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Home My WebLink AboutWentzel, Robert K. - 2012 FPPC Campaign Disclosure Forms - R (2) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee ® A ® . INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D.NUMBER Bob Wentzel for Huntington Beach City Council 2012 46-0987198 4.Type of Committee (Continued) •1 U Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY •• • • • ` List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE 0 0 0 • ❑ __/_ Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Date qualified small contributor committee on January 1,2001,enter 1/1/01. 5.Termination Requirements By signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds;and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. FPPC Form 410 (January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Summary Page to whole dollars. Statement covers periodCALIFORNIA from 10/01/2012 SEE INSTRUCTIONS ON REVERSE through 12/31/2012 Page of---t- NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 ToColumn AoD cColuDmn BR Calendar Year Summary for Candidates Contributions Received (FROMATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and 00 1. Monetary Contributions ........................................... schedule A,Line 3 $ 720. $ 870.00 General Elections 2. Loans Received .........................I........,.. .... .... ... Schedule 8,Line 3 0.00 0.00 1/1 through 6/30 7/1 to Date . . .... 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 720.00 $ 870.00 20. Contributions 4. Nonmonetary Contributions.................................... schedule c,Line 3 0.00 0.00 Received $ $ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED .••••..••••• ..............Add Lines 3+4 $ 720.00 $ 870.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... schedule E,Line 4 $ 881.23 $ 881.23 Candidates 7. Loans Made............................................................. schedule H,Line 3 0.00 0.00 881.23 881.23 22• Cumulative Expenditures Made* & SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ $ (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 ..........................................schedule C,Line 3 0.00 0.00 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE................................Add Lines a+9+10 $ 881.23 $ 881.23 $ Current Cash Statement --/--/ $ 12. Beginning Cash Balance....................... Previous summary Page,Line 16 $ 0,00 To calculate Column B,add 13. Cash Receipts ................................................... Column A,Line 3 above 0.00 amounts in Column A to the 0.00 corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash........................... schedule I,Line 4 from Column B of your last reported in Column B. 00 report. Some amounts in 15.Cash Payments.................................................. column A,Line B above 0. Column A may be negative 16. ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ 0.00 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 farnm Lines 2,7,ands(if 18. Cash Equivalents........................................ See instructions on reverse $ 0.00 y) 19. Outstanding Debts......................... Add Line 2+Line 9 in Column B above $ 0.00 FPPC Form 460(Januaryl05) FPPC Toll-Free Helpline: 866/ASK-FPPC(866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONY) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. from 10/01/2012 • - through 12/31/2012 Page of NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE,ALSO ENTERI.D.NUMBER) CODE (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1 -DEC.31) (IF REQUIRED) OF BUSINESS) ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND [:]COM ❑OTH ❑PTY [:]SCC ❑IND ❑COM ❑OTH ❑PTY [:]SCC SUBTOTAL$ *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) Type or print in ink. SCHEDULE B-PART 1 Schedule B—Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. from 10/01/2012 �, ®. 460 h 12/31/2012 page of SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 a IF AN INDIVIDUAL, ENTER (b) (c) (d) (e) (r) FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER BALANCE AMOUNT PAID BALANCEAT OF LENDER (IFSELF-EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAMEOFBUSINESS} P RIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE ❑PAID CALENDARYEAR ❑FORGIVEN RATE PER ELECTION** t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR ❑FORGIVEN RATE PERELECTION** t❑ IND ❑ COM ❑ OTH ❑ PTY 0 SCC DATE DUE DATE INCURRED ❑PAID CALENDARYEAR $ $ _ % $ $ ❑FORGIVEN RATE PERELECTION** t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0.00$ 0.00 $ 0.00 $ 0.00 (Enter(a)on Schedule B Summary Schedule E,Line 3) 1. Loans received this period.................. 0.00 (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes 0.00 IND—Individual 2. Loans paid or forgiven this period .........................................................................................................$ COM—Recipient Committee (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g., business entity) PTY—Political Party 3. Net (change this period. Subtract Line 2 from Line 1.) ............................................... NET $ 0.00 SCC—Small Contributor Committee Enter the net here and on the Summary Page,Column A, Line 2. (May be a negative number} *Amounts forgiven or paid by another party also must be reported on Schedule A. **If required. FP PC Form 460(Januaryl05) FPPC Toll-Free Helpline:8661ASK-FPPC(866/275-3772) SCHEDULE B-PART 2 Schedule B-Part 2 Type or print in ink. Amounts may be rounded Statement covers period Ae . Loan Guarantors to whole dollars. from 10/01/2012 e - SEE INSTRUCTIONS ON REVERSE through 12/31/2012 Page-7— of NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 FULL NAME,STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT BALANCE ZIP CODE OF GUARANTOR CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED CUMULATIVE OUTSTANDING (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE (IF SELF-EMPLOYED,ENTER THIS PERIOD TO DATE TO DATE NAME OF BUSINESS) ❑IND LENDER CALENDARYEAR ❑COM $ OTH DATE PER ELECTION (IF REQUIRED) ❑PTY ❑SCC $ CALENDAR YEAR BIND LENDER ❑COM $ OTH PER ELECTION DATE (IF REQUIRED) PTY SCC $ CALENDARYEAR ❑IND LENDER ❑COM $ PER ELECTION OTH DATE (IF REQUIRED) ❑PTY ❑SCC $ CALENDAR YEAR ❑IND LENDER ❑COM $ ❑OTH DATE PER ELECTION (IF REQUIRED) ❑PTY ❑SCC $ Enteron SUBTOTAL $ 0.00 Summary Page, Line 17 only. - FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule C Type or print in ink. SCHEDULE C Amounts may be rounded Statement covers period Nonrnonetary Contributions Received to whole dollars. • - , , from 10/01/2012 •R through 12/31/2012 Page a of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 CONTRIBUTOR FULL NAME,STREET ADDRESS AND IF AN INDIVIDUAL,ENTER AMOUNT/ CUMULATIVE TO PER ELECTION DESCRIPTION OF DATE DATE ZIP CODE OF CONTRIBUTOR CODE* OCCUPATION AND EMPLOYER GOODS OR SERVICES FAIR MARKET CALENDAR YEAR TO DATE RECEIVED (IF SELF-EMPLOYED,ENTER VALUE IF REQUIRED {IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) (JAN 1-DEC 31) ( ) FIND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC FIN ❑COM ❑OTH t]PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 0.00 Schedule C Summary *Contributor Codes 1. Amount received this period—itemized nonmonetary contributions. IND—Individual (Include all Schedule C subtotals.) 0.00 COM—RecipientCommittee (other than PTY or SCC) 2. Amount received this period—unitem 0.00 OTH—Other(e.g.,business entity) ized nonmonetary contributions of less than$100 ....................................$ PTY—Political Party 3. Total nonmonetary contributions received this period. SCC—Small contributor committee Add Lines 1 and 2. Enter here and on the SummaryPage,Column A, Lines 4 and 10. TOTAL $ 0.00 FPPC Form 460(January/05) FPPC Toll-Free Helpllne:866/ASK-FPPC(866/275-3772) Schedule Type p SCHEDULED Summary®f Expenditures T e or print in ink. Statement covers period Amounts may be rounded o RNI Supporting/Opp using Other to whole dollars. from 10/01/2012 0� � Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE through 12/31/2012 Page of 17- NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 NAME OF CANDIDATE,OFFICE,AND DISTRICT,OR CUMULATIVE TO DATE PER ELECTION DATE TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) OR COMMITTEE PERIOD (JAN.1-DEC.31) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. include all Schedule D subtotals. ....................................... $ 0.00 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 $ 0.00 P P P t rY g } ............ FPPC Form 460(January105) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) Schedule (Continuation Sheet) Type or print in ink. SCHEDULE D CONT. Summary Of ExpendituresAmounts may be rounded Statement covers period to whole dollars. ;CALIFORNMA ® , Supporting/Opposing Other from 10/01/2012 FORM Candidates, Measures and Committees through 12/31/2012 Page of J7- NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 NAME OF CANDIDATE,OFFICE,AND DISTRICT,OR DESCRIPTION CUMULATIVE TO DATE PER ELECTION DATE TYPE OF PAYMENT AMOUNT THIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD ORCOMMITTEE (JAN.1-DEC.31) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ 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 SUBTOTAL $ 0.00 FPPC Form 460(Januaryl05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) SCHEDULE F Schedule F Type or print in ink. Statement covers period • AIW Amounts may be rounded a b Accrued Expenses (Unpaid Bills) to whole dollars. from 10/01/2012 • - through 12/31/2012 IPge� of---f---SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel,lodging,and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs(internet, e-mail) NAME AND ADDRESS OF CREDITOR CODE OR ( ( ( ( OUTSTANDING AMOUNTINCURRED AMOUNN T PAID OUTSTANDING (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 *Payments that are contributions or Independent expenditures must also be SUBTOTALS$ Q,QQ $ Q,QQ $ Q,QQ $ Q,QQ summarized on Schedule D. 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 0.00 accrued expenses of$100 or more, plus total unitemized payments on accrued expenses under$100.) .................................PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 0.00 onthe Summary Page, Column A, Line 9.) ................................................................................................................................................ NET$ May be a negative number FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule F Type or print in ink. SCHEDULE F(CONT.) (Continuation Sheet) Amounts may be rounded Statement covers period ® ' to whole dollars. 10/01/2012 Accrued Expenses (Unpaid Bills) from through 12/31/2012 Page of NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 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 Lv. 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 CREDITOR CODE OR ( (N (N ( OUTSTANDING I AMOUNT INCURRED AMOUNT PAID OUTSTANDING (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 SUBTOTALS $ 0.00 $ 0.00 $ 0.00 $ 0.00 FPPC Form 460(January105) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule Type or print in ink. SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period a CALIFORNIA Contractor(on Behalf of This Committee) to whole dollars. from 10/01/2012 v - ® 0 through 12/31/2012 page.�� of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 NAME OF AGENT OR INDEPENDENT CONTRACTOR 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 (intemet, 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 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 0.00 *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) n SCHEDULE H Schedule H Type or print in ink. Statement covers period e _ * Amounts may be rounded 10/01/2012 e Loans Made to Others to whole dollars. from • SEE INSTRUCTIONS ON REVERSE through 12/31/2012 Page of NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 IF AN INDIVIDUAL,ENTER (a) (b) (c) ( (e) M (9) FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTA DING INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER REPAYMENT OR OF RECIPIENT BALANCE LOANED THIS BALANCE AT RECEIVED AMOUNT OF LOANS IF COMMITTEE,ALSO ENTER I.D.NUMBER) (IF SELF-EMPLOYED,ENTER BEGINNING THIS FORGIVENESS CLOSE OF THIS LOAN TO DATE ( NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD' PERIOD PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION— DATE DUE DATE INCURRED PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION— $ $ $ $ $ DATE DUE DATE INCURRED *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. SUBTOTALS $ 0.00 $ 0.00 $ 0.00 $ 0.00 (Enter(e)on Schedule I,Line 3) Schedule H Summary 1. Loans made this period .............. ............ ......................$ 0. .. ...... . . . . .. ... .. . . ...................................................................... 00 If Required (Total Column(b)plus unitemized loans of less than$100.) 2. Payments received on loans $ 0.00 ...................................................................................................................... (Total Column(c)plus unitemized payments of less than$100.) 3. Net change this period. Subtract Line 2 from Line 1. NET $ 0.00 g p ( )....................................................................................... (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number) FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule l Type or print in ink. SCHEDULE 1 Miscellaneous Increases to Cash Amounts may be rounded Statement covers period FPageJ-7 to whole dollars. 10/01/2012 • ' '_ � tSEE INSTRUCTIONS ON REVERSEfromthrough 12/31/2012 _ of NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF RECEIVED pF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 0.00 Schedule 1 Summary 1. Itemized increases to cash this period. .............. $ 0.00 ............................................................................................... 2. Unitemized increases to cash of under$100 this period...................................... .........$ 0.00 3. Total of all interest received this period on loans made to others. Schedule H, Column e . .............$ 0.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14. .......................... TOTAL $ 0.00 FPPC Form 460(January/05) FPPC Toll-Free Helpline;866/ASK-FPPC(866/275-3772) COVER PAGE Recipient Committee p Type or print in ink. Date Stamp ® _ NIA Campaign Statement ® v ® 1 Cover Page r°µ (Government Code Sections 84200-84216.5) Page of Statement covers period Date of election if applicable from 01/01/2012 (Month, Day,Year) 12 OCT 5 P 5, For Official Use Only SEE INSTRUCTIONS ON REVERSE through 9/30/2012 11/06/2012 t' 1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement: ® Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ® Preelection Statement ❑ Quarterly Statement Q State Candidat mmittee ❑ Semi-annual Statement ❑ Special Odd-Year Report Q Recall O Controlled Termination Statement (Also Complete Part 5) ❑ ❑ Supplemental Preelection � Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 ❑ (Also Complete Part fi)General Purpose Committee ❑ Amendment(Explain below) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER Treasurer(s) MMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Bob Wentzel for Huntington Beach City Council 2012 Linda Wentzel MAILING ADDRESS 8778 Coral Springs Ct.,#202 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 9114 Adams Avenue,#198 Huntington Beach CA 92646 657-204-9468 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Huntington Beach CA 92646-3405 714-395-6039 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 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 10/05/2012 By Date 'Signature of Treasur r ssistant 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 460(January/05) FPPC Toll-Free Helpline:866/ASK.FPPC(86612753772) State of California Type or print in ink. COVER PAGE-PART 2 Recipient CommitteeIPALIFORNJII, Campaign Statement FORM, Cover Page—Part 2 Page � of�i] 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF B OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑ SUPPORT Huntington Beach City Council ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP g 8788 Coral Springs Ct.,#202 Huntington Beach, CA 92646 Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7• Primarily Formed Candidate/Officeholder Committee List names of officeholder(s)or candidate(s)for which this committee is primarily formed. [] YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEE NAME I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES ❑ NO ❑ SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/2763772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period • - NIA Summary Page to whole dollars. ' from 01/01/2012 FORM 461 SEE INSTRUCTIONS ON REVERSE through 9/30/2012 page of NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR Running in Both the State Prima and (FROMATTACHED SCHEDULES) TOTALTO DATE g Primary 15000 150.00 General Elections . 1. Monetary Contributions ........................................... Schedule A,Line 3 $ $ 2. Loans Received ...................................................... Schedule B,Line 3 0.00 0.00 1/1 through 6/30 7/1 to Date 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 150.00 $ 150.00 20. Contributions $ 0.00 $ 150.00 4. Nonmonetary Contributions.................................... Schedule C,Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ 150.00 $ 150.00 Made $ 0.00 $ 0.00 Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E,Line 4 $ $ Candidates 7. Loans Made............................................................. Schedule H,Line 3 22,Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ $ (lf Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ...............................Schedule F Line 3 500.00 500.00 Date of Election Total to Date 10. Nonmonetary Adjustment ..........................................Schedule C,Line 3 (mm/dd/yy) 11, TOTAL EXPENDITURES MADE................................Add Lines 8+9+10 $ 500.00 $ 500.00 11 / 06 / 12 $ 500.00 Current Cash Statement /-J $ 12. Beginning Cash Balance....................... Previous Summary Page,Line 16 $ To calculate Column B,add 13.Cash Receipts ................................................... Column A,Line 3 above amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash........................... Schedule/,Line 4 from Column B of your last reported in Column B. 15,Cash Payments.................................................. Column A,Line s above report. Some amounts inColumn A may be negative 16.ENDING CASH BALANCE.......... Add Lines 12+13+14,then subtract Line 15 $ 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 $ 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 $ 19. Outstanding Debts......................... Add Line 2+Line 9 in Column B above $ 500.00 FPPC Form 460(January/06) FPPC Toll-Free Helpline:866/ASK-FPPC(866/276-3772) Schedule A Type or print in ink. SCHEDULE A Amounts may be rounded Statement covers period Monetary Contributions Received to whole dollars. •_ , from 01/01/2012 •- SEE INSTRUCTIONS ON REVERSE through 9/30/2012 Page of NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE,A IT RE,ALSAND ZIP I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CAL (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED) OF BUSINESS) ®IND 08 b Wentzel ❑COM Retired H.R. 25.00 25.00 8788 Coral Springs Ct.,#202 ❑OTH Manager/ Huntington Beach, CA 92646 ❑PTY ❑SCC ®IND 09/24/2012 Mary Uciechowski ❑COM Retired 7681 Bean Road ❑OTH 25.00 25.00 Woodruff, WI 54568 ❑PTY ❑SCC ®IND 09/24/2012 Duane Grahovec ❑COM Unknown 100.00 100.00 12426 Elm Street ❑OTH Palos Park, IL 60464 ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 150.00 Schedule A Summary •Contributor Codes 1. Amount received this period-itemized monetary contributions. IND-Individual (Include all Schedule A subtotals.) .................................$ 150.00 COM—R(other thant n PTY ................................................................ ••�•�� (other than PTY or 2. Amount received this period-unitemized monetary contributions of less than$100 ............................. $ 150.00 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 SummaryPage, Column A, Line 1. TOTAL $ 150.00 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/276-3772) Type or print in ink. SCHEDULEB-PART1 Schedule B—Part 1 Amounts may be rounded Statement covers period CALIFORNIA Loans Received to whole dollars. from 01/01/2012 FORM • 1 SEE INSTRUCTIONS ON REVERSE through 9/30/2012 Page 1 of NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 IF AN INDIVIDUAL, ENTER a (c) (d) (e) (f) FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER BALANCE AMOUNTPAfD BgLgNCEAT OF LENDER (IF SELF-EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE,ALSO ENTERI.D.NUMBER) NAME OF BUSINESS) D PERIOD THIS PERIOD* P RIOD PERIOD LOAN TO DATE ❑PAID CALENDARYEAR ❑FORGIVEN RATE PER ELECTION*" $ $ $ $ $ tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDAR YEAR ❑FORGIVEN RATE PER ELECTION** $ $ $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDAR YEAR ❑FORGIVEN RATE PER ELECTION" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0.00 $ 0.00 $ 0.00 $ 0.00 (Enter(e)on Schedule B Summary Schedule E,Line 3) 1. Loans received this period......................... $ 0.00 ....................................................................................... (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes 2. Loans paid or forgiven this period $ 0.00 COM Recipient Committee ......................................................................................................... (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g., business entity) PTY—Political Party 3. Net change this period. Subtract Line 2 from Line 1. 0.00 SCC—Small Contributor Committee 9 p ( )............................................................... NET $ Enter the net here and on the Summary Page, Column A, Line 2. (May beanegative number) *Amounts forgiven or paid by another party also must be reported on Schedule A. **If required. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) SCHEDULE B-PART 2 Type or print in ink. Schedule B—Part 2 Statement covers period Amounts may be roundedCALIFORNIA, Loan Guarantors to whole dollars. from 01/01/2012 •- 9+60 SEE INSTRUCTIONS ON REVERSE through 9/30/2012 Page of NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 FULL NAME,STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE BALANCE ZIP CODE OF GUARANTOR CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED OUTSTANDING (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE (IF SELF-EMPLOYED,ENTER THIS PERIOD TO DATE TO DATE NAME OF BUSINESS []IND LENDER CALENDAR YEAR ❑COM $ ❑OTH DATE PER ELECTION (IF REQUIRED) ❑PTY F-1 SCC CALENDAR YEAR ❑IND LENDER ❑COM $ OTH PER ELECTION DATE (IF REQUIRED) ❑PTY ❑SCC $ CALENDAR YEAR ❑IND LENDER ❑COM $ PER ELECTION OTH DATE (IF REQUIRED) ❑PTY []SCC $ LENDER CALENDARYEAR ❑IND COM $ OTH DATE PER ELECTION (IF REQUIRED) ❑PTY ❑SCC $ Enter on SUBTOTAL $ 0.00 Summary Page, Line 17 only. FPPC Form 460(January/05) FPPC Toll-Free_Helpline:866/ASK-FP_P_C_(866/275-3772)_ Schedule C Type or print in ink. SCHEDULE C Amounts maybe rounded l�onmonetary Contributions Received to whole dollars. Statement covers period CALIFORNIA 11 from 01/01/2012 ® - • , SEE INSTRUCTIONS ON REVERSE through 9/30/2012 Page of NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 CUMULATIVE TO IF AN INDIVIDUAL,ENTER AMOUNT/ PER ELECTION FULL NAME,STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF DATE DATE ZIP CODE OF CONTRIBUTOR * OCCUPATION AND EMPLOYER FAIR MARKET RECEIVED CODE (IF SELF-EMPLOYED,ENTER GOODS OR SERVICES CALENDAR YEAR TO DATE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) VALUE (IF REQUIRED) NAME OF BUSINESS) (JAN 1-DEC 31) ❑IND ❑COM ❑OTH ❑PTY ❑SCC MIND ❑COM ❑OTH ❑PTY ❑SCC MIND ❑COM ❑OTH ❑PTY . ❑SCC MIND ❑COM MOTH ❑PTY ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 0.00 Schedule C Summary *Contributor Codes 1. Amount received this period-itemized nonmonetary contributions. IND-Individual Include all Schedule C subtotals. .......... $ 0.00 COM-Recipient Committee 000 (other than PTY or SCC) . 2. Amount received this period-unitemized nonmonetary contributions of less than$100 ....................................$ OTH—Other(e.g., business entity) PTY—Political Party 3. Total nonmonetary contributions received this period. SCC-Small contributor committee Page, Column A, Lines 4 and 10.Add Lines 1 and 2. Enter here and on the Summarye 0.00 ) ......................TOTAL $ FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) Schedule D SCHEDULED Summary of Expenditures Type or print in ink. Statement covers period Supporting/OpposingOther Amounts may be rounded ®" ® 1 to whole dollars. 01/01/2012 FORM Candidates,Measures and Committees from SEE INSTRUCTIONS ON REVERSE through 9/30/2012 Page of NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 CUMULATIVE TO DATE PER ELECTION DATE NAME OF CANDIDATE,OFFICE,AND DISTRICT,OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN.1-DEC.31) (IF REQUIRED) OR COMMITTEE ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 0.00 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. Include all Schedule D subtotals. . . ...... $ 0.00 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 $ 0.00 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) SCHEDULE E Type or print in ink. Schedule Statement covers period Amounts may be roundedCALIFORNIA d a PaymentsSlue to whole dollars. 01/01/2012 e" from SEE INSTRUCTIONS ON REVERSE through 9/30/2012 Page of NAME OF FILER I.D. NUMBER Linda Wentzel 46-0987198 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CUP 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)* O C office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel,lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)" POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs(internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 0.00 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. 0.00 2. Unitemized payments made this period of under$100 $ 0.00 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. ......I... TOTAL $ 0.00 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) SCHEDULEF Schedule F Type or print in ink. Statement covers period Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. from 01/01/2012 ® ' / 6 through 9/30/2012 pa a of SEE INSTRUCTIONS ON REVERSE g NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel,lodging,and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR CODE OR ( OUTS INNDING AMOUNT INCURRED AMOUNN T PAID OUTSTANDING (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 Bob Wentzel 9114 Adams Ave LIT 500.00 0.00 0.00 500.00 Huntington Beach, CA 92646 *Payments that are contributions or independent expenditures must also be SUBTOTALS $ 500.00 $ 0.00 $ 0.00 $ 500.00 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 0.00 accrued expenses of$100 or more, plus total unitemized accrued expenses under$100.)............................................ INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on 0.00 accrued expenses of$100 or more, plus total unitemized payments on accrued expenses under$100.) .................................PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 0.00 onthe Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $ May be a negative number FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/276-3772) Schedule C Type or print in ink. SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period A Contractor(on Behalf of This Committee) to whole dollars. from 01/01/2012 • through 9/30/2012 Pa a of SEE INSTRUCTIONS ON REVERSE g NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants I TG 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(IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 0.00 *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) SCHEDULE H Schedule H Type or print in ink. Statement covers period Loans Made �® Others* Amounts may be rounded 01/01/2012 imm to whole dollars. from through 9/30/2012 Page of SEE INSTRUCTIONS ON REVERSE 9 9 NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 IF AN INDIVIDUAL (a) (b) ,ENTER (cl (d� (e) FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTA DING INTER EST (el ORIGINAL(fl CUMULATIVE OCCUPATION AND EMPLOYER REPAYMENTOR OF RECIPIENT BALANCE LOANED THIS BALANCE AT RECEIVED AMOUNT OF LOANS (IF COMMITTEE,ALSO ENTER I.D.NUMBER) (IF SELF-EMPLOYED,ENTER_ BEGINNING THIS FORGIVENESS CLOSE OF THIS NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD PERIOD LOAN TO DATE PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION" $ $ $ $ $ DATE DUE DATE INCURRED PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION- DATE DUE DATE INCURRED *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must SUBTOTALS $ 0.00 $ 0.00 $ 0.00 $ 0.00 also be reported on Schedule E. (Enter(e)on Schedule I, Line 3) Schedule H Summary 1. Loans made this period ........................ .......$ 0.00 ........................................................................................................... **if Required (Total Column(b)plus unitemized loans of less than$100.) 2. Payments received on loans $ 0.00 ................................................................................................................................... (Total Column(c)plus unitemized payments of less than$100.) 3. Net change this period. Subtract Line 2 from Line 1. NET $ 0.00 (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number) FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) Schedule I Type or print in ink. SCHEDULE I Miscellaneous Increases to Cash Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. J ' from 01/01/2012 • SEE INSTRUCTIONS ON REVERSE through 9/30/2012 Page of NAME OF FILER I.D.NUMBER Linda Wentzel 46-0987198 DATE FULL NAME ANDADDRESS OF SOURCE AMOUNT OF RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 0.00 Schedule I Summary 1. Itemized increases to cash this period. $ 0.00 2. Unitemized increases to cash of under$100 this period..................................................... $ 0.00 3. Total of all interest received this period on loans made to others. Schedule H, Column e . $ 0.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the TOTAL 0.00 Summary Page, Line 14.) .......................................................................................................... $ FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/276-3772) Statement of Organization STATEMENT OF ORGANIZATION Type or print in ink Date Stamp Recipient Committee Statement Type `Initial ❑ Amendment ❑ Termination—See Part 5 I i For official use only Not yet qualified�or List I.D.number. List I.D. number: � # # Date qualified as committee Date qualified as committee Date of Termination Of applicable) 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMIT Bob Wentzel for Huntington Beach City Council 2012 Linda Wentzel STREET ADDRESS( 8788 Coral Springs Court,#202-F STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREACODE/PHONE 8788 Coral Springs Court,#202-F Huntington Beach CA 92646 714-395-6039 CITY STATE ZIP CODE A TANT TREASURER,IF ANY Huntington Beach CA 92646 714-395-6039 STREETADDRESS(NO P.O.BOX) MAILING ADDRESS(IF DIFFERENT) 9114 Adams,#198 Huntington Beach, CA CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS wentzelforhbcouncil@gmail.com NAME OF PRINCIPAL OFFICER(S) COUNTY OF DOMICILE ]COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE STREET ADDRESS(NO P.O.BOX) Orange CITY STATE ZIP CODE AREACODE/PHONE Attach additional information on appropriately labeled continuation sheets. 3. Verification I have used all reasonable diligence in preparing this statement and to the best of 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 foregoing is true and correct. Executed on By —27ZZf7 2 OFTR SISTANT TREASURER Executed on a6 f By DATE SIG RE OFeONTROLLINGr/CEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT FPPC Form 410(April/2011) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Statement ®f Organization STATEMENT OF ORGANIZATION Recipient Committee CAL-4YORNIA a FORM -ti i INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME ,!"w I I.D.NUMBER f^71M L BE)fc-14 L= 4.Type of Committee Complete the applicable sections. a o •a 9 • 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. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY , 4� don-Partisan (ft_t 1�11 CC3(A 111C ❑ 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 o •. e Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (April/2011) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee ® 0 a � ® _ INSTRUCTIONS ON REVERSE Page 3 COMMITTEE N � ( I.D.NUMBER �EACti 4.Type of Committee (Continued) KEN= e o Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY IM 1 1 List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE 0 0 0 0 Date qualified 5.Termination Requirements By signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that all of the following conditions have been met: This committee has ceased to receive contributions and make expenditures; . This committee does not anticipate receiving contributions or making expenditures in the future; o 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: 866IASK-FPPC (866/275-3772)