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CA Form 460 Recipient Committee Semi-Annual Campaign Statement (Jan - June 2017) - Jerry Duhovic COVER PAGE Recipient Committee Campaign Statement RECEIVED CALIFORNIAF 460 Cover Page CITY OF RANCHO PALOS IVI Statement covers period Date of election if applicable: I JUL' 312017 Page of S n '� (Month,Day,Year) For Official Use Only frorr5^ f�( SEE INSTRUCTIONS ON REVERSE througfiAL ? 21 :-71 &-D 3 ti . I ITY CLERK'S OFF'CE 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 El Preelection Statement El Quarterly Statement • State Candidate Election Committee Committee ,+�Semi-annual Statement ❑ Special Odd-Year Report O Recall 0 Controlled ❑ Termination Statement (Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) (Also Complete Part 8) ❑ General Purpose Committee ❑ Amendment(Explain below) O Sponsored ❑ Primarily Formed Candidate/ • O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Arm complete Part n 3. Committee Information I.D.T°B74_0 '7 f Treasurer(s) COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME•F TREASURER . J--Pr_gy Dui-io-vieL, O 0 1 attfAiciLzkrs-- ) CITY L STA E ZIPiODE� ARE E/P O E'er„„, CITY STATE ZIP CODE AREACODE/PHONE NAM F ASSISTANT TREASU .R,IFANY (o- R kip. - 9b 045voi.-:5D-36 I› MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILINGADDRES ei� � . CITY STATE ZIP CODE AREA CODE/PHONE CITY STA E ZIP CODE AREA CODE/PHONE S . i'6731 (31954Z G AI OP IO*`- FAX I E-MAILADDRESAN i OPTIONAL: FAX/E-MAIL ADDRESS ints6 4. O1rification I have used all reasonable diligence in preparing and reviewing this st ; // ,4 • • Da t y 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 of 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDFI� ORA CANDIDATE�A ys NAME OF BALLOT MEASURE ST:e ii" V y D IA.�It t e, OFFICE SOUGHT QR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLet-taAn BALLOT NO.OR LETTER JURISDICTION [SUPPORT giAilAD r E OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY ZIP cAtl j (ii S � ^�a�s, ,6 Identify the controlling officeholder,candidate,or state measure proponent,if any. 1/i1 NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Qt a 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 0 YES El NO ❑SUPPORT 0 OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) 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 from3 It L'7 FORM SEE INSTRUCTIONS ON REVERSE throug1R�ii 4 � 2017 Page of NAME OF FILER I.D.NUMBER --- v antIA\c.,PO—r RPV f l 2 (S i 34-Z674 . Column A Contributicfns Received Column B Calendar Year Summary for Candidates 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 $ 101 T of $ tO 1 b 00 1/1 through 6/30 7/1 to Date 2. Loans Received Schedule B,Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ 10 f VCR' $ 1 O1 0D© 20. ContributionsReceived $ $ 4. Nonmonetary Contributions Schedule C,Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ 101 bOO $ 10i WO Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made Schedule E,Line 4 $ PO $ 0 Candidates 7. Loans Made Schedule H,Line 3 0 0 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ $ (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses(Unpaid Bills) Schedule F,Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment Schedule C,Line 30 (mm Election 11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ 0 $ (0 ______I____I $ Current Cash Statement /j �_/ $ / �] 12.Beginning Cash Balance Previous Summary Page,Line 16 $ L 3b� 4 l To calculate Column B, 13.Cash Receipts Column A,Line 3 above 1 O( MD. OD add amounts in Column l 14.Miscellaneous Increases to Cash Schedule I,Line 4 0 A to the corresponding *Amounts in this section may be different from amounts amounts from Column B reported in Column B. 15.Cash Payments Column A,Line 8 above C`J of your last report. Some amounts in Column A may 16.ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $ 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 $ ( filed for this calendar year, 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 $ 19. Outstanding Debts Add Line 2+Line 9 in Column B above $ X1\JD FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A to whole dollars. Statement covers period Monetary Contributions Received � �� CALIFORNIA 460 from, xik'( l7 FORM ? througtlt7 f 0,20 Page of i5 SEE INSTRUCTIONS ON REVERSE • NAME OF FILER I.D.NUMBER tX1/40011/ 1-- co- ' t v 1 2'tS 171:1--bir* 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 ID NUMBER)NUMBER) CODE (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED) OF BUSINESS) 1.� AAX-lhe.t v t Q c 2 ❑scc { t1 ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑scc ❑IND ❑COM • ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ C al b o o Schedule A Summary *Contributor Codes 1. Amount received this period-itemized monetary contributions. IND—Individual (Include all Schedule A subtotals.) $ © by b COM-Recipient Committee (other than PTY or SCC) 2. Amount received this period-unitemized monetary contributions of less than$100 $ i� OTH—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$ C'Qr CZ 0 FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule B— Part 1 Amounts may be rounded Sta nt period SCHEDULE B-PART 1 to whole dollars. ' covers CALIFORNIA 460 Loans Received from.J( 11'Z E 17 FORM • SEE INSTRUCTIONS ON REVERSE through`�wyALA �'�V Page C of 5 NAME OF FILER I.D.NUMBER 26 1A II& ( 1 - if �L Ct i` 1...5�5— (c) (d) (e) "3 4X14 - FULL NA ,STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL,ENTER OUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER AMOUNT PAID OF LENDER (IF SELF-EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) PERIOD PERIOD LOAN TO DATE p� s j� a. PERIOD THIS PERIOD PERIOD Qf!/I) A 1 :w�' ..if'S.fl `# p ❑PAID ® $CALENDARCR `pGG�f'yf �ri�r " t+++fff ��"��"//�+.tVV.✓ �JA� ) $ qo hfjalS 1)1 / yj,,j)�/J� 'W ❑FORGIVEN RATE PER ELECTION41 ' 04/taw ALiez-cill-cte.c. -RD $ 0 $ t IND ❑ COM 0 OTH ❑ PT�r El SCC $ cc) vot_o_i.,11st - - $15730 ,:._____ p461 DATE DUE DATE INCURRED t ❑PAID CALENDAR YEAR $ $ % $ $ RATE ❑FORGIVEN PER ELECTION" $ $ $ $ $ 1"El IND El COM 0 OTH ❑ PTY El SCC DATE DUE DATE INCURRED ❑PAID CALENDAR YEAR $ $ % $ $ RATE ❑FORGIVEN PER ELECTION" t❑ IND ElCOM ElOTH ❑ PTY ElSCC $ $ $ DATE DUE $ DATE INCURRED $ SUBTOTALS $ $ r0 $ . l $ (Enter(e)on Schedule B Summary Schedule E,Line 3) 1. Loans received this period $ V (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes 2. Loans paid or forgiven this period $ CO IND—Individual COM—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) DPTY—Political Party 3. Net change this period. (Subtract Line 2 from Line 1.) NET $ SCC-Small Contributor Committee 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