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020121 Form 460 HertzRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE SbbmeM eovers Period from 10/18/20 through 12/31/20 Type of Recipient Committee: aucermllwe-cenpleM Perdu f, z,;.sed A. M 31dahoder, Candidata Controlled Committee ED Primarily Formed Ballot Measure U State Candidate Election Commitee O Recall ommiNce Controlled wacw Faia Sponsored ❑ neral Purpose Committee V Sponsored fAto w,`µsraa ❑ Pdmadly Formed Candtdatel (oJ Smal OontrlEutor Committee 011dehoder Committee Political Party/Central committee wmmmumn 3. Committee Information Anne Hertz for Cypress City Council 2020 STREETADDRESS (HO P.O. SOX) STATE 21P CODE ARMCODEIPHONE Cypress CA 90630 M4ILINGADDRESS (IF DIFFERENT) NO. AND STREETOR PO, SOX QTY STATE ZIPCODE A EACODERHONE OPTIONAL: FAX/E-MAILADDRESS COVER PAGE RECEIVED of aleQlan Mapplteeble: (Month, Day, Year) I FEB 0 12021 11/3/2020 I Cigr OI CypfE58 CiN Clerks Office :. Type of Statement: Cl Preelection Statement ❑ Quarterly Statement m Semi-annual Statement ❑ Special OGM1Year Report ❑ Termination Statement (Also file a Form 910 Termination) ❑ AmendmentlExplaindelm) Treasurer(s) NAMEOFTREASURER (esus Mallari MAILIN ADDRESS CITY STATE ZIPCOOE AREACODVPHONE Cypress CA 90630 NAME OF ASSISTANT TREASURER, 6ANY CITY STATE ZIP CODE AREACODEIPHONE OPTIONAL: FAXIE-MAILADDRESS enne.hertz@verizon.net maRarival@yahoo.com 0. Verification I have used all reason" dfligence in preparing and reviewing this Matemenl antl a the n contained herein and in the attached schedules is bug and complete. I ceNITy under penalty of perjury under the Sees of the State of Celif0In that th foregoing E.eculed on 1/31/21 ey a,AK eW ,eoeuttr Executed on 1131/21 0010 By Ins Meeeure poremn ..wn.I "8i�-,d>roen� EXwMed on oab BY s �em,.o•c�,m+.e otiwe w. e.eaueM, wn Pmwn EXeulled on Ie BY ins d C"Mmilog CesvuNx, c. .w. SAW mu aPnwn.M FPPC Form d60 (Jan/2016)) WCAdwce: advim@fppc.m.sd. (866/275-3772) mnvevJppc.ca.8ov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Anne Hertz OFFICE SOUGHT OR HELD (INCLUDE LOCATIONAND DISTRICT NUMBER IFAPPUCABLE) CYPOze car court I RE8IDENTIAIIBUSINEBS ADDRESS (NO.ANDSTREET) CITY STATE ZIP Cypress CA 90630 Related Committees Not Included In this Statement: ListanycOmmltte a not Included In mis stafamanl mar are chnbolledby you ora aprbrmdly furmad w radeA% roMIMMI ns Or make expandeoms an behalf Of your cMaNdacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREETADDRESS (NO P.O.B CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREETADDRESS(NO P.O. BOX) CITY STATE ZIP COOS AREACODEIPHONE Page 2 at T 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Ideneythe oonoolllrg oalcetwlder,p Iclao, or abda measure proponent, a any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee usrnamas Or olrlaaholdm(al or cendralM(a) for which mb conanUt" Is pr/ntadty farmed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT El OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD E SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD El SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SO UGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach conenuadon sheers If necessary HOPE Form CGU (lan/2016) FPPC Advice: advice@tppc.caaov (a66/275-3771) www.(ppc.ca.aov Campaign Disclosure Statement Amounts may be rounded SUMMARY PACE Summary Page tovihole,dollars. statement coven paned —vm•• a 10/16/20 Anne Hertz for Cypress City Council 2020 Contributions ReceivedColumn $ 14216 A ColoristB B, To calculate14775 13. Cash Receipts ........................................................... cdumnA, un 3eeoro TOTAL MIS PEi GIFNWR YEAR 14. Miscellaneous Increases to Cash .........................._ 53heduNl Lasa 0 IrrounnAw®scNEouiap Ato the conesp rdltp....., amounts from Column TOTALMDATE 1. Monetary Contribution................................................... Schedaa AA un3 $ 2775 $ 32185 2. Loans Received................................................................ sahedasa Une3 16. ENDING CASH BALANCE .................Add Uses 12+f3+ 1q then 3wNrau Line 15 12000 16572 3. SUBTOTAL CASH CONTRIBUTIONS .............................. AddLh.sf+2 $ 14775 $ 48757 4. Nonmonstary, Contribution ............................................ sundae e, Lees 0 625 5. TOTAL CONTRIBUTIONS RECEIVED..... ........... .............. Addthas 3+4 $ 14775 $ 49382 Expenditures Made 6. Payments Mede................................................................ Scedw E, Lines S 24033 $ 43799 7. Loans Made .......................................... ............................. soed„e N, Une3 8. SUBTOTAL CASH PAYMENTS ....................................... AddLeea a+7 $ 24033 $ 43799 9. Accrued Expenses (Unpaid Bills) ....... .._............... _... .... ....... 3tledMa F,Lae3 0 0 10. Nontronetary Adjustment. ........................ . ............................ Sanedoa c. Lin 3 0 0 11. TOTAL EXPENDITURES MADE ....... .................. ......... AWLIes 8+9+10 $ 24033 $ 43799 12. Beginning Cash Balance ........................... Rene" sommanpass, Lee Is $ 14216 B, To calculate14775 13. Cash Receipts ........................................................... cdumnA, un 3eeoro add amount In add amount In Column 14. Miscellaneous Increases to Cash .........................._ 53heduNl Lasa 0 Ato the conesp rdltp....., amounts from Column 15. Cash Payments......................................................... ColumnA.teseatsm 24033 ofyourlastrepon. Some amounts in Column A may 16. ENDING CASH BALANCE .................Add Uses 12+f3+ 1q then 3wNrau Line 15 $ 9958 be negative Figures that If this u e terminafron statement, Lam IS most be zero. ahou be subtracted from previous period amounts. If roM a me film report being 17. LOAN GUARANTEES RECEIVED ................................ seiasuree,oart2 $ 0 filed for this calendar year, onh carry over the amounts Cash Equivalents and Outstanding Debts hem Linea 2, 7, am 9 (a 18. Cash Equivalents ................................................ Seemammaons an event S 0 any). 12/31/20 Page 3 of 7 11432333 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections to through WD 711 to Dae 20. Contributions Received $ 0 $ 0 21. Expenditures Made $ 0 so Expenditure Limit Summary for State Candidates 22. CumulafNa ExtrentllWree Made' pnupen to voemmy simanewrs Limp Date of Election Total W Date (mMddiyy) 'Amount in this section may, be different from amount reported In Column B. 19. Outstanding Debts .............................. Add Line 2+Line Bin COMnneehmx $ 0 I IFPC Form 460(1an/20161) FPPC Advice: advice@fppc.ca.gov (866/275-3772) vLww.ippc.ca.gov Schedule A Amounts may be rounded to whole dollars SCHEDULE A Monetary Contributions Received sdminem covers period7YE�RTO from 10/18/20 a r SEE INSTRUCTIONS ON REVERSE ihro4Bh 12/31/20 4 7 NAME OF FILER Anne Hertz for Cypress City Council 2020 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF IRAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE ELECTION RECEIVED CONTRIBUTOR CONTRIBUTOR OCCUPATIONANDEMPLOYER RECEIVEDTHIS CALENDA DATE UFCLMMRiEE, RL60 ENiENI D.NIIMBEm CODEe (IFSELREWLOYED. ENTER NAME PERIOD (JAN.1-D,1) (F REQUIRED) ❑IND 10/27/20 Sempra Energy ❑COM 250 250 ®OTH San Diego, CA 92101 ❑ PTY ❑ SCC 10/28/20 Harry and Georgia Manns MIND ❑COM Retired 25 25 ❑ OTH Cypress, CA 90630 ❑ PTY Elect; ❑IND 10/16/20 Cypress Police Officers Association ❑COM 2500 2500 —Cypress CA 90630 m OTH Z PTY ❑ SCC []IND ❑COM ❑ OTH ❑PTY ❑ SCC ❑ IND ❑COM []OTH ❑PTY SCC SUBTOTAL $ 2775 - Schedule A Summary 1. Amount received this period - itemized monetary Contributions. 2775 (Include all Schedule A subtotals.) ........... .............................................................................................. E — 2. Amount received this period - unitemized monetary contributions of less than $100 ...........................$ 3. Total monetary Contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................T07AL $ 2775 --- - •ComrlbNor cores IND -Individual COM-Recipiem Committee (other than PrY or SCC) OTH -Other (e.0. business artily) PTV -Political Party SCC -Small Camdbutor CommMee FPPC Form a60 (/an/20161) FPPC Advice: advice@rrppr czgov (866/276-3772) www.fppc.caiov SCHEDULE a-PART1 u I1F Is—VON & I to whole dollars. Stagment Ones parbtl Loans Received • 1 hum 10/ISYLO SEE INSTRUCTIONS ON REVERSE tllrOWN, 12/31/20 Pew7NAME TMBER OF FILERI.O. N Anne Hertz for Cypress City Council 202D 1432333 FULL NAME, STREET ADDRESS AND LP CODE IF AN INDIVIDUAL ENTER OCCUPATION AND EMPLOYER OUTSTANDING IN AMOUNT al AMOUNT PAID NoBEST OUTSTANDING INT ORIGINAL US CUMULATIVE OFLENDER IX"COMNI1rFE,ALSOENTFRLa Nu1.eER) (IFSE1FEWLOYMENTER BALANCE BEGINNINGTHIS RECENEDTHIS PERIOD OR FORGIVEN THIS PERIOD, BAIANCEAT CLOVERIOp HIS PAIDTHIS PERIOD AMOUNT OF LOAN ONTRIBUTIONS TO DATE NAUEOFWDNEEeI PERIOD Jesus Mallarl Co-owner, Air Technology PNO ND RYEAR Laboratories, Inc. 1 0 14,572 0 % f 4,572 4,572 1 0 FORGIVEN PER ELECTIO?P Cyprus, CA 90630 Not 1457 10 0 9/6/zo i® IND ❑ COM ❑ OTH ❑ PTY ❑ 8CC f DATE DUE DATE REO PNO Anne Hertz President Boys &Girls s f 12,000 12,000 12,000 $ s Club of Greater Anaheim ore Cypress, CA 90630 andC Cypress � ❑Fo"VEN Pen eLecTIDN' O 12,000 F s s 12/17/20 1® IND ❑ COM ❑ OTH ❑ PTY ❑ BCC f f DATE DUE MTEINCUMED ❑ PND CNLENMRYEM [I FORGIVEN Rer¢ PER ELECTION" TIND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ s 5 f f f 6 MTFDUE DATE INCURRED SUBTOTALS $ 12,000 It 0 $ 16,572 E 0 - Schedule B Summary 1. Loans received this period.......................................................................... (Total Column (b) plus unitemized bans of less than $100.) 2. Loans paid or forgiven this period............................................................... (Total Column (c) plus loans under $100 paid or forgiven.) (Indude loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............................. Enter the net here and on the Summary Page, Column A, Line 2. $ 12000 ............. 6............$ 0 ................. NET It 12000 Ixarx..I.axre�...mr tcontrlbutar cotles IND — Intlivloual COM—Redvent Committee (other Nan PTY or SCC) OTH—Other(e.g., lowineaceMity) PTY— PoINPal Party SCC— Smal Conhibutcr Oommmee 'Amowb forgiven or paitl by another party else Must be reponetl on Schedule 0. "0 requke0 FPPC Form 460 (ren/2016)) FPPC Advice: adviceM Cca.Bov (866/275-3)72) www.tpix ca -sew Schedule Amounts may be rountletl Statement coversperlotl to whole dollars. Payments Made eo,n 10118/20 Anne Hertz for Cypress City Council 2020 through 12/31/20 I Page 6 _ of 7 1432333 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemaliarmisa MBR membercommunications RAD radio airtime and production coats CNS campaign consultants MTG meetings and appearances RFD retumed wlrtribudors CTB convi ubon(explein nonmonensinr OFC once expenses SAL campaign workers' salanee CVC civic donations PET pettion dmulaing TEL Le or cable alreme and production costs FIL candidate filing2alot fees PHO phone benks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS NaNapouse travel, lodging, and meals IND independent expenditure suppordn&pposing others(explain)• POS postage, deWery and messenger services TSF transfer betvreen committees ofthe same candbdatelsponsor LEG legal defense PRO professional services(aw, accounting) VOT voter registration LIT campaign literature and mailings PRT prat alts WEB Information technology costs(Internet a-moh NAME AND ADDRESS OF PAYEE IIF CGMMniEE, ALSO ENl m I. D. NUMBER) CODE OR DESCRIPTION OF PAY MENT AMOUNTRAID Event -News Enterprise PRT Ad in news paper 387 B DMH Meyer, Inc LIT Mailer 9747 United Taxpayers of Orange County LIT Slate mailer 940 O `Payments Bret are conMbNons or indepentlant expenditures must also be summarized on Schedule D. SUBTOTAL $ 10574 Schedule E Summary 1. Itemized payments made this period. (include all Schedule E 23923 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 110 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ 24033 FPPC Form 96e (Jan/21)16)) FPPC Advice: advi"OfINBRcmiiov (866/2753772) wvuw.fppc.ca.gov Schedule E SCHEDULE E Amoco whole y b liars,roued "loomed Down rbd (Continuation Sheet) rowholetlollers. M � Payments Made from 10/18!20 Anne Hera for Cypress City Council 2020 through 12/31120 I Ibq 7 of 7 1432333 CODES: If one of the following Codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP wmpalgn paraphernaliaimiec. MBR member communications RAD radio airtime and production costs CNS campaign consullan5 MTG meetings and appearances RFD returned contributions CTS contribution (explain nonmonebryy OFC office expenses SAL campaign workers satlanes CVC civic, donations PET PNttion dreulatimg TEL t.v. or cable airtime and production costs FIL candidate Glinglbalbt fees PHO phone banks TRC candidate navel, lodging, and meals FND hndrai Ping events POL poling and survey research TRS stalbpouse travel , lodging, and meals IND Independent expenditure suppodinglopposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of The game candidats/spoMW LEG legal defense PRO professional smwes(lepal, aaouning) VOT voter registration LIT campaign literature and mailings PRT print aar WEB information technology costs Internet, o -mail) NAME AND ADDRESS OF PAYEE (IF COMMI"BE, HBO ENTER M NUMBIM CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID DMH Meyer, Inc LIT Mailer 7673 C3 Public Strategies WEB Testing campaign 1141 DMH Meyer, Inc LIT Mailer 4342 Dominic Paas MTG Meal and drilla 193 Cypress, CA 'Payments dent are contributions a independent expenditures mart also be summarized on Schedule D. SUBTOTALS 13349