CA Form 460 Recipient Committee Termination Campaign Statement - Ben Kelly Recipient Committee Date Stamp COVER PAGE
CALIFORNIA460
Cover Page
Campaign Statement R ,(fi°�•
FORM
of 4
R
CITY o1=
RANCI-10 PALO
Statement covers period Date of election if applicable:
10/22/17 (Month,Day,Year) FEg 2 20�3 For Official Use Only
from
SEE INSTRUCTIONS ON REVERSE through 11/29/17 November 7th 2017 ' LE:
OFFIe
1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement:
Ei Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement 0 Quarterly Statement
O State Candidate Election Committee Committee 0 Semi-annual Statement 0 Special Odd-Year Report
O Recall 0 Controlled 12 Termination Statement
(Also Complete Part 5) 0 Sponsored
(Also file a Form410 Termination)
(Also Complete Part 6)
❑ General Purpose Committee 0 Amendment(Explain below)
O Sponsored 0 Primarily Formed Candidate!
O Small Contributor Committee Officeholder Committee
0 Political Party/Central Committee (Also Complete Part 7)
3. Committee Information ID.NUMBER Treasurer(s)
1397825
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
Ben Kelly for RPV City CounciI2017 Benjamin Kelly
MAILING ADDRESS
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Rancho Palos Verdes CA 90275 310
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Rancho Palos Verdes CA 90275 310
MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS
Same as above
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.
certify under penalty of perjury under the laws of the State of California that the foregoing is true and
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(Jan/2016)
FPPC Advice:advices fooc.ca.eov M66/275-37721
COVER PAGE-PART 2
Recipient Committee CALIFORNIA
Campaign Statement FORM 460
Cover Page — Part 2
Page 2 of 4
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
Benjamin Kelly
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
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
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
0 SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 SUPPORT
O 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
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
Summary Page to whole dollars. Statement covers period
CALIFORNIA 460
from 10/22/17 FORM
SEE INSTRUCTIONS ON REVERSE
through 11/29/17 Page 3 of 4
NAME OF FILER I.D.NUMBER
Benjamin Kelly 1397825
Contributions Received ToColum TAL THIS E oD CALENDAR Calendar Year Summary for Candidates
(FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and
General Elections
1. Monetary Contributions Schedule A,Line 3 $ 0 $ 4702.11
0 0 1/1 through 6/30 7/1 to Date
2. Loans Received Schedule B,Line 3
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ 0 $ 4702.11 Received $ $
4. Nonmonetary Contributions Schedule C,Line 3 0 560.61 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ 0 $ 5262.72 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made Schedule E,Line 4 $ $ 4702.11 Candidates
7. Loans Made Schedule H,Line 3 0
8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ $ 0
22. Cumulative Expenditures Made*
Subject to Voluntary Expenditure Limit)
9. Accrued Expenses(Unpaid Bills) Schedule F,Line 3 0 Date of Election Total to Date
10. Nonmonetary Adjustment Schedule C,Line 3 0 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ $ 4702.11 ______I_J $
Current Cash Statement _--I $
12. Beginning Cash Balance Previous Summary Page,Line 16 $ 92.12
0 To calculate Column B,
13.Cash Receipts Column A,Line 3 above 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,Line 8 above 92.12 of your last report. Some
amounts in Column A may
16.ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $ 0 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
18. Cash Equivalents See instructions on reverse $ 0 any).
19. Outstanding Debts Add Line 2+Line 9 in Column B above $ 0 FPPC Form 460(tan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www fppc.ca.gov
Schedule E Amounts may be rounded Statement covers eriod SCHEDULE E
to whole dollars. P CALIFORNIA /� 6O
Payments Made 10/22/17 FORM 'T
from
SEE INSTRUCTIONS ON REVERSE through 11/29/17 Page 4 of 4
NAME OF FILER I.D.NUMBER
Benjamin Kelly 1397825
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(intemet,e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Robert Magee
RFD 92.12
*Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) $ 0
2. Unitemized payments made this period of under$100 $ 92.12
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 $ 92.12
FPPC Form 460(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov