HomeMy WebLinkAbout2014_10_23 Form 460 - Mary-Lynne Bernald Recipient Committee Type COVER PAGE
or print in ink. Date Stamp , ,
Campaign Statement 7Only CoverPage(Government Code Sections 54200-54216.5) Statement covers period Date of election if applicable: e of
from10/1/2014 (Month, Day, Year) OCT 23 2014 For Official Use
SEE INSTRUCTIONS ON REVERSE through 10/18/2014 11/4/2014 By
1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement:
® Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ® Preelection Statement ❑ Quarterly Statement
O State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report
O Recall Q Controlled ❑ Termination Statement ❑ Supplemental Preelection
(Also Complete Part 5) O Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495
General Purpose Committee (Also Complete Part 6) E] Amendment(Explain below)
❑
Q Sponsored ❑ Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee
Q Political Party/Central Committee (Also Complete Part 7)
3, Committee Information I.D. NUMBER Treasurer(s)
1365458
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
Mary-Lynne Bernald for Council 2014 Judy Johnstone
MAILING ADDRESS
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Saratoga CA 95070
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
Saratoga CA 95070'
MAILING ADDRESS (IF DIFFERENT) NO,AND STREET OR P.O. BOX MAILING ADDRESS
STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
Saratoga CA 95070
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 underthe laws of the State of California that the foregoing is true and correct.
Executed on CC,4,per._ a O By I
—
Date X 'gnatureofTreasurero ssistantTreasurer
Executed on c k a 3 _ an t Q- gy
Datef SignatureofC n IfindOfficaldler,Candidate,State Measure ProponentorResponsible Officer ofSponsor
Executed on By
Date Signature ofControlling Officeholder,Candidate,Staff Measure Proponent
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(January/05)
FPPC Toll-Free Helpline:666/ASK-FPPC(866/275-3772)
State of California
Type or print in ink. COVER PAGE-PART 2
Recipient Committee CALIFORNIAi
Campaign Statement FORM
Cover Page—Part 2
Page 2 of
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
Mary-Lynne Bernald
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑ SUPPORT
❑ OPPOSE
Saratoga City Council
RESIDENTIAUBUS[NESS ADDRESS (NO.AND STREET) CITY STATE ZIP
Saratoga, CA 95070 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.
COMMITTEENAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate/Officeholder Committee List names of
officeholders)or candidate(s)for which this committee is primarily formed.
❑ YES ❑ NO
COMMITTEEADDRESS STREETADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
COMMITTEE NAME I.D. NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT
❑ OPPOSE
NAME OFTREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
❑ YES ❑ NO ❑ SUPPORT
❑ OPPOSE
COMMITTEE ADDRESS STREETADDRESS (NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460(January/06)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/2764772)
State of California
Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE
Amounts may be rounded Statement covers period -
Summary Page to whole dollars. I ,FOXi
from 10/1/2014 • -
SEE INSTRUCTIONS ON REVERSE
through 10/18/2014 7,ag 3 of
NAME OF FILER MBER
Mary-Lynne Bernald for Council 2014 1111 1365458
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTALTHISPERIOD CALENDARYEAR Runningin Both the State Prima and
(FROMATTACHEDSCHEDULES) TOTALTODATE Primary
General Elections
1. Monetary Contributions ........................................... Schedule A,Linea $ 399.00 $ 9541.00
2. Loans Received ...................................................... Schedule s,Line 3
0 4767.00 1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ 399.00 $ 14308.00 20. Contributions
Received $ $
4. Nonmonetary Contributions.................................... Schedule C,Linea 0 136.91 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ...........................Add Lines 3+4 $ 399.00 $ 14444.91 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made....................................................... Schedule E,Line 4 $ 4177.79 $ 10654.31 Candidates
7. Loans Made............................................................. Schedule H,Line 0 0
4177.79 10654.31 22. Cumulative Expenditures Made'
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+ 7 $ $ (if Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ...............................Schedule F,,Line 0 0 Date of Election Total to Date
10. Nonmonetary Adjustment..........................................Schedule C,Line 0 136.91 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE................................Add Lines a+9+10 $ 4177.79 $ 10791.22 -J� $
Current Cash Statement $
12. Beginning Cash Balance ....................... Previous Summary Page,Line 16 $ 7432.48 To calculate Column B,add
13. Cash Receipts ................................................... Column A,Line 3above 399.00 amounts in Column A to the
corresponding amounts *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash........................... Schedule 1,Line 4 0 from Column B of your last reported in Column B.
15. Cash Payments.................................................. Column A,Line 8above 4177.79 report. Some amounts in
Column A may be negative
16. ENDING CASH BALANCE.......... Add Lines 12+ 13+ 14,then subtract Line 15 $ 3653.69 figures that should be
subtracted from previous
If this is a termination statement, Line 16 must be zero. period amounts. If this is
the first report being filed
17. LOAN GUARANTEES RECEIVED ........................... Schedule B,Part $ 0 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 8 above $ 4767.00 FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/2753772)
Schedule Type or print in ink. SCHEDULE A
Amounts may be rounded Statement covers period
Monetary Contributions Received to whole dollars. • - '
10/1/2014
from • -
SEE INSTRUCTIONS ON REVERSE through 10/18/2014 Page 4 of
NAME OF FILER I.D. NUMBER
Mary-Lynne Bernald for Council 2014 1365458
DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED CODE (IFSELF-EMPLOYED,ENTER NAME PERIOD (JAN.1 -DEC.31) (IF REQUIRED)
OF BUSINESS)
®IND
10/4/2014 William T Brooks ❑COM attorney/Brooks and
[]OTH Hess $150.00 $150.00
❑PTY
[:]SCC
MIND
10/7/2014 Jan Birenbaum ❑COM retired
[]OTH $150.00 $150.00
❑PTY
❑SCC
❑IND
❑COM
[]OTH
❑PTY
❑SCC
❑IND
❑COM
❑OTH
❑PTY
[:]SCC
❑IND
❑COM
❑OTH
❑PTY
[:]SCC
SUBTOTAL$ 300.00
Schedule A Summary *Contributor Codes
1. Amount received this period—itemized monetary contributions. IND—Individual
(Include all Schedule A subtotals.) ......................................................................................$ $300.00 COM—R then thant n
PTY
•••••••••••••••••• (other than PTY or SCC)
99.00 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. SCC—Small contributor committee
Add Lines 1 and 2.Enter here and on the Summa Page,Column A,Line 1. TOTAL $ 399.00
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:S66/ASK-FPPC(866/2753772)
SCHEDULE E
Schedule E Type or print in ink. Statement covers period , • . ,
Amounts may be rounded A f
Payments Made to whole dollars. from 10/1/2014 • -
SEE INSTRUCTIONS ON REVERSE
through 10/18/2014 Page of
NAME OF FILER I.D. NUMBER
Mary-Lynne Bernald for Council 2014 1365458
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 PAYEE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID
Omega Printing
SometimesY
Stileto's Wine Bar
CMP $500.00
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 4088.46
Schedule E Summary
1. Itemized payments made this period. Include all Schedule E subtotals. $ 4088.46
2. Unitemized payments made this period of under 100 $ 89.33
3. Total interest paid this period on loans.(Enter amount from Schedule B,Part 1,Column(e).)............................................................................... $ 0
4. Total payments made this period. Add Lines 1,2, and 3. Enter here and on the Summary Page,Column A, Line 6. TOTAL $ 4177.79
FPPC Form 460(January/05)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)