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460 Pena 2022 from 01/01 to 06/30COVER PAGE Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 1/1/2022 through 6/30/2022 1. Type of Recipient Committee: All committees -Complete Parts t, 2, 3, and 4. miceholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 8ffState Candidate Election Committee ommlttee O Recall E Controlled (Also CorrgJaleAarl5) O Sponsored (Also Complete Part 6) ❑gneral Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complele Pad 7) 3. Committee Information I.D. NUMBER 1370057 COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 STREET ADDRESS (NO P.O. BOX) 51405 STATE ZIP CODE AREA CODE/PHONE LA QUINTA CA 92253 7605644184 ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX 51405 CALLE HUENEME CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS JOHNPENA4LQ of election if applicable: (Month, Day, Year) RECEDE VR_ JUL 2 9 2U22 Page --L— of I For Official Use Only CITY OF LA QUINTA ITY CLERK DEPARTMEN 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement m Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER SHERRY LOVE-PENA MAILING ADDRESS 51405 STATE ZIP CODE AREA COD PHONE LA QUINTA CA 92253 7605644184 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 certify under penalty of perjury under the laws of the State of California that the foregoing is true an orre Executed on � � G a Z-, By a[a gnat L"IBy TI.-, Signature of Controlling O nhbldo', Cs a .- Nat herein and in the attached schedules is true and complete, I Executed on By Date Signature of Controlling Officeholder, Candidate, Slate Measure Proponent Executed on By DaleSignature of ConLrolling Officeholder, Candidate, Slate Measure Proponent FPPC Form 496 (Feb/2019) 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 JOHN PENA OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE) CITY COUNCIL RESIDENTIAL/BUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP LA QUINTP 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 COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page - of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER i 1SDICTION ❑ 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 commtrwo 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 to whole dollars. Summary Page Statement covers period from 1/1/2022 SUMMARY PAGE through 6/30/2022 Page __0 of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER COMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 1370057 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDAR YEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 1. Monetary Contributions................................................... schedule A, Line 3 $ 0 $ 19133 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule B, Line 3 0 1100 0 20233 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ $ Received $ $ 0 6290 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 0 26523 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED ................................ Add Lines 3+4 $ $ Expenditures Made 6. Payments Made ...... .......... --............... ..................... ..------ Schedule E, Line 4 $ 103 $ 12133 7. Loans Made ................. . Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 103 $ 12133 9. Accrued Expenses (Unpaid Bills) ....................................... Schedule F Line 3 0 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 103 $ 12133 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 353 13. Cash Receipts .................... Column A, Line 3 above 0 ............................... 14. Miscellaneous Increases to Cash ..._ ............................. Schedule I, Line 4 0 15. Cash Payments ........................................ Column A, Line 8above 103 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 250 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED.. Schedule B, Part 2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ O 19. Outstanding Debts................ .............. Add Line 2 + Line 9 in Column B above $ 1100 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). 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 496(Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 Schedule B — Part 1 �to whole dollars. �cy Statement covers period CALIFORNIA Loans Received from 1/1/2022 a FORM through 6/30/2022 Page of _51- SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2018 1370057 FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE AMOUNT AMOUNT PAID OUTSTANDING BALANCEAT INTEREST PAID THIS ORIGINALtONTRIBUTIONS AMOUNT OF UMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER D, NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN THISPERIOD. CLOSEOFTHIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD PERIOD PAI{7 A1100 Y R JOHN PENA JOHN PENA & ASSOC 0 0 1100 s1100 LA QUINTA, CA 92253 ❑ FORGIVEN RATE PER ELEr-rio " 1100 S 0 S 0 5 12/22 0 S 1100 S tla IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED DATE DUE PAID CALENDA EAR $ S % S $ PER ELECTION" ❑ FORGIVEN RATE S S S S DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE ❑ PAID CALENDAR YEAR S S % S 5 ❑ FORGIVEN RATE PER ELECTION" $ S $ $ S DATE DUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC 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.)................................................... -......... NET $ 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. If required. (Enter (e) on Schedule E, Llrre 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 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period from 1/1/2022 CALIFORNIA FORM SEE INSTRUCTIONS ON REVERSE through 6/30/2022 Page 5of 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 paraphemalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants CTB contribution (explain nonmonetary)' MTG OFC meetings and appearances office expenses RFD returned contributions SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)' PHO POL POS phone banks polling and survey research postage, delivery and messenger services TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor LEG legal defense LIT campaign literature and mailings PRO PRT professional services (legal, accounting) print ads VOT voter registration WEB information technology costs (internet, e-mail) Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 60.00 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).)............................................................................. $ 60.00 43.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 103 FPPC Form 496(Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov