HomeMy WebLinkAbout250731 Form 460 Hertz 2020 Recipient Committee _ _. _ _ COVER PAGE
Campaign Statement
RE-cElv�� I'.ALIFORNIA 460
Cover Page
• L� FORM
Statement covers period Date of election if applicable:
. Page t of 3
from
1/1/2025 (Month. Day,Year) For Official Use Only
CITY CLERKS OFFICE
SEE INSTRUCTIONS ON REVERSEthrough 6/30/2025
1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement:
E Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement
O State Candidate Election Committee Committee 0 Semi-annual Statement ❑ Special Odd-Year Report
O Recall 0 Controlled ❑ Termination Statement
(Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination)
(Also Complete Pert 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 i formation 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
or 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
Summary Page to whole dollars.
Statement covers period CALIFORNIA 460
from 1/1/2025 FORM
through
6/30/2025 Page 'Z of 3
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,Line3 $ 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. Contributions 0 Received $ $ 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 $ 0 $ 0 Candidates
7. Loans Made Schedule H,Line 3 0 0
8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ 0 $ 0 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 0 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ 0 $ 0 / $
Current Cash Statement _i_i $
12. Beginning Cash Balance Previous Summary Page,Line 16 $ 4362
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 t,Line 4 amounts from Column B reported in Column B.
15. Cash Payments Column A,Line 8 above 0 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,Part2 $ 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 B — Part 1 Amounts may be rounded SCHEDULE B-PART 1
to whole dollars. Statement covers period CALIFORNIA
Loans Received from 1/1/2025 FORM 460
SEE INSTRUCTIONS ON REVERSE through 6/30/2025 Page 3 of 3
NAME OF FILER I.D.NUMBER
Anne Hertz for Cypress City Council 2020 1432333
IF AN INDIVIDUAL,ENTER (a) (B) (c) Td) (e) (r) (g)
FULL NAME,STREET ADDRESS AND ZIP CODE OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE
OF LENDER 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
Jesus Mallari Co-owner,Air Technology ® PAID CALENDAR YEAR
$ 0 $4,572 0 % $ 4,572 $ 4,572
Laboratories,Inc. RATE
Cypress,CA 90630 ❑FORGIVEN PER ELECTION
$ 4572 $ 0 $ $ 0 9/6/20 $
t 1 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 Cypress ❑ FORGIVEN PER ELECTION
12,000 $ $ 0 12/17/20 $
t® 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
Schedule B Summary (Enter(e)on Schedule E,Line 3)
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