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HomeMy WebLinkAboutCommittee Against Measure Q - 2010 FPPC Campaign Disclosure (2) S STATEMENT OF ORGANIZATION Statement o$ Organization Recipient CommitteeALIF "R MA INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D.NUMBER Committee Against Measure Q 2010 1332301 4.Type of Committee Complete the applicable sections. • List the name of each controlling officeholder, candidate,or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election. • List the political party with which each officeholder or candidate is affiliated or check"non-partisan." • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY ❑ Non-Partisan ❑ Non-Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election"committees only) NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION E (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE SUPPORT OPPOSE Measure Q Advisory Measure regarding wireless communication City of Huntington Beach, CA X SUPPORT OPPOSE FPPC Form 410 (June/09) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) S STATEMENT OF ORGANIZATION Statement of Organization Recipient Committee ® " INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D.NUMBER Committee Against Measure Q 2010 1332301 4.Type of Committee (Continued) •o . Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ®CITY Committee ❑COUNTY Committee ❑STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Committee Against Measure Q 2010 6.I o -. .' F List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE o e a s Date qualified 55.Termination RequirementS By signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. -- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511 - 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (June/09) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Type or print in ink. COVER PAGE-PART 2 Recipient Committee CA e Campaign Statement FORM ® 1 Cover Page—Part 2 Page 2 of 5 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Measure Q OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑ SUPPORT Q Huntington Beach ® OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY 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 List names of officeholder(s)or candidate(s)for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEE NAME I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES [-I NO ❑ SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period page s - Summary Page to whole dollars. from 10/17/10 SEE INSTRUCTIONS ON REVERSE through 12/31/10 3 of 5 NAME OF FILER 1(� I.D. NUMBER U Contributions Received TOColumn A Column B Calendar Year Summary for Candidates TALTHISPERIOD CALENDARYEAR Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTALTO DATE g Primary General Elections 1. Monetary Contributions ........................................... Schedule A,Line 3 $ 226 $ 7053 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... Schedule e,Line 3 -4452 5133 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ -4226 $ 12,186 Received $ $ 4. Nonmonetary Contributions.................................... Schedule C,Line 3 0 2318 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ -4226 $ 14,504 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E,Line 4 $ $ 12,186 Candidates 7. Loans Made............................................................. Schedule H,Line 3 12 186 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ $ (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ...............................Schedule F Line 3 ' Date of Election Total to Date 10. Nonmonetary Adjustment ..........................................schedule c,Line 3 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE................................Add Lines 8+9+10 $ $ 12,186 $ Current Cash Statement $ 12. Beginning Cash Balance....................... Previous Summary Page,Line 16 $ 4226 To calculate Column B,add 13.Cash Receipts ................................................... Column A,Line 3 above -4226 amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash........................... Schedule 1,Line 4 from Column B of your last reported in Column B. 15. Cash Payments.................................................. Column A,Line a above ,� report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ 0 figures that should be subtracted from previous if this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED .................... Schedule 8,Part 2 $ for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7,and 9(if Q g any). 18. Cash Equivalents........................................ See instructions on reverse $ 19. Outstanding Debts......................... Add Line 2+Line 9 in Column a above $ 0 FPPC Form 460(January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC(8661275-3772) Schedule A Type or print in ink. SCHEDULE A I�1011eta CO11$rIl3U�lOrIS Received Amounts may be rounded Statement covers period 17/ to whole dollars. 