CA Form 460 Recipient Committee Semi-Annual Campaign Statement (July - Dec 2016) - Jerry Duhovic c
Recipient Committee COVER PAGE
_ n Campai Statement Eft CALIFORNIA 460
Campaign FORM
Cover Page 'OF RANCHO PAL
C1T OS _
Page of
Statem nt covers period Date of election if applicable: JAN 3 1 2017
(Month,Day,Year) For Official Use Only
from q C
SEE INSTRUCTIONS ON REVERSE3 I LERK
I�+through SO��� 1C�
1. Type of Recipient Committee: All Committees-Complete Parts 1,2,3,and 4. 2. Type of Statement:
:1h Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement 0 Quarterly Statement
0 State Candidate Election Committee Committee A Semi-annual Statement 0 Special Odd-Year Report
0 Recall 0 Controlled
0 Termination Statement
(Also Complete Part 5)
Sponsored (Also file a Form 410 Termination)
(Also Complete Part 6)
0 General Purpose Committee 0 Amendment(Explain below)
0 Sponsored 0 Primarily Formed Candidate/
0 Small Contributor Committee Officeholder Committee
0 Political Party/Central Committee (Also Complete Part 7)
3. Committee Information I.D.NUMB R/31-it 0 it Treasurer(s)
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAM• OF TREASURER
1 $ f CL_ S (i,x
vs.r-fr,12/2—Y I)a Fib vi W MAILING AD'T'ESS •
)
CITY STATE ZIP CODE AREA CODE/PHONE N OF AS STANT TRE URER,IF ANY
MAILING AD R S(IF DI FERENT)N .AND STREET OR P.O.BOX ILING AD RES '
CITY STATE ZIP CODE AREA CODE/PHONE CITY
("
OPTIONA • FAX E-MAIL ADDRESS
I have used all reasonable diligence in preparing and reviewing this statement and
Proponent 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(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 2of_4-
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDERR CANDIDATE NAME OF BALLOT MEASURE
J:e.,V1
0 u,ht-vt e..,
OFFICE SOUGHT O HELD(INCUDE LOC ION AND ISTRICT NUMB R IF PLICABLE)\ BALLOT NO. LETTER -JURISDICTION ID SUPPORT
AttAke.,I./Lb Pa its . eC at no(
0 OPPOSE
RESIDENTIAUBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP
NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT
Related Committees Not Included in this Statement: List any committ es
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.
0 YES 0 NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 SUPPORT
O OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ SUPPORT
O OPPOSE
COMMITTEE NAME I.D.NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
0 SUPPORT
❑ OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
El 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
to whole dollars.
SummaryPage
Statement covers period CALIFORNIA
from
FORM
i:1'
aag
through
INSTRUCTIONS ON REVERSE f2‘)/4' Page of
SEE N
NAME OF FILER I.D.NUMBER
f474.,fr 1-y' 1)Wilt-14 C-Ptif l
C-- /34-0674-
Column A Column B Calendar Year Summary for Candidates
Contribute ns Received TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and
General Elections
1. Monetary Contributions Schedule A,Line 3 $ 0 $ 0
2. Loans Received Schedule1/1 through 6/30 7/1 to Date
3 C Ci B,Line
�`-� 20. Contributions
Add Lines 1+2 $ �--' $ Received
3. SUBTOTAL CASH CONTRIBUTIONS $ $
Contributions Schedule C,Line 3 21. Expenditures
4. Nonmonetary P
RECEIVED Add Lines 3+4 0 $ o Made $ $
5. TOTAL CONTRIBUTIONS $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made
Schedule E,Line 4 $ $ 0 Candidates
7. Loans Made
Schedule H,Line 3 o
0 22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ $ (ff Subject to VoluntaryExpenditure Limit)
9. Accrued Expenses(Unpaid Bills) Schedule F,Line 3 -
Date of Election Total to Date
P t P a
10.Nonmonetary Adjustment Schedule C,Line 3 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ $
Current Cash Statement -/ $
12.Beginning Cash Balance Previous Summary Page,Line 16 $ To calculate Column B,
13.Cash Receipts Column A,Line 3 above add amounts in Column
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 of your last report. Some
amounts in Column A may
Lines 12+13+14 then subtract Line 15 13O be negative figures that
16.ENDING CASH BALANCE Add $
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 $ filed for this calendar year,
only carry over the amounts
Cash Equivalents and Outstanding Debtsfrom Lines 2,7,and 9(if
10 any).
18. Cash Equivalents See instructions on reverse $
43:i
19. Outstanding Debts Add Line 2+Line 9 in Column B above $ t szt 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
r Schedule B — Part 1 to whole dollars. State ent covers period
CALIFORNIA 460
Loans Received
fro r FORM
SEE INSTRUCTIONS ON REVERSE throug ( age of
NAME OF FILER I.D.NUMBER
budit4:1-�T 11� \ ��'I1�
IF AN INDIVIDUAL,ENTER a (�) (d) (a) (fl--- 134-6674–
9
FULL NAME,S EET ADDRESS AND ZIP CODEOUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE
OCCUPATION AND EMPLOYER AMOUNT PAID
OF LENDER BALANCE RECEIVED THIS BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) (IF SELF-EMPLOYED,ENTER BEGINNING THIS OR FORGIVEN* CLOSE OF THIS
NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE
\.1244s1 '01 ld 5S: i 0 PAID
CALENDAR YEAR
_-11,14,r.
-ect(-77)4.._ $ rb $ $ �? Z
DIA) 7-tcsi"-IQ-) RATE
0 FORGIVEN PER ELECTION"
r '✓— �C�. 0 Alv ' ,Al
16 1 �lJw- 5 1,to
IND COM OTH P SCC .
__,1 • , DATE DUE DATE INCURRED
I
❑PAID CALENDAR YEAR
$ $ % $ $
RATE
❑FORGIVEN PER ELECTION**
$ $
$ $ $
t❑ IND 0 COM 0 OTH PTY SCC DATE DUE DATE INCURRED
❑PAID CALENDAR YEAR
$ $ % $ $
RATE
❑FORGIVEN PER ELECTION**
$ $
t❑ IND 0 COM 0 OTH 0 PTY 0 SCC $ $ $
DATE DUE DATE INCURRED
SUBTOTALS $ ff0 $ 0 $ 31150t $ 'ID
on
Schedule B Summary (Enter
Schedule E,,Line 3)
1. Loans received this period $ 0
(Total Column (b)plus unitemized loans of less than $100.) tContributor Codes
2. Loans paid or forgiven this period $ /0 IND—Individual
(Total Column (c)plus loans under$100 paid or forgiven.) COM—Recipient Committee
(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 thisperiod. (Subtract Line 2 from Line 1. NET0 SCC Small Contributor Committee
g ) $
Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number)
*Amounts forgiven or paid by another party also must be reported on Schedule A. FPPC Form 460(Jan/2016)
**If required. FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov