HomeMy WebLinkAboutCornejo For City Clerk 2022 - 10.23.2022-12.31.2022_RedactedRecipient Committee Date StamCOVER PAGEp ,
Campaign Statement ' s
Cover Page
Statement covers period
from October 23, 2022
SEE INSTRUCTIONS ON REVERSE I through December 31, 2022
1, Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
0 Officeholder, Candidate Controlled Committee
0 State Candidate Electlon Committee
0 Recall
WW Coagtlela Per! 5]
❑ General Purpose Committee
Sponsored
Small Contributor Committee
Political Party/Central Committee
3. Committee Information
COrnejo for City Clerk 2022
❑ Primarily Formed Ballot Measure
ommittee
Controlled
Sponsored
(Also C Wela Pan G)
❑ Primarily Formed CandidateJ
Officeholder Committee
EArse corwaN Part IJ
I.D. NUMBER
CITY 5JAI t tll'Quut AHt:A[;QI.)WF'111JNt
CITY STATE ZIPCODE AREACODEJPHONE
OPTIONAL: FAX IE-MAIL ADDRESS
4. Verification
I have used all teas
certify under p alty of
Executed
Executed
ence in preparing and reviewing this statement and to
under the laws of the State of California that the M
Executed on
Date
Executed on
Date
Date of election If applicable:
(Month, Day, Year)
November 8, 2022 1
2. Type of Statement:
❑ Preelection Statement
m Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Page t of 3
For Offidal Use Only
AZUSA CId CLERK
2023 JAN - W
❑ Quarterly Statement
❑ Special Odd -Year Report
Treasurer(s)
NAME OF TREASURER
Jeffrey Lawrence Cornejo, Jr.
MAI LI NG AD D R ES S
CITY STATE ZIP CODE AREA CODEIPHONE
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREACODEJPHONE
OPTIONAL FAX IE-MAIL ADDRESS
attached schedules Is true and complete
By
Signature of Controffin 0lrioeholdar, Candidsta. Stale Measure Proponent
FPPC Form 460 (Janj2015))
FPPC Advice: advice@fppc.ca.gov (966/275-3772)
........ a--- -- --..
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Jeffrey Lawrence Cornejo, Jr.
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE)
City Clerk, City of Azusa
RESIDENTIALIBUSINESS ADDRESS LNO. AND STREET] CITY STATE ZIP
Related Committees Not Included in this Statement: List any committees
not included In this statement that are controlled by you or are primarily formed to recehre
contributlons or make expenditures on behalf of your candidacy.
COMMITTEE NAME
NAME OF TREASURER
COMMITTEE ADDRESS
I.D. NUMBER
C
❑ YES ❑ NO
CITY STATE ZIP CODE AREA COOEIPHONE
COMMITTEE NAME
NAME Of TREASURER
COMMITTEE AD
I.C. NUMBER
❑ YES ❑ NO
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
Page 2 of 3
S. primarily Formed Ballot Measure Committee
!NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION
❑ SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any,
NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT
OFFICE SOUGHT OR HELD
DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee List names of
officeholder(s) or candida[e(s) for which this committee Is primarily Formed.
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@Dfppc.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
• ,
from October 23, 2022
• -
December 31, 2022
Page 3 of 3
SEE INSTRUCTIONS ON REVERSE
through
NAME OF FILER
I.D. NUMBER
Cornejo for City Clerk 2022
1355059
Contributions Received
Column A
TOTAL THIS PERIOD
Column B
CALENDAR YEAR
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 $ $
0
1/1 through 6/30 7/1 to Date
2. Loans Received................................................................
Schedule A Line 3
0
0
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $
Received $ $
4. Nonmonetary Contributions ............................................
Schedule C, Line 3
0
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED...............................Add
Lines 3+4 $ $
0
Made $ $
Expenditures Made
6. Payments Made................................................................ Schedule E, Line 4
$
$ 0
7. Loans Made....................................................................... Schedule H, Line 3
0
8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6 + 7
$
$ 0
9. Accrued Expenses (Unpaid Bills) ........... Schedule F, Line 3
0
10. Nonmonetary Adjustment......................................................... Schedule C, Line 3
0
11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10
$
$ 0
Current Cash Statement
12. Beginning Cash Balance """""""""""".... Previous Summary Page, Line 16
$ 395.46
To calculate Column B,
13. Cash Receipts Column A, Line 3 above
0
add amounts in Column
0
A to the corresponding
14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4
amounts from Column B
15. Cash Payments Column A, Line 8 above
y .............................. .........................
0
of your last report. Some
amounts in Column A may
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15
$ 395.46
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 A 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 B above
$
IExpenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
I I $
'Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (966/275-3772)
www.fppc.ca.gov