10/17/10 d ® 1 from • SEE INSTRUCTIONS ON REVERSE through 12/31/10 Page 4 of 5 NAME OF FILER r- }� aO I.D. NUMBER COrrlm i e,�, O�i 4� I 'I SU V e DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE,ADDRESS ZIP I.D.NUMBER)O CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN. 1 -DEC.31) (IF REQUIRED) OF BUSINESS) ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ Schedule A Summary `Contributor Codes 1. Amount received this period-itemized monetary contributions. IND-Individual (Include all Schedule A subtotals.) $ COM—RecipientCommittee (other than PTY or SCC) 226 OTH—Other(e.g., business entity) 2. Amount received this period-unitemized monetary contributions of less than$100 ............................. $ PTY—Political Party 3. Total monetary contributions received this period. SCC-Small contributor committee Add Lines 1 and 2. Enter here and on the Summary1. TOTAL $ 226 ( Page,Column A, Line � FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Type or print in ink. SCHEDULEB-PART1 Schedule B— Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. 10/17/10 ® . from SEE INSTRUCTIONS ON REVERSE through 12/31/10 Page 5 of 5 NAME OF FILER I.D. NUMBER �ffl�Y11 � t n �.��1�,71r� �.. d-01 0 .. IF A INDIVIDUAL, ENTER OUTSTANDING O (c) OUTSTANDING (e) (fI (g) FULL NAME,STREET ADDRESS AND ZIP CODE AMOUNT AMOUNTPAID INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER BALANCE BALANCEAT OF LENDER (IFSELF-EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IFCOMMITTEE,ALSO ENTERED.NUMBER) NAMEOFBUSINESS) PERIOD PERIOD THIS PERIOD" PERIOD PERIOD LOAN TO DATE Jeff &Cindy Busche ®PAID CALENDARYEAR CEO $ 4552 $ 0 , $ 2670 $ 9685 [venture IZ FORGIVEN RATE PER ELECTION"" $ 9585 $ 100 $ 5133 11/30/10 $ 9/29/10 $ tv IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PER ELECTION** t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PER ELECTION*" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 100 $ 4552 $ 0 $ (Enter(e)on Schedule B SIAmQ'4'lary Schedule E,Line 3) 1. Loans received this period....................................................................................................................$ 100 (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes -4452 IND—individual 2. Loans paid or forgiven this period ......................................................................................................... $ COM—Recipient Committee (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH-Other(e.g., business entity) PTY—Political Party a this period. (Subtract Line 2 from Line 1. NET $ -4452 SCC—Small Contributor Committee 3. Net change p )............................................................... (Maybe a negative number) 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. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period / - Summary page to whole dollars. 10/1/10 • - � • from SEE INSTRUCTIONS ON REVERSE through 10/16/10 Page 2 of 8 NAME OF FILER I.D. NUMBER e ak 1332301 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR (FROM ATTACHED SCHEDULES) TOTALTODATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A,Line 3 $ 3202 $ 6827 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... Schedule s,Line 3 6915 9585 10,117 16,412 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ $ Received $ $ 4. Nonmonetary Contributions.................................... Schedule C,Line 3 1568 2318 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ 11,549 $ 18,594 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E,Line 4 $ 9585 $ 12,186 Candidates 7. Loans Made............................................................. Schedule H,Line 3 0 0 22. Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 9585 $ 12,186 (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 ..........................................ScheduleC,Linea 0 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE................................Add Lines 8+9+10 $ 9585 $ 12,186 $ Current Cash Statement $ 12. Beginning Cash Balance ....................... Previous summary Page,Line 16 $ 3694 To calculate Column B,add 13. Cash Receipts ................................................... Column A,Line 3 above 10,117 amounts in Column A to the corresponding amounts "'Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1,Line 4 0 from Column B of your last reported in Column B. 15. Cash Payments.................................................. column A,Line 8 above 9585 report. Some amounts inColumn A may be negative 16.ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ 4226 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... Schedule e,Part 2 $ 0 for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7,and 9(if � � 0 any). 18. Cash Equivalents........................................ See instructions on reverse $ 19..Outstanding Debts......................... Add Line 2+Line 9 in Column B above $ 9585 FPPC Form 460(January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC(866/275-3772) Type or print in ink. SCHEDULE B-PART 1 Schedule B-Part 1 Amounts may be rounded Statement covers period Loans Deceived to whole dollars. from 10/1/10 a] ® e A SEE INSTRUCTIONS ON REVERSE through 10/16/10 Page 5 of 8 NAME OF FILER I.D. NUMBER �)m i4e—e— OS4) Leuve I d( l o 1332301 IF AN INDIVIDUAL, ENTER a V (b) (c) (d) (e) (f) W FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER BALANCE AMOUNT PAID BALANCEAT OF LENDER (IF SELF-EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAMEOFBUSINESS) PERIOD PERIOD THIS PERIOD" PERIOD PERIOD LOAN TO DATE Jeff & Cindy Busche ❑PAID CALENDARYEAR C.E.O. $ $ 9585 , $ 2670 $ 9585 Iventure ❑FORGIVEN RATE PER ELECTION— $ 2670 $ 6915 $ 11/30/10 $ 9/29/10 $ tv IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PER ELECTION'* t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PERELECTION— t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED 1IM" SUBTOTALS $ 6915 $ $ 9585 $ :' (Enter(e)on Schedule B Summary Schedule E,Line 3) 1. Loans received this period.................................................................................................................... $ 6915 (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes IND—Individual 2. Loans paid or forgiven this period ......................................................................................................... $ 0 COM—RecipientCommittee (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g., business entity) PTY—Political Party 3. Net change this period. (Subtract Line 2 from Line 1.)................ NET $ 6915 SCC—Small Contributor Committee 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. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) type or print In Ink. COVER PAGE-PART 2 Recipient Committee CALIFORNIA Campaign Statement FORM ' • Cover Page--Part 2 Page 2a of 6 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Measure 0 OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑ SUPPORT Q Huntington Beach QI OPPOSE RESIDENTUdJBUSINESS ADDRESS (NO.AND STREET) CITY 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: ust any com► iftes not Included in this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO.IF ANY cont►Ibutlons or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D..NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed CandidatelOfficeholder Committee ust names of officeholder(s)or candkbWs)tar which this committee is prknardy formed. ❑ YES ❑ NO COMMITTEEADDRESS STREET ADDRESS (NO RO.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑OPPOSE CITY STATE ZIP CODE AREA CODEIPHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑OPPOSE COMMITEENAME I.Q.NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD Y ❑SUPPORT ES ❑ NO ❑OPPOSE COMMITTEE ADDRESS STREETADDRESS (NO P.O.BOX) CITY SU44E ZIP CODE AREA CODE/PHONE Attach continuation sheets U necessary FPPC Form 460(Jenuwyffi% FPPC Tali-Rreo Helpline:41MASK-FPPC(86WM 3?M State of cawomia Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period e Summary Page to whole dollars. 10/1/10 ••~ from SEE INSTRUCTIONS ON REVERSE through 10/16/10 Page 2 of 6 NAME OF FILER I.D.NUMBER Committee Against Measure Q 2010 1332301 ColumnA Column B Calendar Year Summary for Candidates Contributions Received TOTALTHePERIOD CALENDARYEAR Running in Bath the State prima and (FRaMMACHEDS�CHEYULE3) TOTAi.ToDATE g t Primary 1. Monetary Contributions ........................................... schedule A,Line 3 $ 1501 $ 5126 General Elections 2. Loans Received 2670 111 through 6130 711 to Dace ...................................................... Schedule B.Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ _ 1501 $ 7796 20. Contributions 1568 2318 Received $ $ 4. Nonmonetary Contributions..................................... schedule C,Line 3 _- 21, Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ 3069 $ 10,114 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E,Line 4 $ 0 $ 2601 Candidates 7. Loans Made............................................................. Schedule H,Line 3 0 0 22.Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 0 $ 2601 (it Subject tnvetuntoryExpenditureUndQ 9. Accrued Expenses (Unpaid Bills)...............................schedule F Line 3 0 0 Date of Election Total to Dale 10.Nonmonetary Adjustment..........................................Schedule C,Line 3 0 0 (mm/dd/yy) 11.TOTAL EXPENDITURES MADE................................Add Lies a+9+10 $ 0 $ 2601 $ Current Cash Statement $ 12.Beginning Cash Balance .... Previous Summary Page,Line 16 $ 5202 '^•••••••••••••••' To calculate Column 8,add 13.Cash Receipts ................................................... Column A,Line 3 above 1501 amounts in Column A to the 0 corresponding amounts *Amounts in this section may be different from amounts 14.Miscellaneous Increases to Cash............................ schedule!,Line 4 from Column 6 of your last reported in Column S. 15.Cash Payments.................................................. Column A,Line 8 above 0 report. Some amounts in Column A may be negative 16.ENDING CASH BALANCE..........Add Lines 12+13+14,then subtract Line 15 $ 6703 figures that should be subtracted from previous tf this is a termination statement, Line 16 must be zero. period amounts. If this Is the first report being filed 17.LOAN GUARANTEES RECEIVED ... Schedule a Part 2 $ 0 for this calendar year,only carry over the amounts Equivalents and Outstanding Debts from Lines a,7,ands(if Cash E q 9 0 any). 18. Cash Equivalents........................................ see Instructions on reverse $ 19. Outstanding Debts........................ Add Line 2+Line 9 in Column B above $ _ 2670 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) Type or print in ink. SCHEDULES-PART1 Schedule B—Part I statement covers period Amounts may be rounded in= to whole dollars, 1011/10 �,Oert�S l�eceivea� from ......�.... SEE INSTRUCTIONS ON REVERSE through 10/16l10 Page 5 of 6 NAME of FILER 1,0.NUMBER Committee Against Measure®2010 1332301 IF AN INDIVIDUAL,ENTER OUTSTANDING bI tal OUTS ANDING a U FULL NAME,STREET ADDRESS AND ZIP CODE AMOUNT AMOUNTPAID INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION CC FSELF-EMPLOYED,IMENTERYER BEGIN BALANCE(3 THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IFCOMMrrTEE,ALSO ENTER IS).NUMBER) NAME nF SUSINEss) PERIOD THtS PERIOD* PERIOD LOAN TO DATE Jeff&Cindy Busche ©PAID CALENDARYEAR C.E.O. $ - $ 2670 2670 $ 2670 IVenture []FORGIVEN RATE PER ELECTION" $ 2670 $ $ 11/30/10 $ 9129f10 $ 110 IND [] COM ❑OTH [] PTY [] SCC DATE DUE DATE INCURRED n PAID CALENDAR YEAR $ --_ $ % $ $_________._ 0 FORGIVEN RATE PER ELECTION"* $ $ $ $ $ t[] IND © COM [J OTH [:1 PTY [] SCC DATE DUE DATE INCURRED PAID CALENDAR YEAR $ $ _ 96 $ $- --- n FORGIVEN RATE PERELECTION"* $ .. $ $ $ $ t[] IND ❑COM ❑OTH ❑ PTY 0 SCC DATE DUE DATE INCURRED SUBTOTALS $ $ $ 2670 S '—` (Enter(a)on Schedule S Summary scneduweE,LIM3) I. Loans received this period.................................................. .................................................................$ (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes IND—Individual 2. Loans paid or forgiven this period ........ ................................................................................................$ COM—Recipient Committee (Total Column(c)plus loans under$100 paid or forgiven.) , (other than PTY or SCC) (include loans paid by a third party that are also itemized on Schedule A.) OTH-Other(e.g.,business entity) PTY—Political Party 3. Net change this period. Subtract Line 2 from Line 1. NET $ SCC--Small Contributor Committee Enter the net here and on the Summary Page,Column A,Line 2. (May be a negative numbar) *Amounts forgiven or paid by another party also must be reported on Schedule A. "*It required. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866IASK-FPPC(8661275-3772) Lugar, Robin From: Lugar, Robin Sent: Thursday, December 09, 2010 6:13 PM To: 'noonmeasureq@gmail.com' Subject: Request for Amendment to Committee Against Measure Q 2010 Pre-election Statement (10/1/10 to 10/16/10) The City Clerk's Office has completed review of pre-election statements filed in Huntington Beach on October 21, and requests that you file a 460 Amendment that corrects the following identified errors: • Cover Page - Part 2 Missing • Summary Page 2 is incomplete (portions cut off; Name of Filer box blank) • Schedule A Page 3 is incomplete (missing header and summary sections; Name of Filer box blank) • Name of Filer box blank on pages 4-6 • Schedule B Summary Page 5 incomplete (portions cut off) If you have any questions, please the FPPC's toll-free advice line at 1-866-275-3772. Peskin Lugar, CSC Assistant City Clerk City of Huntington Beach 2000 Alain Street Huntington Beach CA 92648 (714) 536-5405 1 Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period ® - Summary Page to whole dollars. from 10/1/10 ® ' 10/16/10 pa e 2 of 6 SEE INSTRUCTIONS ON REVERSE through 9 NAME OF FILER I.D. NUMBER 1332301 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTALTODATE g Primary 1. Monetary Contributions ........................................... Schedule A,Line 3 $ 1501 $ 5126 General Elections 2. Loans Received ...................................................... Schedule e,Line 3 2670 1/1 through 6130 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 1501 $ 7796 20. Contributions 4. Nonmonetary Contributions.................................... Schedule c,Line 3 1568 2318 Received $ $21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ 3069 $ 10,114 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E,Line 4 $ 0 $ 2601 Candidates 7. Loans Made............................................................. Schedule H,Line 3 0 0 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 0 $ 2601 (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 MADE................................Add Lines s+s+10 $ 0 $ 2601 J � $ Current Cash Statement $ 12. Beginning Cash Balance....................... Previous summary Page,Line 16 $ 5202To calculate Column B,add 13.Cash Receipts ................................................... Column A,Line 3 above 1501 amounts in Column A to the n corresponding amounts *Amnunts in this-prtion may he different frnm amounts Schedule B-Pal't 1 Type or print in ink. Statement covers period SCHEDULEB-PART1 Amounts may be rounded p CALIFO. Loans Received to whole dollars. 10/1/10 � . � • from SEE INSTRUCTIONS ON REVERSE through 10/16/10 page 5 of 6 NAME OF FILER I.D. NUMBER 1332301 ------------- IF AN INDIVIDUAL, ENTER a (b) (�) (d) (e) f) (g) FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER BALANCE AMOUNT PAID BALANCEAT OF LENDER (IF SELF-EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD'` PERIOD PERIOD LOAN TO DATE Jeff&Cindy Busche ❑PAID CALENDARYEAR C.E.O. $ $ 2670 % $ 2670 $ 2670 Iventure ❑FORGIVEN RATE PERELECTION*" $ 2670 $ $ 11/30/10 $ 9/29/10 $ tv IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PER ELECTION** tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PER ELECTION** t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ $ $ 2670 $ rs .. .. �. (Enter(e)on Schedule B Summary Schedule E,Line 3) 1. Loans received this period....................................................................................................................$ (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes IND—Individual 2. Loans paid or forgiven this period ......................................................................................................... $ COM—RecipientCommittee (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g.,business entity) PTY—Political Party SCC—Small Contributor Committee Type or print in ink. SUMMARY PAGE Campaign Disclosure Statement Amounts may be rounded Statement covers period CALIFORNIASummary Page to whole dollars. from 9/1/10 (inception) FORK SEE INSTRUCTIONS ON REVERSE through 9/30/10 Page 2 of 6 NAME OF FILER I.D. NUMBER Committee Against Measure Q 2010 1332301 Column A Column B Calendar Year Summary for Candidates Contributions Received - TOTALTHISPERIOD CALENDARYEAR Running i Both the State Pi and (FROM ATTACHED SCHEDULES) TOTALTODATE gn e ae Primary General Elections 1. Monetary Contributions ........................................... Schedule A,Line 3 $ 3625 $ 3625 2. Loans Received ...................................................... Schedule a,Line 3 2670 2670 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 6295 $ 6295 20. Contributions Received $ $ 4. Nonmonetary Contributions.................................... Schedule C,Line 3 750 750 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ..•...................•••••AddLines3+4 $ 7045 $ 7045 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E,Line 4 $ 2601 $ 2601 Candidates 7. Loans Made............................................................. Schedule H,Line 3 0 0 22. Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 2601 $ 2601 (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 ..........................................ScheduleC,Linea 0 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE................................Add Lines 8+9+10 $ 2601 $ 2601 $ Current Cash Statement $ 12.Beginning Cash Balance....................... Previous Summary Page,Line 16 $ 0 To calculate Column B,add 13.Cash Receipts ................................................... Column A,Line 3 above 6295 amounts in Column A to the 0 corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash........................... Schedule 1,Line 4 from Column B of your last reported in Column B. 15.Cash Payments.................................................. column A,Line 8 above 2601 report. Some amounts inColumn A may be negative 16.ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ 5202 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17.LOAN GUARANTEES RECEIVED ........................... Schedule e,Part 2 $ 0 for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2,7,and s(if 0 any). 18. Cash Equivalents........................................ See instructions on reverse $ 19. Outstanding Debts......................... Add Line 2+Line 9 in Column 8 above $ 2670 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Type or print in ink. SCHEDULEB-PART1 Schedule B—Part I Amounts may be rounded Statement covers period ® e Loans Received to whole dollars. 9/1/10 (inception) ® e from SEE INSTRUCTIONS ON REVERSE through 9/30/10 Page 4 of 6 NAME OF FILER I.D. NUMBER Committee Against Measure Q 2010 1332301 IF AN INDIVIDUAL, ENTER OUTSTANDING (b) (e) OUTSTANDING (e) (f) W FULL NAME,STREET ADDRESS AND ZIP CODE OCCUPATION AND EMPLOYER BALANCE AMOUNT AMOUNT PAID BALANCEAT INTEREST ORIGINAL CUMULATIVE OF LENDER (IF SELF-EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE,Also ENTER LD.NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE Jeff&Cindy Busche ❑PAID CALENDARYEAR C.E.O. $ $ 2670 % $ 2670 $ 2670 (venture ❑FORGIVEN RATE PER ELECTION** $ 2670 $ 2670 $ 11/30/10 $ 9/29/10 $ t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PER ELECTION** $ $ $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PERELECTION** tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 2670$ $ 2670 $ (Enter(e)on Schedule B Summary Schedule E,Line 3) ............................................................................................... 2670 1. Loans received this period..................... $ (Total Column(b)plus un item ized loans of less than$100.) tContributor Codes IND—Individual 2. Loans paid or forgiven this period ..........................................................................................................