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Home My WebLink AboutJeffrey Cornejo 01.01.2021-06.30.2021_Redacted' Recipient Committee Dow SAM COVER PAGE Campaign Statement a' s Cover Page SEE INSTRUCTIONS ON REVERSE yam, January 1, 2021 through June 30.2021 Type Or Recipient Committee: all Commidees- eamplew Pans 1. 2, a, arch m Contmlled Commutes ❑ Primarily Formed Ballot Measuro rholder,Candidae State Candidate Election Committee Committee O Tracer O Controlled pmmy»Wn9 o Sponsored WufaRiNPNq ❑ purpose Committee Sponsortl C(O1J El Primarily Formedeta Small Conidb OfiiCommittee Pdgvl PartyCentral Committee (AbQxvftW 3. Committee Information Coml for Clerk 2013 STREET ADDRESS (NO P.O, aO%) CITY STATE ZIPCOOE AREA COOHPHONE CITY STATE ZIPCOOE AREA DOMINIONS OPTIONAL FA%IE MAILAOORESS If applicable: Page 1 of 3 Y, Year) AZUSA CITY C RN For Official Use Only I021 JR -1 A Ir: 30 2. Type of Statement: ❑ Preelection Slatendet ❑ Cuertedy Statement ® Sens"nnual SWlement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termmafon) ❑ Amendment (Explain below) Treasurers) Jeffrey Lawrence Carrie]% Jr. CI ZIPCOOE AREA CODE/PHONE CITY STATE ZIP CODE AREACOOENHONE OPTIONAL: FAX IE-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing an reviewing this statement and W th m my knowledge OOTWM�'SMNwesulor Intelherein end In t ached schedules is true and Complete. I cediry under penal pe - ry Mer the laws of the State of California Wet the f Execul¢a / ��02 eb Scowled Ev¢¢uleO on�� IanaWmo on W Exeama on COW By sammwm Ows"i oaamms,, Rini SUW M.emm eAsemal FPPC Porm 460 (lan/2016)) FPPC Advice: advicealfppc.cai(866/2T5-3D21 www.ipoc.ca.8av Instructions for Recipient Committee Campaign Statement — Cover Page Period Covered by a Statement: The "period covered" by a campaign statement begins the day after the closing date of the last campaign statement filed. For example, if the closing date of the last statement was September 30, the beginning date of the next statement will be October 1. If this is the committee's first campaign statement, begin with January 1 of the current calendar year. The closing date of the statement depends on the type of statement you are filing. Date of Election: If you are filing this statement as a preelection statement in connection with an election, enter the date of the election. Type of Recipient Committee: Check one box to indicate the type of committee filing the statement. General descriptions are provided on the cover sheet to this form, or contact your filing officer or the FPPC for assistance. Following are some additional guidelines: Controlled Committee • A controlled committee is one that is controlled by a candidate, officeholder or, in the case of a state ballot measure committee, by the proponent of the measure. A committee is "controlled" if the candidate, officeholder, or proponent, his or her agent, or any other committee he or she controls, has a significant influence on the actions or decisions of the committee. Sponsored Committees • A sponsored committee is one that has a sponsor —a business entity, organization, union, or other entity —that meets certain criteria. Sponsored ballot measure committees and general purpose committees must include the name of the sponsor in the name of the committee. Small Contributor Committees • This term is significant only if the committee makes contributions to candidates running for elective state office. Type of Statement: Check the appropriate box(es) to indicate the type of statement you are filing (or amending). Amendments: If you are filing an amendment to a previously filed statement, give a brief explanation of the amendment and list the schedules being amended. Include an amended summary page, if applicable. Be sure to enter the period covered of the statement you are amending. Termination: A committee must continue filing campaign statements each year until it is eligible to terminate and files a Form 410 Termination. Most officeholders must continue filing campaign statements until they have terminated all controlled committees and have left office. Committee I.D. Number: If the committee has not yet received an identification number from the Secretary of State, enter "Not Yet Received." File Form 410 to obtain an I.D. Number. Verification: The statement must be signed by the committee treasurer or the assistant treasurer named on the committee's Statement of Organization (Form 410). An officeholder, candidate, or state measure proponent who controls the committee must also sign the statement. If two or three officeholders, candidates, or proponents control the committee, each must sign the statement. If more than three control the committee, one may sign on behalf of the others. Under certain circumstances, the responsible officer of a sponsoring organization must sign the statement. Additional Important Information: Refer to the FPPC Campaign Disclosure Manual for your type of committee for information about: • When, where, and what type of statements the committee is required to file. • Closing date of campaign statements. • Sponsored committee criteria. • Termination criteria. Recordkeepinp requirements and prohibitions. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov IV- Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Jeffrey Lawrence Comejo, Jr. OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Clerk City of Azusa RESIDENTIAUBUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any commlaaes not Mcludedlnr make wmentturm; a behaff of oraorare Pnmanly! metl mraceWa conbibutlons or make eXpmditurea an hMaaof your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLEDCOMMITTEE? []YES ❑ NO COMMITTEEADORESS STREETADDRESS(NO P.O. BOX) CITY STATE ZIP CODE AREACODE,PHONE COMMITTEENAME I.O. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS(NO P.O, BOX) CITY STATE ZIP CODE AREACODERPHONE COVER PAGE -PART 2 Page Z Of 3 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOTNO.ORLETTER IURIUDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure preppmaM, Ifany. NAME OF OFFICEHOLDER. CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Famed Candidate/Officeholder Committee Wl names of o okWs) orcandmalals)i watch sm Fommmea fa pnmararnamed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE "ME OF OFFICEHOLDER OR CANDIDATE OFFICESOUGHTORHELD ❑ SUPPoRT ❑ OPPOSE NAME OFOFFICEHOLDER OR CANDIDATE OFFICE SOUGHTOR NEW ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE BOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets ffnecessary FPPC Form MIT ()an/2016) FPPC Advice: advice@fppc.Ta.Bov(866/275-3)R) wwwlppara.8ov Instructions for Recipient Committee Campaign Statement — Cover Page Officeholder or Candidate Controlled Committee: Candidates must have a separate bank account and committee to run for different elective offices. A candidate who is required to file campaign statements in connection with more than one elective office but is only receiving contributions and making expenditures for one of the offices, may include both offices on one Form 460. In Part 5 of the cover page, enter the candidate's name and under "Office Sought or Held," identify each office, and state whether the candidate is seeking or holding the office. The Form 460 must be filed with the appropriate filing officer(s) for each office. For example, a city councilmember is raising funds to run for the county board of supervisors. She has no committee and is not raising or spending funds in connection with the city office, and has formed a controlled committee for the county office. To comply with the requirements to file campaign statements for both her city office and her county candidacy, she may complete one Form 460 each campaign reporting period, which she will file with the city clerk and the county elections department. In Part 5 of the Form 460 Cover Page, under "Office Sought or Held," she will state that she is holding the office of city councilmember (including the name of the city) and that she is seeking a seat on the board of supervisors (including the name of the county). Ballot Measure Committee: Part 6 of the Form 460 Cover Page must be completed by committees that are primarily formed to support or oppose the qualification or passage of a single ballot measure or two or more measures being voted on in the same city, county, multicounty, or state election. A "general purpose" ballot measure committee (one that supports or opposes a variety of state and/or local ballot measures) is not required to complete Part 6. FPPC Form 460 (Jan/2016)j FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summary Page g to whole dollars. Statement covers period I - ' from January 1, 2012 - • June 30, 2021 page 3 of 3 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Cornejo for Clerk 2013 1355059 Contributions Received Column A TOTAL THIS PERIOD Column B CALENDARYEAR Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ $ 1i1 through 6130 7l1 to Date 2. Loans Received................................................................ Schedule 8, Line 3 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ $ Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ Schedule E, Line 4 $ $ Candidates 7. Loans Made....................................................................... Schedule H, Line 3 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 3 Date of Election Total to Date 10. Nonmonetary Adjustment......................................................... schedule C. Line 3 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ $ J/ $ $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 405.23 To calculate Column B, 13. Cash Receipts ........................................................... Column A, Line 3 above 0 add amounts in Column 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 0 A to the corresponding amounts from Column B *Amounts in this section may be different from amounts 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 $ 405.23 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 $ filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column 8 above $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov