CA Form 460 Recipient Committee Preelection Campaign Statement No. 1 - Eric Alegria COVER PAGE
Recipient Committee Date Stamp
Campaign Statement CALIFORNIA 460
FORM
Cover PageEG IV D
Statement coversP eriod Date of election if Erainior IANCHO PAWS VERS age of /�
Jan. 12017 (Month,Day,Year) For Official Use Only
,from SEP 2017
SEE INSTRUCTIONS ON REVERSE through Sept.23,2017 Nov. 7,2017 „,,,.„
1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. Z. Type of Staggg
CLEflK'&
® Officeholder,Candidate Controlled Committee 0 Primarily Formed Ballot Measure We Preelection Statement 0 Quarterly Statement
Q State Candidate Election Committee Committee 0 Semi-annual Statement
Q Recall 0 Controlled ❑ Special Odd-Year Report
(Also Complete Pan Pert s�5) 0 Sponsored ❑ Termination Statement
(Also�!e a Form 410 Termination)
(Also Complete
0 General Purpose Committee 0 Amendment(Explain below)
Q Sponsored 0 Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
Q Political Party/Central Committee falx Complete Pert 7)
3. Committee information I.D.NUMBER Treasurer(s)
1398463
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
Eric Alegria for RPV City Council 2017 Brianna Freiheit
MAILING ADDRESS
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Culver City CA 90232 (213)394-2925
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Culver City CA 90232 (213)394-2925
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
State Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent
Executed on Date By 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
COVER PAGE-PART 2
Recipient Committee CALIFORNIA 460
Campaign Statement FORM
Cover Page -- Part 2
Page 2 of
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
Eric Alegria (Candidate)
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑SUPPORT
City Councilmember-City of Rancho Palos Verdes (Office Sought) ❑OPPOSE
RESIDENTIAUBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP
Identify the controlling officeholder,candidate,or state measure proponent,if any.
Rancho Palos Verdes CA 90275
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
7. Primarily Formed Candidate/Officeholder Committee List names of
NAME OF TREASURER CONTROLLED COMMITTEE? 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
0 SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 SUPPORT
0 OPPOSE
COMMITTEE NAME I.D.NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 SUPPORT
0 OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 YES 0 NO ❑SUPPORT
COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) ❑ 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
Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE
Statement covers period
Summary Page
to whole dollars. CALIFORNIA 460
Jan. 1,2017 FORM
from
Sept.23,2017 Page I of I 0
through
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D.NUMBER
Eric Alegria for RPV City Council 2017 1398463
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
General Elections
14,500 14,500
1. Monetary Contributions Schedule A,Line 3 $ $
10,000 10,000 1/1 through 6/30 7/1 to Date
2. Loans Received Schedule B,Line 3
24,500 24,500 20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ $ Received $ $
465 465
4. Nonmonetary Contributions. Schedule C,Line 3 21. Expenditures
24,965 24,965 Made $ $
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made Schedule E,Line 4 $ 9,971 $ 9,971 Candidates
7. Loans Made Schedule H,Line 3 0 0
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS. Add Lines 6+7 $ 9,971 $ 9,971 (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 3 465 465 (mmidd/yy)
11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ 10,436 $ 10,436
....................JI $
Current Cash Statement ........____L__......../ $
0
12.Beginning Cash Balance Previous Summary Page,Line 16 $
To calculate Column B,
13.Cash Receipts Column A,Line 3 above 24,500 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.
9,971 of your last report. Some
15.Cash Payments Column A,Line 8 above
amounts in Column A may
16.ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $ 14,529 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
0 filed for this calendar year,
17.LOAN GUARANTEES RECEIVED Schedule B,Part 2 $
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 $ 10,000
FPPC Form 460(Jan/2016)
FPPC Advice:advIce@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
{ E
Schedule A Amounts may be rounded SCHEDULE A
to whole dollars. Statement covers period
Monetary Contributions Received CALIFORNIA 460
from *fan. 1,2017 FORM
through Sept. 23,2017 Page 4 of ,0
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D.NUMBER
Eric Alegria for RPV City Council 2017 1398463
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED CODE - (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED)
OF BUSINESS)
Rendon for Assembly2016(FPCC ID#137359 ❑IND
9/10/2017 �COM 2 500 2 500 2 500
ElOTH '
Long Beach CA 90807 0 PTY
❑scc
0 IND
Steve Alegria 9/10/2017 g 0 coM Chairman 1,000 1,000 1,000
❑OTH CPC International
Yakima WA 98908 0 PTY
❑SCC
®IND
Manuel Carmona ❑coM Manager
9/10/2017 ❑0TH 100 100 100
City of Pasadena
Altadena CA 91001 ❑PTY
❑scc
le ETI IND �®ASV �'
Andreana Valiere-Co
9/19/2017 y ❑COM 100 100 100
❑oTH
Los Alariliit?
