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HomeMy Public PortalAboutCASANOVA FOR CITY COUNCIL 2022 - FORM 460 - PREELECTION STATEMENT - 10/27/2022, Recipient Committee Campaign Statement Cover Page • (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from 09/25/2022 through 10/22/2022 Date of election if applicable: (Month, Day, Year) 11/08/2022 CI CIT TY OF LYNWOOD Y CLERKS OFFICr COVER PAGE For Official Use Only 1. Type of Recipient Committee: All committees- Complete Parts 1,2,3, and 4. ❑X Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part 5) Q Sponsored (Al so Complete Pan 6) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee Q Political Party/Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 2. Type of Statement: ❑X Preelection Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 3. Committee Information I.D. NUMBER 1444226 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Casanova for City Council 2022 STREET ADDRESS (NO P.O. BOX) 12501 Imperial Hwy. 200 CITY STATE ZIP CODE Norwalk CA 90650 AREA CODE/PHONE (213)489-4792 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS (213)489-4818 / dlgould@gouldorellana.com Treasurer(s) NAME OF TREASURER Jorge Casanova MAILING ADDRESS 11100 Elm Street CITY Lynwood STATE ZIP CODE CA 90222 AREA CODE/PHONE (310)930-2783 NAME OF ASSISTANT TREASURER, IF ANY David Gould MAILING ADDRESS 12501 Imperial Hwy. Ste. 200 CITY Norwalk STATE ZIP CODE CA 90650 AREA CODE/PHONE (213)489-4792 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 under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on _ . 2.3 702 Z Date Executed on _ D ch 2': '202. By Date Executed on Date Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent and in the attached schedules is true and complete. I certify Can fate Measure Proponent or Responsible Officer of Sponsor Signature of Controlling Officeholder, Candidate,State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Recipient Committee • Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE Jorge Casanova OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member Lynwood RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 11100 Elm Street Lynwood CA 90222 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you o 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 COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 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 List names 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 www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/2753772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. SUMMARY PAGE Statement covers period from 09/25/2022 through 10/22/2022 Casanova for City Council 2022 Contributions Received 1. Monetary Contributions Schedule A, Line 3 2. Loans Received Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2 4. Nonmonetary Contributions Schedule C, Line 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) 3,000.00 0.00 3,000.00 0.00 3,000.00 Column B CALENDAR YEAR TOTALTO DATE 36,800.00 0.00 36,800.00 0.00 36,800.00 CALIFORNIA 460 FORM Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contributions Received $ 21. Expenditures Made $ 1/1 through 6/30 7/1 to Date Expenditures Made 6. Payments Made Schedule E, Line 4 $ 7. Loans Made Schedule H, Line 3 8. SUBTOTALCASHPAYMENTS Add lines 6+7 $ 9. Accrued Expenses (Unpaid Bills) Schedule F, Linea 10. Nonmonetary Adjustment Schedule C, Line 3 11. TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10 $ 10,160.30 $ 0.00 14,572.30 2,000.00 10,160.30 $ 16,572.30 4,495.00 0.00 4,495.00 0.00 14,655.30 $ 21,067.30 Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 13. Cash Receipts Column A, Line 3 above 14. Miscellaneous Increases to Cash Schedule 1, Line 4 15. Cash Payments Column A, Line 8 above 16. ENDING CASH BALANCE Add Lines 12+ 13+ 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. $ 27,388.00 3,000.00 0.00 10,160.30 20,227.70 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents 19. Outstanding Debts www.netfile.com See instructions on reverse Add Line 2 +Line 9 in Column B above 2,000.00 4,495.00 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) $ Total to Date `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 wmouncs may oe rounaea Monetary Contributions Received to whole dollars. SEE INSTRUCTIONS ON REVERSE covers period from 09/25/2022 CALIFORNIA `FORM Page 460Statement 4 of 11 through 10/22/2022 NAME OF FILER Casanova for City Council 2022 I.D. NUMBER 1444226 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IFCOMMHTEE,ALSO ENTERI.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IFSELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVETO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 10/11/2022 Arnold Glasman 13181 Crossroads Pkwy. North Suite 400 West Tower Industry, CA 91746 ©IN0 Attorney Alvarez -Glassman & Colvin 3,000.00 Received through intermediary: eeundraising Connections 2831 c Street Ste. 120 Sacramento, CA 95814 3,000.00 G2022 $3,000.00 •COM • OTH • pr( • SCC • IND ■ COM ❑ OTH ❑ PTY • SCC • IND ■ COM • OTH • PTY • SCC • IND ❑COM ❑ OTH ❑ PTY ■ SCC ■ IND ■ COM • OTH III PTY ■ SCC SUBTOTAL$ 3,000.00 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 $ SCHEDULE A www.netfile.com 3,000.00 0.00 3,000.00 *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 Schedule D SCHEDULE D Jummary OT txpenanures Su OTtln �� osin Other Amounts maybe rounded PP g PP g to whole dollars. Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE statement covers period from 09/25/2022 CALIFORNIA FORM Page . 460 through 10/22/2022 5 of 11 NAME OF FILER Casanova for City Council 2022 I.D. NUMBER 1444226 • DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, COMMITTEE TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (, . _DEC. 31) (JAN.1 PER ELECTION TO DATE (IF REQUIRED) 09/27/2022 Luis Navas City Council Member City of Norwalk 2,500.00 7,500.00 © Monetary Contribution • Nonmonetary Contribution Independent Expenditure El Support • Oppose 10/07/2022 Gabriela Camacho City Council Member Lynwood 1,500.00 2,998.33 © Monetary Contribution • Nonmonetary _Contribution • independent Expenditure E1 Support • Oppose 10/12/2022 Luis Navas - City Council Member City of Norwalk - 5,000.00 - 7,500.00 © Monetary Contribution 0 Nonmonetary Contribution • Independent Expenditure ES Support • Oppose SUBTOTAL $ 9,000.00 ' Schedule D Summary 1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) 2. Unitemized contributions and independent expenditures made this period of under $100 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $ www.netfile.com 14,495.00 0.00 14,495.00 FPPC Form 460 (Jan12016) FPPC Advice: advice©fppc.ca.gov (866/275.3772) www.fppc.ca.gov Schedule D (Continuation Sheet) SCHEDULE D (CONT.) Summary of Expenditures Amounts may be rounded to whole dollars. Supporting/Opposing Other Candidates, Measures and Committees Statement covers period from 09/25/2022 — _. CALIFORNIA /1 CO FORM �1 V Page 6 of 11 through 10/22/2022 NAME OF FILER Casanova for City Council 2022 ID. NUMBER 1444226 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN.1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 10/18/2022 Blanca Pacheco State Assembly Person Assembly District District 64 1,000.00 1,000.00 © Monetary Contribution • Nonmonetary Contribution • Independent Expenditure © Support • Oppose 10/20/2022 Gabriela Camacho Council Member Lynwood IN KIND DONATION MAILER 1,498.33 2,998.33 •City Monetary Contribution © Nonmonetary Contribution • Independent Expenditure Q Support • Oppose 10/20/2022 Marisela Santana City Council Member City of Lynwood IN KIND DONATION Mailer 1,498.33 1,498.33 Monetary Contribution Ip Nonmonetary Contribution • Independent Expenditure © Support • Oppose 10/20/2022 Jose Solache City Council Member City of Lynwood IN KIND DONATION Mailer 1,498.34 1,498.34 Monetary Contribution Li Nonmonetary Contribution • Independent Expenditure © Support • Oppose SUBTOTAL $ 5,495.00 www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Statement covers period from 09/25/2022 through 10/22/2022 Casanova for City Council 2022 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP CNS CTB CVC FIL FND LEG UT campaign paraphemalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings MBR MTG OFC PET PHO POL POS PRO PRr member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB SCHEDULE E radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IFCOMMITTEE.ALSOENTERIA.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Luis Navas for City Council 2022 (ID# 1449779) 12501 Imperial Hwy. Ste. 200 Norwalk, CA 90650 CTB 2,500.00 Gabriela Camacho for Lynwood City Council 2022 (ID# 1452266) 12501 Imperial Hwy. Ste. 200 Norwalk, CA 90650 CTB 1,500.00 Luis Navas for City Council 2022 (ID# 1449779) 12501 Imperial Hwy. Ste. 200 Norwalk, CA 90650 CTB 5,000.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 9,000.00 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 $ www.netfile.com 10,135.30 25.00 0.00 10,160.30 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) . Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Statement covers period from 09/25/2022 through 10/22/2022 Casanova for City Council 2022 SCHEDULE E (CONT.) CODES: If one of the following codes accurately describes the p CivP campaign paraphernalia/misc. INS campaign consultants CTB contribution (explain nonmonetary)' CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)` LEG legal defense LIT campaign literature and mailings NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER ID. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID eFundraising Connections 2831 G Street Ste. 120 Sacramento, CA 95814 CMP Credit Card Processing Fee 135.30 Blanca Pacheco for Assembly 2022 (ID# 1443511) 249 E. Ocean Blvd., Ste. 670 Long Beach, CA 90802 CTB 1,000.00 MBR MTG OFC PET PHO POL POS PRO FRT ayment, you may enter the code. Otherwise, describe the payment. member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (Internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,135.30 www.netfile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) www.fppc.ca.gov SCHEDULE F Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Statement covers period from 09/25/2022 through 10/22/2022 Casanova for City Council 2022 CODES: If one of the following codes accurately describes the OVP campaign paraphernalia/misc. CAS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)' LEG legal defense LIT campaign literature and mailings NAME AND ADDRESS OF CREDITOR (IF COMMITTEE. ALSO ENTER I. U. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) BALANCE LANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON 0) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD Valencia Marketing 13104 E. Philadelphia Street 0207 Whittier, CA 90601 LIT 0.00 4,495.00 0.00 4,495.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. MBR MTG OFC FEr PHO POL POS PRO PRf payment, you may enter the code. Otherwise, describe the payment. member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) SUBTOTALS$ 0.00$ 4,495.00$ 0.00$ 4,495.00 Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 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 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 on the Summary Page, Column A, Line 9.) 4,495.00 0.00 NET $ 4,495.00 May be a negative number www.netfile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) www.fppc.ca.gov , Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Statement covers period from 09/25/2022 through 10/22/2022 Casanova for City Council 2022 NAME OF AGENT OR INDEPENDENT CONTRACTOR Valencia Marketing SCHEDULE CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CRS CTB CVC FlL FND ND LEG LfT campaign paraphemalia/misc. campaign consultants contribution (explain nonmonetary)• civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)' legal defense campaign literature and mailings MBR MTG OFC FET R10 POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE ORCREDROR (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID U.S. Postmaster 7101 S. Central Ave. Los Angeles, CA 90001 POS 3,038.00 RAD RFD SAL TEL 1RC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (intemet, e-mail) Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 3,038.00 • Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule H Loans Made to Others* Amounts may ofe arros. to whole dollars. SEE INSTRUCTIONS ON REVERSE SCHEDULE H from through Statement covers period 09/25/2022 CALIFORNIA (wy FORM •6U 10/22/2022 Page 11 of 11 NAME OF FILER Casanova for City Council 2022 I.D. NUMBER 1444226 FULL NAME, STREET ADDRESS AND ZIP CODE OF RECIPIENT (IF COMMITTEE, ALSO ENTER I.D. NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) OUTSTANDING BALANCE BEGINNING THIS PERIOD AMOUNT LOANED THIS PERIOD REPAYMENT OR FORGIVENESS THIS PERIOD` (� OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD (e) INTEREST RECEIVED (0 ORIGINAL AMOUNT OF LOAN (s) CUMULATIVE LOANS TO DATE Lynwood Families for Progress (ID# 1399406) 12501 Imperial Hwy. Ste. 200 Norwalk, CA 90650 $ 2,000.00 g 0.00 0 PAID $ 0.00 $ 2,000.00 g % $ 2,000.00 CALENDAR YEAR $ 2,000.00 FORGIVEN g 0.00 01/01/0001 ROTE 0.00 05/11/2022 PERELECTION"* g DATE DUE DATE INCURRED S $ PAID $ $ $ % RATE PERELECTIONn $ CALENDAR YEAR $ I:FORGNEN $ $ 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 $ 0.00 $ 0.00 $ 2,000.00 $ 0.00 (Enter (e) on Schedule 1, Line 3) 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.) NET $ o. Do (May boa negative number) 0.00 (Enter the net here and on the Summary Page, Column A, Line 7.) www.netfile.com $ 0.00 elf Required FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov