑ 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 to whole dollars. Summary Page Statement covers period CALIFORNIA from SEPTEMBER 20, 2020 FORM • Current Cash Statement ' 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 5024 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above OCTOBER 17, 2020 Page 3 Of 8 SEE INSTRUCTIONS ON REVERSE Ato the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 amounts from Column B through 1878 of your last report. Someamounts in Column A may NAME OF FILER $ 4560 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. I.D. NUMBER ZACH COURSER FOR CLAREMONT CITY COUNCIL 2020 this is the first report being 17. LOAN GUARANTEES RECEIVED Schedule B, Part2 $ 1429606 ................................ only carry over the amounts from Lines 2, 7, and 9 (if Column A Column B any). Calendar Year Summary for Candidates Contributions Received 19. Outstanding Debts .............................. Add Line 2+Line gin Column B above TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ 1414 $ 11918 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule B, Line 3 1414 11918 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 1414 11918 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ Schedule E, Line 4 $ 1878 $ 7358 Candidates 7. Loans Made....................................................................... Schedule H, Line 3 1878 7358 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ $ (If Subject to Voluntary Expenditure Lim it) 9. Accrued Expenses (Unpaid Bills) ����������� ��� Schedule F, Line 3 2950 2950 Date of Election Total to Date 10. Non monetary Adjustment......................................................... Schedule C, Line 3 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+s+10 $ 4828 $ 10308 $ Current Cash Statement ' 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 5024 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above 1414 add amounts in Column Ato the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 amounts from Column B 15. Cash Payments......................................................... Column A, Line 8 above 1878 of your last report. Someamounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 4560 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, Part2 $ 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 instructionsonreverse $ 19. Outstanding Debts .............................. Add Line 2+Line gin Column B above $ 2950 I JJ $ *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 Srharllllp A Amounts may be rounded SCHEDULE A to whole aondrs. Monetary Contributions Received Statement covers period CALIFORNIA 460 from SEPTEMBER 20, 2020 . � through OCTOBER 17, 2020 Page 4 of 8 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER ZACH COURSER FOR CLAREMONT CITY COUNCIL 2020 1429606 FULL NAME, STREETADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 9/30/2020 JON SHIELDS Z IND PROFESSOR 250 250 250 ❑ COM 425 BOWLING GREEN DR ❑ OTH CLAREMONT MCKENNA CLAREMONT CA 91711 ❑ PTY COLLEGE ❑ SCC 10/5/2020 KATHERINE 14ASKINS Z IND HOMEMAKER 250 250 250 F1 COM 18201 BRIDGEPORT AV ❑ OTH CLAREMONT CA 91711 ❑ PTY ❑ SCC 10/7/2020 L JOHN NELSON ® IND ATTORNEY 100 100 100 El 49 SUTTON PL EAST ❑ OTH LEWIS BRISBOIS PALM DESERT CA 92211 ❑ PTY ❑ SCC 10/8/2020 GEORGEANN SPIVACK Z IND RETIRED 100 100 100 El COM 752 SANTA CLARA AV ❑ OTH CLAREMONT CA 91711 ❑ PTY ❑ SCC 10/11/2020 CHELINA ODBERT Z IND URBAN PLANNER 200 200 200 ❑ COM 403 W 12TH ST ❑ OTH KDI CLAREMONT CA 91711 ❑ PTY ❑ SCC SUBTOTAL $ 900.. . :. Schedule A Summary Amount received this period — itemized monetary contributions. 1050 (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.) 364 $ — *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 ....TOTAL $ 1414 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 A (CONT.) to whole dollars. Monetary Contributions Received p Statement covers periodrI.DNUMBER _ from SEPTEMBER 20, 2020through � OCTOBER 17, 2020 of 8 NAME OF FILER ZACH COURSER FOR CLAREMONT CITY COUNCIL 2020 1429606 FULL NAME, STREETADDRESS AND ZIP CODE OF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I. D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 10/11/2020 GLENN MIYA ® IND PHYSICIAN 50 250 250 El COM 2627 SAN ANDRES WY ❑ OTH KAISER PERMANENTE CLAREMONT CA 91711 ❑ PTY ❑ SCC 10/17/2020 PER DAHLIN ®IND CHILD CARE 100 100 100 El COM 421 W 7TH ST ❑ OTH CLAREMONT CA 91711 ❑ PTY CHILD CARE ❑ SCC T)ND nA M TNT ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC El IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY SCC SUBTOTAL $ 150111; F t `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 ZACH COURSER FOR CLAREMONT CITY COUNCIL 2020 Amounts may be rounded to whole dollars. SCHEDULEE Statement covers period CALIFORNIA I from SEPTEMBER 20, 2020 FORM through OCTOBER 17, 2020 Page 6 of 8 I.D. NUMBER 1429606 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 PAYEE CODE OR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT AMOUNT PAID MCDONNELL TECHNOLOGY SERVICES WEB 310 608 W 23RD ST UPLAND CA 91784 GOOGLE WEB 337 1600 AMPHITHEATRE PKWY MOUNTAIN VIEW CA 94043 FACEBOOK WEB 1 HACKER WY MENLO PARK CA 94025 Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary 204 SUBTOTAL $ 851 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.) ................... 1683 195 .... TOTAL $ 1878 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded SCHEDULE E (CONT.) Statement covers period (Continuation Sheet) to whole dollars.CALIFORNIA , • ' • - Payments Made from SEPTEMBER 20, 2020 SEE INSTRUCTIONS ON REVERSE through OCTOBER 17, 2020 page 7 of 8 NAME OF FILER I.D. NUMBER ZACH COURSER FOR CLAREMONT CITY COUNCIL 2020 1429606 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 PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID UNITED STATES POSTAL SERVICE 3355 N WHITE AV LA VERNE CA 91750 POS 832 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 832 FPPC Form 460 (Jan 2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEF Amounts may be rounded Schedule F Statement covers period CALIFORNIA� � ' to whole dollars. Accrued Expenses (Unpaid Bills) from SEPTEMBER 20, 2020 FORM through OCTOBER 17, 2020 8 8 SEE INSTRUCTIONS ON REVERSE Page of NAME OF FILER I.D. NUMBER ZACH COURSER FOR CLAREMONT CITY COUNCIL 2020 1429606 .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 (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNTINCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD A TO Z PRINTING COMPANY INC LIT 0 2950 0 2950 4330 VAN BUREN BLVD, RIVERSIDE CA 92502 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0 $ 2950 $ 0 $ 2950 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 2950 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 2950 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