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HomeMy WebLinkAbout460 09/28/2016 Recipient Committee Campaign Statement 07/01/2016 - 09/24/2016 Schelly SustarsicRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period Date of election if applicabl c q n Page 7/1/16 (Month, Day, Year) SEP 8 8 2016 from through 9/24/16 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 0 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Aao Complete Pans) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party /Central Committee 3. Committee Information ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) Friends of Schelly Sustarsic for City Council 2016 STREET ADDRESS (NO P.O. BOX) MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR PO BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX /E -MAIL ADDRESS Schellys @aol.com For Official CFFY CPERI( 11/08/16 Cur f OF SEAL BEACH. 2. Type of Statement: 52 Preelection Statement ❑ Quarterly Statement ❑ Semi - annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) COVER PAGE of NAME OF TREASURER Patricia Campbell MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY CITY STATE ZIP CODE AREACODE /PHONE OPTIONAL: FAX /E -MAIL ADDRESS Campbellpe @aol.com 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 la /ws of the State of California that the foregoing is tru nnjd /cyorrrre-c�t. Executed on ( /T" By'^'�' -� pate ( , Date Sionature of Controlling ORiceholtl antlitlate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Data Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Data Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan /2016) FPPC Advice: advicilPoc.ca.aov (866/275 -3772) Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Schelly Sustarsic OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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. CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEE NAME I I.D. NUMBER NAME OF TREASURER ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE /PHONE COVER PAGE - PART 2 Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE 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 UIS I K0..I NU. Ir ANT 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 0 SUMMARY PAGE Statement covers period 0 . Summary Page to whole dollars. g To Calculate Column B, 13. Cash Receipts ............................ ............................... Column A, Linea above 5,779 add amounts in Column 7/1/16 D Ato the corresponding 14. Miscellaneous Increases to Cash ... ............................... schedule 1, Line q amounts from Column B from 0. of your last report. Some 9/24/16 3 8 SEE INSTRUCTIONS ON REVERSE 16. ENDING CASH BALANCE ..................Add Lines 12 * 13 + 14, then subtract Line 15 $ be negative figures that through Page of NAME OF FILER If this is a termination statement, Line 16 must be zero. previous period amounts. If I.D. NUMBER Schelly Sustarsic this is the first report being 17. LOAN GUARANTEES RECEIVED . Schedule 6, Part 2 $ 0 1388801 Contributions Received Column A TOTAL THIS PERIOD Column B Calendar Year Summary for Candidates 0 any). (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and 2 779 2 779 General Elections 1. Monetary Contributions .................... ............................... Schedule A, Line 3 $ $ 3,000 3,000 v1 through s/3e 7n to Date 2. Loans Received ................................. ............................... schedule e, Line 3 — — — — — — — T779- 5,779 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS. ............... .......... Add Lines t F 2 $ $ Received $ $ 117 4. Nonmonetary Contributions ............. ............................... Schedule C, Line 3 21. Expenditures 5,896 5,896 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED ... .... .... ._ . .. ..... .- ....AddLines3 +q ......_ $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ............ ....... ............. ......... .......... ............ schedule E, Line q $ 1,082 $ 1,082 Candidates 7. Loans Made ........................................ ............................... Schedule H, Line 3 0 0 1, 082 1, 082 22. Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS ........... ............................... Add Lines 5 +7 $ $ (Ifeubject 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 3 117 117 (mm /dd /yy) 11. TOTAL EXPENDITURES MADE ...... ....... ......__.........Add Lines S.9110 $ 1,199 $ 1,199 1 1 $ Current Cash Statement 0 12, Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ To Calculate Column B, 13. Cash Receipts ............................ ............................... Column A, Linea above 5,779 add amounts in Column D Ato the corresponding 14. Miscellaneous Increases to Cash ... ............................... schedule 1, Line q amounts from Column B 15. Cash Payments ........................ ...._ ............... Column A, Line eabove 1,082 of your last report. Some 4,697 amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 * 13 + 14, then subtract Line 15 $ 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 6, 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 0 any). 18. Cash Equivalents ................. ............................... See instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column 8 above $ $ `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 Amounts may be rounded SCHEDULE A Monetary Contributions Received to wno e, oonars. statement covers period o _ iI 7/1/16 • a from • � i 9124/16 4 8 SEE INSTRUCTIONS ON REVERSE through Page Of NAME OF FILER I.D. NUMBER Schelly Sustarsic 1388801 DATE FULL NAME, STREETADDRESSAND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTFRi O. NUMBER) CONTRIBUTOR IF AN 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) Gary Miller B IND retired 8/12/16 ❑ OTH ❑ PTY ❑ SCC Bea Kuebler 0 IND realtor, independent 8/29/16 ❑ OTH ❑ PTY ❑ SCC Sharman Snow ® IND retired 917/16 ❑ OTH ❑ PTY ❑ SCC Jennifer Hayter ® IND retired 917/16 E] OTH ❑ PTY ❑ SCC Mindy Sander ® IND homemaker 9!7116 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 1,000 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.) ....... 2,049 730 TOTAL $ 2,779 IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTV — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www fnnr ra onv Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary Contributions Received to whole dollars. Statement covers period a 7/1/16 • • from 9/24116 5 8 through Page of NAME OF FILER I.D. NUMBER Schelly Sustarsic 1388801 DATE FULL NAME, STREETADORESS AND ZIP CODE OF CONTRIBUTOR REET AIDESSANDZICNUMBER) CONTRIBUTOR IF AN 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) Wendi Debie ®IND investor 9/19/16 El OTH ❑ PTY ❑ SCC David Feldman OIND dentist 9119/16 ❑ OTH ❑ PTY ❑ scC Marc Loopesko 01ND retired 9/19/16 ❑ OTH ❑ PTY ❑ SCC Patricia Campbell RIND retired 9/19/16 El OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC I SUBTOTAL$ 1,049 g xN 'A?`(?5 `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 B - PART 1 Schedule B — Part 1 to whole dollars. Statement covers period ° . , I�4 Loans Received 7/1/16 ° from • 9/24/16 8 8 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Schelly Sustarsic 1388801 FULL NAME, STREET ADDRESS AND ZIP CODE OCIF AN INDIVIDUAL, ENTER CUPATION AND EMPLOYER OUTSTANDING AMOUNT e AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL g CUMULATIVE OFLENDER pr CWWTTEE,ALSO ENTER I. D. NUMBER) (IF SELF - EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD GR FGRGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS NAME Or BUSINESS) PERIOD THIS PERIOD' PERIOD PERIOD LOAN TO DATE Schelly Sustarsic homemaker ❑ PAID CALENDAR YEAR 4288 Candleberry Avenue 0 $ $ 3,000 3,000 $ 3,000 Seal Beach, CA 90740 _% $ E] FORGIVEN FORGIVEN PER ELECTION" $ 0 $ 3,000 $ 0 $ 8/10/16 $ tid IND ❑ COM ❑ OTH ❑ PTY [-I SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR g $ % $ 3 E] FORGIVEN FORGIVEN PER ELECTION" $ $ $ $ S DATE DUE DATE INCURRED tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION" RATE $ $ $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 3,000 $ $ 3,000 $ „I "'W1 9P;' 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 $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ....... ............................... Enter the net here and on the Summary Page, Column A, Line 2. "Amounts forgiven or paid by another party also must be reported on Schedule A. "" If required. . ..............................$ 3.000 ...$ 0 ...............NET $ 3,000 (May be a negative number) (Enter (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) www.fppc.ca.gov Schedule C Amounts may be rounded SCHEDULE C Nonmonetary Contributions Received VQ� �� Statement covers period 4. 711/16 a e from 9/24/16 7 8 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Schelly Sustarsic 1388801 DATE FULLP NAME, CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE COD OFCO CONTRIBUTOR CONTRIBUTOR CODE CODE • OCCUPATION (IF SELF. AND EMPLOYER (IF SELF ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF COMMITTEE. ALSO ENTER LD. NUMBER) AL OF NAME OF BUSINESS) (JAN 1 -DEC 31) (IF REQUIRED) ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL g Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.) ............................................................ ............................... 2. Amount received this period — unitemized nonmonetary contributions of less than $100....... 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ....... ..................... $ $ $117 ........TOTAL $ $117 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 E Payments Made SEE INSTRUCTIONS ON REVERSE Schelly Sustarsic Amounts may be rounded to whole dollars. Statement covers period 7/11/16 from through 9/24/16 I Page 8 of 8 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment 1388801 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 (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I. D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Minute Man Press 5480 Katella Avenue LIT $130 Los Alamitos, CA 90720 campaign LA 15518 S. Broadway Street CMP $710 Gardena, CA 90248 ` Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ $840 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.) $840 $ $242 ............................... $ .................. TOTAL $ $1,082 FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov E