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Home My Public Portal About03. Form 460 (Jan 1, 2022-Jun 30, 2022) COVER PAGE Recipient Committee Date Stamp Campaign Statement CALIFORNIA 460 Cover Page RECEIVE Pam 1 of 5 Statement covers period Date of election if applicable: 01/01/2022 (Month,Day,Year) JUL 1 8 2022 For Official Use Only from 0 SEE INSTRUCTIONS ON REVERSE through 06/30/2022 11/08/2022 CITY CLERK 1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement TY OF CLARCMO 4T RI Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement O State Candidate Election Committee Committee ® Semi-annual Statement ❑ Special Odd-Year Report Q Recall 0 Controlled ❑ Termination Statement (Also Complete Parts) 0 Sponsored (Also file a Form 410 Termination) (Also CosFlde Pat 6) ❑ General Purpose Committee ❑ Amendment(Explain below) O Sponsored ❑ Primarily Formed Candidate! O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also cash Pal D 3. Committee Information I.D.NUMBER Treasurer(s) 1424487 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Jennifer Stark for Claremont City Council 2022 Simon Brown MAILING ADDRESS 1420 N Claremont Blvd, Ste 204C STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE 242 Eagle Grove Avenue Claremont CA 91711 909-541-0713 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER.IF ANY Claremont CA 91711 909-913-2580 MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS 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 of m knowled the formation contained herein and in the attached schedules is true and complete. I certify under penalty of perj /ry under he taws of the State of Califomia that the foregoing true and correct. Executed on 9/' ze rZ- B I y Da��fn�/7' £ Asastant r urer iExecuted on l01� B Date ignature of Con ng date, tate asure Proponent or Responsible Officer of nsor Executed on Date By Signature of Controlling Officeholder,Candidate,Stale Measure Proponent 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 Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summary Page to whole dollars. Statement covers period CALIFORNIA 460 from 01/01/2022 FORM throw h 06/30/2022 page 3 of 5 SEE INSTRUCTIONS ON REVERSE g I.D.NUMBER NAME OF FILER Jennifer Stark for Claremont City Council 2022 1424487 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and 1000.00 1000.00 General Elections 1. Monetary Contributions Schedule A,Line 3 $ $ 0 0 ill through 6/30 7/1 to Date 2. Loans Received Schedule B,Line 3 1000.00 1000.00 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ $ Received $ S 4. Nonmonetary Contributions Schedule C,Line 3 0 0 21. Expenditures S 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ 1000.00 $ 1000.00 Made $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made Schedule E,Line 4 $ 129.90 $ 129.90 Candidates 7. Loans Made Schedule H,Line 3 0 0 129.90 129.90 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 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment Schedule C,Line 3 0 0 (mmtddlyy) 11. TOTAL EXPENDITURES MADE Add Lines 8+g+10 $ 129.90 $ 129.90 / / $ Current Cash Statement / / $ 12. Beginning Cash Balance Previous Summary Page,Line 16 $ 2082.15 To calculate Column B, 13. Cash Receipts Column A,Line 3 above 1000.00 add amounts in Column 0 A to the corresponding *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash Schedule I,Line 4 amounts from Column B reported in Column B. 15. Cash Payments Column A,tine a above 129.90 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE Add Lines 12+13+14.then subtract Line 15 $ 2952.25 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 Cash Equivalents and Outstanding Debts from Lines 2.7,and 9(if any). 18. Cash Equivalents See instructions on reverse $ 0 19. Outstanding Debts Add Line 2+Line 9 in Column B above $ 0 FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov 1 Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA 460 from 01/01/2022 FORM through 06/30/2022 Page 4 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Jennifer Stark for Claremont City Council 2022 1424487 ' FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR I IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE.ALSO ENTER IL.NUMBER) CODE (IF SELF-EMPLOYED.ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED) OF BUSINESS) Jil Stark 0 IND 01/15/2022 890 E. Harrison Ave,Apt. 28 El OTH retired 250.00 250.00 Pomona, CA 91767 ❑PTY ❑scc VI IND Phalana Tiller Director of Learning 02/21/2022 636 Wellesley Dr ❑OTH 250.00 250.00 Claremont, CA 91711 ❑PTY ClaremontGraduate ❑scc University V IND 06/28/2022 Janet Stark ❑COM Personal Assistant 250.00 250.00 725 Eucalyptus ❑OTH Linda Ronstadt Novato, CA 94947 ❑PTY ❑scc Jeffrey Fanfelle 0 IND 06/28/2022 725 Eucalyptus 0TH retired 250.00 250.00 Novato, CA 94947 ❑PTY El scc El IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 1000.00 Schedule A Summary *Contributor Codes 1. Amount received this period-itemized monetary contributions. INo-Individual $ 1000.00 COM—Recipient Committee (Include all Schedule A subtotals.) (other than PTY or SCC) 2. Amount received thisperiod-unitemized monetarycontributions of less than $100 $ 0 OTH-Other(e.g.,business entity) PTY-Political Party 3. Total monetary contributions received this period. SCC-Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ 1000.00 FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Amounts may be rounded Statement covers period — -- ---- to whole dollars. CALIFORNIA 460 Payments Made 01/01/2022 FORM from through 06/30/2022 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 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 i *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 0 Schedule E Summary I 0 1. Itemized payments made this period. (Include all Schedule E subtotals.) $- $ 129.90 2. Unitemized payments made this period of under$100 0 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 $ 129.90 FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov