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460 Pena 2018 from 01/01 to 06/30Recipient Committee Campaign Statement Cover Page Statement covers period from 1 /1 /2018 SEE INSTRUCTIONS ON REVERSE through 6/30/2018 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Pad 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Pad 5) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Pad 7) I.D. NUMBER 1370057 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMII'I'EE) COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE LA QUINTA CA 92253 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAILADDRESS Date Stamp RECEIVED Date of election if applicabl:: JULI I c 2018 (Month, Day, Year) V COVER PAGE CALIMRAIAi • .- Page of For Official Use Only 11 /6/2018 CITY OF LA QUINTA i:FTY CLERK DEPARTMENT 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER GERRI LYNCH MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE LA QUINTA CA 92253 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE 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 contained herein and in the attached schedules is true and complete certify under penalty of perjury and r the la sl of the State of California that the foregoing is true and correct*iholdsr, Executed on{+• By e taasurar or 5sistani Treasurer Executed on [ ++ By to Signature of Conlro to, 5I Measure Proponent or Responslhle OHker 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 Recipient Committee Campaign Statement Cover Page — Part 2 S. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE JOHN J. PENA OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) COUNCILMEMBER, CITY OF LA QUINTA RES] DENTIAL/B USI NESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP LA QUINTA, CA 92253 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 contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER COMMITTEE ADDRESS CITY COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS CITY CONTROLLED COMMITTEE? ❑ YES ❑ NO STREETADDRESS (NO P.O. BOX) STATE ZIP CODE AREA CODE/PHONE I.D. NUMBER CONTROLLED COMMITTEE? ❑ YES ❑ NO STREETADDRESS (NO PO. BOX) STATE ZIP CODE AREA CODE/PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION COVER PAGE - PART 2 CALIFORNIA .-4•1 Page 2, of ! .i ❑ SUPPORT ❑ OPPOSE Identify the controlling 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 CandidatelOfficehoider Committee Listnames of officeholder(s) or candidaie(s) 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 Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 Contributions Received 1. Monetary Contributions................................................... Schedule A, Line $ 2. Loans Received................................................................ schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 4. Nonmonetary Contributions...... . ........................ ... :+_.... schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 $ Expenditures Made Amounts may be rounded to whole dollars. Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) 1500 250 1750 0 1750 6. Payments Made................................................................ Schedule E, Line 4 $ 7. Loans Made................................................................... schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 11. TOTAL EXPENDITURES MADE ........................................ Add Lines s+ s + 10 $ Current Cash Statement 12. Beginning Cash Balance....... ..................... Previous summary Page, Line 16 $ 13. Cash Receipts........................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 15. Cash Payments......................................................... Column A, Line 8above 16. ENDING CASH BALANCE ..................Add lines 12 + 13 + 14, then subtract Line 15 $ if this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instructions on reverse $ 19. Outstanding Debts ............................,. Add Line 2 + Line 9 in Column B above $ 212 0 212 h V 0 212 380 1750 G 212 1918 U 0 150 Statement covers period from 1 /1 /2018 through Column B CALENDAR YEAR TOTAL TO DATE 1500 250 1750 0 1750 304 0 304 G 0 304 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). SUMMARY PAGE 6/30/2018 Page :� of I.D. NUMBER 1370057 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made` (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) "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 Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 DATE RECEIVED 5/10/18 5/10/18 Amounts may be rounded to whole dollars. SCHEDULE A Statement covers period CALIFORNIA from 1 /1 /2018 FORM • r through 6/30/2018 Page C! of I.D. NUMBER 1370057 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN.1 -DEC. 31) (IF REQUIRED) OF BUSINESS) E COLE BURR OIND ❑ COM PRESIDENT El OTH BURRTEC WASTE 750 750 TEMECULA, CA 92592 ❑ PTY ❑ SCC TRACY BURR Ia IND ❑ COM ❑OTH 750 750 TEMECULA, CA 92592 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC 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.)........ SUBTOTAL $ 1500 F_ l *Contributor Codes IND- Individual $ 1500 COM — Recipient Committee (other than PTY or SCC) $ OTH — Other (e.g„ business entity) .......... PTY — Political Party SCC — Small Contributor Committee TOTAL $ 1500 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule B - Part 1 Loans Received Amounts may be rounded to whole dollars. Statement covers period from 1 /1 /2018 6/gin/9ni A SEE INSTRUCTIONS ON REVERSE through NAME OF FILER COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 FULL NAME, STREETADDRESS AND ZIP CODE INDIVIDUAL, ENTER a OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING (IFBALANCEAT COMMITTEEO,ALSOEDNTER ER DNUMBER) OCIFAN CFSELF-OEMPLOYAND EENTOYER BEGINNING THIS BALANCE RECEIVED THIS OR FORGIVEN* C OSE OFT IS NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD PERIOD JOHN PENA JOHN PENA & ASSOC ❑ PAID 51405 LO 92253 s s ❑ FORGIVEN $ $ 250 11 /6/18 t 0 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ DATE DUE ❑ PAID s s ❑ FORGIVEN t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC s s s DATE DUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Schedule B Summary ❑ PAID s s ❑ FORGIVEN s s s SUBTOTALS $ $ $ 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.)................................... Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another parry also must be reported on Schedule A. ** If required. DATE DUE (e) INTEREST PAID THIS PERIOD 0 % RATE s �o RATE s RATE s $ (Enter (e) on Schedule E, Line 3) SCHEDULE B - PART 1 Page of I.D. NUMBER 1370057 M (9) ORIGINAL CUMULATIVE AMOUNTOF CONTRIBUTIONS LOAN TO DATE CALENDAR YEAR $ 250 s 250 PER ELECTION" 5/2018 250 $ DATE INCURRED CALENDAR YEAR s s PER ELECTION" a DATE INCURRED CALENDAR YEAR a a PER ELECTION" a DATE INCURRED $ 9r;n tContributor Codes n IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party NET $ SCC — Small Contributor Committee (May be a negative number) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Amounts may be rounded Statement covers period to whole dollars. CALIFORNIA 460 Payments Made from 1 /1 /2018 FORM through 6/30/2018 Page SEE INSTRUCTIONS ON REVERSE — of NAME OF FILER I.D. NUMBER COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 1370057 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 RAID 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 FIND 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 1.13 NUMBER) RABOBANK LA QUINTA, CA 92253 CODE OR " Payments that are contributions or independent expenditures must also be summarized on Schedule D, Schedule E Summary BANK FEES 1. Itemized payments made this period. (include all Schedule E subtotals.) ....................................... DESCRIPTION OF PAYMENT 2. Unitemized payments made this period of under$100................................................................................................. 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).).................................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) SUBTOTAL$ ............................... $ ....................... I....... $ ......................................... $ ..,......... I .............. TOTAL $ AMOUNT PAID 120 120 92 6 212 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov