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Home My WebLink AboutHuntington Beach 2020 Vision PAC, A Committee In Support of (2) Supplemental Independent Type or print in ink. SUPPLEMENTAL INDEPENDENT EXPENDITURE Amounts may be rounded Report covers period "Page--23--- Expenditure Report to whole dollars. from 10/21/2012 12/31/2012 SEE INSTRUCTIONS ON REVERSE through 3 NAME OF FILER I.D.NUMBER(if recipient corn.) Huntington Beach 2020 Vision PAC 1331365 4. Summary 33,105.72 1. Total independent expenditures of$100 or more made this period. (Part 3.)........................................................................................... $ 2. Total independent expenditures under$100 made this period. Not itemized. .....................•.....• $ 0.00 3. Total independent expenditures made this period (Add Lines 1 + 2.) ..........................................................................................TOTAL $ 33,105.72 5. Filing Officers Enter the name and address of each filing officer with whom the filer's most recent campaign statements(Form 450, 460 or 461) have been filed. 1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET) CITY STATE ZIP CODE CITY STATE ZIP CODE 2) NAME OF FILING OFFICER 4) NAME OF FILING OFFICER ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET) CITY STATE ZIP CODE CITY STATE ZIP CODE 6. Verification I certify that the"independent expenditure(s)"disclosed in this statement were not"made at the behest a candidate or committee that benefitted from the expenditure(s) as those terms are defined in Government Code Section 82031 and FPPC Re ation 18225.7. 1 hav use all and diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herei Is true n omplete. I under penalty of perjury under the laws of the State of California that the foregoing is true and/ rect. Executed on By DATE SIGNATURE OF R,TREASURER OR ASSISTANT TREASURER Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,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 465(June/09) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) ~~ ~ auFp�s�swl�� |wospswoswTsxpswongns i�� Supplemental Independent Type oxp,mtm -- � ---�'- --- ---� -- __ __ Amounts may be rounded Report covers period Expenditure Report t o whole dollars. from 10/21/2012 —IBM SEE INSTRUCTIONS ON REVERSE through 12/31/2012 Page 3 of 3 NAME OF FILER I.D, NUMBER(if recipient com.) Huntington Beach 2020 Vision PAC 1331365 4LSummary 14'e4z.c4 1. Total independent expenditures of$100or more made this period. (Part 3j.................................................................................. ...... $ 2. Total independent expenditures under$100 made this period. (Not itomizodj ..... —................................................. ....... ..................... $ o.o« 3.Total independent expenditures made this period (Add Lines 1 + 2j .................................................................... ......... ...........TOTAL $ 14'e41.24 5. Filing OfficerS Enter the name and address of each filing officer with whom the filer's most recent campaign statements(Form 450, 460 or401) have been filed, 1) NAME op FILING OFFICER w NAME o~FILING OFFICER ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET) CITY STATE ZIP CODE CITY STATE ZIP CODE 2) NAME OF FILING OFFICER 4) NAME OF FILING OFFICER Aoonsoo (No AND STREET) *oows»» (mu AND STREET) CITY STATE ZIP CODE CITY STATE ZIP CODE 6' Verification |certify that the"independent expendUure(s) disclosed in this statement were not"made o|the behest of^the candidate or committee that benefitted from the expendUure(a mo those terms are defined in Government Code Section 8203l and l ,§225.7, I have'4-)sed all reasonable diligence in preparing and reviewing this statement and to the best o/my knowledge the information contained at the foregoing i d Executed on ' By DATE SIGNATURE'�F FILER,TREASURER OR ASSISTANT TREASURER Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,STATE MEASURE PROPONENT,OR RESPONSIBLE OFFICER OF SPONSOR Executed on By DATE SIGNATURE or CONTROLLING OFFICEHOLDER, CANDIDATE,STATE MEASURE PROPONENT Executed on By mns SIGNATURE or CONTROLLING OFFICEHOLDER,CANDIDATE,STATE MEASURE PROPONENT pppn Form 46epvnemY pppn Toll-Free*e/nnno:uoammm-pppc(ooamrn'nrrz) Type or print in ink. COVER PAGE-PART 2 Recipient Committee ®_ Campaign Statement C'ALIF. • 1 NIA Cover Page— Part 2 Page 2 of 16 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 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 ❑ YES ❑ NO ❑ SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREETADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(January/06) FPPC Toll-Free Helpline:866/ASK-FPPC(866/276-3772) State of California www.netfile.com Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period CALIFORNIA Summary Page to whole dollars. from 10/21/2012 FORK 4650 SEE INSTRUCTIONS ON REVERSE through 12/31/2012 Page 3 of 16 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC 1331365 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR (FROMATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A,Line 3 $ 96,113.00 $ 228,396.90 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... Schedule B,Line 3 0.00 0.00 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 96,113.00 228,396.90 20. Contributions$ Received $ $ 4. Nonmonetary Contributions.................................... Schedule C,Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ 96,113.00 $ 228,396.90 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... ScheduleE,Line $ 117,171.65 $ 227,087.07 Candidates 7. Loans Made............................................................. Schedule H,Line 3 0.00 0.00 22. Cumulative Expenditures Made" 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ 117,171.65 $ 227,087.07 (IfSubjeetto 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 ................................ (mm/dd/yy) ..........Schedule C,Line 3 0.0 0 0.0 0 11. TOTAL EXPENDITURES MADE................................Add Lines a+9+10 $ 117,171.65 $ 227,087.07 $ Current Cash Statement ii $ 12. Beginning Cash Balance....................... Previous Summary Page,Line 16 $ 22,706.69 To calculate Column B,add 13. Cash Receipts ................................................... Column A,Line 3 above 96,113.00 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............................ 117,171.65 report. Some amounts in Column A,Line a above Column A may be negative 16. ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ 1,648.04 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,Part 2 $ 0.00 for this calendar year, only carry over the amounts Clash � uivalents and Outstandin Debts from Lines 2, 7, and 9(if � g any). 18. Cash Equivalents........................................ See instructions on reverse $ 0.00 19. Outstanding Debts......................... Add Line 2+Line 9 in Column B above $ 0.00 FPPC Form 460(January105) FPPC Toll-Free Helpline:8661ASK-FPPC(8661275-3772) www.netfile.com Schedule SCHEDULED Sum maryof Expenditures Type or print in ink. Amounts may be rounded Statement covers period Supporting/Opposing Other to whole dollars. •R Candidates, Measures and Committees from 10/21/2012 SEE INSTRUCTIONS ON REVERSE through 12/31/2012 Page 8 Of 16 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC 1331365 DATE NAME OF CANDIDATE,OFFICE,AND DISTRICT,OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE PER ELECTION MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) CALENDAR YEAR TO DATE ORCOMMITTEE PERIOD (JAN.1-DEC,31) (IF REQUIRED) 10/30/2012 Monetary 17,450.00 17,450.00 � Contribution BIZ PAC ❑ Nonmonetary Contribution ❑ Independent Support ❑ Oppose Expenditure 10/30/2012 Barbara Delgleize ❑ Monetary LIT 10,544.48 33,105,72 Contribution City Council Member Huntington Beach ❑ Nonmonetary Contribution ❑x Independent © Support ❑ Oppose Expenditure 10/30/2012 Barbara Delgleize ❑ PDS 7,620.00 33,105.72 Monetary City Council Member Contribution Huntington Beach ❑ Nonmonetary Contribution Independent Support ❑ Oppose Expenditure SUBTOTAL $ 35,614.48`s Schedule D Summary 1. Itemized contributions and independent expenditures made this period. Include all Schedule D subtotals. 80,496.96 2. Unitemized contributions and independent expenditures made this period of under$100 ..................................................................................... $ 0,00 3. Total contributions and independent expenditures made this period. Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $ 80,496.96 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule (Continuation Sheet) Type or print in ink. SCHEDULED CONT Summary of Expenditures Amounts may be rounded Statement covers period to whole dollars. , Supporting/Opposing Other from 10/21/2012 • Candidates, Measures and Committees through 12/31/2012 Page 9 of 16 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC 1331365 NAME OF CANDIDATE, OFFICE,AND DISTRICT,OR DESCRIPTION CUMULATIVETO DATE PER ELECTION DATE TYPE OF PAYMENT AMOUNT THIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN.1-DEC.31) (IF REQUIRED) OR COMMITTEE 10/30/2012 Barbara Delgleize POS 2,204.50 33,105.72 ❑ Monetary City Council Member Contribution Huntington Beach ❑ Nonmonetary Contribution ® Independent ❑x Support ❑ Oppose Expenditure 10/30/2012 Barbara Delgleize ❑ Monetary LIT 5,272.24 33,105.72 City Council Member Contribution Huntington Beach ❑ Nonmonetary Contribution ❑x Independent Q Support ❑ Oppose Expenditure 10 30 2012 Barbara Delgleize POS 3,810.00 33,105.72 ❑ Monetary City Council Member Contribution Huntington Beach ❑ Nonmonetary Contribution ❑x Independent Q Support ❑ Oppose Expenditure Barbara Delgleize 10/30/2012 ❑ Monetary LIT 3,654.50 33,105.72 Contribution City Council Member Huntington Beach ❑ Nonmonetary Contribution ® Independent © Support ❑ Oppose Expenditure kSUBTOTAL $ 14,941.24 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule (Continuation Sheet) Type or print in ink. SCHEDULED CONT. Summary of Expenditures Amounts may be rounded Statement covers period Supporting/Opposing Other to whole dollars. ® e e 1 from 10/21/2012 Candidates, Measures and Committees through 12/31/2012 Page 10 of 16 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC 1331365 NAME OF CANDIDATE,OFFICE,AND DISTRICT,OR DESCRIPTION CUMULATIVE TO DATE PER ELECTION DATE TYPE OF PAYMENT AMOUNT THIS MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) CALENDAR YEAR TO DATE OR COMMITTEE PERIOD (JAN.1-DEC.31) (IF REQUIRED) 10/30/2012 Devin Dwyer ❑ Monetary POS 2,204.50 14,941.24 City Council Member Contribution Huntington Beach ❑ Nonmonetary Contribution ® Independent 0 Support ❑ Oppose Expenditure 10/30/2012 Devin Dwyer ❑ Monetary LIT 5,272.24 14,941.24 City Council Member Contribution Huntington Beach ❑ Nonmonetary Contribution 0 Independent © Support ❑ Oppose Expenditure 10 30 2012 Devin Dwyer POS 3,810.00 14,941.24 ❑ Monetary City Council Member Contribution Huntington Beach ❑ Nonmonetary Contribution 0 Independent © Support ❑ Oppose Expenditure Devin Dwyer 10/30/2012 ❑ Monetary LIT 3,654.50 14,941.24 Contribution City Council Member Huntington Beach ❑ Nonmonetary Contribution ® Independent © Support ❑ Oppose Expenditure SUBTOTAL $ 14,941.24 ' 3 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) www.netfile.com Schedule D (Continuation Sheet) Type or print in ink. SCHEDULED CONT. Summary of Expenditures Amounts may be rounded Statement covers period to whole dollars. � - � Supporting/Opposing Other from 10/21/2012 ® - Candidates, Measures and Committees through 12/31/2012 Page 11 of 16 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC 1331365 NAME OF CANDIDATE,OFFICE,AND DISTRICT,OR DESCRIPTION CUMULATIVE TO DATE PER ELECTION DATE TYPE OF PAYMENT AMOUNTTHIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD JAN.1-DEC.31 OR COMMITTEE ( ) (IF REQUIRED) 10/31/2012 orange County Taxpayers PAC 15,000.00 15,000.00 ❑x Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑x Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure 4 '& SUBTOTAL $ 15,000.00 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule G Type or print in ink. SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period ®e � Contractor(on Behalf of This Committee) to whole dollars. from 10/21/2012 ®R SEE INSTRUCTIONS ON REVERSE through 12/31/2012 Page 16 of 16 NAME OF FILER I.D.NUMBER Huntington Beach 2020 vision PAC 1331365 NAME OF AGENT OR INDEPENDENT CONTRACTOR The Monaco Group 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 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) "Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR(IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID USPS POS 7,620.00 Sunflower Station Santa Ana CA USPS POS 4,409.00 Sunflower Station Santa Ana CA USPS IND POS 7,620.00 Sunflower Station Santa Ana CA Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 19,649.00 "Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) www.netfile.com Type or print in ink. 497Contribution Report AmourAsrrtaybe rounded to whole dollam. - 4g7 CONTRIBUTION REPORT NA OF Fr ER Date of Data Stamp a " ' a m Huntington Beach 2020 Vision PAC, a cflarnittee in euppnrt of Measure E t�- This Filir~g 11/06/2012 1 ? r�t'i ' AREA CODEWHONE NUMBER I.D.NUMBER faleppfwLM) For Official Use Only Report No. Lo 714-540-229S 1331365 STREET ADDRESS Arr1BRrlfn@rlt 211 Main St-B - - to Report No. . CITY STATE ZIP CODE (explarnbalrlmr) Huntington, Beach, CA 52648 No. of Pages t 1. Contribution(s) Deceived IFAL, RULL NAME,STREET ADDRESS AND ZIP couE OF CONTRI�.ITOR EONRUTOR �EPZ4R�A�IIAND EMPLOYER RECEIVED RECEIVED co4At:IrEE.ALSO ENTER€n.1R MEN E* 4E OF BnSINESSI 11/06/2012 Ayres Brookhurst Plaza ❑ (ND 1,500.00 355 Bristol St NA ❑ COM ® OTH D Check if Loan Costa Mesa, CA 92626 ❑ PN 0 SCC provide trrteTest rate ❑ ONE) - ❑ COM ❑ OTH Cheek if Loan � PTY ❑ SCC se P;ovede inEerest to€e ❑ 1ND ❑ CAM ❑ OTH ❑ Check if Loan ❑ PT( ❑ SCC 9A Provide inteiiast rate °CoWbutor Codes I NO—lndividual COM—Recoent Committee(other than PTY or SCC) OTH—Ofher(e.g-,business entity) PTY—Political Party Reason for Amendment: SCC—Small Contributor COMMittee FPRC Form 497 (Marchf2011) FPPC Toll-Free Helptlne; 866JASK-FPPC (SW275-37T2) � 8fflf�@.COl1� Type or print in ink, 497 Contribution Report Amounts may be rounded to whole dollars. i, , = f. i`" 497 CONTi21BUT10NFifPORT NAME OF FILER Date of Date Stamp Hvntin ton Beach 2020 Vision PAC, comwdttee in support of Measure Z ,- y ' 9 This Filing 11/02/2012 1 f ��OV _� Phil 9 48 a - AREA CD"RONE NUMBER I.D.NUMBER(�lapp.ka&q) ForOrMciai Use Only 714-540-2295 1331365 Report No. 9 STREETADDRESS 211 Main ,St-B ❑ Amenrlment. to Report No. CITY STATE ZIPCODE (explain68low) Huntington Beach, CA 92648 - No. of Pages 1 1. Contribut I F AN INDIVIDUAL. PRE-C MOUNT DATE FULL NAME,STREET ADDRESS AND 21P CODE OF CONTRIBUTOR CONTRIBUTOR ENTER OCCUPATJON AN ED QrCOAYMTTL-ALSOF BRW.NUMBER) CODE IIFSEFFNPLOYE€I,EhrrERNAME-OFBUSINESSEIVED 11/02/2012 Huntington Capital Corp ❑ IND oao.00 16166 Seach Blvd #200 ❑ cm Sacramento, CA 92647 OTH Q Check if Loan ❑ PTY ❑ SCC Provide interest rate 21/02/2012 Tom Harman for Board of Rqualizationl 2014 (#1334860) �❑I IND 2,060.00 2105 River Plaza Dr # 150 IJ COm Sacramento, CA 95833 ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC % Provide Interest ra€e ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ MY ❑ SCC Provide interest rate `ConJributor Codes IND-Individual COM-Recipient Committee(other than PTY or SCC) OTH-Other(e.g_,business entity) M-Political Party Reason for Amendment: SCC-Sma€I Contributor C MMiRee FPPC Form 497 {March12011) FPPC Toll-Free Helpline: 8661ASK-FPPC (86I31275-3T72) www.neffile.com Type or print in ink. 497 Contribution Report Amounts may be rounded fowhole dollars. 497 OONTRIBLIITION REPORT NAME OF FILER weslarrip Huntington Beach 202D Vision PAC, a comrndttee in Support of Measure Z Date of 6 This Filing 11/02/2012 F OfHOl Use Only AREA CODEWHONE NUMBER ID.NUMBER rwappocaue) For Official Use Only 714-540-2295 1331365 Report No. 9 STREETADDRIESS E]Amendment 211 Main St-11 to Report Plc. CITY STATE ZIP CODE (eypla-hW-j) Huntington Beach, CA 92648 No. of Pages 1. Contribution(s) Received DATE FULL NAME,STREET ADORESS AND ZIP CODE OF CONTRIBUTOR CONTR AMOUNT RECEIVED CODE ENTER OCCUPATICN AND EMPLOYER RECEIVED j1FC06MfTff-_ALSO ENMR 1.0.NUMEM JIF SELF ENPLOYED,rNIY:R NAWE OF W-r-MESS) Capital Corp ❑ IND 11 000.Do 16166 Beach Blvd #2D0 ❑ com Sacramento, CA 92647 OTH El Check if Loan ❑ PTY EJ SCC Provide interesi rate 11/02/2012 Tom HaMarL for Boaxd of Hqualizationl 2014 141334860) F-1 IND 2,000.00 2105 River Plaza Dx 0 3.50 Fx] OW Sacramento, CA, 95833 El OTH Ej Check IF Loan F1 PTY [j SCC Provide interest rile IND ❑ com El 07H Q Check if Loan El PTY n SGC Provide Interest rate `Contributor Codes IND-Individual COM-Recipient Committee(other than PTY cw SCQ OTH-Other(e.g., business entity) PTY-Politiml Party Reason for Amendment: SCC-Small CoritributDr Committee FPPC Form 49T (Mar&12011 1) FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772) Typ+r or print in ink. 497 Contribution Report Artyounts may he rounded to whole dollars. ^ ' 497 CONTRIB1JT ION REPORT NAIVE OF FILER Date of bete Starr Huntington Beach 2020 Vision PAC, a coimnittee in support of Measure Z This Fit This ling 11/01/2012 NCJ1a{ AREA CODJPHONE NUMBER ID.NUMBER ffT*6;caW For O€ficial Use Only Report No. s 714-540-2295 1331365 STREET ADDRESS ❑ Amendment 211 Alain St-B to Report No. CITY STATE ZIP CODE (explain balmy) Huntington Beach, CA 92648 No.of Pages i 1. Contribution(s) Received DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. /�iAOUNT RECEtV6D (IF C0?Ak4nTEE,P39OENE-RLaNUMBER CODE A ENELF-i` UPATICdRNAMFUN RECEIVED {IF S�F�AFtAYFq ENTER NAME Cf E�raxssl 11/01/2012 Orange CcIunty Sobs Coalition (#1351853) ❑ IND 5,D00.00 3699 Wilshire Blvd #1290 0 com Los Angeles, GA 90010 ❑ OTH D Check if Loan ❑ PTY ❑ SCC Provide interest rolele 0 IND ❑ OOM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide inlerast rate ❑ IND ❑ com ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC P€ovide interest rate "CORtributor Codes IND—Individual COM—Recipient Committee(otherthan PTY or SCC) OTH—Other(e.g_,business entity) PTY—Political Party Reason for Amendment- SCC—Small Contributor Committee FPPC Form 497 (March12011) FPPC Toll-Free Helpline. 8661ASK-FPPC (8661275-3772) Type or print in ink. 497 Contribution Report Accounts may be rounded to whole dollars, 497 CONTRIBUTION REPORT NAME OF FILER Daf6 Scam Huntington Beach 2020 Vision PAC, a comiQittee in support This Filing of Measure g Date 10/31/2012 P 3 l ° � AREA CODE/PNONE NUMBER I.D.NUMBER firv�.aPnla) �� Safi �1 �� For4frieial Use Onty 714-540-2295 1331365 Report No, 7 STREFETADDRESS hf ,;•I 211 Main st-B ❑ Amendment s to Report No. CITY. STATE ZIP OODE (Main 6elaw) Huntington Beach, CA 92648 No.of Pages 1 2. Contribution(s)Made DATE F DRESS AND ZIP CODE OF RECIPIENT GAtJDIDATEAND OFFICE AMOUNT OF ON MADE IIFC07AMnTEE,ALSOENTERLD.r"BER) OR CONTR�BUTI ON (IF DATE OF OF ELECTION MEASURE AND JURISDICTION ICABLQ 10/31/2D12 Orange County Taxpayers PAC (41288619) 15,000.00 1127 11th St 4300 Sacramento, CA 95814 Reason forAmendrnent; FPPC Form 497 (Hlarch/2011) FPPC Toll-Free Helpfine: 866/ASK-FPPC (866/275-3772) ® Je.com 497 Contribution Report Type or print in ink. Amounts may be rounded to whole dollars,. - 4W CONTRI BUTION.REPORT NAME OF FILER Date Stamp Huntington Beach 202U Vision PACT a comittee in support of Measure Z Date of r r, • a This Filing 10/? n{ 2612 I v i 12: 3 e AREA CODE/PHONE NUMBER I.D.NUMBER(iramonaue) For Official Use Only 714-540-2295 1331365 Report No. 6 STREET ADDRESS R , 211 Main St-B ❑ Amendment to Report No, C STATE ZIP CODE (explainbe3orr/) Huntington Beach, CA 92646 No.of Pages 2 1. Contribution(s) Receave IF AN INDIVIDUAL, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR AMOUNT DATE FULL NAME, RECEIVED (IF CO D.NLRA13ER) ENTER OCCUPATIONAND `'�� IIF Sr.iF`EMPLOYED,ENTER NAME OF BUSINESS) RECEIVED 10/30/2012 Bella Terra ❑ I 5,000.00 60 8 Market St P1120 Q Crm San Jose, CA 95113 Q OTH ❑Check if Loan Q PTY Q 5CC Provide inlerest rate 10/30/2012 Inner Circle Investments ❑ IND 2D,000.00 3620 Pacific Coast hwy ❑ com Torrance, CA 90505 ® OTH ❑ Check if Loan ❑ PTY ❑ SCC % Provide interest Tsr£ 10/30/2012 AIHHT PAC (iiB20165) - _ 6,000.00 ❑ IND 30151 Tomas0 Cam Rancho Santa Margari, CA 926BB ❑ OTH ❑ Check if Loan ❑ P' Q SCC Provide inteTW We 'Contributor Codes IND-tndividual CON)-Recipient Committee(other than PTY or SCC) OTH-Other(e_g., business entity) PTY-Political Party Reason forArrtendment: SCC-Small Contributor Committee FPPC Form 497 (Marc:W2011) FPPC Toll-Free tfelpline: 8S61ASK-FPPC (H61275-3772) elyww,Re t{r/e.com Ty� int 497 Contribution Report Amounts may b or pre roundein ink. d to whole dollars. 497 CONTRIBUTION REPORT NAME OF FILER Date Stamp Huntington Beach 2020 Vision PAC, a committee in support of }Measure Z Date of C CT 3- 1 N Date,Stamp This Filing 10 ?2 AREA CODEPHONE NUMBER I.D.NUIWBERp12Mf1rab?ej 0 For Official Use Only 714-540-2295 1331365 Report No. 6 -- STREET ADDRESS 213 Main St-8 ❑Amendment to Report No. CITY STATE ZIP CODE {a)Valn Wow) Huntington Beach, CA 92648 No.of Pages 2 1. Contribution(s) Received DATE FULL NAME E OF CONTRIBUTOR CONTRIBUTOR W AN INDIVIDUAL, AMWNT E RECEIVED (IF COM"TTEF-ALS0EVrER I.D.W.WER) CWE ENTER OCCUPATI ON AND EMPLOYER RECENED (�F SELF-OA-LOYSD,ENTEn NAME OF BLJSVEs LU/30/2D12 PC Group De-tail ❑ IND 5,000.00 60 S Market St ft1120 ❑ GOM San Jose, CA 9S113 OTH ❑Check 0 Loan ❑ PTY El SCC Provide interest rate ❑ IND ❑ com ❑ OTH E] Check If Loan E] PTY ❑ SCC V. Provide interest rate ❑ IND El cQM [] OTH ❑ Check if Loan El PTY ❑ SCC Provide interest rate Contributor Codes IND-Individual COM-Recipient Committee(other than PTY or SCC) OTH-Other(e.g..business entity) Reason for Amendment: PTY-Polilical Pally SCC-Small Contributor Committee FPPC Form 497 (Marc:W201 11) FIPPC Toll-Free Helpline. 8661ASK-FPPG (86612753772) www.ineW#le.com 497 Contribution Report Type or print in ink. Amounts may be rounded to whole dollars. _ r 497CONTRIBUTION REPORT NAME OF Fp FR safe Stamp Huntington Beach 2020 vision PAC, a committee in support of Measure z Date of R , � This Filing l0/31/2012 2 12 OC 31 r { 1$: 3 •- AREACODEePHONE NUMBER I.D.NUA48ER(#4ppsvvare) For Official Use Only Report No. 5 714-540-2295 1331365 STREET ADDRESS 211 Main St-B Amendment to Report No. CITY STATE . ZIP CODE (�woafn belmv) Huntington Beach, Ca 92648 No.of Pages z- 1.Contribution(s) Received DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR C INDIVIDUAL, AMOUNT RECEIVED IIFOOMMR-ME;ALSOENTERI.D.NUMBER) CODE * ENTER OCCUPATION AND EMPLOYER RECEIVED OF SELF.EMPLOYED,ENTER NAME OF RUENE55) 10/31/2012 Svinerton Incorporated ❑ IND 24,000.00 260 Townsend St ❑ COM. San Francisco, CA 94107 0 OTH ❑ Check if Loan ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ OOM ❑ OTH ❑ Check if Loan ❑ PTY ❑ SCC % Provide interest rate ❑ IND ❑ COM ❑ OTH ❑Check if Loan PTY ❑ SCC �t Provide inlerest rate `Contributor Codes IND—Individual COM—Recipient Committee(otherthan PTY or SCC) OTH—Other(e.g_,business entity) PTY—Political Party Reason for Amendment: SCC:—Small ContrlbutorCommitlee FPPC Form 497 (Marchl2011) FPPC Toll-Free Helpline; 8661ASK-FPPC (8661275-3772) ® Mite.cam Type or print inInk. 497 Contiribution Report Amounts maybe rounded to whale dollars, 497 00NTRI BIITION REPORT NAME OF FILER Date Stamp ,ai, , Date of I 6 Huntington Beach 2020 Vision PACT a committeeThis Filling in support of Measure Z 1.0/30/2012 `1« AREA COD 1PHONENUMBER I.D.INUMBER(tfaMkAN*l 4 for MIA Use'Only 714-540-2295 1331365 Report No. ti STREET ADDRESS 211 Main St-B ❑Amendment to Report No. CITY STATE ZIP CODE (explain below) Huntington Beach, CA 92648 No.of Pages 1 2. Contribution(s)Ma AME.STREET ADDRESS AND ZJP CODE OF RECIPIENT CANDIDATEAN D OFFICE AMOUNT OF DATE OF ELECT#DN MADE (If COMMfrTEE,At50ENTER1D.Nt1MBER) OR CONTRIBUTION OFAPPLIGABL€# MEASURE AND JURISDICTION 10/30/2D12 BIZPAC (##BU2010) 17,450.00 2 Park Plata ##100 Irvine, CA 92814 BIZ PAC Reason forArnendment: FPPC Form 497 (March128911) �- FPPC Tall-free Helpline: 86WASK-FPPC (8661275-3772) www.neff/e.Com 496 Independent Expenditure Report Type or print in ink. Amounts may be rounded to whole dollars. 496 IINDEPEN013WE)TENDITURE REPORT NAME OF FILER Date Stxnp Huntington Beach 2020 Vision PAC, a committee in support of Measure Z Date of 10/30/201 - IN I MCI 14 UE�. ONE NUMBER I.D. NUMBER(app&abh,) This Filing I 17. 0 U,1 3 1 AH 7- 36.19011RCTIM I 3 For Official Use Only 1331-365 Report No. iI STREET ADDRESS 211 Main St-33 Amendment to Report No. CITY STATE ZIP CODE (expldh telim) Huntington Beach, (_A 9264E No. of Pages 1. List Only One Candidate or Ballot Measure NAVE OF CANDID)M SUPPORTED OR OPPOSED NAME Of BALLOT MEASURE SUPPORTED OR OPPOSED Devin Dwyer OFFICE SOUGHT OR HELD DISTRICT'NO. SUPPORTI OPPOSE &ALLOT NOAETTER 1JURISDICTION SUPPORT OPPOSE City Council Member Huntington Beach 2. Independent Expenditures Made Affac*ad&Vona11a!brMafim oPaWqprfafeJy"e4edccnfij7ua&Dn sheets, DATE DESCRIPTION OF EXPENDITURE AMOUNT 10130/2012 POS 2,204.5D 10/30/2DI2 LIT 5,272.24 10/30/2022 POS 3,810.00 1D/30/2012 LIT 3,654.50 Reason for Arnencim ent: FPPC Form 496(March/201 1) FPPC TolWree Helpline: 866fASK-FPPC(866f275-3772) www.netfile.com Type or print in ink. 496 Independent Expenditure Report Amounts may be rounded to whole doffam. 496 INDEPENDENT EXPENDrTURE REPORT HAVE OF FILER Date StarV Huntington Beach 2020 Vision PAC, a committee in support of Measure Z Date of This Filing 10/30/201.2 2f 12 OCT 3 1 AVI 7: 36 AREA CODEIPHONE NUMBER L D.NU For Official Use Only 724-540-2295 1331365 Report No. 2 STREET ADDRESS 211 Main St-B Amendment to Report CITY STATE ZIP CODE (aqwain bedmv) Huntington Beach, CA 92648 No. of Pages 2 1. List Only One Candidate or Ballot Measure NAME OF CANDIDAE SUPPORTED OR OPPOSED NAME OF SALL07 MEASURE SUPPORTED OR OPPOSED Barbara Delgleize OFFICE SOUGHT OR HELD D167RICT NO. SUPPORT OPPOSE LLOT NO./LETTER JURISDICTION SUPPORTI OPPOSE City Council Member X Huntington Beach I I I I Z Independent Expenditures Made AUschadc*Wnalinfofmationan appropriately fabetedeantoplationsheets, DATE DESCRIPTION OF EXPENDITURE AMOUNT 10/30/2012 LIT 10.544.113 10/30/2012 POS 7,620.OD 10130/2012 POS 2,204.50 ID/30/2012 LIT 5,272.24 Reason for Amendment: FlPPC Form 496(MarchfMlli) FPPC Toll-Free Herpline: 866/ASK-FPPC(8661 M3772) tfife.com 496 Independent Expenditure Report Ty pe or prinit in ink. Amounts may be rounded to whole dollars. q 7" 496 INDEPENDENT EXPENDITURE REPORT NAME OF FILER DalieSfarkip Huntington Beach 2020 Vision PAC, a committee in support of Measure Z Date of This Filing 10/30/ 012 17 OCT 3 1 MBER I.D.NUMBER WeAwtah6) FFor WOffidal Use Only 714-540-2295 1331365 Report No. 2 STREET ADDRESS 211 Main St-B C] Amendment to Report No. CITY SLATE ZIPCODE (eVlaln belmv) Huntington Beach, CA 92648 No.of Pages 2 1. List Only One Candidate or Ballot Measure NAME OF CANDID9E SUPPORTED OR OPPOSED IWIE OF BALLOT MEASURE SUPPORTED OR OPPOSED Barbara Delgleize OFFICE BOUGHT OR HELD DISTRFCTNO. SUPPORT OPPOSE BALLOT NO.ILETTER JURISDICTION SUPPORT OPPOSE City Council member X Huntington Beach 2. Independent Expenditures Made Adacha"donalfthIbmaton onappmprfaWylabe;L-dconiiiruaConsheets. DATE DESGRfPTION OF EXPENDITURE AMOUNT 10/30/2012 POS 3,810.00 10/30/2013 LIT 3,654-50 Reason for Amendment: FPPC Form 496 (March1201 I) FP13C Toll-Free l-lelpline: 8661ASK+FPC (8661275-3M) www.neffile.com 12— Recip ient Committee �f��cL COVERPAGE Type P Stamp T e or print in ink. Date Campaign statement ®' � • 1 Cover Page (Government Code Sections 84200-84216.5) Statement covers period Date of election if applicaN! £} ./ ., t., � ;1 L, Page 1 of 11 l0/01/2012 (Month, Day, Year) from For Official Use Only SEE INSTRUCTIONS ON REVERSE through 10/20/2012 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 ❑ Quarterly Statement O State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Od O Recall O Controlled Termination Statement E] Termination Supplemental Preelection (Also Complete Par red (Also file a Form 410 Termination) Statement-Attach Form 495 (Also Complete Part 6) x❑ General Purpose Committee ❑ Amendment(Explain below) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER Treasurer(s) 1331365 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) ntington Beach 2020 Vision PAC, a committee in support of Measure Z Lysa Ray MAILING ADDRESS 603 E Alton Ave Suite H STREET ADDRESS(NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 211 Main St-B Santa Ana, CA 92705 714-540-2295 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Huntington beach, CA 92648 714-540-2295 MAILING ADDRESS (IF DIFFERENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS 603 E Alton Ave STE H CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE Santa Ana, CA 92705 OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS 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 I Ns of the/tate of California that the foregoing is true and Ferree Executed on By 1/./.�� Date Signature of Treasurer or Assistant Treasurer Executed on By Date Signature of Controlling Officeholder,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 Signatureof Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) State of California www.netfile.com Type or print in ink. COVERPAGE-PART2 Recipient Comm i tee Campaign Statement � ®®� � ® ® 0 Cover page— part 2 Page 2 of 11 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 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 PROPGNENT 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 ❑ YES ❑ NO ❑ SUPPORT ❑ 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(86612763772) State of California www.netfile.com Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period Summary Page to whole dollars. from 10/01/2012 ®. SEE INSTRUCTIONS ON REVERSE through 10/20/2012 Page 3 of 11 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 ColumnA Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR (FROM ATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A,Line $ 44,674.00 $ 132,283.90 1!1 through 6l30 7!1 to Date 2. Loans Received ...................................................... Schedule B,Line 3 0.00 0.00 ,674.00 132,283.90 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 44 $ Received $ $ 4. Nonmonetary Contributions............... .................... Schedule C,Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............... ..AddLines3+4 $ 44,674.00 $ 132,283.90 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E,Line 4 $ 51,428.94 $ 109,915.42 Candidates 7. Loans Made............................................................. Schedule H,Line 3 0.00 0.00 22. Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ 51,428.94 $ 109,915.42 (IfSubjectto 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................................AddLines8+9+10 $ 51 428.94 $ 109,915.42 $ Current Cash Statement $ 12. Beginning Cash Balance....................... Previous Summary Page,Line 16 $ 29,461.63 To calculate Column B,add 13. Cash Receipts ................................................... Column A,Line 3above 44,674.00 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 s above 51,428.94 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ 22,706.69 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,Part 2 $ 0.00 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 $ 0.00 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(866/276-3772) www.netfile.com Schedule A Type or print in ink. SCHEDULE A ®�eta�/Contributions Received may be rounded Statement covers period to whole dollars. d from 10/01/2012 SEE INSTRUCTIONS ON REVERSE through 10/20/2012 page 4 of 11 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION RECEIVED COMMITTEE,ALSND .D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1 -DEC.31) (IF REQUIRED) OF BUSINESS) 10/20/2012 Donald Ayres ®IND Cons ,000.00 ❑COM 355 Bristol St #A ❑OTH Ayres Group Costa Mesa, CA 92626 ❑PTY 0/09/2012 Big Bear of California Photom Fireworks ❑IND 5,000.00 15,000.00 ❑COM 4 Ste. 218 Z OTH Corona, CA 92880 ❑PTY ❑SCC 10/20/2012 Big Bear of Califo s ❑IND 10,000.00 15,000.00 ❑COM 4740 Green River Rd., Ste. 218 ❑X OTH Corona, CA 92880 ❑PTY ❑SCC 10/09/2012 CA Real Estate PAC (#890106) ❑IND 10,000.00 23,000.00 x❑COM 525 S. Virgil Avenue ❑OTH Los Angeles, CA 90020 ❑PTY ❑SCC 10/09/2012 Linda Howit ❑RIND Retired 2,500.00 2,500.00 [:]COM 2340 Vista Ridge Ln. ❑OTH Signal Hill, CA 90755 ❑PTY ❑SCC 14 ; SUBTOTAL$ 28,500,00 " Schedule A Summary 'Contributor Codes 1. Amount received this period-itemized monetary contributions. IND-Individual (Include all Schedule A subtotals.) $ 44,500.00 COM—RecipientCommittee (other than PTY or SCC) 2. Amount received this period-unitemized monetary contributions of less than$100 ............................. $ 174.oo OTH—Other l Part business entity) P rY 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 $ 44,674.00 ( Page, Column A, Line )�� FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. ® � d from 10/01/2012 through 10/20/2012 Page 5 of 11 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION RECEIVED ( COMMITE,ALSND .D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS TO DATE (IFSELF-EMPLOYED,ENTER NAME PERIOD (JAN.1 -DEC.31) (IF REQUIRED) /20/2012 Realistic Products Inc ❑IND 400.00 400.00 ❑COM 2845 Supply Ave 40 ❑PTY ❑SCC 10/16/2012 William Saksa WIND Retired 100.00 100. ❑COM 18082 Freshwater Cir. ❑OTH Huntington Beach, CA 92648 ❑PTY ❑SCC 10/1 omes, LP ❑ IND s,000.00 5,000.00 ❑COM 8800 N. Gainey Center Dr., Suite 350 W OTH Scottsdale, AZ 85258 ❑PTY ❑SCC 10 /09/2012 Rodney Stout ❑xIND Retired 2,500.00 2,500.00 ❑COM 213SS Estepa Cir. ❑OTH Huntington Beach, CA 92648 ❑PTY ❑SCC 10/11/2012 Theoryr Properties, LLC ❑IND 8,000.00 12,500.00 ❑COM i Hammond Road ❑X OTH ❑PTY Ladera Ranch, CA 92694 El SCC LJ SUBTOTAL$ 16,000.00 'Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH—Other(e.g., business entity) PTY—Political Party FPPC Form 460(January/05) SCC—Small Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) www.netfile.com SCHEDULEE Schedule E Type or print in ink. Statement covers period ®. Payments Made Amounts may be rounded I to whole dollars. 10/01/2012 from SEE INSTRUCTIONS ON REVERSE through 10/20/2012 Page_6 of 11 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 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 PEr 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 p legal, accounting) VOT voter registration mailings PRT print ads WEB informatio NAME AND ADDRESS OF PAYEE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Budget Watchdogs Newsletter (#135115) LIT 4,337.00 1954 W. Carson St. #B Torrance, CA 90501 CA Public Safety (#1298740) LIT 1,888.00 30011 Ivy Glenn Dr., Ste 223 Laguna Niguel, CA 92677 CA Voter Green (#1323171) LIT 1,001.40 11645 West Olympic Blvd., Suite 645 Los Angeles, CA 90064 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 7,226.40 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ 51,428.94 2. Unitemized payments made this period of under$100 .......................................................................................................................................... $ 0.00 3. Total interest aid this period on loans. Enter amount from Schedule B, Part 1,Column e . 0.00 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. ............ TOTAL $ 51,428.94 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.nettile.com Schedule SCHEDULE E(CONT.) Type or print in ink. period(Continuation Sheet) Amounts may be rounded Statement covers p �CAILIFOIRINIIA � � Payments Made to whole dollars. from 10/01/2012 FORM -SEE INSTRUCTIONS ON REVERSE through 10/20/2012 Page 7 of 11 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 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 gs PRT print ads WEB information technology costs (internet, e-ma NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION PAID (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CA Voter Guide (#595004) Carson St. #B Torrance, CA 90501 LIT 2,507.0 rnment 728 W Edna P1. LIT 1,172.36 Covina, CA 91722 COPS voter Guide (#599014) 705-2 E. Bidwell St. #370 LIT 1,778.00 Folsom, CA 95630 Democratic Voters Choice (#595002) 777.16 728 W Edna P1. LIT Covina, CA 91722 Election Digest 2012 (#1345303) LIT 2,108.00 13701 Riverside Dr., Suite 604 Sherman Oaks, CA 91423 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 8,342.52 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) www.netfile.com SCHEDULE E(CONT.) SCheduOe E Type or print in ink. Statement covers period (Continuation Sheet) Amounts may be rounded • ' a • Payments Made to whole dollars. from 10/01/2012 through 10/20/2012 pa e 8 of 11 SEE INSTRUCTIONS ON REVERSE g NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 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 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 PRC professional services (legal, accounting) VOT voter registration gn literature and mailings PRT print ads WEB information t nternet, e-mail) NAME AND ADDRESS OF PAYEE RIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE,ALSO ENTER I.D.NUMBER) ent 15562 Chemical Ln Huntington Beach, CA 92849 474.10 JustinAdamLopez 1100 East Palm St. WEB 2,050.00 Altadena, CA 91001 Molly Kiefer Photography 8892 Skiff Circle CMP 150.00 Huntington Beach, CA 92646 Lysa Ray Campaign Services 655.00 603 E. Alton Ave., Suite H PRO Santa Ana, CA 92705 Vince Monaco LIT 11,295.38 25 Corn Flower St. Coto De Caza, CA 92679 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 14,624.48 FPPC Form 460(January/05) FPPC Toll-Free Helpiine:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule E SCHEDULE E(CONT.) Type or print in ink. Statement covers period (Continuation Sheet) Amounts may be rounded o Payments Made from whole dollars. 10/01/2012 • RM from through 10/20/2012 Page 10 of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER �11 D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 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 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 servic voter registration LIT campaign literature and mailings PR EB information technology costs (internet, e-mail) E CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE,ALSO ENTER I.D.NUMBER) SBAC Newsletter (41322623) 30011 Ivy Glenn Dr., Ste 223 Laguna Niguel, CA 92677 LIT 1,416.00 The Monaco Group 10,815.00 1011 S. Linwood Ave. POS Santa Ana, CA 92705 Woman's Voice (#i293667) 30011 Ivy Glenn Dr., Ste 223 LIT 1,325.00 Laguna Niguel, CA 92677 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 13,556.00 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) www.neffile.com Schedule G Type or print in ink. SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period ® - 4 • - Contractor(on Behalf of This Committee) to whole dollars. from 10/01/2012 ® 1 through 10/20/2012 Page 11 of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 NAME OF AGENT OR INDEPENDENT CONTRACTOR The Monaco Group 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 communlcations 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 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) "Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE,ALSO ENTER I.D.NUMBER) USPS POS 10,815.00 Sunflower Station Santa Ana CA Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 10,815.00 *Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com https://www.fedex.com/shipping/httnl/en/PrintIFrame.html From: (714)540 2295 Origin ID:DTHA Ampedbikes � ActWgt:1.0 LB CAD:1042870481INET3300 603 E Alton Ave Suite H De s Bar Code Santa Ana,CA 92705 J12201210150325 I I IIII I III I III II II I III��I I I III I III II I II III SHIP TO: (714)540-2925 BILL SENDER Ref# City Clerk Invoice# City of Huntington Beach PD# 2000 MAIN ST Dept# HUNTINGTON BEACH, CA 92648 FRI - 26 OCT Al 0 0# 7939 3411 0367 STANDARD OVERNIGHT ' 92648 WZ APVA SNA 515G1f90CB/AA44 After printing this label: 1. Use the'Print button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedexcom.FedEx vinll not be responsible for any claim in excess of$100 per package,whether the result of loss, damage, delay, non-delkery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of$100 or the authorized declared value. Recovery cannot exceed actual documented loss.Maxlmum for items of extraordinary value is$1,000, e.g.jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits, see current FedEx Service Guide. 1 of 1 10/25/2012 1:06 PM 497 Contri butlo n Report Type or print in ink. Amounts may be rounded to whole doltars. C., a r_ I .. 497 CONTRIBUTION REPORT NAME OF FILER Date Stamp Huntington Beach 2020 Vision PAC, support of Measure Z Date of + This Filing 3-0/24/201.2 �i12 OCT 2 4 A[; rForOfffirldial AREA CODE(PKONENUMBER I.O.NUMBER(tvapuNabkj Use Only Report No. 1 719-540-2245 1331365 STREET ADDRESS 211 [lain St-B Ej Amendment. to Report No. CITY STATE ZIPCODE (expWibefow) Buntington Beachr CA 92648 No.of Pages } 9. Contribution(s) Received DATE ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTORIF AN INDIVI DUAL AM(Y1NT RECEIVED 0FC0fiMTTEE,ALS0EKrrER ID.WMBM a ENTER OCCUPATIONANDEMPLOYER CODE (IF F -F-EMPLMED,FMER NAME OF BLONESS) RECOVED 10/24/2012 California Real Estate Independent Rxp Committee f#960326) ❑ IND 20,000.00 525 S Virgil Ave COM Los Angeles, CA 90020 ❑ OTH ❑Check If Loan ❑ PTY ❑ SCC Provide interest rate ❑ IND ❑ COM Q OTH ❑ Check if Loan ❑ PTY ❑ SCC % Provide inlerest fate ❑ IND ❑ COM ❑ OTH ❑ Check if Loan ❑ PTY Q SCC % Provide interest rate "Cortfributor Codes IND—individual CO@A—Recipient Committee(other than PTY or SCC} OTH—Other(e.g., business entity) Reason for Amendment- PTY—Political PartySCC—SmallContrfbutorCommittee FPPC. Form 497 (Marohl2011) FPPC Toll-Free Helpiine: SHIASK-FPPC (SM275.3772) ® (file.com COVER PAGE Recipient Committee Type or print in ink. Date Stamp Campaign Statement - g `� • 1 Cover page (Government Code Sections 84200-84216.5) 1^ _ �;tt Statement covers period Date of election if applica I 13"i ' (Month, Day, Year) Page 1 of 9 from 07/01/2012 For Official Use Only SEE INSTRUCTIONS ON REVERSE through 09/30/2012 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 ❑ Quarterly Statement Q State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report O Recall Termination Statement (Also Complete Part5) Sponsored ❑ E-] Supplemental Preelection p Termination) Statement-Attach Form 495 FXj (Also Complete Part 6)General Purpose Committee ❑ Amendment(Explain below) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D. NUMBER Treasurer(s) 1331365 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Huntington Beach 2020 V in support of Measure Z Lysa Ray MAILING ADDRESS 603 E Alton Ave Suite H STREET ADDRESS(NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 211 Main St-B Santa Ana, CA 92705 714-540-2295 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Huntington Beach, CA 92648 714-540-2295 MAILING ADDRESS (IF DIFFERENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS 603 E Alton Ave STE H CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE Santa Ana, CA 92705 OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS 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. Executed on By 9, Date'" Signature ofTreas rerorAssistantTreasurer Executed on By " Date Signature of Controlling Officeholder,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(8661275-3772) State of California www.netfile.com Type or print in ink. COVER PAGE-PART 2 Recipient Committee CALIFO. Campaign Statement FORM, 4160 Cover page— mart 2 Page 2 of 9 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 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 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 STREETADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(January/06) FPPC Toll-Free Helpllne:866/ASK-FPPC(866/276-3772) State of California www.netfile.com Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period CALIFORNIA Summary Page to whole dollars. a from 07/01/2012 •' 60 SEE INSTRUCTIONS ON REVERSE through 09/30/2012 Page 3 of 9 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDAR YEAR Running in Both the State Primary and (FROMATTACHED SCHEDULES) TOTALTO DATE g r General Elections 1. Monetary Contributions ........................................... Schedule A,Line $ 52,300.00 $ 87,609.90 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... Schedule a,Line 3 0.00 0.00 00.300 87,609.90 20. Contributions , 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 52 $ Received $ $ 4. Nonmonetary Contributions.................................... Schedule C,Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ 52,300.00 $ 87,609.90 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule e,Line.4 $ 27,295.76 $ 58,486.48 Candidates 7. Loans Made............................................................. Schedule H,Line 3 0.00 0.00 22. Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ _ 27,295.76 $ 58,486.48 (if Subjectto Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills)...............................ScheduleF,,Line -4,379.92 0,00 Date of Election Total to Date 10. Nonmonetary Adjustment ...............................I...........ScheduleC,Line 1 0.00 0.00 (mm/dd/yy) 11. TOTAL FXPENDITURES MADE................................Add Lines 8+9+10 $ _ 22,915.84 $ 58,486.48 J-�- _ $ Current Cash Statement $ 12. Beginning Cash Balance....................... Previous Summary Page,Line 16 $ 4,457.39 To calculate Column B,add 13. Cash Receipts ................................................... Column A,Line 3 above 52,300.00 amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash........................... Schedule 1,Linea 0.00 from Column B of your last reported in Column B. 15.Cash Payments.................................................. Column A,Line 6 above 27,295.76 report. Some amounts inColumn A may be negative 16. ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ 29,461.63 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 a,Part 2 $ 0.00 for this calendar year, only carry over the amounts from Lines 2,7, and 9(if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents........................................ See instructions on reverse $ _ 0.00 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) www.netfile.com Schedule A Type or print in ink. SCHEDULE A Amounts may be rounded Statement covers period Monetary Contributions Deceived to whole dollars. CALIFORN from 07/01/2012 ® 1 SEE INSTRUCTIONS ON REVERSE through 09/30/2012 page 4 of 9 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVETO DATE PER ELECTION RECEIVED ( COMMITTEE,ALSENTERI.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR ELF-EMPLOYED,ENTER NAME PERIOD (JAN. 1-DEC.31) (IF REQUIRED) OF BUSINESS) 08/28/2012 C/o Reed & Davidson LLP Bu OF SIC ❑IND 5,000.00 10,000.00 ❑COM 3699 Willshire Blvd., Suite 1290 ❑x OTH s, CA 90010 PTY ❑SCC 09/21/2012 California Real Estate PAC (#890106) ❑IND 10,000.00 13,000.00 525 S. Virgil Avenue ❑OTH ' Los Angeles, CA 90020 El PTY ❑SCC s Goodell ❑KIND Executive 9,800.00 9,800.00 ❑COM 2140 Via Mar Valle ❑OTH California Coastal Del Mar, Ca 9201.4 ❑PTY Communities.Inc. ❑SCC 07/26/2012 MHET PAC (#820165) ❑IND 1,000.00 1,000.00 ❑x COM 30151 Tomas ❑OTH Rancho Santa Margari, CA 92688 ❑PTY ❑SCC 09/28/2012 Protect Prop 13 931447 ❑IND 2,500.00 2,500.00 (]COM 1321 7th St Ste 205 ❑OTH Santa Monica, Ca 90401 ❑PTY ❑SCC 28,300 00 N E SUBTOTAL$ Schedule A Summary •Contributor Codes 1. Amount received this period—itemized monetary contributions. IND—Individual (Include all Schedule subtotals.)........................................................................................................$ S2,300.00 COM—RecipientCommittee (other than PTY or SCC). 2. Amount received this period—unitemized monetary contributions of less than$100 ............................. $ 0.00 OTH—Other(e.g., business entity) PTY—Political Party 3. Total monetary contributions received this period. SCC—Small contributor committee Add Lines 1 and 2. Enter here and on the SummaryPage, Column A, Line ....... TOTAL $ 52,300.00 9 1.) FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period RNIA to whole dollars. ® I from 07/01/2012 • RM 60 through 09/30/2012 Page 5 of 9 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED ( COMMITTEE,ALSNDI.D.NUMBER) CODE * RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1 -DEC.31) (IF REQUIRED) OF BUSINESS) 09/05/2012 Signal Landmark []IND 24,000.00 24,000.00 ❑COM 27285 Las Ramblas, Suite 200 Q OTH Mission Viejo, CA 92691 PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 24,000 00 'Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH—Other(e.g., business entity) PTY—Political Party FPPC Form 460(January/05) SCC—Small Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com SCHEDULEE Schedule E Type or print in ink. Statement covers period so= Pa fens blade Amounts may be rounded from to whole dollars. 07/01/2012 SEE INSTRUCTIONS ON REVERSE through 09/30/2012 Page 6 of 9 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 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 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 cam ngs PRT print ads WEB information technology costs (internet, e-mail OF PAYEE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE ON OF PAYMENT AMOUNTPAID California Latino Voters Guide (#1322246) LIT 800.00 930 Colorado Blvd. Bldg 2 Los Angeles, Ca 90041 Continuing the Republican Revolution (#59B641) LIT 500.00 1300 Bristol North, Suite 100 Newport Beach, CA 92660 Home Run Entertainment LIT 2,192.71 15562 Chemical Ln Huntington Beach, CA 92849 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3,492.71 Schedule E Summery 1. Itemized payments made this period.(Include all Schedule E subtotals.)............ ............ $ 27,270.76 2. Unitemized payments made this period of under$100 .......................................................................................................................................... $ 25.00 3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column e . $ o.00 4. Total payments made this period. Add Lines 1,2, and 3. Enter here and on the Summary Page,Column A, Line 6. TOTAL $ 27,295.76 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) www.netfile.com Schedule E Type or print in ink. SCHEDULE E(CONT.) (Continuation Sheet) Amounts may be rounded Statement covers period CALIFORNIA , • Payments Made to whole dollars. from 07/01/2012 FORM through 09/30/2012 Page 7 Of 9 SEE INSTRUCTIONS ON REVERSE g NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 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 ilings PRT print ads WEB information technology costs (inter E AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PA (IF COMMITTEE,ALSO ENTER I.D.NUMBER) Lysa Ray Campaign Services te H Santa Ana, CA 92705 PRO 130.63 Lysa 03 E. Alton Ave., Suite H PRO 213.75 Santa Ana, CA 92705 Lysa Ray Campaign Services 603 E. Alton Ave., Suite H PRO 308.75 Santa Ana, CA 92705 Powers Communication, Inc. 5,000.00 1198 Pacific Coast Hwy., #D317 CNS Seal Beach, CA 90740 Powers Communication, Inc. CNS 2,000.00 1198 Pacific Coast Hwy., #D317 Seal Beach, CA 90740 "Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 7,653.13 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) www.neffile.com Schedule E Type or print in ink. SCHEDULE E(CONT.) (Continuation Sheet) Amounts may be rounded Statement covers period � . ll to whole dollars. � Payments Made from 07/01/2012 • h 9 SEE INSTRUCTIONS ON REVERSE through 09/30/2012 8 Page of NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 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 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 vote campaign literature and mailings PRT print ads WEB information t (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE,ALSO ENTER I.D.NUMBER) Rutan & Tucker 3000 E1 Camino Real #200 Palo Aito, CA 94306 LEG 4,379.92 Wilson Perkins Allen Opinion Research. 1319 Clasen Dr. POL 11,745.00 Oklahoma City, OK 73103 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 16,124.92 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com SCHEDULEF Schedule F Type or print in ink. Statement covers periodCALIFORNIA Accrued Expenses (Unpaid Bills) Amounts may be rounded to whole dollars. from 07/01/2012 • ' I ® '. SEE INSTRUCTIONS ON REVERSE through 09/30/2012 Page 9 of 9 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 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 CREDITOR CODE OR ( ( ( ( OUTSTANDING AMOUNTINCURRE NG (IF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Rutan & Tucker LEG 4,379.92 0.00 4,379.92 0.00 3000 E1 Camino Real 4200 Palo Alto, CA 94306 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS$ 4,379.92 $ 0.00$ 4,379.92$ 0.00 Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of$100 or more, plus total unitemized accrued expenses under$100.)............................................ INCURRED TOTALS $ 0.00 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of$100 or more, plus total unitemized payments on accrued expenses under$100.) ..... ...........................PAID TOTALS $ 4,379.92 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9. ....................................... NET$ -4,379.92 9 ) ......................................................................................................... May be a negative number FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com statement of Organization STATEMENT OF ORGANIZATION Typeor print in ink Date Stamp Recipient Committee 7CALIFORNIAFORK Statement Type ❑Initial ❑x Amendment ❑ Termination—See Part 5 M12 SUP 17 Pi=1 2: 43 For Official Use Only Not yet qualified❑ or List I.D.number: List I.D.number: # 1331365 # 10 Date qualified as committee Date qualified as committee Date of Termination (If ap tee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z Lysa Ray STREET ADDRESS(NO P.O.BOX) 603 E Alton Ave Suite H STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE St-B Santa Ana, CA 92705 714-540-2295 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY Huntington Beach, CA 92648 714-540-2295 STREET ADDRESS(NO P.O.BOX) DRESS(IF DIFFERENT) 603 E Alton Ave STE H Santa Ana, CA 92705 CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS NAME OF PRINCIPAL OFFICER(S) COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT Ed Mountford/Principal Officer THAN COUNTY OF DOMICILE STREET ADDRESS(NO P.O.BOX) 211 Main St-B Orange Orange CITY STATE ZIP CODE AREA CODE/PHONE Attach additional information on appropriately labeled continuation sheets. Huntington Beach, CA 92648 714-540-2295 3. Verification I have used all reasonable diligence in preparing this statement and to the best of my know) ge the information contained herein 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 I.y B I. DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed onBy DATE SIGNAURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATESIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDNE,OR STATE MEASURE PROPONENT FPPC Form 410(April/2011) www.netfile.com FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) Statement Of ®PganlZa$IOn STATEMENT OF ORGANIZATION OWLIFORNIA Recipient Committee ®RK 41: INSTRUCTIONS ON REVERSE 2 of 4 COMMITTEE NAME I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support 1331365 2a. Additional Officers NAME OF OTHER PRINCIPAL OFFICER(S) NAME OF OTHER PRINCIPAL OFFICER(S) Dick Harlow/Other Principal Officer MAILING ADDRESS MAILING ADDRESS 211 Main St-B CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE Huntington Beach, CA 92648 714-540-2295 NAME OF OTHER PRINCIPAL OFFICER(S) NAME OF OTHER PRINCIPAL OFFICER(S) MAILING ADDRESS MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OTHER PRINCIPAL OFFICER(S) NAME OF OTHER PRINCIPAL OFFICER(S) MAILING ADDRESS MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OTHER PRINCIPAL OFFICER(S) NAME OF OTHER PRINCIPAL OFFICER(S) MAILING ADDRESS MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE FPPC Form 410(June/09) FPPC Toll-Free Helpline:866/ASK-FPPC www.netfile.com ' StatementSTATEMENT OF ORGANIZATION of Organization CALIF Recipient Committee FOORNIARM 410 INSTRUCTIONS ON REVERSE 3 of 4 I.D.NUMBER COMMITTEE NAME Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 4.Type of Committee Complete the applicable sections. e . . e • 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 CAN DIDWEIOFFICEHOLDER/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 Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) (INCLUDE DISTRICTNO.,CITY ORCOUNTY,ASAPPLICABLE) CHECK ONE SUPPORT OPPOSE X Z City of Huntington Beach SUPPORT OPPOSE FPPC Form 410(April/2011) FPPC Toll-Free Helpline:866/ASK-FPPC www.netFiile.com Staternent of Organization STATEMENT OF ORGANIZATION Recipient Committee ® ' aFORK 1 0 INSTRUCTIONS ON REVERSE 4 of 4 COMMITTEE NAME I.D.NUMBER Huntington Beach 2020 Vision PAC, a committee in support of Measure Z 1331365 4.Type of Committee (Continued) + Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑x CITY Committee ❑COUNTYCommittee ❑STATECommittee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Support or oppose issues or candidates inthe City of Huntington Beach List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE e o + e ❑ — 1 J Date qualified 5.Terrninatioln RegluirementS By signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that all ofthe 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(April/2011) FPPC Toll-Free Helpline:866/ASK-FPPC www.netfile.com COVER PAGE Recipient Committee Type or print in ink. Date Stamp Campaign Statement Cover Page ® ' (Government Code Sections 84200-84216.5) Statement covers period Date of election if applicab � g e (Month, Day,Year) � 2 J)` ' 27 i f,(i s�i«.` 12 Page 1 of 9 from 01/01/2012 For Official Use Only SEE INSTRUCTIONS ON REVERSE through 06/30/2012 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 ❑ Quarterly Statement 0 State Candidate Election Committee Committee ® Semi-annual S ❑ Special Odd-Year Report 0 Recall 0 Controlled ❑ Termination Statement ❑ Supplemental Preelection (Also Complete P ored (Also file a Form 410 Termination) Statement-Attach Form 495 (Also Complete Part 6) X❑ General Purpose Committee ❑ Amendment(Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER Treasurer(s) 133136S COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Huntington Beach 2020 Vision PAC Lysa LING ADDRESS 603 E Alton Ave Suite H STREET ADDRESS(NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 211 Main St-B Santa Ana, CA 92705 714-540-2295 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Huntington Beach, CA 92648 714-540-2295 MAILING ADDRESS (IF DIFFERENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS 603 E Alton Ave STE H CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE Santa Ana, CA 92705 OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the informations ontained 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 corre / 24/20127/ Executed on 0 By Date Signature of Treasurer orAssistant Treasurer Executed on By Dam Signature of Controlling Officeholder,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(Januaryl05) FPPC Toll-Free Helpline:866IASK-FPPC(8661275-3772) State of California www.netfile.com Type or print in ink. COVER PAGE-PART 2 Recipient Committee A ® _ Campaign Statement ® - a ® i Cover Page—Part 2 Page 2 of 9 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 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 Listnamesof 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 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(866/276-3772) State of California www.netfile.com Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period • - Summary Page to whole dollars. I from 01/01/2012 SEE INSTRUCTIONS ON REVERSE through 06/30/2012 Page 3 Of 9 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC 1331365 ColumnA Column Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR Running (FROMATTACHED SCHEDULES) TOTALTO DATE g in Both the State Primary ry and General Elections 1. Monetary Contributions ........................................... schedule A,Line $ 35,309.90 $ 35,309.90 2. Loans Received ...................................................... schedule B,Line 3 0.00 0.00 1/1 through 6/30 7/1 to Date 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 35,309.90 $ 35,309.90 Received $ $ 4. Nonmonetary Contributions.................................... Schedule C,Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED •••••.•....••..............AddLines3+4 $ 3-9,309.90 $ 35,309.90 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... schedule E,Line 4 $ 31,190.72 $ 31,190.72 Candidates 7. Loans Made............................................................. schedule H,Line 3 0.00 0.00 22. Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ 31,190.72 $ 31,190.72 (IfSubjectto Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills)...............................schedule F Line 3 0.00 4,379.92 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+lo $ 31,190.72 $ 35,570.64 Current Cash Statement $ 12. Beginning Cash Balance....................... Previous Summary Page,Line 16 $ 338.21 To calculate Column B,add 13.Cash Receipts ................................................... Column A,Line 3 above 35,309.90 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 8 above 31,190.72 report. Some amounts inColumn A may be negative 16.ENDING CASH BALANCE.......... Add lines 12+13+14,then subtract Line 15 $ 4,457.39 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,Part 2 $ 0.oo for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2,7,and 9(if any). 18. Cash Equivalents........................................ See instructions on reverse $ 0.00 19. Outstanding Debts......................... Add Line 2+Line 9 in Column B above $ 4,379.92 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule A Type or print in ink. SCHEDULE A Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. I CAL I F• ' I from 01/01/2012 • - SEE INSTRUCTIONS ON REVERSE through 06/30/2012 Page 4 of 9 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC 1331365 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION. RECEIVED ( COMMITTEE,ALSND I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR ELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED) OF BUSINESS) 06/12/2012 C/O Reed & Davidson LLP Building Industry ASSOC OF SIC ❑COM 3699 Willshire Blvd., Suite 1290 ❑x OTH Los Angeles, CA 90010 El PTY ❑SCC ng Industry Association of Southern California ❑IND 10,000.00 10,000.00 (#990142) ❑x COM Park Circle ❑OTH , Suite 170 ❑PTY Irvine, CA 92614 ❑SCC 04/17/2012 Califo C (#890106) RIND 3,000.00 3,000.00 ❑x COM 525 S. Virgil Avenue ❑OTH Los Angeles, CA 90020 ❑PTY ❑SCC 04/17/2012 Jack Gosney X❑IND Retired 5,000.00 5,000.00 ❑COM P.O.Box 1134 El OTH Del Mar, CA 92014 ❑PTY ❑SCC 05/25/2012 Huntington S orec i s ❑IND 6,750.00 6,750.00 ❑COM 1400 E. 4th Street ❑X OTH Santa Ana, CA 92701 [:]PTY ❑SCC SUBTOTAL$ 29,750.00 =r Schedule A Summary "Contributor Codes 1. Amount received this period—itemized monetary contributions. IND—Individual (Include all Schedule A subtotals.)........................................................................................................$ 35,250.60 COM—Recipient Committee (other than PTY or SCC) 2. Amount received this period—unitemized monetary contributions of less than$100.............................$ 59.90 OTH—Other(e.g., business entity) PTY—Political Party 3. Total monetary contributions received this period. SCC—Small contributor committee Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1. TOTAL $ 35,309.90 FPPC Form 460(January/05) FPPC Toil-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com SCHEDULEE Schedule E Type or print in ink. Statement covers period Amounts may be rounded ®R d Payments Made to whole dollars. from 01/01/2012 SEE INSTRUCTIONS ON REVERSE through 06/30/2012 page 6 of 9 NAME OF FILER I.D. NUMBER Huntington Beach 2020 Vision PAC 1331365 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 ND 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 WEB information technology costs (internet, e-mail) ADDRESS OF PAYEE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF PAYMENT AMOUNTPAID DMI Direct PET 323.25 1145 W. Collins Avenue Orange, CA 92867 GOCO Consulting LLC PET 10,000.00 4730 J Street Sacramento, CA 95819 GOCO Consulting LLC POL 3,000.00 4730 J Street Sacramento, CA 95819 ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 13,323.25 Schedule E Summary 1. Itemized payments made this period.(include all Schedule E subtotals.).............................................................................................................. $ 31,117.82 2. Unitemized payments made this period of under$100 ............................ ................................. $ 72.90 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1,Column(e).)............................................................................... $ 0.00 4. Total payments made this period. Add Lines 1,2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 31,190.72 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule Type or print in ink. SCHEDULE E(CONT.) (Continuation Sheet) Amounts may be rounded IL Statement covers period ® Made r to whole dollars. ® - PaymentS Made from 01/01/2012 h SEE INSTRUCTIONS ON REVERSE through, 06/30/2012 7 Page of 9 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC 1331365 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 ND 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 registra campaign literature and mailings PRT print ads WE technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE OF PAYMENT AMOUNT PAID (IF COMMITTEE,ALSO ENTER I.D.NUM LC 4730 J Street Sacramento, CA 95819 POL ng LLC 4730 J Street PET 10,631.00 Sacramento, CA 95819 Lysa Ray Campaign Services 603 E. Alton Ave., Suite H PRO 300.00 Santa Ana, CA 92705 Lysa Ray Campaign Services 203.75 603 E. Alton Ave., Suite H PRO Santa Ana, CA 92705 - Lysa Ray Campaign Services 603 E. Alton Ave., Suite H PRO 85.00 Santa Ana, CA 92705 ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 13,219.7S FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com Schedule SCHEDULE E(CONT) Type or print in ink. (COIItItlUatl011 Sheet) Amounts may be rounded Statement covers period CAILIFORNAA to whole dollars o Payments Made from. o1/ol/zolz SEE INSTRUCTIONS ON REVERSE through 06/30/2012 Page 8 of 9 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC 1331365 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 M 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, ration LIT campaign literature and mailings PRT prin n technology costs (internet, e-mail) NAME AND YEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID LSO ENTER I.D.NUMBER) Lysa Ray Campaign Services 603 E. Alton Ave., Suite H Santa Ana, CA 92705 - PRO 300.00 RedZone Strategies 10252 Wesley Circle CNS 597.30 Huntington Beach, CA 92646 Jenniffer Rodriguez 3245 Spectrum Dr CMP 1,677.52 Irvine, CA 92618 Jenniffer Rodriguez 2,000.00 3245 Spectrum Dr CMP Irvine, CA 92618 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 4,574.82 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866IASK-FPPC(8661275-3772) www.netfile.com SCHEDULEF Schedule F Type or print in ink. Amounts may be rounded Statement covers period ® - d Accrued Expenses (Unpaid Bills) to whole dollars. from 01/01/2012 SEE INSTRUCTIONS ON REVERSE through 06/30/2012 Page 9 of 9 NAME OF FILER I.D.NUMBER Huntington Beach 2020 Vision PAC 1331365 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) (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNTIN ANDING (IF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCEAT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Rutan & Tucker LEG 4,379.92 0.00 0.00 4,379.92 3000 E1 Camino Real #200 Palo Alto, CA 94306 *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS$ 4,379.92 $ 0.00$ 0.00$ 4,379.92 Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of$100 or more, plus total unitemized accrued expenses under$100.)............................................ INCURRED TOTALS $ 0.00 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of$100 or more, plus total unitemized payments on accrued expenses under$100. 0.00 P P P Y P ) .................................PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) ..................... NET$ 0.00 May be a negative number FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) www.netfile.com