Rancho Palos Verdes CA 90275 ❑PTY
❑scc
Monique White-Dominguez!']IND
com 90TH
Ph100 100 1009/20/2017 City of Hope
Rancho Palos Verdes CA 9 275
0 PTY
0 scc
SUBTOTAL$ 3,840
Schedule A Summary *Contributor Codes
1. Amount received this period-itemized monetary contributions. IND-Individual
(Include all Schedule A subtotals.) $ 14,500 COM-Recipient Committee
(other than PTY or SCC)
2. Amount received this period-unitemized monetary contributions of less than$100 $ 0 0TH-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 $ 14,500
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
,
Schedule A(Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.)
Monetary Contributions ntributions Received to whole dollars. Statement covers period CALIFORNIA 460
from Jan. 1,2017 FORM
through Sept.23, 2017 Page g• of to
NAME OF FILER I.D.NUMBER
Eric Alegria for RPV City Council 2017 1398463
CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE (IF SELF-EMPLOYED,ENTER NAME
OF BUSINESS) PERIOD (JAN.1-DEC.31) (IF REQUIRED)
Alen Bilan ®IND Manager
9/22/2017 ❑COM100 100 100
❑OTH Bilan Construction
Rancho Palos Verdes CA 90275 ❑PTY
❑SCC
Kim Lee Johnson ®IND Self-Employed
9/23/2017 ID COM OTH V-04 L jP� M 100 100 100
❑
Rancho Palos Verdes CA 90275 ❑PTY
❑scC
Rob Hamilton ®IND Manager
9/23/2017 ❑COM OTH ADP 504 500 500
❑
Rancho Palos Verdes CA 90275 ❑PTY
❑SCC
PhillipChen for Assembly2018(FPCC ID IND
2 COM ,
10,000 10,000 10,000
9/23/2017 #1392379) ❑OTH
Diamond Bar CA 91765 ❑PTY
❑scc
❑IND
❑COM
❑OTH
❑PTY
❑SCC
SUBTOTAL$ 10,700
*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
,
Amounts may be rounded SCHEDULE B-PART 1
Schedule B — Part 1 to whole dollars. Statement covers period CALIFORNIA
460
Loans Received Jan. 1,2017
from FORM
throw h Sept.23,2017 page of I D
SEE INSTRUCTIONS ON REVERSE 9
NAME OF FILER I.D.NUMBER
Eric Alegria for RPV City Council 2017 1398463
IF AN INDIVIDUAL ENTER (a) (b) (C) (d) (a) ' {f} (9)
FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE
OCCUPATION AND EMPLOYER BALANCE AMOUNT PAID BALANCE AT
OF LENDER (IF SELF-EMPLOYED,ENTER RECEIVED THIS OR FORGIVEN PAID THIS AMOUNT OF CONTRIBUTIONS
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) BEGINNING THIS PERIOD THIS PERIOD* CLOSE OFjHIS PERIOD LOAN TO DATE
PERIOD PERIO
Eric Alegria Vice President ❑PAID CALENDAR YEAR
Monarch HealthCare $ 0 $ 10,000 % $ 10,000 $
Rancho Palos Verdes CA 90275 0 FORGIVEN RATE PER ELECTION'"`
$ 0 $ 10,000 $ 0 $ 0 07/31/17 $
to IND 0 COM 0 OTH 0 PTY 0 SCC DATE DUE DATE INCURRED
❑PAID CALENDAR YEAR
$ $ % $ $
RATE
❑FORGIVEN PER ELECTION`
t IND COM OTH PTY SCC $ $ $ DATE DUE $ DATE INCURRED $
❑PAID CALENDAR YEAR
$ $ % $ $
RATE
0 FORGIVEN PER ELECTION"
❑ IND 0 COM 0 OTH 0 PTY 0 SCC $ $ $ DATE DUE $ DATE INCURRED $
t
SUBTOTALS $ 10,000 $ 0 $ 10,000 $ 0
(Enter(e)on
Schedule B Summary Schedule E,Line 3)
1. Loans received this period $ 10,000
(Total Column (b)plus unitemized loans of less than$100.)
tContributor Codes
2. Loans paid or forgiven this period $ a IND-Individualc0M-Recipient Committee
(Total Column (c)plus loans under$100 paid or forgiven.) (other than PTY or SCC)
(Include loans paid by a third party that are also itemized on Schedule A.) OTH-Other(e.g.,business entity)
PTY-Political Party
3. Net change this period. (Subtract Line 2 from Line 1.) NET $ 10,00o SCC-Small Contributor Committee
Enter the net here and on the Summary Page,Column A,Line 2. (May be a negative number)
r*Amounts forgiven or paid by another party also must be reported on Schedule A. FPPC Form 460 Jan/2016)
`**If required. J FPPC Advice:advice@ffppc.ca.gov(866/275-3772)
www.fppc.ca.gov
i 4
Schedule C Amounts may be rounded
SCHEDULE C
dll
Nonrnonetary Contributions Received to whole oars. Statement covers period CALIFORNIA 460
from Jan. 1,2017 FORM
through Sept.23,2017 Page of It
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER 1.D.NUMBER
Eric Alegria for RPV City Council 2017 1398463
IF AN INDIVIDUAL,ENTER AMOUNT/ CUMULATIVE TO
DATE FULL NAME,STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF DATE PER ELECTION
OCCUPATION AND EMPLOYER FAIR MARKET TO DATE
GOODS OR SERVICES CALENDAR YEAR
RECEIVED ZIP CODE OF CONTRIBUTOR CODE* (IF SELF-EMPLOYED,ENTER
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) VALUE
NAME OF BUSINESS) (JAN 1-DEC 31) (IF REQUIRED)
IND
Eric Alegria com Vice President CNS: Data&
08/24/17 00TH Monarch HealthCare Maps 413 413 413
Rancho Palos Verdes CA 90275 0 PTY
0 SCC
[71 IND
Christine Alegria COM Founder LIT: Copy&Print
09/21/17 52 52 52
00TH Christodoulo Boutique Services
Rancho Palos Verdes CA 90275 oPTY
o SCC
IND
0 COM
00TH
PTY
El scc
IND
El COM
00TH
PTY
SCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 465
Schedule C Summary "Contributor Codes
1. Amount received this period-itemized nonmonetary contributions. IND-Individual
(Include all Schedule C subtotals.) 465 COM-Recipient Committee
(other than PTY or SCC)
2. Amount received this period-unitemized nonmonetary contributions of less than$100 0 0TH-Other(e.g.,business entity)
PTY-Political Party
3. Total nonmonetary contributions received this period. SCC-Small Contributor Committee
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) TOTAL $ 465
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 from Jan. 1,2017 FORM
Sept. 23,2017
Pa
through ge B of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D.NUMBER
Eric Alegria for RPV City Council 2017 1398463
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
COGS South Signs
3309 S. Main St. CMP 1044
Santa Ana,CA 92707
Ford Printing&Mailing
1440 Arrow Hwy Unit F LIT 519
Irwindale,CA 91706
John Mattera Photography
1911 N.Gaffey St., Suite F LIT 400
San Pedro,CA 90731
*Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,963
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) 9,690
2. Unitemized payments made this period of under$100 281
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1,Column(e).) 0
4. Total payments made this period. (Add Lines 1,2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ 9,971
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
•
Schedule E Amounts may be rounded SCHEDULE E(CONT.)
Statement covers period
(Continuation Sheet) to whole dollars. CALIFORNIA 460
Payments Made from Jan. 1,2017 FORM
Sept.23,2017
through Page ei of 170
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D.NUMBER
Eric Alegria for RPV City Council 2017 1398463
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
Political Data Inc
12501 Imperial Hwy,Suite 200 CNS 2,060
Norwalk,CA 90650
Zero Week Solutions
PO Box 3011 CNS 2,000
Thousand Oaks,CA 91359
Ford Printing&Mailing
1440 Arrow Hwy Unit F LIT 1,772
Irwindale, CA 91706
Ford Printing&Mailing
1440 Arrow Hwy Unit F POS 1,895
Irwindale, CA 91706
*Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 7,727
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
wwwippc.ca.gov
t
Schedule G SCHEDULE G
Payments Made by an Agent or Independent Amounts may be rounded Statement covers period CALIFORNIA 460
2017
l
hoe dollars. 1,
Contractor (on Behalf of This Committee) to wfrom Jan. FORM
Sept.23, 2017
through Page 0 of r0
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D.NUMBER
Eric Alegria for RPV City Council 2017 1398463
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Ford Printing&Mailing
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)
*Payments that are contributions or independent expenditures must also be summarized on Schedule D.
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
US Postal Service
116 Live Oak Ave,Arcadia,CA 91006 POS 1,895
Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 1,895
*Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460(Jan/2016)
independent contractor as reported on Schedule E. FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov