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Home My Public Portal About02. Form 460 (July 1, 2021 - Dec. 31, 2021)Recipient Committee Campaign Statement Cover Page Statement covers period from 07/01/2021 SEE INSTRUCTIONS ON REVERSE through 12/3112021 1.. Type Of Recipient Committee:. All Committees—Complete Parts 1, 2, 3, and 4. I� Officeholder, Candidate Controlled Committee ❑ Primarily Formedbaflot Measure 0 State Candidate Election Committee Committee O Recall O Controlled (AkoCaepflePart 6) 0 Sponsored (AkeCoWlete Part 6) ❑ General Purpose Committee, O Sponsored ❑ Primarily Formed Candidate! O Small Contributor Committee Officeholder Committee - O 'Political Party/Central Committee JAI. Gr�.P6Part 7) 3. Committee information I.D. 1, COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Jennifer Stark for Claremont City Council 2022 STREET ADDRESS (NO P.O. BOX) 242 Eagle Grove Avenue CITY STATE ZIP'CODE AREACODEIPHONE Claremont CA 91711 909-913-2580 MAILING ADDRESS (IF DIFFERENT) NO. AND°STREET OR P.O. BOX CITY STATE ' ' ZIPtCODE _ AREA CODEIPHONE COVER PAGE Date Stamp 9 - .i RECEIVE Date of election if applicable: Page 1 of 5 (Month, Day, Year} JAN 18 2022 For of trial Use Only 1:1/.08/2022 CITY CLERK I RE TY OF CLAIIAO T 2. Type of Statement: Preelection Statement ❑ Quarterly Statement V 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 ADDRESS 1420 N Claremont Blvd; Ste 204C CITY STATE ZIPCODE AREACODE/PHONE Claremont. CA 91711 909-541-0713 NAME OFASSISTANTTREASURER. IFANY MAILING ADDRESS CITY STATE ZIPCODE AREACODEIPHONE OPTIONAL: FAX/E-MAILADDRESS OPTIONAL: FAX I E-MAIL ADDRESS simon@claremontcraftales.com 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the st o y knowledg the in ormation contained herein and in the attached schedules is true and complete. I certify under penalty ofperjury under the laws•of the :State of California that#heforegoing is ue anCcorrect. Executed on t / By Date ignatur iT asurerorAssistan re rer' Executed on - to B nature of Controlli Officeholder Ca idat , State Measure Proponent or Respo i te'Officer: of Sponsor Executed on BY Date Executed on BY 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 Con -i riii+ee 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 RESIDENTIAUBUSINESS 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 yourcandidacy. CITY STATE 'ZIP'CODE AREACODElPHONE COVER PAGE - PART 2 Page 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT_ MEASURE' BALLOT NO-OR.LETTER JURISUICTIUN ❑ SUPPORT ❑ OPPOSE identify the controlling officeholder, candidate, or statemeasure proponent, if any.. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT' IF ANY 7. Primarily Formed.. Candidatd/Officeholder Committee Listnames of ofrrceholder(s) orcandidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER.OR CANDIDATE OFFICE SOUGHT OR HELD I] SUPPORT E 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 Q .SUPPORT El 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 Disclosure lncglro #atcncr�o!?t Amounts may be rounded to whole dollars. Summary Page SEE INSTRUCTIONS ON REVERSE PAGE Statement covers period from 07/01/2021 through 12/31/2021 I Page 3 of 5 NAME OF FILER W. NUN{#5CK Jennifer Stark for Claremont City Council 2022 1424487 Contributions Bever. ed 1. Monetary Contributions................................................... Schedule A, Line 2. Loans Received................................................................ Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 4. Nonmonetary Contributions.. .......................................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED.................................:..Add Lines 3+4 Column A TOTAL THSS PER;00 (FROM ATTACHED SCHEDULES) $ 250.00 0 c 250.00 $ 0 250.00 Expenditures Made Amounts in this section may be different from amounts amounts from Column B 6. Payments Made ................................................... schedule E. Line 4 $ 95.39 7. Loans Made .................................... ...................... . schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7 $ 95.39 previous period amounts. If 9. Accrued Expenses (Unpaid Bills).. ........................................ Schedule F Line 0' 10. Nonmonetary Adjustment. ................ .......... ...... . Schedule c, Line 3 0 11. TOTAL EXPENDITURES MADE. ...................... ...... Add Lines a+g+lo $ 95.39 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 1927.54 13. Cash Receipts .. Column A, Line 3 above 250.00 14. Miscellaneous Increases to Cash ..... Schedule /, Line 4 0 15. Cash Payments ................................................. Column A. Line 8 above 95.39 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 20$2.15 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 Equivalent ................................................ See instructions on reverse $ 0 Equivalents 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 Column B CALENDAR YEAR TOTAL TO DATE $ 250.00 0 $ 250,00 0 $ 250.00 95.39 0 $ 95.39 0 $ 95.39 To calculate Column B, add amounts in Column 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/ddlyy) Ato the corresponding Amounts in this section may be different from amounts amounts from Column B reported in Column B. of your last report. Some amounts in Column Amay 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). FPPC Form 460 (!an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Receivedto whole dollars. Statement covers period ®' otl` 07/01/2021 from through 12/31/2021 Page 4 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.O. NUMBER Jennifer Stark for Claremont City Council 2022 1424487 DATE NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR FULL NA 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 * OF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) II IND 11/16/21 Laura Roach ❑COM Managing Partner 250.00 250.00 310 W. Radcliffe Dr. ❑ OTH Lunghi Media. Group Claremont, CA 91711 ❑ PTY ❑ SCC IND E Com ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SGC ❑ IND ❑ COM ❑ OTH ❑ PTY El SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 250.00 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 $ 250.00 0 250.00 "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 �t �,�unts Sle t;, .P -'.mo may be rounded Statement covers period SCHEDULE E 0 - N 1` Payments Made to whole dollars. from 07/01/2021 0 -`� _ - • through 12/31/2021 page 5 of 5 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER Jennifer Stark for Claremont City Council 2022 1424487 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions SAL campaign workers' salaries CTB contribution (explain nonmonetary)" OFC PET office expenses petition circulating TEL t.v. or cable airtime and production costs CVC civic donations 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 TSF transfer between committees of the same candidate/sponsor IND independent expenditure supporting/opposing others (explain)' POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) VOT voter registration WEB information technology costs (intemet, e-mail) LIT campaign literature and mailings PRT print ads NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID " Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary SUBTOTAL $ 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 $ 95.39 95.39 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov