460 Pena 2018 from 07/01 to 09/22Recipient Committee Date Stamp COVER PAGE
Campaign Statement NPW
Cover Page RECEIVEDStatement covers period Date of election if applicabl: 1p Pag
from
7/1 /2018 (Month, Day, Year) S E P 2 7 2O 10 For Official Use Only
CITY OF LA QUINTA
SEE INSTRUCTIONS ON REVERSE through 9/22/2018 11 /6/2018 [ :ITY CLERK DEPARTMENT
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2.T.yfpe of Statement:
R1 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure LJ Preelection Statement ❑ Quarterly Statement
O State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd -Year Report
O Recall O Controlled ❑ Termination Statement
(Also C—p/efe Part 5) O Sponsored
(Also Complete Pert 8) (Also file a Form 410 Termination)
El General Purpose Committee ❑ Amendment (Explain below)
O Sponsored ❑ Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee
O Political Party/Central Committee (Also Complete Pad7)
3. Committee Information I.D. NUMBER Treasurer(s)
1370057
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 GERRI LYNCH
MAILING ADDRESS
STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
LA QUINTA CA 92253
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
LA QUINTA CA 92253
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE CITY STATE ZIP CODE AREACODEIPHONE
OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX I 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. I
certify under penalty of pedu a derth(�laws of the State of California that the foregoing is true and correct.-;
Executed on 7 By
❑a"5a Slgnaw Trea r Asslan st Creaeurer
1 a! ~
Executed on � • By
alb Signature of Conuol i g i . C iddaa e 'tote Measure Proponent or Responsible Cfflcer of Sponsor
Executed on By U
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on By
Dale 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
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
CITY COUNCIL CITY OF LA QUINTA
RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) 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
STREET ADDRESS (NO P.O. BOX)
STATE ZIP CODE AREA CODE/PHONE
I.D. NUMBER
CONTROLLED COMMITTEE?
❑ YES ❑ NO
STREETADDRESS (NO P.O. 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 Z of
l ❑ SUPPORT
1 ❑ 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 Candidate/Officeholder Committee List names of
officeholder(s) or candidate(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 Amounts may be rounded SUMMARY PAGE
Summary Page to whole dollars. Statement covers periodCALIFORNIA
g from 7/1 /2018 FORM • 1
h 9/22/2018 Page of
SEE INSTRUCTIONS ON REVERSE through
NAME OF FILER I.D. NUMBER
COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 1370057
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
0
1. Monetary Contributions................................................... Schedule A, Line $ 0 $ 1250 0 1/1 through 6/30 7/1 to Date
2. Loans Received................................................................ Schedule A Line 3
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 0 $ 1750 Received $ $
4. Nonmonetary Contributions ............................................ Schedule C, Line 3 0 0 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 $ 0 $ 1750 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made..........,....................................................... Schedule E Line 4 $ 1037 $ 1341 Candidates
7. Loans Made........................................................................ Schedule H, Line 3 0 0
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS...... .................................... Add Lines 6 + 7 $ 1037 $ 1341 (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 ......................... b 0 (mm/dd/yy)
................................ Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ........................................ Add Lines 6 + s + 10 $ 1037 $ 1341 $
Current Cash Statement $
12. Beginning Cash Balance Previous Summary Page, Line 16 $ 1918
To calculate Column B,
13. Cash Receipts.............................................................. Column A, Line 3 above 0 add amounts in Column
0 Ato the corresponding *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 amounts from Column B
reported in Column B.
15. Cash Payments .......................... Column A, Line 8 above 1341 of your last report. Some
""""" """"'"''" amounts in Column A may
16. ENDING CASH BALANCE .................Add Lines 12 + 13 + 14, then subtract Line 15 $ 577 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 $ 0 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
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 250 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
Schedule B - Part 1 to whole dollars. Statement covers period
CALIFORNIA
Loans Received from 7/1/2018 - � r 1
9/22/2018 Ll
SEE INSTRUCTIONS ON REVERSE
through
Page of
NAME OF FILER
I.D. NUMBER
COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018
1370057
FULL NAME, STREET ADDRESS AND ZIP CODE IFAN INDIVIDUAL, ENTER
OCC AND EMPLOYER
ia) lb�
OUTSTANDING AMOUNT
(c)
AMOUNT PAID
ln) (e)
OUTSTANDING INTEREST
IT) Ig)
ORIGINAL CUMULATIVE
OF LENDER F SELF -ON
ENTER
(IF COMMITTEE,ALSO ENTER I D. NUMBER)
BALANCE RECEIVED THIS
BEGINNING THIS PERIOD
OR FORGIVEN}
C ALA C THIS PAID THIS
PERIOD
AMOUNT OF CONTRIBUTIONS
LOAN TO DATE
NAME OF BUSINESS)
PERIOD
THIS PERIOD
PERIOD
JOHN PENA JOHN PENA & ASSOC
❑ PAID
CALENDAR YEAR
51405
0 %
$ 250 s 250
LA QUINTA, CA 92253
$
RATE
❑ FORGIVEN
PER ELECTION*"
s 250 $
11 /6/2018 s
5/20/18 s
t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
$
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
RATE
PER ELECTION**
5 S
S
E
5—
t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
RATE
PER ELECTION"*
S
E
§
S
t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATE DUE
DATE INCURRED
SUBTOTALS $
$
$ $
I '
(Enter (e) on
Schedule B Summary
Schedule E, Llne
3)
1. Loans received this period.........................................................................................................................$
n
(Total Column (b) plus unitemized loans of less than $100.)
tContributor Codes
2. Loans paid or forgiven this period ................................
$
r)
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 parry that are also itemized on Schedule
A.)
OTH — Other (e,g., business entity)
PTY—Political Party
3. Net change this period. Subtract Line 2 from Line 1.
9 p ( )..............................................................
NET $
n
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
SCHEDULE E
Amounts may be rounded
Schedule to whole dollars. Statement covers period CALIFORNIA I
Payments Made from 7/1/2018 FORMSEE INSTRUCTIONS ON REVERSE
through 9/22/2018 Page --s- of
NAME OF FILER I.Q. 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
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
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 (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER 1.13 NUMBER)
CITY OF LA QUINTA
CITY OF LA QUINTA
CODE OR
FIL
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
Schedule E Summary
DESCRIPTION OF PAYMENT
SIGN PERMITT FEES
SUBTOTAL $
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).).............................................................................. $
AMOUNT PAID
500
462
962
75
0
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 1037
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov