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020121 Form 460 amendment HertzRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE (Toon 1/1/2020 through 9/24/2020 porbd 1. type of FtecipientComm(fiee:A11 CoMMN - COMI Pada 1, 2, 3, and 4. m 8fiCONOlder, Candidate Controlled Committee U ❑ Primarily Formed Elallot Measure Stale Candgate Flection Committee ommines O Recall Controlled Fh*DxWePMS Sponsored ❑ CCCCCC��ene rpwe Co=mings Wro C✓MMl Per9 Sponsored ❑ PNmadty rined el milCo Small Contributor Committee er Officeholder Commitee Committee Political Party/CeMnl Committee Neom.PtNP.el]) 3. Committee Information Anne Hertz for Cypress City Council 2020 STREET ADDRESS (NO P.O. BOX) CITY STATE 21P CODE gREACODFIPHONE Cypress CA 90630 MAILINOADDRESS (IF DIFFERENT) NO. AND STREET Oft P.0.6O% Cm STATE 21POODE AREAOOOHPHONE OPTHNUL: FAX IE -MAIL ADDRESS RECEIVED a Data aslaeBn N otppneable: P'g• (Month, Day. Year) FEB 01 2021 Far Moot u/3/2020 City of Cypress 2. Type of Statement: --- ❑ Preebction Statement ❑ Quarterly Statement ❑ Senn"nnwl Statement ❑ Special Cdd-Yesr Report ❑ Termination Statement 0 jAhaf Amendment � 410 Tenninatlon) meMaM ( tWbin below) Addition to Sdtedule & omitted in original submittal Revision to Summary Page due to above Treasurer(s) NAMEOFTREASURER Jesus Mallad AILINOADDRESS CIN STATE APDODE AREACODEIP ONE Cypress CA 90630 NAME OFASSISTANT TREASURER, IF ANY CrrY STATE 21P CODE ARfACODE/PHONE OP IONAL: FAXIE-I.IMLADDRESS anne.hertziMverizonnet mallarival@yahoo cam 4. Verification I hove used al reasonatAe diligence in preparing and reOewi g this Statement and to the best of m M ined herein and in the attached schedules Is two and complete. I ear* Under p 112KY M perjury under the IawS of the Stale of California that the foregoi Emernedon 1/31/21 BY Doe 1/31/21 mm nmmr Ew �d o gY nPngmem or r pmwrChina c=oma an N BY N,m DMr r, gnome. • aura npor,.0 EmMed on n BY Mnre om .eaemLbr, uaN, smM wn Pon= FPPC Form 460 (ran/2016)) RPC Advice: advicelsfppc.ca.gov(866/2TS3T]2) Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. from 111/20 g - ' • 1 through 9/24120 papa 3 0/ 8 LU NUMBER Anne Hertz for Cypress City Council 2020 Yet to be received Contributions Received 1. Monetary ContrlbulIons................................................... acnsouseA fina3 $ 25,300 $ 25,300 2. Loans Received................................................................ ao6 as. Una3 4,572 4,572 3. SUBTOTAL CASH CONTRIBUTIONS .............................. AMtinw t,2 $ 29'872 $ 29,872 4. Nonmonetary Conidbtnions............................................ 6anedltrCJ1e3 304 304 5. TOTAL CONTRIBUTIONS RECEIVED._...........................Aaaurre,3.4 ............. ........... senadwe F uw 3 $ 301176 $ 30,176 Expenditures Made Expenditure Limit Summary for State 12. Beginning Cash Balance ............ ............... FYallouaummeryPape, Laa is $ 0 6. Payments Made................................................................ smaauaE, une4 S 13207 7. Loans Made....................................................................... Sanelua H. L"m3 16. ENDING CASH BALANCE ............... .. Add Units f2. 13 r 14, sen su6ewltM u D 6. SUBTOTAL CASH PAYMENTS ...................... ............ .... Adauw, e, 7 $ 13207 9. Accrued Expenses (Unpaid Bills) ............. .._. ............. ........... senadwe F uw 3 0 10. Nonmonatary Adjustment ...................................................... sahacw o, Law3 0 11. TOTAL EXPENDITURES MADE .. ........ .................. ...... Aaauw9s, a, 10 $ 13207 Current Cash Statement Expenditure Limit Summary for State 12. Beginning Cash Balance ............ ............... FYallouaummeryPape, Laa is $ 0 13. Cash Receipts........................................................... CdvmhA, uw3eeow 29,872 14. Miscellaneous Increases to Cash ................................ Scheaub 4 L'w4 0 15. Cash Payments ...... ............................................. CaumnA, tare 8a6aw 13207 16. ENDING CASH BALANCE ............... .. Add Units f2. 13 r 14, sen su6ewltM u g 16665 11 Chia a a Annotation statement, Line 16 huddler zero. (mmwaryy) 17. LOAN GUARANTEES RECEIVED ................................ sah*d1ArB Pane $ 0 16. Cash Equivalents— ............................................. se.a,wawne en reuersa $ 0 19.Outstanding Debts .............................. sad una2+uwaa cw.an 6.lwxe $ 0 Calendar Year Summary for Candidate Running in Both the State Primary and General Elections to through aqe 7/1 to Us 20. Received! $ 0 $ 30,176 21. Experldaures Made $ 0 $ 8,635 Expenditure Limit Summary for State $ 13207 Candidates 0 22 DgrllgIOOO E6PMdit ms Made' Ia9WIW b VeluMry EgmJmn LMU $ 13207 0 Date of Election Total to Dale 0 (mmwaryy) $ 13207 $ —J—/_ $ To calculate Column B, stld amounts in Column Alo me wnesporssirg -Ameunts in that sector may he different from amounts amounts from Column B reported in Column B. of your las report Some amounts in Column A may be negative figures that should be subtracted from geHDus period amounts. IF Its s the first report being Mae for this calendar year, only carry over the amounts from Unee 2,7 and 9 (if any). FPPC Form 460 (lan/2016)) FPPC Advice: advice@flgx..o .gov (666/275-3772) v aw.fpx.ea.gov ":'-Schedule E Amounts may be rounded ,.k0entlnuation Sheet) to whole dollars. Sla»men Payments Made grom vv20 SEE INSTRUCTIONS ON Anne Hertz for Cypress City Council 2020 through 9/24/20 1 Page 8 of 8 Yet to be received CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign pamphernaliarmiso. MBR member communications RAD radio airtime and production costs CNS campaign consultants Mi meetings and appearances RFD returned contriballons CTB contribution(elrylain nonmonemnir OFC office expenses SAL campaign workers' salaries CVC FIL Ovid donations PET pethlon dreulatirg TEL Ly or cable airtime and production costs candidate mirglballot fees PHO phone banks TRC candidem travel, lodging, and meals FND IND fundrasing events POL polling and survey research TRS Stag/spouse travel, lodging, and meals independent expenditure supporting/opposing other (explain)' POS postage, delivery and meaeengerservic rs TSF transfer between OOMMMees of Me Same candidamisponsor LEG legal defense PRO professional services legal, accounting) VOT voter registration UT campaign literature and maill PRT pdM ads WEB information technology costs (internal, e-mail) NAME AND ADDRESS OF PAYEE pF COMMmEE. AWO ENTER LD. Nuper-m CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID California Voter Guide LIT 517 Election Digest LIT 786 AH American Sign Campaign banners, lawn signs 1,869 Event News Enterprise , A Mlln _ o PRT Newspaper Ad 4572 Payments that are contributions or Independent expendllums court also be summarized on Schedule D. SUBTOTAL $ 7744 Fonn 460 ran 2016 FPPC Advice: advlce®fppc.m.gov (Sai/275d772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Shtemnrt covers perlod nzleefaleedon B appBeamm FEB "0.12021 1 peg" Van, 9/20/20 (MOMh, Day, Vear) 11/3/2020 I City of Cypress through 10/17/20 City Clefles Office 1. Type of Recipient Committee: All camnNllen- Complete Pam t, z, a, end 4. 1� Qlfarees Candidate Corholled Committee ElPrimanly Formed Balm Measure U State Candidate Eledion Commi t"Commitee O Recall l / =011ed (Me CMAMIANa V Sponsored MmmmeNP.ns ❑ eneral Purpose Committee Sponsored ❑ Pdmadly Formal Candidatel Small Contributor Commitee Offloeholdel Committee Political PartylCentral Commitee pmomsssvm4 3. Committee Information Anne Hertz for Cypress City Council 2020 STREETADDRESS INO P.O. eO%I STATE ZIP CODE ARFACODE/PHONE Cypress CA 90630 MAILING ADDRESS pF DIFFERENT) NO. ANO STREET OR P. O. % CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FA%/E-0IMLADORESS COVER PAGE Of Preelection Statement BOuanedy Statement Semi-annual Statement Speolal Odd -Year Report Terminalion Statement a (Also Aran 410 Terminator) (EgNaln below) Revision to Summary Page due to revision in previous summary page Revision to Schedule A contributor name and address Treasurer(s) NAME OFTREASURER Jesus Mallari MAILINDADDRES STATE ZPCO E AREACODVPHONE CvPress CA 90630 NAME OF ASSISTANT TREASURER, IF ANY MAILINGADORESS CITY STATE ZPCODE AREACOOVPHONE OPTIONAL'. F"iE-MAILADORESS anne.hertz@verizon.net mailarival@yahoo.com 4. Verification I have used all reasonable dilgence in preparirg and revievdng this statement aM ed herein and in he attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California tlmt the (o ESPnU ion 1/31/21 By r ..sus E,reculad on 1/31/21 Byllllillllllllillililliliililiiiliiiili m PresmM Ev Aawd on By wuco neOffiNsWISAc.mWPW, siMiscore w.N EuwMd M By CAS e1w WCo InB EW,61W eco �nenl FPPC Form 460 (Ian/2016)) FPPC Advice: advke@fppc.ca.aov (866/275.3772) www.fppc.caaov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. SabmaM eovere per od .__ 9120!20 10/17/20 I Page 3 of 8 Anne Hertz for Cypress City CouncB 2020 11432333 c^ Contributions ReceivedColumnA IOTA THIS PEAMA eRounTrAwrosaEourEsr 3 16665 Column CALENDAR YEAR TOTAL TO DATE 4110 Calendar Year Summary for Candidates Running in Both the State Prlmaryand 1, Monetary Contributions ................................................... 2. Loans Received ................................................................ $dxaua A,um3 sdxeare e,Los 3 E 4110 $ 29910 7. Loans Made....................................................................... General Elections Ill trough an0 711 to 0eh 0 4.572 5. SUBTOTAL CASH CONTRIBUTIONS .... .............. ... ...... Add ones I+2 $ 4110$ AaWWwr +7 33982 _� 6559 20. Re tContrace ns 3 0 83'17 4. Nonmdnstary Contributions ......................................... 5. TOTAL CONTRIBUTIONS RECEIVED.............. sdxdue c, Lae3 _..... ....... _Atld Laes3+4 321 $ 625 _ 21. Expenditures Made $ 0 $ 15194 $ 9431 34607 Expenditures Made 12. Beginning Cash Balance ................._......... PxNau, suarmaryPep., Lax fe 3 16665 13. Cash Receipts........................................................... cdumnA, um3ehaw 4110 6. Payments Made................................................................ sdle rn E. Unit S 6559 $ 19766 7. Loans Made....................................................................... sohedWe H. Lima 0 S. SUBTOTAL CASH PAYMENTS ...... _ ............................... AaWWwr +7 $ 6559 $ 19766 9. Accrued Expenses (Unpaid Bills) ... ........................... ............ serious F, um 3 0 10. Norm onetaryAdlustment......_.............................................. sdxdus c. Lae 3 0 11. TOTAL EXPENDITURES MADE......... ..................._..... Adduma e+ r+10 $ 6559 $ 19766 Current Cash Statement 12. Beginning Cash Balance ................._......... PxNau, suarmaryPep., Lax fe 3 16665 13. Cash Receipts........................................................... cdumnA, um3ehaw 4110 14. Miscellaneous Increases to Cash .................................. scnnue.q Llm4 0 15. Cash Payments......................................................... Cdumn A. umeebme 6559 16. ENDING CASH BALANCE ...Ara taxa 12+ 13 • 14, man sAvrectum 15 $ 14216 1f MIS is a rumination statement, line 16 must be aero. 17. LOAN GUARANTEES RECEIVED ................................ sdxmae B. Fertz $ 0 1 15. Cash Equivalents ................................................ see aemxl nsmxveme $ 0 19. Outstanding Debts .............................. Amterez «taesmcwmnea6ow IF 0 To calculate Column B, add amounts in Column AtothecorrespmNna amounts from Column B of yourlevern rt. Some amounts in Column A may be ne9anver figures that shouts be subtracted from previous period amounts. If this is the fret teport being filed for M5 calernar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Expenditure Limit Summary for State Candidates 21 Cumulstive Expenditures Made' InaugeClN WMtary ErpeMlLre Limn) Date a Election Total to Date (nurld]lyy) 'Amounts in this seccon may be different from amounts reponed In Column e, FPPC Form 460 ilan/2036)) FPPC Advice: advice@fppc,w.gov(866/275-3772) www.lppc.ce.gov Schedule A (Continuation Sheet) Amounts maybe rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers pmlod ME •� firm 9/20/20 - a - 'Carmlbulor Codes IND—Indhridual COM —Recipient Committee (other than FN or SCC) OTH—Other (e.g., baseness Emily) PTV—Polakal Party SCC—Small Contributor Committee PPPC Form 460 (Jan/2016)) FPPC Advice: advice@flax.ca.gov(S66/275-3772) www.fppc.ce.aov through 10/17/20 Page 5 at 8 NAIVE OF FILER I. .NU R Anne Hertz for Cypress City Council 2020 1432333 DATE FULL NAME, STREET ADDRESS AND ZIP 000E OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR CONTRIBUTOR OCCUPATONAND EMPLOYER RECENEOTHIS CALENDARYEAR TO DATE IIF COMMITTEE , ALSO ENTER J1 NUMBER) CODE IIF BEL FFMPLOT®ENiBt NAME) PERIOD (JAN.t - DEC. 91) OF REQUIRED) 10/17/20 Andrew Lachine ®IND Attorney - Andrew Laclum 100 ❑ COM — ❑ OTH Cypress, CA 90630 PTY ❑ SCC 10/17/20 Richard Tkach 0 IND Procurement Analyst- 100 ❑COM [I OTH R°eNg Anaheim, CA 92804 ❑ PTY 0 SCC 10/17/20 Henry H. Machal ®IND Insurance Agent - Henry 150 11 COM ❑ OTH Machal Cypress, CA 90630 0 pTy ❑ $cc 10/17/20 Nathan Almada ®IND ❑ COM Na ❑ OTH Temecula, CA ❑ pr ❑ SCC 10/12/20 Orange County Professional Firefighters Association- ❑IND 2500 All Purpose PAC Account ID 950925 ® COM ❑ OTH —Tuazi0. CA 92780 ❑ PTY SCC SUBTOTAL Ji 3350 'Carmlbulor Codes IND—Indhridual COM —Recipient Committee (other than FN or SCC) OTH—Other (e.g., baseness Emily) PTV—Polakal Party SCC—Small Contributor Committee PPPC Form 460 (Jan/2016)) FPPC Advice: advice@flax.ca.gov(S66/275-3772) www.fppc.ce.aov