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Home My WebLink About460 10/27/2016 Recipient Committee Campaign Statement 09/25/2016 - 10/22/2016 Schelly SustarsicRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period 9/25/16 from 10/22/16 through 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 0 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall O Controlled (Also Complete Pan 5) O Sponsored (Also Complete PM 6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate( 0 Small Contributor Committee Officeholder Committee O Political Party /Central Committee (Also Complete Part 7) 3. Committee Information LD. NUMBER 1388801 '.OMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Friends of Schelly Sustarsic for City Council 2016 STREETADDRESS(NO P.O. BOX) MAILING ADDRESS (IF DIFFERENT) NO AND STREET OR PC BOX CITY STATE ZIPCODE AREA CODE /PHONE Date of election if appli (Month, Day, Year) IMIECEUVED OCT 272016 COVER PAGE Page of For Official Use 11 /8/16 CITY CLERK CITY 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) NAME OF TREASURER Patricia Campbell 4433 Ironwood Avenue CITY STATE ZIP CODE AREA CODE/PHONE Seal Beach CA 90740 562 - 598 -3941 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIPCODE AREA CODE /PHONE OPTIONAL: FAX /E -MAIL ADDRESS OPTIONAL: FAX /E -MAIL ADDRESS Schellys @aol.com Campbelipe @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 laws of the State of California that the foregoing is true an /c/oor�rre�c — Executed on '0' -2-7 11 6 By v - Data Signature of Controlling Offioeho Cantlitlate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Offceholtler, Cantlitlate, State Measure Proponent FPPC Form 460 (Jan /2016) FPPC Advice: advice@fppc.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) City Council, District 4 RESIDENTIAL)BUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page 2 of 7 ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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. NAME NAME OF TREASURER I.D. NUMBER ❑ YES ❑ NO 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 HELD ANY 7. Primarily Formed Candidate /Officeholder Committee Listnames of officeholder(s) or candidates) 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 Tian /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. frorr Statement covers period 9/25/16 SUMMARY PAGE FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov 10/22/16 3 7 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Schelly Sustarsic 1388801 Contributions Received Column A TOTAL THIS PERIOD Column B CALENDAR YEAR Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and 1,116 3895 General Elections 1. Monetary Contributions .................... ............................... Schedule A, Line 3 $ $ Q 300 1/1 through 8/30 7/1 to Date 2. Loans Received ................................. ............................... Schedule s, Line 3 1116- 6895 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS...._ ................... Add Lines I +2 $ $ Received $ $ 240 4. Nonmonetary Contributions... .................. ............ ........ . Schedule C, Line 3 21. Expenditures 1356 7252 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED ... ...... ... .......... ._._ ........AddLines3 +a $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ......... ................ ..... ....... ... ........ ...._........ Schedule E, Line 4 $ 1696 $ 2778 Candidates 7. Loans Made... ............ ....... ............ ......................... ............ Schedule H, Line 3 0 0 1696 2778 22, Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS.. .......... -- ................. Add Lines 6 r 7 $ $ (if Subject to Voluntary Expenditure Limitj 9. Accrued Expenses (Unpaid Bills) .......... ............................... Schedule F Line 3 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment ....... .............._... __..__._......_.ScheduleC.Line3 240 357 (mm /dd/yy) 11. TOTAL EXPENDITURES MADE . ..... ..____ ...................... Add Lines 8+9.10 $ 1936 $ 3135 $ $ Current Cash Statement 4697 12. Beginning Cash Balance.. ......... ................ Previous Summary cage, Line 1s $ To calculate Column B, 13. Cash Receipts ... ................ ....... ................. .... Column A, Line 3above 1116 add amounts in Column 14. Miscellaneous Increases to Cash ... ............................... Schedule 1, Line 4 D A to the corresponding amounts from Column B 'Amounts in this section may be different from amounts 1696 of your last report. Some reported in Column B. 15. Cash Payments..._ ............. ... ......... .............. .. ........ Column A, line aabove amounts in Column A may 4117 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 e,Part z $ fled for this calendar year, only carry overIteamounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents... ................ .................. See instructions on reverse $ 3000 19. Outstanding Debts .............................. Add line 2 +Line 9 in Column a above $ FPPC Form 460 (tan /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 wnoia dollars. Statement covers period e , 9/25/16 , 0 from _ 10/22/16 4 7 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Schelly Sustarsic 1388801 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER LD. 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) Donna Kastner IND retired 9/25/16 ❑ OTH ❑ PTY ❑ SCC Karon Duzich OIND retired 9/27/16 ❑ OTH ❑ PTY ❑ SCC Diana Carey B IND Councilwoman 10/9/16 ❑ OTH ❑ PTY ❑ SCc Ann Tuler O IND Real Estate Agent 1017/16 E] OTH ❑ PTY ❑ SCC Paul Yost 0IND Physician 10/8/16 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 575 " f s + Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) .......................... I................... 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.) ........... 575 541 .....TOTAL $ 1116 `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) urww fnnr ra .nv A tc .. b AAA SCHEDULE B - PART 1 Schedule B — Part I to whole dollars. Statement covers period Loans Received 9/25/18 ° from 10/22/18 7 !ER SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NU Schelly Sustarsic 1388801 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL 9 CUMULATIVE OFLENDER OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IF COMMITTEE.ALSO ENTER D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE Schelly Sustarsic Homemaker 0 PAID CALENDAR YEAR 4288 Candleberry Avenue $ $ 3000 3000 3000 $ Seal Beach, CA 90740 _% $ ❑ FORGIVEN RTE PER ELECTION" 3000 0 $ 3 $ 8 $ DATE DUE DATE INCURRED 10 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION- RATE DATE DUE DATE INCURRED 1[:] IND ❑ COM ❑ OTH ❑ PTV ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION'S RATE DATE DUE DATE INCURRED 1❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0$ 0 $ 3000 $ i"+ y vt-1 I" 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 $ 0 (May be a negative number) (m „ ,r, Sahe&le E, Line 3) 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 In I d II SCHEDULE C I Nonmonetary Contributions Received 0 w o a o am. Statement covers eriod p 9/25/16 from F 10122/16 7 SEE INSTRUCTIONS ON REVERSE through P NAME OF FILER Schelly Sustarsic 11 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR CODE " OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER ID. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) (IF REQUIRED) Elizabeth Kane ®IND Operations Manager food & beverage 10/8/16 ❑ OTH Co ❑ 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 $ 200 �L' . fir' ,a«v zm mY. Schedule C Summary Amount received this period — itemized nonmonetary contributions. 200 (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.) .....................TOTAL $ 40 240 '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 E Payments Made SEE INSTRUCTIONS ON REVERSE Schelly Sustarsic Amounts may be rounded to whole dollars. SCHEDULE E Statement covers period . I 9/25/16 • from 10/22/16 7 7 through Page Of 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 ID.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Minuteman Press 5480 Katella Avenue LIT 605 Los Alamitos, CA 90720 Seal Beach Sun 216 Main Street PRT 960 Seal Beach, CA 90740 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1565 Schedule E Summary 1565 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................. ............................... $ 131 2. Unitemized payments made this period of under $ 100 ........................................................................................................... ............................... $ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column ( e).) .............................................. ............................... $ 1696 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov