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)