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HomeMy WebLinkAbout460 - 10/23/2022 thru 12/28/2022_ Redacted (TJH)Recipient Committee Campaign Statement Corer Page SEE INSTRUCTIONS ON REVERSE Statement covers Period from 10123/22 through 12128/22 Date Stamp RECEIVED Date of election if applicable: (Month, Day, Year) DEC 2 g 20D November 8, 2022 OF ARCA,D(A 1. Type of Recipient Committee: All Commltteea— Complete Parts 1, 2, 3, and 4. 2. Type of Statement: Z 3 iceholder, Candidate Controlled Committae [� State Candidate Election Committee Q Recall ❑ Primarily Formed Ballot Measure ommittes Controlled El ❑ m Preelection Statement Semi-annual Statement Termination Statement fAko Gum MPad65 Sponsored {,vas CwcplafePeff W ❑ (Also file a Form 410 Termination) Amendment (Exptairl below) ❑ aneral Purpose Committee Sponsored ❑ Primarily Formed Candidate) Small Contributor CDmrinkee Officeholder Committee Political PartylCentrai Comrnittne (AeaC&rnplelaPad 7) 3. Committee information Y.D. NUMBER 1453245 4. COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Tracy Jensen to Arcasiia, City Council, 2022 STREETADDRESS (NO P.O. BOX) Arcadia CA 91007 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREAGODEIPHONE OPTIONAL: FAX/P-MAILADDRESS Verification I have used all reasonable diligence in preparing and reviewing this statement a certify under penalty of perjury under the laws of the State of California that the Executed on 12 28122 ee Executed on 1212S/22 Dote Executed on Executed on Die COVER PAGE Page I of For OTicisI Us Only ❑ Quarlerly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Raymond Jensen MAILING ADDRESS CITY STATE ZIP CODE AREA CODEJPHONE Temple City CA 96780 NAME OF ASSISTANT TREASURER, IFANY LING ADDRESS CITY STATE ZIP CODE AREA GODEIPHONE OPTIONAL: FAX 1 E-MAILADDRES& is is true and complete. I cy gnethr6 of CArYtnsllYng Qfrxehoider, Candidate, Stake bleasu[a Proi=onsnr By igneWre of Cantrdlhp Officeholder, Candldete, Ste%Mew ure P oponant FPPC Farm 460 {Jan/2016)) FPPC Advice: advice@fppe.ca-grog (866127S-9772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Tracy Jensen Han OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE] Arcadia City Council, District 2 RESIDENTIALIBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP Arcadia CA 91UO7 Related Committees Not Included in this Statement: L►stanycommftes not Mcluded In this stateownt that are conftiled by you or are prlmadlyWmad to receive contributions or make expenditures an behelfcf your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES [] NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE COVER PAGE - PART 2 Page 2- of 5. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7_ Primarily Formed Candidate[Officeholder Committee t-lstnamesof a►Hceholdsr(s) of candldate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form450 (Jan/201E] FPPC Advice: advice@fppc.ca.gov 1966/275-37721 www.fppr.co.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Tracy Jensen Han to Arcadia City Council, 2022 Contributions Received Amounts may be rounded to whole dollars. $faterrnntcovers period from 10/23/22 through 12/2$122 Column A Column B TOTAL Tr IS PERIOD CALEJNDM YEAR (F1ioNATTACHED SCHEDULES) TOTAL. To DATE I. Monetary Contributions ................................................ Schedule A. Ldne 3 $ 3809.25 $ 7153.25 2. Loans Received .................. .. Schedule B, Line 3 (5000.00) 0 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Limas 4 + z $ (1190.75) 7153.25 4. Nonmonetary Contributions ............................................ Schedule C. Line 3 0 0 5. TOTAL CONTRIBUTIONS RECEIVED ................. ............. AddLlnes3+4 5 (1190.75) $ 7153.25 Expenditures Made 6. Payments Made ........................ ................... Schedule e. Line 4 $ 3,955.63 $ 7153.25 7. Loans Made....................................................................... Schedule R, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines B + 7 $ 3955.63 $ 715315 9. Accrued Expenses (Unpaid BIBs Schedule F tine 3 0 0 10. Nonmonetary Adjustment .................. ...................................... schedule C, Urfa 3 0 0 11. TOTAL EXPENDITURES MADE .Add Lines 8+9+ to S 3955.63 $ 715525 Current Cash Statement 12. Beginning Cash Balance .. Pretllbussfrrrmarypage, [ins ra ........................ $ 5146.38 To calculate Column B, 13. Cash Receipts . 4bdturrnA, Line 3 above (1190.75) add amounts in Column 14. Mise t'llaneous Increases to Cash .................................. Schedule 1, Llrta 4 0 A to the correspondingamounts from Column 9 15, Cash Payments .................................... CaAwraaa A, line 8 above 3955.63 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE .............. ... Add Urm 12+13 + 14, often subtract Lino 15 $ 0 be negative figures that ff this is a ferrnination statement Lft 16 must be zero. should be subtracted from previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ schedule s, part 2 $ filed for this calendar yesr, Only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any), 18. Cash Equivalents ................................................ See irrsthucHoris on reverse $ 19. Outstanding Debts .............................. Add Line 2 +Line 91n Column B ahovs $ SUMMARY PAGE I.U. NUMBER 1453M Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 10 through 0130 W1 to Date 20. Contnbutions ReceivAd $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' of 8ublect to Voluntary Expenditure Llmltt Date of Election Total to Date (mmlddlyy) `Amounts in this section may be different from amounts reported in Cofumn B. FPPC Form 460 (3an12016)) FPPC Advice., advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Schedule A Monetary Contributions Received Amounts may be rounded to whole dollars. etalloment covers period from 10/23/22 SCHEDULE A 12/28122 Page &F SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Committee to Elect Tracy Jensen Han to Arcadia City Council, 2022 1453245 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE To DATE PER ELECTION RECEIVED CONTRIBUTOR CODE DpEPF-EQoYEp. NYN AND ERNAMeR RECEIVED THIS CALENDAR YEAR TO DATE ;IF GQWTTFF.ALS0 ENTER LD, NUMBER) of "I NEW PERIOD (JAN. 1- DEC. 31 ) (IF REQUIRED) IND 11/1122 ulie Mc unkin ❑ coM Senior Account Exec. $100.00 $100.00 $100.00 ❑ OTH Principal Pinancial Group Rancho Santa Margarita, CA 92688 ❑ PTY scc m IND 111i122 Tom Camou ❑ COM Homemaker $k500.00 $500.00 $500.00 ❑ OTH arrest Grove, Oregon, 97116 ❑ PTY ❑ SCC ® IND 11/1122 Bob &Kath Jensen ©Com Retired $100.00 $100.00 $100.00 ❑ OTH Chino Hills, CA 91709 ❑ PTY 0 ❑ SCC ®N o 10/25122 Shirley Kanaan © GOM Self $100.00 1110.00 $100.00 ❑ OTH Katraanl Construction, Inc. Arcadia, CA 91007 ❑ P7" ❑ SGC El I N 0Q 10/26122 Michelle Cicoietti ElChA Homemaker $500,40 $500.00 $5W.00 ❑ OTH Charlotte, NC ❑ PTY ❑ SCC SUBTOTAL $ 1300.00 Schedule A Summary 1. Amount received this period - itemized monetary Contributions. 3685.25 (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period -- unitemized monetary contributions of less than $100 $ 124'00 3. Total monetary contributions received this period. 3809,25 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)...................... TOTAL ; "Contributor Codes IND - Individual COM - Recipient Committee (other than PTY ar SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Commie FPPC Form +460 (Jan11016)j FPPC Advice_ advice@fppc.ca.gov (866/275-3772) www.fppcca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) monetary Contributions Kecelvea zo whole aouam. Staderlient COVers Wod CALIFORNIA from 10/23/22 FORM 460 throh 12/28/22 Nee NAME OF FILER I.D. NUMBER Committee to Elect Tracy Jensen Han to Arcadia City Council, 2022 1453245 DATE FULL. NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IFAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR ■ CODE OCCUPATION AND ER EMPLOYER (IF SELF-EMPLOYED, ENTER TER NAME) RECEIVED THIS CALENDAR YEAR TO DATE QFCOMNIiTEE,AL$dENTERI,D,NUMBER) OF5USINEe9) PERioo (JAN. I -DEC. 31) (IFREQUIIRED) IND 10/30/22 FarryMurph ❑COM Web Designer $100.00 $100.00 $100.00 ❑ OTH GoFish.Rocks Ventura, CA 93003 ❑ PTY ❑ 5CC ® i N D 10/25/22 Damon Mcjunkin El COM Ranger !; $100.00 $100.00 $100.00 ❑ OTH US Forestry Service Whittier, CA 90601 ❑ PTY ❑ scc m I N D 10/25/22 Patrick Whalen ❑ com Accountant $100.00 $100.00 $1130.00 ❑ OTH The Trade Desk CamarilkN CA 93012 ❑ PTY ❑ 8CC m I N D 1111122 Jeff Buttikoffer ❑ COM Retired. $500.00 $500.00 $500.00 ❑ OTH Chino Valley, AZ 86323 ❑ PTY _ � ❑ 5CC SIN D 1112122 ❑COD Retired $600.00 ' Now ❑ OTHGt�,��{try Temple City, CA 91780 ❑ PTY ISCC SUBTOTAL $ 1400.00 'Contributor Codes IND — Individual CONE — Recipient Committee [other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party 5CC — Small Contributor Committee Schedule A (Continuation Sheet) Amounts may bemulnded SCHEDULER (CONT.) monetary Uontrieutions Received T°'M110w coma . Statement covers period CALIFORNIA 460 from 10123/22 FORM through 12/28/22 page 60 Of _ NAME OF FILER I.D. INUMBER Committee to Elect Tracy Jensen Han to Arcadia City Council, 2022 1453245 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTORIF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR „ CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME) RECEIVED THIS CALENDARYEAR TO DATE (IF COM<+ M79F, ALSO ENTER I.D. NUMBER) OF EUSIt*SS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ® IND 12/20/22 Tra Jensen Han [I COl�! [I Sta -at-Home parent $985.25 $960.25 $960.25 ❑ OTH Arcadia, CA 914D7 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY sCc ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ com 0 OTH ❑ PTY SCC �] IND ❑ CAM ❑ OTH ❑ PTY SCC SUBMTAL $ 985.25 'Contributor Codes IND — I ndividuat CON+ — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY —Political Party SCC — Small Contributor Committee Amniinfe meu he ■n­derl SCHEDULE S- PART i ounuume d — Ill 'i to whole dollars. Statement covers period 1, Loans Received CALIFORNIA i from 10/23/22FORM SEE INSTRUCTIONS ON REVERSE through 12128/22 _ Page of-3-- NAME OF FILER I.D. NUMBER Committee to Elect Tracy Jensen Han to Arcadia City CaunC 1, 2D22 1453245 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INT' EST ORIGINAL CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNINGTHIS RECEIVED THIS PERIOO ORFORGIVEN THISPER100t BALANCE AT CLOSEOFTHIS PAID THIS PERIOD AMOUNTOF LOAN CONTRIBUTIONS TO DATE NAME OF 9 U$iNESS) PERIOD PERIOD PAlD ALENl7RR YEAR Tracy Jensen Han Stay -at -Home Parent 4014.75 0 5000.00 985.25 3 so x $ s PER ELECTICrZ' Arcadia, CA 91007 ® FCRaIVEN RATE 51000 e 0 $ 985.25 1211/22 s 0 9/18122 0 to IND ❑ r,OM ❑ OTH C] PTY ❑ SCC DATE DUE DATE WOURRED PAID ❑ FORGIVEN RATE PER ELECTION'~ t❑ IND ❑ C,OM ❑ OM ❑ PN ❑ SCC = S s DATE INWRREp S DATE DUE ❑ PAID GALENDyARYEAR $ a % $ I; ❑ FORGIVEN RATE PER ELECTION" t❑ IND ❑ COMA ❑ OTH © PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0 $ 5001].00 $ 0 0 7- Schedule B Summary 1. Loans received this period....................................................................................................................$ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period................................................,........................................................$ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule AA 0 5000.00 3. Net change this period. (Subtract Line 2 from Line 1 } .......NET $-(5000.00) ........................................................ Enter the net here and on the Summary Page, Column A, Line 2. (Mey be s negative number) 'Amounts forgiven or paid by another party also must be reported on Schedule A. "" If required. [fir ta]an Sdtadila E, Lliss 8y tContributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH -Other (e.g„ business entity) PTY - Political Party SCC - S mall Contributor Committee FPPC Farm 46D PanJ2016]l FPPC Advice,. advice@fppc.ca.gov t866/275-3772j www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Tracy Jensen Han to Arcadia City Council, 2022 Amounts may be rounded to whole dollars. SCHEDULE E covers period from 10/23/22 through 12/28/22 I page -a- M 1453245 CODES, If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalialmisc. MBR membar communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution {explain nonmonetarff CFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t•v, or cable airtime and production costs FIL candidate fit inglballot fees PHC phone banks TRC candidate travel, lodging, and meals FIND fundraising events POL polling and survey research TRS stafflspouse travel, lodging, and meals IN❑ Independent expenditure supportinglopposing others (explain)" POS postage, delivery and messenger services TEF transfer between committees of the same candidate/sponsor LEG legal defense PRC professional. services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information tachm ogy costs (fnternet, e-mail) NAME AND ADDRESS OF PAYEE {IF COMMITTEE, ALSO ENTER I.D. NUMBER] Office Depot ornple City, CA 90784 I SLB Printing Los Angeles, CA 90034 U.S. Postal Service Beverly Hills, CA 90210 CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID LIT I Printing for door to door flyers 1 $224.18 LIT I Printing for mailers I $1866.13 IS w Payments that are oontrit]utians or independent expenditures mu st also be sunvrmftod on Schedule D. Postage for Mailers 1 $1672.09 SUBTOTAL $ 3,762.40 Schedule E Summary 1 _ Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 3762.40 2_ Uniternized payments made this period of under$100.......................................................................................................................................... $ 193.23 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e)) $ Q 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Urea 6.)........................... TOTAL $ 3955.63 FPPC Form 460 (Jon/2016)) FPPC Advice: advice ftpc.ca.gov (866/275-3712) www.fppc.ca.gov