COVER PAGE

Recipient Committee Date Stamp hiiYJJd!SdS P 9 W

Campaign Statement
Cover Page FILED
Statement covers period Date of election if applicable:
(Month, Day, Year)
JAN 9 2017 For Official Use Only
from 10/23/2016
COUNTY ELECTIONS
SEE INSTRUCTIONS ON REVERSE through 12/31/2016 November 8, 2016

1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 2. Type of Statement:
D Officeholder, Candidate Controlled Committee D Primarily Formed Ballot Measure D Preelection Statement D Quarterly Statement
O State Candidate Election Committee Committee D Semi-annual Statemenl D Special Odd-Year Report
O Recall O Controlled li2I Termination Statement
(Also Complele Par/ 5) O Sponsored (Also file a Form 410 Termination)
(Also Comp/a/a Par/ 6)
D General Purpose Committee D Amendment (Explain below)
O Sponsored Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee
(Also Comp/a/a Par/ 7)
O Political Party/Central Committee
1.0. NUMBER
3. Committee Information Treasurer(s)
1385655
COMMITIEE NAME (OR CANDIDATE'S NAME IF NO COMMITIEE) NAME OF TREASURER

Committee to Elect Rick Stephens Truckee Tahoe Airport Board Sherrin Fielder
MAILING ADDRESS

STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE

CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY

Gail Sephens
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 I E-MAIL ADDRESS OPTIONAL: FAX I 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 conta ined herein and in the attached schedules is true and complete.
certify under penalty of perjury under the laws of the State of California that the foregoing is true~ nd c rrect. _4_
Execuledon 113/2017 By - - - -=
Date ...,.. -•-..,.,.._,...,,-.nt""T"",.-..-..-,.-,- - - - - - - - - -

Executed on 1/3/2017 By - .. . --- ·-

Date

Execuled o n - - - - - - - , , - , - - - - - - - - - BY-----------,,S~lg-na~tu-re-o-.f~
Co__n...
tro~U~lng"""o~ffi~c--eh--o~ld...
er-., C~a-nd~id~a--te-.
, S~ta~le~M~e--a"""su...
ra~P~ro--p"""on--e~
nt___________
Dale

Execuled on Date By Signature of Controlling Officeholder, Candidate, Stale Measure Proponent

FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
 COVER PAGE - PART 2
Recipient Committee .soc
Campaign Statement
Cover Page - Part 2

5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee

NAME OF OFFICEHOLDER OR CANDIDATE NAME 9F BALLOT MEASURE

Rick Stephens
OFFICE SOUGHT OR HELO (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LEITER JURISDICTION
O SUPPORT
O OPPOSE
Truckee Tahoe Airport Board
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Identify the controlling officeholder, candidate, or state measure proponent, If any.

NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT

Related Committees Not Included in this Statement: List any committees

not included In this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
contributions or make expenditures on behalf of your candidacy.

COMMITIEE NAME I.D. NUMBER

7. Primarily Formed Candidate/Officeholder Committee List names of

NAME OF TREASURER CONTROLLED COMMITIEE? offlceholder(s) or candldate(s) for which this committee Is primarily formed.
O YES ONO '
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX)
O SUPPORT
O OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
O SUPPORT
O OPPOSE
COMMITIEE NAME I.D. NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
O SUPPORT
O OPPOSE

NAME OF TREASURER CONTROLLED COMMITIEE?

NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELO
O SUPPORT
O YES ONO
O OPPOSE
COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX)

CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary

FPPC Form 460 (Jan/2016)

FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
 Amounts may be rounded
Campaign Disclosure Statement SUMMARY PAGE

Summary Page
to whole dollars.

from
Statement covers period
10/23/2016
CALIFORNIA
FORM
460
through 12/31/2016 Page
3' of _ __
13
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER 1.0. NUMBER
Committee to Elect Rick Stephens Truckee Tahoe Airport Board 1385655
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTAL TH IS PERIOD CALENDAR YEAR
(FROM ATIACHED SCHEDULES) TOTAL TO DATE Running In Both the State Primary and
General Elections
$ . 13106.87 74080.48
1. Monetary Contributions Schedule A, Line 3 $
1/1 through 6/30 7/1 to Date
2. Loans Received ................................................................ Schedule B, Line 3
0 0
13106.87 74080.48 20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2 $ $ Received $------
$ _ _ __
1558.25 4064.61
4. Nonmonetary Contributions...... ...................................... Schedule c, Line 3 21 . Expenditures
14665.12 78145.09 Made $ _ _ _ _ __ $ _ _ __
5. TOTAL CONTRIBUTIONS RECEIVED .......... ...................... ....Add Lines 3 + 4 $ $

Expenditures Made Expenditure Limit Summary for State

6. Payments Made................................................................ Schedule E, Line 4 $ 16992.95 $ 74095.21 Candidates
7. Loans Made ....................................................................... Schedule H, Line 3 0 0
22. Cumulatlve Expenditures Made*
8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 1 $ 16992.95 $ 74095.21 (If Subject to Voluntary Expenditure Limit)

9. Accrued Expenses (Unpaid Bills) ....................... Schedule F. Line 3 0 0

Date of Election Total to Date
10. Nonmonetary Adjustment... ................................................. ..... Schedule c, Line 3 0 0 (mm/dd/yy)

11. TOTAL EXPENDITURES MADE ........................................ Add Lines B + 9 + 10 $ 16992.95 $ 74095 .21 _ _ J _ _ J_ _ $ _ _ __

Current Cash Statement _ _ J _ _ J_ _ $ _ _ __

12. Beginning Cash Balance Previous Summary Page, Line 16 $ 3907.35
To calculate Column B,
13. Cash Receipts Column A, Line 3 above 13106.87 add amounts in Column
A to the corresponding
14. Miscellaneous Increases to Cash Schedule I, Line 4
0 *Amounts in this section may be different from amounts
amounts from Column B reported in Column B.
15. Cash Payments ......................................................... Column A, Line B above
16992.95 of your last report. Some
amounts in Column A may
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 0 be negative figures that
should be subtracted from
If this is a termination sta_tement, Line 16 must be zero. previous period amounts. If
this is the first report being
17. LOAN GUARANTEES RECEIVED Schedule 8 , Part 2 $
0 filed 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

19. Outstanding Debts .............................. Add Line 2 + Line 9 In Column B above $ 0 f PPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A Amounts may be rounded SCHEDULE A
Monetary Contributions Received
to whole dollars. Statement covers period
from 10/23/2016
CALIFORNIA
FORM
460
through 12/31/2016 4·
Page of 13
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D . NUMB.ER
Committee to Elect Rick Stephens Truckee Tahoe Airport Board 1385655

DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR

(IF COMMIITEE. ALSO ENTER I.D. NUMBER)
I CONTRIBUTOR
CODE *
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN . 1 - DEC . 31) (IF REQUIRED)
OF BUSINESS)

Rick Stephens ~IND

DCOM Retired
10/26/2016 $12809.87 $62581.,02
DOTH
DPTY
Dscc
DINO
DCOM
DOTH
DPTY
Dscc
DINO
DcoM
DOTH
DPTY
Dscc

DINO
DcoM
DOTH
DPTY
Dscc
DINO
DCOM
DOTH
DPTY
Dscc

SUBTOTAL$ 12809.87

Schedule A Summary *Contributor Codes

1. Amount received this period - itemized monetary contributions. . IND - Individual
12809 87 COM - Recipient Committee
(Include all Schedule A subtotals.) .. .. ............. ....... .. .. ............... ........................................................... ... $ · (other than PTY or SCC)
297 00 OTH - Other (e .g., business entity)
2. Amount received this period - unitemized monetary contributions of less than $100 ... .. .. .. ................. .$ · PTY - Political Party
3. Total monetary contributions received this period. sec - Small Contributor Committee
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ... .. .......... .......TOTAL $ 13106 ·87
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
 Amounts may be rounded SCHEDULE B - PART 1
Schedule B - Part 1
Loans Received
to whole dollars.
from
Statement covers period

10/23/2016
CALIFORNIA
FORM
460
SEE INSTRUCTIONS ON REVERSE
through 12/31/2016 5_
Page __ of~
NAME OF FILER I.D. NUMBER

1385655
-.
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
OUTSTANDING
BALANCE
AMOUNT
RECEIVED THIS
(c)
AMOUNT PAID
I OUTSTANDING
BALANCE AT
.e.
INTEREST
PAID THIS
ORIGINAL
g
CUMULATIVE
(IF SELF-EMPLOYED, ENTER AMOUNT OF CONTRIBUTIONS
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) BEGINNING THIS OR FORGIVEN• CLOSE OF THIS
NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE
PERIOD

NONE O PAID CALENDAR YEAR

_ _ _%
RATE
O FORGIVEN PER ELECTION**

to IND O COM O OTH O PTY O SCC

DATE DUE
I $ DATE INCURRED
$

O PAID . CALENDAR YEAR

---%
I
RATE
O FORGIVEN PER ELECTION**

to IND O COM O OTH O PTY O sec DATE DUE I $ DATE INCURRED

$

O PAID CALENDAR YEAR

_ _ _% I
RATE
O FORGIVEN PER ELECTION**

to IND O COM O OTH O PTY O SCC

DATE DUE I $ DATE INCURRED
$

SUBTOTALS $ $ $ $
(Enter (e) on
Schedule B Summary Schedule E, Line 3)

1. Loans received this period ....................... .............. ..... .. ...... ........................... ....... ... ............. .............. ..$ Q
(Total Column (b) plus unitemized loans of less than $100.) · tContributor Codes
IND - Individual
2. Loans paid or forgiven this period ........ ......... ......... ... ................................. .......................... ... ......... .....$ _ _ _ _ __
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 $ sec - Small Contributor Committee
Enter the net here and on the Summary Page, Column A, Line 2. (Maybaanegatlvenumbar)

• Amounts forgiven or paid by another party also must be reported on Schedule A. FPPC Form 460 (Jan/2016)
•• If requ ired . FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
 SCHEDULE B - PART 2
Schedule B - Part 2
Loan Guarantors
Amounts may be rounded
to whole dollars. Statement covers period

from 10/23/2016
CALIFORNIA
FORM
460
through 12/31 /2016 Page 6 of_µ_
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.O . NUMBER

1385655
FULL NAME, STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT BALANCE
CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED CUMULATIVE OUTSTANDING
ZIP CODE OF GUARANTOR
(IF COMMITIEE, ALSO ENTER 1.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER
THIS PERIOD TO DATE TO DATE
NAME OF BUSINESS)

LENDER CALENDAR YEAR

NONE DINO
DCOM
PER ELECTION
DOTH DATE
(IF REQUIRED)
DPTY
Dscc
CALENDAR YEAR
LENDER
DINO
DCOM
PER ELECTION
DOTH DATE (IF REQUIRED)

DPTY
Dscc
CALENDAR YEAR
LENDER
DINO.
DCOM
PER ELECTION
DOTH DATE (IF REQUIRED)

DPTY
Dscc
CALENDAR YEAR
LENDER
DINO
DCOM
PER ELECTION
DOTH DATE (IF REQUIRED)

DPTY
Dscc
nteron
SUBTOTAL $ Summary Page,
Line 17 only.

FPPC Form 460 (Jan/2016)

FPPC Advice: advlce@fppc.ca .gov (866/275-37~2)
www.fppc:ca.gov
Schedule D SCHEDULED
Summary of Expenditures
Supporting/Opposing Other
Amounts may be rounded
to whole dollars.
Statement covers period
CALIFORNIA
FORM
460
from 10/23/2016
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
through 12/31/2016 Page __8_ of -12_
NAME OF FILER I.D. NUMBER

1385655

DATE I NAME OF CANDIDATE, OFFICE , AND DISTRICT, OR

TYPE OF PAYMENT DESCRIPTION AMOUNT THIS
ICUMULATIVE TO DATE I PER ELECTION
MEASURE NUMBER Ofi LEITER AND JURISDICTION,
ORCOMMITIEE
(IF REQUIRED)
I PERIOD
CALENDAR YEAR
(JAN . 1 - DEC. 31)
TO DATE
(IF REQUIRED)

Office Boss 0 Monetary Mailer

10/26/2016 I Contribution
I
D Nonmonetary
I $8,107.87 $25,386.25
Contribution
D Independent
O Support O Oppose Expenditure

10/24/2016 I
Truckee Tahoe Radio Monetary
Contribution
IRadio Ads
D Nonmonetary I $608.00 I $3,408
Co.ntribution
D Independent
Expenditure
O Support D Oppose

Moonshine Ink li2I Monetary Newspaper Ads

11/1/2016 I Contribution
I
D Nonmonetary
I $707.75 $707.75
Contribution
D Independent
O Support O Oppose I Expenditure

SUBTOTAL $

Schedule D Summary
1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ............................................ : .......... $ 16,992.95

2. Unitemized contributions and independent expenditures made this period of under $100 ..... .. ...... ....................................................................... $ 0

3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ..... ..... TOTAL..$ 16,992.95

FPPC Form 460 (Jan/2016)

FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca .gov
Schedule D
(Continuation Sheet) Amounts may be rounded
to whole dollars.
Summary of Expenditures Statement covers period

Supporting/Opposing Other from 10/23/2016

Candidates, Measures and Committees
through 12/31/2016 9_ o f ~
Page _ _
N,A.ME OF FILER I.D. NUMBER

1385655

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
PERIOD
OR COMMITTEE (JAN. 1 - DEC. 31) (IF REQUIRED)

JVP Communications ill Monetary Public Relations

11/7/2016 I Contribution Consulting
$850.00 $5,600.00
O Nonmonetary
Contribution
O Independent
O Support O Oppose Expenditure
---
Vaca Consulting ill Mqnetary Campaign Voter
11/28/2016 I Contribution Consulting
$5,702.00 $24,404.00
O Nonmonetary
Contribution
O Independent
Expenditure
D Support O Oppose
---
Placer County Elections 10 Monetary Refund of Sign Deposit
12/16/2016 Contribution
($200.00)
O Nonmonetary
Contribution
O ln~ependent
O Support O Oppose Expenditure
---
O Monetary
Contribution
O Nonmonetary
Contribution
O Independent
O Support O Oppose Expenditure

SUBTOTAL $

FPPC Form 460 (Jan/2016)

FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule .D
(Continuation Sheet) Amounts may be rounded
to whole dollars.
Summary of Expenditures Statement covers period

Supporting/Opposing Other from 10/23/2016

Candjdates, Measures and Committees
through 12/31/2016 Page ___!Q_ of _Q_
NAMEOFFTCER LO . NUMBER

1385655

NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION CUMULATIVE TO DATE PER ELECTION
DATE TYPE OF PAYMENT AMOUNT THIS
MEASURE NUMBER OR LETIER AND JURISDICTION, {IF REQUIRED) CALENDAR YEAR TO DATE
PERIOD
ORCOMMITIEE {JAN . 1 • DEC. 31) {IF REQUIRED)

Mountain Area Preservation 0 Monetary Donation

12/13/2016 Contribution
$500.00 $500,00
O Nonmonetary
Contribution
O Independent
0 Support O Oppose Expenditure
---
Family Resourse Center of Truckee 0 Monetary Donation
12/16/2016
O
Contribution
Nonmonetary
$250,00 v:;o.i:P
Contribution
O Independent
0 Support O Oppose Expenditure
---
Family Resourse Center of N. Lake Tahoe 0 Monetary Donation
12/16/2016 Contribution
$250.00 ,i,·~o.d>
O Nonmonetary
Contribution
O Independent
Support D Oppose Expenditure
---
Boys and Girls Club of N. Lake Tahoe 0 Monetary Donation
12/30/2016
O
Cohtribution
Nonmonetary
$217.33 ~\1 ,0j)
Contribution
O Independent
0 Support O Oppose Expenditure

SUBTOTAL $ 1,217.33

FPPC Form 460 (Jan/2016)

FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
 SCHEDULE F
Schedule F
Accrued Expenses (Unpaid Bills)
Amounts may be rounded
to whole dollars. Statement covers period CALIFORNIA
FORM
460
from 10/23/2016

SEE INSTRUCTIONS ON REVERSE

through 12/31/2016 Page _ 1_1_ of _Q_
NAME OF FILER 1.0. NUMBER

1385655
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
eve 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 AMOUNT INCURRED AMOUNT PAID OUTSTANDING
(IF COMMITTEE, ALSO ENTER 1.0 . NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD

NONE

• Payments that are contributions or Independent expenditures must also be

summarized on Schedule D.
SUBTOTALS $ $ $ $

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 $100.) .... ......................................... .INCURRED TOTALS$ O
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 $100.) ............ ........ . PAID TOTALS$ 0
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$ . O
, May be a negative number

FPPC Form 460 (Jan/2016)

FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule G SCHEDULE G
Payments Made by an Agent or Independent Amounts may be rounded
to whole dollars.
Statement covers period
10/23/2016
f rom _ _ _ _ _ _ _ __
CALIFORNIA
FORM
460
Contractor (on Behalf of This Committee)

SEE INSTRUCTIONS ON REVERSE

NAME OF FILER
through · 12/31/2016
Page~
I.D. NUMBER
ot-\4
1385655
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.
eMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
eTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries
eve 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 pri~t ads WEB information technology costs (internet, e-mail)

* Payments that are contributions or independent expenditures must also be summarized on Schedule 0 .

NAME AND ADDRESS OF PAYEE OR CREDITOR

(IF COMMITIEE, ALSO ENTER 1.0 . NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID

NONE

Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 0

• Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460 (Jan/2016)
independent contractor as reported on Schedule E. FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
 SCHEDULE H
Schedule H Amounts may be rounded Statement covers period l&.iil&JJdlJLE PS .'I
to whole dollars.
Loans Made to Others* from 10/23/2016

through 12/31/2016 1_3_

Page_ of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER 1.0. NUMBER

1385655

FULL NAME, STREET ADDRESS AND ZIP CODE

IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
(b)
AMOUNT
(c)
REPAYMENT OR
I fd)
OUTSTANDING
(e)
INTEREST
(I)
ORIGINAL
(g)
CUMULATIVE
OF RECIPIENT BALANCE LOANED THIS FORGIVENESS BALANCE AT RECEIVED LOANS
(IF SELF-EMPLOYED, ENTER AMOUNT OF
(IF COMMITIEE, ALSO ENTER 1.0 . NUMBER) BEGINNING THIS THIS PERIOD* CLOSE OF THIS
NAME OF BUSINESS) PERIOD LOAN TO DATE

NONE D PAID CALENDAR YEAR

_ _ _%
$
RATE
D FORGIVEN PER ELECTION**

DATE DUE
---
DATE INCURRED
$

D PAID CALENDAR YEAR

___..
RATE
-
D FORGIVEN PER ELECTION*'

DATE DUE DATE INCURRED

I $

*Loans that are contributions to another candidate or committee must

also be summarized on Schedule 0. Loans forgiven must also be
reported on Schedule E. SUBTOTALS 1$ $ $ $
(Enter (e} on
Schedule I, Line 3)

Schedule H Summary
1. Loans made this period ............... ....................................................... ...... ... .......... .............................. .... .. ...... .................$ - - - - - ~
(Total Column (b) plus unitemized loans of less than $100.) **If Required

2. Payments received on loans .. ................ ........................ .. ................................................................................................$ _ _ _ _ __..._

(Total Column (c) plus unitemized payments of less than $100.)

3. Net change this period . (Subtract Line 2 from Line 1.) NET$ _ _ _ __..._
(Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number)

FPPC Form 460 (Jan/2016)

FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov