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460 Llort 2016 from 09/25 - 10/22Recipient Committee :11date Stamp L Campaig"n Statement E. E CITY. LA QUINTA Cover Page GAL IFORNIA Statement covers period Date of election ifa licable: from 9.25.2016 (Month,Day,)M 0Cr ] ill 9; pg SEE INSTRUCTIONS ON REVERSE through EE 10.22.2016 November 8, 2016 _ _ COVER PAGE Page 1 of 7 For Official Use Only 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 m_ Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee. ❑ S.emi-annual Statement ❑ Special Odd -Year Report 0, -Recall O Controlled (AIso,ComplefePart 6) 0 S ❑ Termination Statement Sponsored (Also file a Form 410 Termination) (Also Complete Part 6) ❑ General Purpose Committee ❑ Amendment (Explain below) O Sponsored— ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part 7) 3. Committee Information J I.D. NUMBER _ 1385920 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Victoria Llort for La Quinta City Council 2016 STREET ADDRESS (NO P.O. BOX) 81676 Charismatic Way CITY STATE ZIP CODE AREA CODE/PHONE La Quinta . CA 92253 7607741567 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX — 78015 Main St, Suite 202 CITY STATE ZIP CODE AREA CODEIPHONE La Quinta CA 92253 OPTIONAL: FAX/ E-MAIL ADDRESS 4. Verification Treasurer(s) NAME OF TREASURER Irick Petersen MAILING ADDRESS 52205 Desert Spoon Court CITY STATE ZIP CODE AREA CODE/PHONE La Quinta CA 92253 310.699.0920 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX/E-MAIL ADDRESS 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 correct. �U Executed on By rr• ha,ture or Trp surer or Assistant Treasurer Executed on F By 4 • � "r Date Signature of Controlling' OfFceholdar, Candidata, Stale Maasura Proponent or Rpsponsiblo Officer of Sponsor Executed on Date Executed on. Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, Stale Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Recipient Committee Campaign Statement Cover Page — Part 2 5: 4Dfficeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Victoria Llort OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) La Quinta City Council, Riverside County RESIDENTIALBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 81676 _Charismatic Way _ La Quinta, CA 92253, Related Committees Not Included in this Statement: Listony committees not included in this statement that are controlled by yob or -are prlmadly formed to receive -'-contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME'OF TREASURER CONTROLLED COMMITTEE? ❑ YES -❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.D. BOX) CITY STATE . ZIP CODE. AR5A,CQDE/PHONE COMMITTEE NAME I.D. NUMBER NAME'OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO PO. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 7 -6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify thezontrofling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. .Primarily Formed Candidate/Officeholder Committee List names'of officehoiderfs) or candidatefs) for which this committee is primarily formed. .NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE 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 NIA Summa Pato whole dollars. Statement covers periodeeeeeee . ge from 9.25.2016 FORM 4 • SEE INSTRUCTIONS ON REVERSE 12. Beginning Cash Balance ............................ Previous Summary Pape, Line 16 $ through 10.22.2016 Page 3 of 7 NAME OF FILER add amounts in Column 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 0 Ato the corresponding,,• amounts from Column B 15. Cash Payments.................•....................................... column A, Line 8 above I.D. NUMBER Victoria Llort of your last report. Some 8,101 amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 1385920 Contributions Received be negative figures that If this is a termination statement Line 16 must be zero. Column A Column B. Calendar Year Summary for Candidates 17. LOAN GUARANTEES RECEIVED ................................ schedule B, Parte $ 0 TOTALTHIS PERIOD . (FROMATTACHEDSCHEDULES) CALENDAR YEAR ToTALToDA`GE Running in Both the State Primary and only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0 any). General Elections 1. Monetary Contributions.................................................... -Schedule A, Line 3 $ 2,425 $ 11,018 0 -'867 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule B, Line 3 3. SUBTOTALCASHCONTRIBUTIONS .............................. .Add Lines/+2 $ 2,425 $ 11,885 20. Contributions Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 0 1,731 21. Expenditures 5. .TOTAL CONTRIBUTIONS RECEIVED .............. :................. _Add Lines 3+ 4 $ 2,425 $ 13,618 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments,Made................................................................ Schedule E, Line 4 $ 2,362 $ 3,784 Candidates 7. Loans Made....................................................................... _ Schedule H, Line 3 0 0 8. SUBTOTALCASH PAYMENTS .......................................... .Add Lines 6_+7 $ 2,362 $ 3,784 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment......................................................... schedule c, Line 3 0 1,731 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE..........:.............................Add-Lines 8+9+10 $ 2.362 $ 5,515 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Pape, Line 16 $ 8,038 To calculate Column B, 13. Cash Receipts........................................................... Column A; Line:3 above 2,425 add amounts in Column 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 0 Ato the corresponding,,• amounts from Column B 15. Cash Payments.................