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Home My WebLink About250731 Form 460 Hertz 2020 COVER PAGE Recipient Committee '-teStamp CALIFORNIA Campaign Statement 460 Cover Page ; ;rv� ' FORM Statement covers period Date of election if applicable: • �/ L Page E of I 7/1/2024 (Month,Day,Year) • JUL 3 202j For Official Use Only from /+ SEE INSTRUCTIONS ON REVERSE through 12/31/2024 CITY CLERKS OFFICE 1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement: ' Z Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee 56 Semi-annual Statement ❑ Special Odd-Year Report 0 Recall 0 Controlled ❑ Termination Statement (Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) (Also Complete Part 6) 0 Amendment(Explain below) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D.NUMBER Treasurer(s) 1432333 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Anne Hertz for Cypress City Council 2020 Jesus Mallari MAILING ADDRESS STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Cypress CA 90630 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY Cypress CA 90630 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/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 under the laws of the State of California that the foregoing is true and correct. Executed on 7/31/2025 By Date Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder,Candidate,State Measure Proponent Executed on By Date Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(Jan/2016)) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers period Summary Page 7/1/2024 CA FIFORNIA 460 from through 12/31/2024 Page -2--- of SEE INSTRUCTIONS ON REVERSE 9 NAME OF FILER I.D.NUMBER Anne Hertz for Cypress City Council 2020 1432333 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions Schedule A,Line 3 $ 0 $ 0 1/1 through 6/30 7/1 to Date 2. Loans Received Schedule B,Line 3 0 0 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ 0 $ 0 20. ContributionsReceived $ 0 $ 0 4. Nonmonetary Contributions Schedule C,Line 3 0 0 - 21. Expenditures 0 0 5. TOTAL CONTRIBUTIONS RECEIVED AddLines3+4 $ 0 $ 0 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made Schedule E,Line 4 $ 596 $ 596 Candidates 7. Loans Made Schedule H,Line 3 0 0 8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ 596 $ 596 22. Cumulative Expenditures Made* (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 75 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ 596 $ 671 _____/_/ $ Current Cash Statement _i—i $ 12. Beginning Cash Balance Previous Summary Page,Line 16 $ 4958 To calculate Column B, 13. Cash Receipts Column A,Line 3 above 0 add amounts in Column 0 A to the corresponding *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash Schedule I,Line 4 - amounts from Column B reported in Column B. 15. Cash Payments Column A,Line 8 above 596 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $ 4362 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED Schedule B,Part 2 $ 0 filed 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 $ 0 19. Outstanding Debts Add Line 2+Line 9 in Column B above $ 0 FPPC Form 460(Jan/2016)) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded SCHEDULE E to whole dollars. Statement covers period CALIFORNIA 460 Payments Made 7/1/2024 FORM from 12/31/2024 through Pae 3 of SEE INSTRUCTIONS ON REVERSE g NAME OF FILER I.D.NUMBER Anne Hertz for Cypress City Council 2020 1432333 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 CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE,ALSO ENTER I.D.NUMBER) Pacific Premier Bank Bank Fees 596 C_-._ A___ C A nf,nn no n o *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 596 Schedule E Summary 596 1. Itemized payments made this period. (Include all Schedule E subtotals.) $ 2. Unitemized payments made this period of under$100 $ 0 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 $ 596 FPPC Form 460(Jan/2016)) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule B — Part 1 Amounts may be rounded SCHEDULE B-PART 1 to whole dollars. Statement covers period CALIFORNIA Loans Received from 7/1/2024 FORM 460 SEE INSTRUCTIONS ON REVERSE through 12/31/2024 Page of Li NAME OF FILER I.D.NUMBER Anne Hertz for Cypress City Council 2020 1432333 IF AN INDIVIDUAL,ENTER (a) (b) (c) (d) (e) (f) (g) FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE,ALSO ENTER I.D.NUMBER) (IF SELF-EMPLOYED,ENTER BEGINNING THIS PERIOD THIS PERIOD. CLOSE OF THIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD PERIOD m PAID CALENDAR YEAR Jesus Mallari Co-owner,Air Technology $ 0 $4,572 0 $ 4,572 $ 4,572 % Laboratories,Inc. RATE Cypress,CA 90630 ❑ FORGIVEN PER ELECTION $ 4572 $ 0 $ $ 0 9/6/20 $ t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR Anne Hertz CEO Boys&Girls Clubs of $ 0 $ 12,000 0 % $ 12,000 $ 12,000 Greater Anaheim and RATE Cypress,CA 90630 C ress ❑ FORGIVEN PER ELECTION` YP 12,000 $ $ 0 12/17/20 $ t Z IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ $ % $ $ RATE ❑ FORGIVEN PER ELECTION** $ $ $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0 $ 0 $ 16,572 $ 0 3 # 4, (Enter(e)on Schedule E,Line 3) Schedule B Summary 1. Loans received this period $0 (Total Column (b) plus unitemized loans of less than $100.) ,- 0 tcontributor Codes 2. Loans paid or forgiven this period $ IND—Individual (Total Column (c) plus loans under$100 paid or forgiven.) COM—Recipient Committee (Include loans paid by a third party that are also itemized on Schedule A.) (other than PTY or SCC) 3. Net change this period. (Subtract Line 2 from Line 1.) NET $ 0 OTH—Other(e.g.,business entity) Enter the net here and on the Summary Page, Column A, Line 2. PTY—Political Party SCC—Small Contributor Committee (May be a negative number) *Amounts forgiven or paid by another party also must be reported on Schedule A. **If required. FPPC Form 460(Jan/2016)) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov