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Home My WebLink AboutHuntington Beach Municipal Employees Association - 2012 FPPC (2) SHURIFORM Recipient Committee Type or print in ink. Date stamp ® e 57361753 Campaign Statement — Short Form - I, SEE INSTRUCTIONS ON REVERSE Statement covers period Date of election if applicable: Page 1 of 3 For use by recipient committees that have not received a 01/01/2012 (Month,Day,Year 2112 A!J13 1 �� _� 4; �.i, contribution or other receipt that must be itemized, have not from For official Use only received or made loans, and have no outstanding accrued expenses. through 04/27/2012 04/27/2012 - - 1. Type of Recipient Committee: 2. Type of Statement: Committee 0 General Purpose Committee ❑ Pre-election Statement ❑ Quarterly Statement Q Primarily Formed Q Sponsored ❑ Semi-annual Statement ❑ Special Odd-year Report Q Controlled Q Small Contributor Committee ® Termination Statement ❑ Supplemental Pre-election Q Sponsored Statement-Attach Farm 495 ❑ Primarily Formed Candidate/ ❑ Amendment(Explain) Officeholder Committee (Also check type of statement you are amending) NUMBER3. Committee Information I.D. Treasurer(s) 961623 COMMITTEE NAME E OF TREASURER Huntington Beach Municipal Empl ical Action ' Committee -94ww k...Reue-lea. MAILING ADDRESS PO Box 449 STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE 2000 Main Street Huntington Beach, CA 92648 (714) 374-1564 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY Huntington Beach, CA 92648 7143741564 MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS 4.Verification I have used all reasonable diligence in preparing and reviewing this statement and to the bes -f my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the for going is true an correct. Executed on _--n l 12' By �I DATE "^I SIGNATURE OF TREASURER OR ASSISTANT TREASURER f 9 Executed on r DATE f ATU EOF ONTROLLING 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 450(Jan/05) FPPC Toll-Free Helpline: 866/ASK-FPPC Recipient Committee Type or print in ink. SHORT FORM pmayAmountsStatement covers period Campaign Statement to whole dollars. ® - 1 d Summary Page from 01/01/2012 through 04/27/2012 Page 2 of 3 NAME OF COMMITTEE I.D.NUMBER Huntington Beach Municipal Employees Political Action Committee 961623 Expenditures Made 1. Expenditures of$100 or more made this period .............................................................................................................I............... $ 15B.75 2. Expenditures under $100 made this period Not itemized. ................................ 0.00 3. SUBTOTAL EXPENDITURES MADE THIS PERIOD .......................................................... 15B.7s .............................................................................Add Lines 1 +2 $ 4. Nonmonetary Adjustment............................ ..........From Line 8 Below 0.00 5. Total expenditures made from previous statement .........................................................................Previous Summary Page, Line 6 $ 0.00 (If this is the first statement for the calendar year, enter zero.) 6. TOTAL EXPENDITURES MADE TO DATE.................................................................................................................................................Add Lines 3 +4 +5 $ 158.7S Contributions Received 7. Monetary contributions received this period .................................................................................................................................. $ 0.00 8. Non-monetary contributions received this period........................................................................................................................... 0.00 9. Total contributions received from previous statement ................................................................... Previous Summary Page, Line 10 $ 0.00 (If this is the first statement for the calendar year, enter zero.) 10.TOTAL CONTRIBUTIONS RECEIVED TO DATE......................................................................................................................................Add Lines 7+ 8+9 $ 0.00 Current Cash Statement 11. Beginning cash balance............................................................................................................. Previous Summary Page, Line 15 $ 15B.7s 12.Cash receipts this period................................................................... .... Line 7 above 0.00 13.Miscellaneous increases to cash .............. ........................................................... $ 0.00 14.Cash expenditures this period .................................................................................................................................. Line 3 above 1sB.7s 15.ENDING CASH BALANCE THIS PERIOD ..............................................................................................Add Lines 11 + 12+ 13, then subtract Line 14 $ 0.00 FPPC Form 450(Jan105) FPPC Toll-Free Helpline: 8661ASK-FPPC * SHORT FORM Recipient Committee Type or print in ink. Statement covers period Amounts may be rounded Campaign Statement — Short Form to whole dollars. from 01/01/2012 through 04/27/2012 Page 3 of 3 SEE INSTRUCTIONS ON REVERSE NAME OF COMMITTEE I.D.NUMBER Huntington Beach Municipal Employees Political Action Committee 961623 5. Payments Made (if more space is needed,use additional copies of this page for continuation sheets.) NAME OF CANDIDATE AND OFFICE OR DATE*' NAME AND ADDRESS OF PAYEE DESCRIPTION OF PAYMENT NAME OF BALLOT MEASURE AND AMOUNT CUMULATIVE (IF ER) BALLOT NUMBER OR LETTER THIS PERIOD AMOUNTS 10 DATE*, ANDJURISD1CT10N 01/06/2012 CTPAC PAC Fund Closing HBMEA Pac since 158,75 Calendar Year we joined Teamsters Union 1127 llth Street $ St#501 Sacramento CA 95814 Other Support [] Oppose Contribution E] Ind. Exp. $ Calendar Year Other Support [] Oppose Contribution F] Ind. Exp. $ Calendar Year $ Other Support Oppose ❑ Contribution [] Ind. Exp. $ SUBTOTAL $ 158.75 Required only for payments which are contributions or independent expenditures. FPPC Form 450(Jan/05) FPPC Toll-Free Helpline: 866/ASK-FPPC