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460 Pena 2019 from 07/01 to 12/31Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1 /2019 through 12/31 /2019 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. W1 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D NUMBER 1370057 (OR CANDIDATE'S NAME IF NO COMMITTEE) 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 AREACODE/PHONE COVER PAGE Date Stamp RECEIVED�A�nc Date of election if applicabl { - Page __/__ of (Month, Day, Year) For Official Use Only CITY OF LA QUINTA :ITY CLERK DEP; RTMENT 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 ANDREA OLIVER GILMORE MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE LA QUINTA CA 92253 NAME OF ASSISTANT TREASURER, IF ANY SHERRY LOVE-PENA MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE LA QUINTA CA 92253 OPTIONAL: FAX/E-MAIL ADDRESS 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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on , / w By � I oat W Signalure of Treasurer orAssistantTram orer Executed on if `� �0 By _ D to Signature of Contr, ling OfflCeholder, Candidato, Slate Measure Proponent or Responsible Officer of Sponsor Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on g Date y Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Recipient Committee Campaign Statement Cover Page — Part 2 NAME OF OFFICEHOLDER OR CANDIDATE JOHN J. PENA OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL CITY OF LA QUINTA RESIDENTIAUBUSINESS 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 CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTFr ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE I Page 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 of BALLOT NO. OR LETTER JURISDICTION ❑ 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 Candidate/Officeholder Committee Listnames 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 7/1 /2019 • - � 6 0 from SEE INSTRUCTIONS ON REVERSE through 12/31 /2019 Page of NAME OF FILER I.D. NUMBER COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 1370057 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ 0 $ 12093 0 750 1/1 through 6/30 7l1 to Date 2. Loans Received .................................. .......... ...... .............. Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ..................... ........ Add Lines 1 +2 $ 0 $ 12843 20. Contributions Received $ $ 4. Nonmonetary Contributions ... .................. .................... schedule C, Line 3 0 6290 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED .......... :....................... .Add Lines 3 + 4 $ 0 $ 19133 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ schedule E Line 4 $ 96 $ 11977 Candidates 7. Loans Made....................................................................... schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 +7 $ 96 $ 11977 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 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADt............. ...........l—........... Add Lines 8+ 9+ 10 $ 96 $ 11977 $ $ Current Cash Statement 12. Beginning Cash Balance ..............:............. Previous summary Page, Line 16 $ 401To calculate Column B, 13. Cash Receipts—........................................................ Column A, Line 3 above 0 add amounts in Column 14. Miscellaneous Increases to Cash .... .................. ........... schedule ►, Line 4 0 A to the corresponding amounts from Column B *Amounts in this section may be different from amounts reported in Column B. 15. Cash Payments...................................................... Column ALine 8 above 96 of your last report. Some, amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 305 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 from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any) 18. Cash Equivalents. ............... --- ............. --- ....... see instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 750 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 Schedule 6 — Part 1 to whole dollars. Statement covers period . Loans Received 7/1/2019 • , from • SEE INSTRUCTIONS ON REVERSE through 12/31 /2019 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 OCCUPATION AND EMPLOYER OUTSTANDING �� AMOUNT c () AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D NUMBER) EN (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN* BALANCEAT CLOSE OF HIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE JOHN J. PENA JOHN PENA ASSOC ❑ PAID CALENDAR YEAR $ 0 $ 750 0 % $ 750 $ 750 ❑ FORGIVEN LA QUINTA, CA 92253 RATE PER ELECTION" $ 750 0 $ 0 12/31 /20 $ 9/2018 $ 750 to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION*' t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ DATE INCURRED $ DATE DUE ❑ PAID CALENDAR YEAR $ $ % $ $ ❑ FORGIVEN PER ELECTION*" RATE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ $ DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ 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.)...................................... 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. $ 0 .......$ NET $ (May be a negative number) { tmer (e) 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) wwwJppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 Amounts may be rounded to whole dollars. Statement covers period from 7/1 /2019 through 12/31 /2019 Page —L of I.D. NUMBER 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 FND fundraising events POL polling and surrey 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 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary AMOUNT PAID E 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 0 2. Unitemized payments made this period of under$100...........................................................................................................................,.............. $ 96 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).).............................................................................. $ 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 $ 96 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov