CA Form 460 Recipient Committee Preelection Campaign Statement No. 1 - Ben Kelly 1.: 4' Y
COVER PAGE
Recipient Committee
CALIFORNIA
Campaign StatementREMED 460
FORM
Cover Page t, Of RANCHO PALOS V:
Statement covers period Date of election if applicable: SEP 2 8 2011
Page 1 of 7
7/1117 (Month,Day,Year) For Official Use Only
from
SEE INSTRUCTIONS ON REVERSE through
9/23/17 Nov. 7, 2017 CITY 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 0 Primarily Formed Ballot Measure ® Preelection Statefnent 0 Quarterly Statement
Q State Candidate Election Committee Committee 0 Semi-annual Statement ❑ Special Odd-Year Report
O Recall 0 Controlled 0 Termination Statement
(Also Complete Pert 5) 0 Sponsored (Also file a Form 410 Termination)
(Also Complete Pert 6)
0 General Purpose Committee 0 Amendment(Explain below)
O Sponsored 0 Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee
Pert
0 Political Party/Central Committee Complete7)
3. Committee information I.D.NUMBER . Treasurer(s)
1397825
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
Ben Kelly for Rancho Palos Verdes City Council 2017 Benjamin Kelly
MAILING ADDRESS
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Rancho Palos Verdes CA 90275 (310)9404152
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Rolling Hills Estates CA 90274 (310)9404152
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
kellyforcounciI2017@gmail.com
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the info ation 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 is true and
Executed on 9/28/17 By
y
or Responsible Officer of Sponsor
Executed on Date By Signature of Controlling Officeholder,Candidate,State Measure Proponent
Executed on Date By Signature of Controlling Officeholder,Candidate,State Measure Proponent
t 1
t i
1
COVER PAGE-PART 2
Recipient Committee CALIFORNIA 460
Campaign Statement FORM
Cover Page — Part 2
Page 2 of 7
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
-
RESIDENTIAL/BUSINESS 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 1.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
❑ SUPPORT
❑ OPPOSE
COMMITTEE NAME I.D.NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT
0 OPPOSE
NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
ElYES 0 NO SUPPORT
El
❑ 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:advicetefopc.ca.Rov(866/275-3772)
t
Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE
to whole dollars. Statement covers period
Summary Page CALIFORNIA 460
7/1/17 FORM
from
9/23/17 3 7
through Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D.NUMBER
Ben Kelly for Rancho Palos Verdes City Council 2017 1397825
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
3491.11 4702.11
1. Monetary Contributions Schedule A,Line 3 $ $
0.00 0.00 1/1 through 6/30 7/1 to Date
2. Loans Received Schedule B,Line 3
3491.11 4702.11 20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ $ Received $ $
560.61 560.61
4. Nonmonetary Contributions Schedule C,Line 3 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ 4051.72 $ 4612.33 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made Schedule E,Line 4 $ 4538.85 $ 4609.99 Candidates
7. Loans Made Schedule H,Line 3 0.00
8. SUBTOTAL CASH PAYMENTS Add Lines 8+7 $ 4538.85 $ 4609.99 22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses(Unpaid Bills) Schedule F,Line 3 0.00
Date of Election Total to Date
10. Nonmonetary Adjustment.. Schedule C,Line 3 0.00 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ 4538.85 $ 4609.99
.._,............J.......................I $
Current Cash Statement ._.__a____i $
12. Beginning Cash Balance Previous Summary Page,Line 16 $ 1139.86
To calculate Column B,
13. Cash Receipts Column A,Line 3 above 3491.11 add amounts in Column
0.00 A to the corresponding *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash Schedule!,Line 4 amounts from Column B reported in Column B.
4538.85 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 $ 92.12 be negative figures that
should be subtracted from
If this is a termination statement,Line 16 must be zena previous period amounts. If
this is the first report being
17. LOAN GUARANTEES RECEIVED Schedule B,Part 2 $ 0.00 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 $ 0.00
19. Outstanding Debts Add Line 2+Line 9 in Column B above $ 0.00 FPPC Form 460(Jan/2016)
FPPC Advice:advketefopc.ca.gov(866/275-3772)
s
L
Schedule A Amounts may be rounded SCHEDULE A
to whole dollars.Contributions Received Statement covers period
CALIFORNIA 460
from 7/1/17 FORM
through 9/23/17 Page �' of 7
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D.NUMBER
Ben Kelly for Rancho Palos Verdes City Council 2017 1397825
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 1.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)
0 IND
Benjamin Kelly ❑CoM Student
7/5/17 RPV CA 90275 OTH 1400.16 1900.16
❑PTY
❑SCC
0 IND
Robert Magee 0 CoM President
7/7/17 RPV CA 90275 ❑OTH Strategoi Inc.
