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HomeMy WebLinkAboutPemberton, Dorothy - 460 (09-24-23 thru 10-21-23) Amendment_RedactedCOVER PAGE Recipient Committee Date stamp Campaign Statement am Cover Page ', Page of Statement covers period Date of election if applica616 (Month, Day, Year) For Official Use Only from f t� SEE INSTRUCTIONS ON REVERSE / through { t 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 2, Type of Statement: Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ ❑ Statement Quarterly Statement Q State Candidate Election Committee Committee Semi-annual ❑ ❑ Special Odd -Year Report 0 Recall O Controlled Termination Statement (Also Complete Parts) 0 Sponsored Complete (Also file a Form 410 Termination) Amendment (Explain below) (Also Pad6) ❑ General Purpose Committee Q Sponsored El Primarily Formed Candidate/ ¢v °,- - 8 i Small Contributor Committee" Officeholder Committee ~��- e . Political Party/Central Committee (Also Complete Part7) ;l 0 6'." ov ICU I- 3. Committee .information I.D. NUMBEFi� -Treastarer(s) COMMITTEE NAME (OR CANDIDATE'S NAMEIF NO COMMITTEE) NAME OF TREASURER Y re "Ag .. d� la/ �A P RS C p� MAILINGADDIR/E[SSAr \ sl J/ STREET ADDRESS (NO RO. BOX) CITY STATE ZIP CODE AREA CODE/PHONE � V_%_A CITY STATEZIP CODE AREA CODE/PHONE NAMEf OF ASSISTANT TRUSURER, IF ANY �j MAILING ADDRESS (IF FERENT) NO. AND STREET OR P.O. BOX MAILINGADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ' 170 ZIP CODE AREA CODE/PHONE Z OPTIONAL: FAX / E-MAIL ADDRESS S2"-V y OPTIONAL`. FAX / E-MAIIYDRESS ® 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. I ' ? By Executed on ea"_-t Mt. / —. ®._ By Executed on _ ;. Date ., Signature of C risible Officer of Sponsor Executed on BY Date Signature o ontro mg ice o er, an i a e, a e easure roponant Executed on BY Date FPPC Form 460 (tan/2016)) Signature of Controlling Officeholder, Candidate,: State Measure Proponent FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Fart' COVER PAGE —PART 2 Page of 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CA (DATE NAME OF BALLOT MEASURE er on OFFICE SOUGHT OR HELD f((IINCLUD�EE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ElSUPPORT owne,� i.,l y YI r� " gCJIc ❑OPPOSE l :STATE ZIP 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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I,D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7, Primarily Formed Candidate/Officeholder Committee t isrnames of officeholder(s) or candidate(s) for which this committee is primarily farmed. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME LID, NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) 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 El SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Amounts may be rounded SCHEDULE A o whole oars. MonetaryContributions Received Statement covers period from q. y - it • # � j � � through 1 42 -f s r Page of SEE INSTRUCTIONS ON REVERSE N ME OF FILER p �y/^� �tr,y j, / } wNUMBER 31"C10 (,li1! i eii t ty `71 Ylir� � !l p p t c� I ! DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I:D, NUMBER) CODE .. (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) " PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) [IIND ❑ COM C] OTH ❑ PTY El SCC Gt o n 4y 0 n l? t y ,r IN D07) COM to ^I MiM❑ ❑OTH'l% � 6 ty {� f ❑ PTY ❑SCC Fl c?h--f NrIND 0 COM f o �-- t 60 CI OTH El /� Girl es l i/ � PTY D SCC pd f {� r / et rdr0 BIND COM ksol Ej TH 1 t c(}j i' > �lcc 6 [71 PTY ❑ SCC f j ort-FSV) RIND ❑COM ❑ OTH j �% 'loot ,�,�t ,o //7� 0 a) r} L l 7 0 4 [] PTY Q SCC SUBTOTAL $ Schedule A Summary *Contributor Codes IND1. Amount received this period - itemized monetary contributions. CO -Individual P rY COM -Recipient Committee (Include all Schedule A subtotals.) .... ... -... ..::.:... ...:.............:.............. ........ ....... .........$ (other than PTY or SCC) OTH - Other (e.g., business entity) 2. Amount received this period - uniternized monetary contributions of less than $100 ....... ... $ PTY- Political Party SCC - Small Contributor Committee 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page Column A, tine 1.).......... .........TOTAL $ FPPC Form 460 (Janf2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 1 1 19 1 tl Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period - A `7 ° o ®- • from... through / % Page of NAME OF FILER !y1 A� r^ I�iJ(/ -- t «� I.D. NUMBER C '66t , ii�i &✓ t j i r "' + ! Ci y' i' + JG:r'� t t +.,�, f / FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER CONTRIBUTOR * RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CDDE. (IFSELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) .PERIOD (JAN, 1-DEC. 31) (IF REQUIRED) r5 INDn . C�;, fur l f+ ��.✓✓ 5 f ❑OTH qy a/yqo PTY SCC c *Ty IND [� COM L OTH m rra� l' t..^'� � } ❑ PTY ❑ SCC COM El � �/ i ac 1�IJfiJ. .,, yMM OTN a) ` , 0t � (j ❑ PTY 7 [I SCC j J c°r 1% 1 .) FIND rR-1 Hm ', 9 �!(l)}l f C1� ❑ PTY C1scC in'(I�//^N//^ryD (�t% 4 r ❑ PTY /Y) 47 A e m i/d SCC SUBTOTAL *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'(86 /275-37721 www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA,(CONT.) Monetary Contributions Received to whole dollars. Statement covers period from ? ', 2-'3 .— • " through 1 " ' v7' of— In' NAME OF FILER I.D. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL; ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER CONTRIBUTOR * RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER:I.D. NUMBER) OF BUSIN_ESS)S).. " PERIOD (JAN, I - DEC. 31) (IF REQUIRED) ,,,++ Az,qr (%�i77t �1L.7 �i' IND ZL7% I� f �COM — t ` r-4�t_ OTH reJ iticj5 y �o ❑PTY d-r SCC ❑ IND ❑ COM D OTH ❑ PTY _ ❑ SCC =(� IND ❑ COM OTt t PTY Cl SCC IND " El COM ❑ OTH ❑ PTY ❑ SCC ❑ IND COM CITH ❑ PTY SCC SUBTOTAL $' 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCO) OTH — Other (e.g., business entity) PTY—Political Party SCC — Small Contributor Committee FPPC Form 460 {JanJ2016)} FPPC Advice:advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 Amounts may oe rounaea Schedule B -- Part 1 to whole dollars. Statement covers period . Loans Received from__ • 1 � ° page j 4 through of _ SEE INSTRUCTIONS ON REVERSE NAME OF FILER Pon &,(�A Ar a// _/2/j-0 I.D. NUMBER 145 -9910 : FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER e OUTSTANDING BALANCE AMOUNT RECEIVED THIS C AMOUNT PAID OR FORGIVEN d OUTSTANDING BALANCE AT e INTEREST PAID THIS ORIGINAL AMOUNT OF 9T CUMULATIVE CONTRIBUTIONS OF LENDER (IF COMMITTEE,Atso ENTER Lo. NUMBER} (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) BEGINNING THIS PERIOD PERIOD THISPERIOD- CLOSE OF THIS PERIOD PERIOD LOAN TO DATE //���/ i7� yt l fi ! yry f 1✓ l % t r M ❑ PAID $ 0$ $ GALENDAR YEAR $ U.� ....RATE60 { FORGIVEN PER ELECTIONk* CA, �Oaql DATE DUE DATE INCURRED t n IND C] COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID GALENDARYEAR` ElFORGIVEN RATE PER ELECTION" ... t [I IND ❑ COM ❑ OTH [:1 PTY El SCC $ $ DATE CLUE DATE INCURRED © PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION" -RATE $ $ $ $ $ DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ $ $ $ ....E c E.E�,.� (Enter te} on -C,--u e , ne . } Schedule B Summary r 1 Loans received this period ................ .... .......... .............. ........$ r (Total Column (b) plus unitelnized loans of less than $100 ) 2. Loans paid or forgiven this period. .......... .......... ....... .......... ................... ___ ................... :................$ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loads paid by a third party that are also itemized on Schedule A) r� { 60 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 bL a negative. number) *Amounts forgiven or paid by another party also must be reported on Schedule A. �« If required, FPPC Form 460 (.€anJ20i6)} FPPC Advice: adv€ce@fppc.ca.gov(866/275.3772) ;www.fppc.ca.gov SCHEDULEE Schedule E Amounts may be rounded to whole dollars. Statement covers period Payments Made ` `�' '� • " from / through Page of SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. GMP campaign paraphernalia/miser 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 FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supportinglopposing 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 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID fJ/y!�.��/lyaj`-�.«� �lI p��++^�(J * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ c Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ....,. $ IL66. 0 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 Lilies 1,.2, and 3. Enter here and On the Summary Page, Column A, Line 6.)....... ........:..,..... TOTAL. $ LL FPPC Form 460 (Jan/2026)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) " www.fppc.ca.gov' Schedule E SCHEDULE E (CONY.) Amounts may rounded to whole dollars. Statement cowers period (Continuation Sheet) �?" Payments MadefromSEE F!!F through la—U` Zol INSTRUCTIONS ON REVERSE NAME OF FILER _ I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalialmisc. 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 FND 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) • . CODE OR w DESCRIPTION OF r t- t " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ & p FPPC Form 460 Jan 2016)) FPPC Advice advice@fppc.ca.gov (866/275-3772) wwwfppc.ca.gov