•....................................... column A, Line 8 above 2,362 of your last report. Some 8,101 amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ be negative figures that If this is a termination statement Line 16 must be zero. should be subtracted from previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ schedule B, Parte $ 0 filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0 any). 19. Outstanding Debts.,., ......•.................. Add Line 2 + Line 9 in Column B above $ 867 I f $ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SchedufeA Amounts may be rounded SCHEDULE A to wno(e sonars. Monetary Contributions Received Statement covers period • - from 9.25.2016 , � • - through 10.22.2016 Page 4 of 7 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I . NUMBER Victoria Llort 1385920 DATE FULL NAME, STREETADDRESS AND 21P CODE OF CONTRIBUTOR _ (IFcommrTTEE,ALs6 ENTER I.D. NUMBER)- CONTRIBUTOR IFAN INDIVIDUAL, ENTER - OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) IND 9/26/16 Kite Family Trust. -Richard Richard Kite ❑coM El Retired $100 $100 71205 Thunderbird Terrace N. ❑ OTH Rancho Mirage, CA 92270 ❑ PTY ❑ scc m IND 9/29/16 Wesley_ Horn El COM Associate; McKeon $100 $100 42510 30th Street West [1OTH Group Lancaster, CA 93536 ❑ PTY ❑ scc ® IND 9/30/16 Mery Kolb acoM Retired $300 $360 45190 Seeley Dr ❑ o7H La Quinta, CA 92253 ❑ PTY ❑ scC W] IND 9/30/16 Terje Berger 52705 Avenida Obregon El COM ❑ OTH Retired $100 $300 La Quinta, CA 92253 ❑ PTY ❑ scc Jim Egan W) IND ❑ COM Retired 10/03/16 27 Villaggio Place ❑ OTH $200 $200 Rancho Mirage, CA 92270 ❑ PTY ❑ scc SUBTOTAL$ =800 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.).......................................................:.................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 2,300 125 2,425 "Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule -A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions' Received to whole dollars. Statement covers period CALIFORNIA from 0.25.2016 FORM _through 10.22.2016 page 5 of 7 NAME OF FILER I.D. NUMBER Victoria Llort 1385920 DATE FULL NAME;•STREETADDRESSAND ZIP CODE OF CONTRIBUTOR D. CONTRIBUTOR * IF AN INDIVIDUAL, ENTER - OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE • RECEIVED (1F COMMITTEE. ALSO ENTER I. NUM9ER) CODE (IFSELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) IND Chandi Personal Contributions - Nachhattar 0 Com Chandi Group USA, 10/05/16 Chandi❑ OTH owner $1,000 $1,000 42270:Spectrum St, Indio, CA 92203 ❑ PTY ❑ scc CalFire Local 2881, PAC # 790318 ❑ IND 1z coM 10/18/16 1731 J Street, Ste 100 ❑ OTH $500 $500 Sacramento, CA 95811 ❑ PTY ❑ SCC E] IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ $1,500 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) 0TH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 5chedule B — Part 1 to who dollars. Statement covers period Loans Received 9.25.2016 from • Page 6 of 7 SEE INSTRUCTIONS ON REVERSE through ® 10.22.2016 NAME OF FILER I.D. NUMBER Victoria Llort 1385920 FULL NAME, S,TREETADDRE$SAND ZIP CODE IF AN INDIVIDUAL, ENTER - OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT (c) AMOUNT PAID'- OUTSTANDING e INTEREST ORIGINAL 9 CUMULATIVE OF LENDER (IFCOMMITTEE. ALSO ENTER ED. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE:. BEGINNING THIS RECEIVED THIS OR FORGIVEN* -gALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE Victoria Llort Victoria Llort []PAID CALENDAR YEAR 81676 Charismatic Way $ _ $ 867 0 °, $ 867 $ 867 ❑ FORGIVEN La Quinta, CA 92253 RATE PER ELECTION** $ 867 $ 0 g $ IND $ t ❑ COM El OTH El PTY El SCC DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR PER ELECTION** ❑ FORGIVEN RATE $ $ $ $ $ . DATE DUE DATE INCURRED t ❑ IND El ❑ OTH ❑PTY ❑SCC © PAID CALENDAR YEAR $ % $ $ PER ELECTION*" ❑ FORGIVEN RATE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ S $ DATE INCURRED $ DATE DUE SUBTOTALS $ $ $ 867 $ Schedule B Summary 1. Loans received this period....................................................................................................................$ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.).............................................................. NET $ Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. (May be a negative number) (Enter (o) on Schedule E, Line 3) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedwle•E ' Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Victoria Llort Amounts may be rounded to whole dollars. SCHEDULE E Statement covers period • . from 9.25.2016 • through 10.22.2016 page 7 of 7 I.D. NUMBER 1385920 CODES: If one of the following codes accurately describes -the payment, -you may -enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc: ,E 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 donati-ens .- - 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 FIND fundraising events POL dolling and survey research: TRS staff/spouse travel, lodging, and meals INDr, 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 liferature-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 City of La Quinta City Permit for Signage 78495 Calle Tampico FIL $400 La Quinta, CA 92253 Zoo Printing Printing - Sign 5700 Bandini Blvd CMP $1,647 Commerce, CA 90040 Educate Your Vote G16 Mailer 3447 Circulo Adorno Lit $200 Carlsbad, CA 92009 "Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,247 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).. ............................................................................... $ 2.. Unitemized payments made this period of under $100.......................................................................................................... 3. Total interest paid this period on loans. (;Enter amount from Schedule B, Part 1, Column(e).)............................................. 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........ 2,247 115 TOTAL $ 2,362 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov