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Home My WebLink AboutHardy, Jill - 2011 FPPC Campaign Disclosure Forms - Successf COVERPAGE fZeClplent Committee Type or print in ink. Date Stamp Campaign Statement . a • 0 Cover Page E-filed on: Government Code Sections 84200-84216.5) Statement covers period Date of election if applicable: cfi Page 1 of 4 from 07/01/2011 c tt ay�Y ar Y; `g g For Official Use Only >EEINSTRUCTIONS ON REVERSE through 12/31/2011 1. Type of Recipient Committee: All Committees-complete Parts 1,2,3,and 4. 2. Type of Statement: x❑ Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee x❑ Semi-annual Statement ❑ Special Odd-Year Report Q Recall Q Controlled Termination Statement (Also Complete Part 5) Sponsored ❑ ❑ Supplemental-Attach Formp (Also file a Form 410 Termination) Statement-Attach Form 495 ❑ General Purpose Committee (Also Complete Part 5) ❑ Amendment(Explain below) Q Sponsored ❑ Primarily Formed Cand mall Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D. NUMBER Treasurers) 1244691 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER to Elect Jill Hardy Andrew Farley MAILING ADDRESS 4702 Madrid Way STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 19082 Hamden Huntington Beach CA 92649 (714) 612-2243 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Huntington Beach CA 92646 (714) 593-5839 MAILING ADDRESS (IF DIFFERENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS jill@jillhardy.com blair@surfcitylocals.com i. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my kn Wedge 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. Executed on_ By —7—k'z L� ate nature fTreasureror ssi ntTreasurer Executed on ( + 'e)- By Date gnatur o ontr lingOfficehol r,Candidate,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 Officeholder,Candidate,State Measure Proponent FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275.3772) State of California Type or print in ink. COVER PAGE-PART 2 Recipient Committee CALIF Campaign Statement .. �NIA a • 1 Cover Page—Part 2 Page 2 of 4 i. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE RESIDENTIAUBUSINESS 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. COMMITTEENAME 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 COMMITTEENAME 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 ❑ 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 :ampaign Disclosure Statement Type or print In Ink. SUMMARY PAGE Amounts may be rounded Statement covers perio A - 3ummary Page to whole dollars. I 1 from 07/01/2011 - ;EE INSTRUCTIONS ON REVERSE through 12/31/2011 Page 3 of 4 IAME OF FILER I.D. NUMBER 'ommittee to Elect Jill Hardy 1244691 Column A Column B Calendar Year Summary for Candidates '.ontributions Received TOTALTHISPERIOD CALENDARYEAR (FROMATTACHEDSCHEDULES) TOTALTO DATE Running in Both the State Primary and General Elections Monetary Contributions ........................................... Schedule A,Line $ $0.00 $ $0.00 111 through 6130 711 to Date Loans Received ...................................................... Schedule a,Line 3 $0.00 $0.00 SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ $0.00 $ $0.00 20. Contributions Received $ $ Nonmonetary Contributions.................................... Schedule C,Line 3 $o.o o $o.o0 21. Expenditures i. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ $0.00 $ $0.00 Made $ $ xpenditures Made Expenditure Limit Summary for State i. Payments Made....................................................... Schedule E,Line 4 $ $0.00 $ $0.00 Candidates Loans Made............................................................. Schedule H,Line 3 $0.00 $0.00 22. Cumulative Expenditures Made* I. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ $0.00 $ $0.00 (if Subject to Voluntary Expenditure Limit) I. Accrued Expenses (Unpaid Bills) ...............................Schedule F Line 3 $0.00 $0.00 Date of Election Total to Date 0.Nonmonetary Adjustment ..........................................Schedule C,Line 3 $0.00 $0.00 (mm/dd/yy) 1. TOTAL EXPENDITURES MADE................................Add Lines 8+9+10 $ $0.00 $ $0.00 $ :urrent Cash Statement $ 2. Beginning Cash Balance....................... Previous Summary Page,Line 16 $ $6,328.48 To calculate Column B,add 3. Cash Receipts ................................................... Column A,Line 3 above $0.00 amounts in Column A to the $1,051.00 corresponding amounts *Amounts in this section may be different from amounts 4. Miscellaneous Increases to Cash........................... Schedule 1,Line 4 from Column B of your last reported in Column B. report. Some amounts in 5.Cash Payments.................................................. column A,Line 8 above $0.00 Column A may be negative 6. ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ $7,3 7 9.4 8 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 7. LOAN GUARANTEES RECEIVED ........................... Schedule e,Part 2 $ $0.00 for this calendar year, only carry over the amounts :ash Equivalents and Outstanding Debts from Lines 2, 7,and 9(if � g $o.00 any). 8. Cash Equivalents........................................ See instructions on reverse $ 9. Outstanding Debts......................... Add Line 2+Line 9 in Column B above $ $0.00 FPPC Form 460(January105) FPPC Toll-Free Helpline:8661ASK-FPPC(866/275-3772) ached u le 9 Type or print in ink. SCHEDULE I Wiscellaneous Increases t0 Cash Amounts may be rounded Statement covers period CALIFORNIA, to whole dollars. ® . from 07/01/2011 SEE INSTRUCTIONS ON REVERSE through 12/31/2011 page 4 of 4 LAME OF FILER I.D.NUMBER :ommittee to Elect Jill Hardy 124469 DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH 08/02/2011 City of Huntington Beach Refund from candidate statement $1,051.00 PO Box 190 Huntington Beach CA 92649 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ $1,051.00 Schedule I Summary 1. Itemized increases to cash this period. .......................................................................................................................$ $1,051.00 ?. Unitemized increases to cash of under$100 this period. ............................................................................................$ $0.00 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) .. $ $0.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ..................................................................................... ..................................... TOTAL $ $1,051.00 FPPC Form 460(January/05) FPPC Toll-Free Helpiine: 866/ASK-FPPC(866/275.3772) Type or print in ink. COVER PAGE-PART 2 Recipient Committee NIA Campaign Statement ®RM® _ ' ®01 1 Cover Page—Part 2 Page 2 of 3 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER 7 JURISDICTION ❑ SUPPORT ❑ 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 STREETADDRESS (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 ❑ SUPPORT ❑ YES ❑ NO ❑ OPPOSE COMMITTEE ADDRESS STREETADDRESS (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(8661275-3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period im Summary Page to whole dollars. efrom 01/01/2011 SEE INSTRUCTIONS ON REVERSE I through 06/30/2011 Page 3 of 3 NAME OF FILER I.D. NUMBER Committee to Elect Jill Hardy 1244691 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTALTODATE 9 Primary General Elections 1. Monetary Contributions ........................................... Schedule A,Line $ $0.00 $ $0.00 2. Loans Received Schedule B,Line 3 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ $0.00 $ $0.00 20. Contributions Received $ $ 4. Nonmonetary Contributions.................................... Schedule C,Line 3 $0.00 $0.00 21, Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ••••.••.........••.•.••••••Add Lines 3+4 $ $0.00 $ $0.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E,Line 4 $ $0.00 $ $0.00 Candidates 7. Loans Made............................................................. Schedule H,Line 3 $0.00 $0.00 22, Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ $0.00 $ $0.00 (If Subjectto Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ...............................Schedule F Line 3 $0.00 $0.00 Date of Election Total to Date 10. Nonmonetary Adjustment ..........................................Schedule C,Line 3 $0.00 $0.00 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE................................Add Lines 8+9+10 $ $0.00 $ $0.00 � � $ Current Cash Statement $ 12. Beginning Cash Balance....................... Previous summary Page,Line 16 $ $6,328.48 To calculate Column B,add 13.Cash Receipts ................................................... Column A,Line 3 above $0.00 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 $0.00 from Column B of your last reported in Column B. 15.Cash Payments.................................................. Column A,Line 6 above $0.00 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ $6,32 8.48 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 B,Part2 $ $0.00 for this calendar year, only carry over the amounts from Lines 2,7,and 9(if Cash Equivalents and Outstanding Debts $0.00 any). 18. Cash Equivalents........................................ See instructions on reverse $ 19. Outstanding Debts......................... Add Line 2+Line 9 in Column B above $ $0.00 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)