$ COM—Recipient Committee . (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g., business entity) PTY—Political Party 3. Net change this period. Subtract Line 2 from Line 1. 2670 SCC—Small Contributor Committee g P ( )............................................................... 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. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) SCHEDULEE Schedule E Type or print in ink. Statement covers period Amounts may be rounded CALIFORNIA 1 Payments Made to whole dollars. s/1/10 (inception) ®' from SEE INSTRUCTIONS ON REVERSE through 9/30/10 Page 6 of 6 NAME OF FILER I.D. NUMBER Committee Against Measure Q 2010 1332301 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 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) NAME AND ADDRESS OF PAYEE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Cogs Signs Campaign Signage Huntington Beach CMP 2601 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2601 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. 2601 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. TOTAL $ 2601 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee INSTRUr'TIONS ON REVERSE Page 2 COMMITTEE NAME I.D.NUMBER 1352-3 4.Type of Committee Complete the applicable sections. . •. • List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election. • List the political party with which each officeholder or candidate is affiliated or check"non-partisan." • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDID/U'E/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY ❑ Non-Partisan Non-Partisan • List the financial institution where the campaign bank account is located(controlled"candidate election"committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT N0.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE j�' Huxiil�� SUPPORT OPPOSE o+ 1.1 10 r�1,��x�k.,'Yj \• k�._ / ) SUPPORT PPOSE - . V'C��� ' ,., C0M ,c. rt all / FPPC Form 410(Janl01) FPPC Toll-Free Helpline:666/ASK-FPPC Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee ® ' a INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME C r I.D.NUMBER -L L (�n oL i'�f 6 60 1-3 -�2 3 0 4.Type of Committee (Continued) ++ + Zformed to support or oppose specific candidates or measures in a single election. Check only one box: CITY Committee ❑COUNTYCommittee STATECommittee PROVIDE BRIEF DESCRIPTIOJDN OF}ACTIVITY 0, +v v -+ . List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE 9090=11011131111 El Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a small Date qualified contributor committee on January 1,2001,enter 1/1/01. 5.Termination Requirements By signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that a)Iofthe following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. - There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. -- Additional filing obligations will be incurred if, after terminating, the committee receives or spends any funds, or receives the forgiveness of a loan, repayments of loans made to others, or any other receipts. FPPC Form 410(Jan101) FPPC Toll-Free Helpline:8681ASK-FPPC S STATEMENT OF ORGANIZATION Statement of Organization Recipient Committee CALI FORN41 ib, FORM, INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D.NUMBER Comm+ E'_� Qi nr 1 20L � a 4.Type of Committee Complete the applicable sections. a e o o List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholder controlled,also list the elective office sought or held,and district number,if any,and the year of the election. ® List the political party with which each officeholder or candidate is affiliated or check"non-partisan." ® If this committee acts jointly with another controlled committee,list the name and identification number of the other controlled committee. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Non-Partisan [] Non-Partisan ® List the financial institution where the campaign bank account is located(controlled"candidate election"committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE e e e Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT N0,OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE .�� SUPPORT OPPOSE e v� 1Z I Jre ct�q of Han t on l4(J' SUPPORT OPPOSE i n W irelo is COMMLMTCc o, a me-- FPPC Form 410(Jan103) FPPC Toll-Free Helpline:8661ASK-FPPC Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee pAl ® ' jLF® • INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME ' ^QO I® I.D.NUMBER CL 1m rn IJAO-14pn-A' ftedsave_ (�(}, 4.Type of Committee (Continued) • • Not formed to support or oppose specific candidates or measures in a single election. Check only one box: XCITYCommittee MCOUNTYCommittee M STATECommittee PROVIDE BRIEF DESCRIPTION OF ACTIVITY &M Mi ffCe, e. . . . List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Date qualified small contributor committee on January 1,2001,enter 111/01. 5.Termination Requirements By signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. FPPC Form 410(Janl03) FPPC Toll-Free Helpline:866/ASK-FPPC