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CA Form 460 Recipient Committee Preelection Campaign Statement No. 1 - Susan Brooks - Amendment No. 1 COVER PAGE Recipient Committee Type orrint in ink. Date Stamp P CALIFORNIA 460 Campaign Statement RECEIVED FORM Cover Page (Government Code Sections 84200-84216.5) CITY t RANCHO PALOS VER M / Statement covers period Date of election if applicable: Page of July 1, 2015 (Month, Day, Year) FEB 0 1 2016 For Official Use Only from SEE INSTRUCTIONS ON REVERSE September 19, 2015 November 3, 2Q15 _., through fI Y CLERK'S OFFICE ..... 1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement: ® Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure [ "Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report 0 Recall 0 Controlled Termination Statement (Also Complete Part 5) El Termination Supplemental Preelection 0 Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 (Also Complete Part 6) ❑ General Purpose Committee Q� Amendment(Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ Revise Schedule A(add names identified with an 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) asterisk), Schedule E (Unitemized pymts) and Summary Page. 3. Committee Information I 1 378646 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 i 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 containesd herein and in the attached schedules is true and complete. I certify under penalty of perjury unde the laws of the State of California that the foregoing is true and, )-- i • Executed on By "" Date . ature of Controlling Officeholder,Candidate,State Measure Propo n IR6Sponsible 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 CALIFORNIA 460 Campaign Statement FORM Cover Page— Part 2 " 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 ❑ SUPPORT Rancho Palos Verdes City Council [1] 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. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ 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 ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD El YES ❑ NO ❑ SUPPORT ❑ 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 Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period CALIFORNIA 4.60 Summary Page to whole dollars. July 1, 2015 FORM from September 19, 2015 Page 3 of cSEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Susan Brooks for Rancho Palos Verdes City Council 2015 1378646 , Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and 20,735 20,735 General Elections 1. Monetary Contributions Schedule A.Line 3 $ $ 5,000 5,000 1/1 through 6/30 7/1 to Date 2. Loans Received Schedule a Line 3 25,735 25,735 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ $ 0 0 Received $ $ 4. Nonmonetary Contributions Schedule C.Line 3 21. Expenditures 25,735 25,735 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ $ Made $ $ ....... ...... Expenditures Made Expenditure Limit Summary for State 3,107 3,107 6. Payments Made Schedule E.Line 4 $ $ Candidates 0 0 7. Loans Made Schedule H,Line 3 3,107 3,107 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ $ (If Subject to Voluntary Expenditure Limit) 0 0 9. Accrued Expenses (Unpaid Bills) Schedule F,Line 3 Date of Election Total to Date 0 0 (mm/dd/yy) 10. Nonmonetary Adjustment Schedule C.Line 3 3,107 3,107 11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ $ J I $ Current Cash Statement / / $ 0 12. Beginning Cash Balance Previous Summary Page,Line 16 $ To calculate Column B,add 25,735 13. Cash Receipts Column A,Line 3 above amounts in Column A to the 0 corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash Schedule I,Line 4 from Column B of your last reported in Column B. 3,107 report. Some amounts in 15. Cash Payments Column A,Line 8 above 22,628 Column A may be negative 16. ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $ figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 0 for this calendar year, only 17. LOAN GUARANTEES RECEIVED Schedule B,Part 2 $ carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9(if 0 any). 18. Cash Equivalents See instructions on reverse $ 0 19. Outstanding Debts Add Line 2+Line 9 in Column B above $ FPPC Form 460(January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A Type or print in ink. _ SCHEDULE A Amounts may be rounded period Monetary Contributions Received to whole dollars. Statement covers pCALIFORNIA 460 from July 1, 2015 FORM September 19, 2015 .r1 / SEE INSTRUCTIONS ON REVERSE through Page ' of NAME OF FILER I.D. NUMBER Susan Brooks for Rancho Palos Verdes City Council 2015 1378646 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR 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 I.D.NUMBER) CODE (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Jerome Unatin Trust piIND Doctor 7/18/15 , Torrance, CA 90505 ❑coM South BayOrthopaedic 990 990 990 ❑OTH p ❑PTY Specialists Medical ❑SCC Center Denny Schneider 2IND Retired 7/24/15 LA, Ca 90045 ❑coM 200 200 200 ❑OTH ❑PTY ❑SCC Stephanie Kennedy ®IND Housewife 7/29/15 RPV, CA 90275 111coM 999 999 999 ❑OTH ❑PTY ❑SCC Richard Anchan WIND Retired 7/31/15 RPV, CA 90275 ❑coM 150 150 150 ❑OTH ❑PTY ❑SCC Yoko Sugi BIND Retired 8/3/15 RPV, CA 90275 ❑coM 100 100 100 ❑OTH ❑PTY ❑SCC SUBTOTAL$ 2,439 Schedule A Summary *Contributor Codes 1. Amount received this period—itemized monetary contributions. IND-Individual 18,329 COM-Recipient Committee (Include all Schedule A subtotals.) $ (other than PTY or SCC) 2,406 OTH-Other(e.g., business entity) 2. Amount received this period—unitemized monetary contributions of less than$100 $ PTY-Political Party 3. Total monetary contributions received this period. SCC-Small Contributor Committee 20,735 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ 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 to whole dollars. CALIFORNIA 460 July 1, 2015 FORM from September 19, 2015 - ,-- through Page of (e, NAME OF FILER I.D.NUMBER Susan Brooks for Rancho Palos Verdes City Council 2015 1378646 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATECONTRIBUTOR 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) OF BUSINESS) Frances Stammreich ®IND Retired 8/28/15 , RPV CA 90275 ❑CoM 500 500 500 ❑OTH ❑PTY ❑SCC Mary Lou Xenos ®IND Teacher 8/31/15 RPV CA 90275 ❑COM Torrance Unified School 150 150 150 ❑OTH District ❑PTY ❑SCC John Carlson* ®IND Consultant 8/25/15 Hermosa Beach, CA 90254 ❑CoM Carlson &Associates 100 100 100 ❑OTH ❑PTY ❑SCC Kelvin Vanderlip* IND Computer Systems Adm. 100 8/26/15 RPV, CA 90275 ❑COM Sunrider 100 100 ❑ OTH ❑PTY ❑SCC Thomas Florio* IND Retired 9/3/15 , Southport, NC 28661 ❑COM 100 100 100 ❑OTH ❑PTY ❑SCC SUBTOTAL$ 950 *Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH—Other(e.g.,business entity) PTY—Political Party FPPC Form 460(January/05) SCC—Small Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Type or print in ink. SCHEDULE E Schedule E Statement covers period CALIFORNIA Amounts may be rounded CALIF O Payments Made to whole dollars. July 1, 2015 FORM from aeptember 19, 201! 19 SEE INSTRUCTIONS ON REVERSE through Page of (.,0 NAME OF FILER I.D. NUMBER Susan Brooks for Rancho Palos Verdes City Council 2015 1378646 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,ALSOENTER I .NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Campaign LA, , Gardena CA 90248 POS Mailing Services 1,025 Clix Portrait Studios- South Bay, Torrance CMP Portraits 137 CA 90505 Campaign LA, , Gardena CA 90248 CMP Signs 1,208 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2,370 Schedule E Summary 2,970 1. Itemized payments made this period. (Include all Schedule E subtotals.) $ 137 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).) $ 3,107 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)