CA Form 460 Recipient Committee Preelection Campaign Statement No. 2 - Susan Brooks - Amendment No. 1 COVER PAGE
Recipient Committee Type orprint in ink. Date Stamp
Campaign Statement CALIFORNIA 460
Cover Page RECEIVED FORM
(Government Code Sections 84200-84216.5) CITYPF RANCHO PALOS VE- e /
Statement covers period Date of election if applicable: Page of
September 20, 2015 (Month, Day,Year) DEC 08 2015 For Official Use Only
from
SEE INSTRUCTIONS ON REVERSE October 17, 2015 November 3, 2015
through CI-Y CLERK'S OFFIbE
1. Type of Recipient Committee: Ali Committees-Complete Parts 1,2,3,and 4. 2. Type of Statement:
2 Officeholder,Candidate Controlled Committee 0 Primarily Formed Ballot Measure 0 Preelection Statement ❑ Quarterly Statement
0 State Candidate Election Committee Committee 0 Semi-annual Statement ❑ Special Odd-Year Report
0 Recall 0 Controlled 0 Termination Statement ❑ Supplemental Preelection
(Also Complete Part 5) 0 Sponsored
(Also file a Form 410 Termination) Statement-Attach Form 495
(Also Complete Part s)
0 General Purpose Committee ® Amendment(Explain below)
0 Sponsored ❑ Primarily Formed Candidate/ Correction made to occupations of two donors on Schedule A
Small Contributor Committee Officeholder Committee
C I E."' )
Q Political Party/Central Committee jr�A�OcO"'plete P �/ „, ,i-
cA,,„,,,, faef a ' ye.
3. Committee Information I.1378646 Treasurer(s)
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
Ann Marinovich
Susan Brooks for Rancho Palos Verdes City Council 2015 MAILING ADDRESS
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Rancho Palos Verdes CA 90275
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
Rancho Palos Verdes CA 90275
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/E-MAIL ADDRESS 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 of perjury under the laws of the State of California that the foregoing is true and.• ,,
12/2/15
or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
State of California
Type or print in ink. COVER PAGE-PART 2
Recipient Committee RN
cAL.IFo iA 460
Campaign Statement FORM
Cover Page—Part 2 .
..X_
Page of
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
Susan Brooks
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION 0 SUPPORT
Rancho Palos Verdes City Council 0 OPPOSE
RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP
Rancho Palos Verdes CA 90275 Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT
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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate/Officeholder Committee List names of
officeholder(s)or candidate(s)for which this committee is primarily formed.
0 YES 0 NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
COMMITTEE NAME I.D. NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
12 SUPPORT
❑ OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 YES 0 NO 0 SUPPORT
0 OPPOSE
COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
State of California
Schedule A (Continuation Sheet) Typeprint in ink.
yp or SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
to whole dollars. CALIFORNIA 460
September 20, 2015 FORM
from
October 17, 20153 (f
through Page of
NAME OF FILER I.D.NUMBER
Susan Brooks for Rancho Palos Verdes City Council 2015 1378646
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
(IFSELF-EMPLOYED,ENTER NAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED)
OF BUSINESS)
Beverly Sacher Ea IND Retired
9/28/15 RPV CA 90275 ❑coM 100 100 100
❑OTH
0 PTY
0 SCC
Dave Emenhiser WIND Executive
9/30/15 , RPV CA 90275 ❑COM Community Partners 100 100 100
❑0TH
❑PTY
0 SCC
Jon Spain OIND Retired
9/25/15 RPV CA 90275 ❑COM 250 250 250
0OTH
❑PTY
0 SCC
Edward Piken, MD, Inc 0lND Doctor
10/9/15 Torrance CA 90505 ❑COM Self 100 100 100
❑0TH
❑PTY
0 SCC
Patrick Wilson iia IND Corp Executive
10/9/15 Rolling Hills CA 90274 ❑COM Fast Lane Transportation 250 250 250
❑OTH
0 PTY
❑SCC
SUBTOTAL$ 800
*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(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA
to whole dollars. 460
September 20, 2015
from FORM
October 17, 2015
through Page of
NAME OF FILER I.D.NUMBER
Susan Brooks for Rancho Palos Verdes City Council 2015 1378646
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
(IFSELF-EMPLOYED,ENTER NAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED)
OF BUSINESS)
12 IND
10/9/15 Gregory O'Brien ❑coM Mediator 150 150 150
RPV CA 90275 00TH ADR Services
❑PTY
❑SCC
OIND
10/9/15 Joan Ortolano ❑coM Retired 100 100 100
RPV CA 90275 00TH
0 PTY
❑SCC
01ND 1 500
10/9/15 Charlotte Ginsburg ❑CoM Homemaker 1,500 1,500
RPV, CA 90275 ❑0TH
0 PTY
❑SCC
ha IND 200
10/10/15 Carmen Estrada Schaye ❑CoM Realtor 200 200
Rolling Hills CA ❑OTH Coldwell Bankers
90274 ❑PTY
❑SCC
2IND
10/10/15 Darlene Markovic ❑COM Homemaker 200 200 200
Torrance, CA 90503 ❑OTH
❑PTY
❑SCC
SUBTOTAL$ 2,150
*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(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)