00 1400
D PTY
❑scc
IND
Matthew Oriich ❑coM Retired
7/29/17 RPV 90275 ❑OTH 150 150
❑PTY
❑SCC
eJ IND
Gary Boston ❑COM Retired
8/3/2017 RPV 90275 oTH 183.90 183.90
❑PTY
❑SCC
Carrie Cahill ®IND •
9/20/17
RPV 90275 ❑OTH
❑PTY
❑SCC
SUBTOTAL$ 2834.06
Schedule A Summary *Contributor Codes
1. Amount received this period-itemized monetary contributions. IND-Individual
all Schedule A subtotals.) $ 2834.06 COM-Recipient Committee
(Include (other than PTY or SCC)
2. Amount received thisperiod-unitemized monetarycontributions of less than $100 $ 657.05, 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 $ 3491.11
FPPC Form 460(Jan/2016)
•
Schedule C Amounts may be rounded SCHEDULE C
to whole dollars.
Nonmonetary Contributions Received Statement covers period CALIFORNIA 460
from 7/1117 FORM
SEE 9/23/17 Page 5 of 7
INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D.NUMBER
Ben Kelly for Rancho Palos Verdes City Council 2017 1397825
IF AN INDIVIDUAL ENTER AMOUNT/ CUMULATIVE TO PER ELECTION
DATE FULL NAME,STREET ADDRESS AND CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF FAIR MARKET DATE
RECEIVED ZIP CODE OF CONTRIBUTOR CODE ENTER GOODS OR SERVICES CALENDAR YEAR TO DATE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
(IF SELF-EMPLOYED, VALUE (IF REQUIRED)
NAME OF BUSINESS) (JAN 1-DEC 31)
PIIND
Thomas Magee ❑COM Chief Financial Officer Banner, Toner,
7/17/17 RPV CA ❑OTH Virtium, LLC AC Unit, Office 560.61 560.61
90275 0 PTY Supplies, Repair
❑SCC Equipment
❑IND
❑COM
❑OTH
❑PTY
❑SCC
IND
COM❑COM
OTH
PTY❑PTY
❑SCC
0 IND
❑COM
❑OTH
❑PTY
❑SCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL
Schedule C Summary *Contributor Codes
1. Amount received this period—itemized nonmonetary contributions. IND-Individual
(Include all Schedule C subtotals.) $ 560.61 COM-Recipient Committee
(other than PTY or SCC)
2. Amount received this period—unitemized nonmonetary contributions of less than $100 $ 0.00 OTH-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 $ 560.61
FPPC Form 460(Jan/2016)
FPPC Advice:advicetfppc.ca.aov(866/275-37721
Amounts may be rounded SCHEDULE E
Schedule E Statement covers periodCALIFORNIA
Payments Made . from 7/1/17 FORM
SEE INSTRUCTIONS ON REVERSE
through 9/23/17 Page 6 of 7
NAME OF FILER I.D.NUMBER
Ben Kelly for Rancho Palos Verdes City Council 2017 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(internet,e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Universal Masterfund LLC
9201 W Sunset Blvd, Ste 905, Los Angeles/West Hollywood, CA 90069 OFC 3,000
Political Data Inc.
PO Box 59570, Norwalk, CA 90652 POL 354.19
City of Rancho Palos Verdes
30940 Hawthorne Blvd., RPV CA 90275 FIL 600
*Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3954.19
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) $ (67. 7(i
2. Unitemized payments made this period of under$100 $ 81.15
pY
3. Total interest paid this period on loans.(Enter amount from Schedule B, Part 1, Column (e). $ 0.00
4. Total payments made thisperiod. (Add Lines 1,2, and 3. Enter here and on the SummaryPage, Column A, Line 6. TOTAL $ 4538.85
)
FPPC Form 460(Jan/2016)
FPPC Advice:advice.fppc.ca.Rov(866/275-3772)
•
Schedule ESCHEDULE E(CONT.)
Amounts may be rounded Statement covers period CALIFORNIA(Continuation Sheet) to whole dollars. 460
Payments Made from 7/1/17 FORM
through
9/23/17 7 of 7
SEE INSTRUCTIONS ON REVERSEPage
NAME OF FILER I.D.NUMBER
Ben Kelly for Rancho Palos Verdes City Council 2017 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(internet,e-mail)
•
NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
Signs on the Cheap
11525A Stonehollow Dr. Suite 100,Austin, TX 78758 LIT 503.51
*Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 503.51