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Form 460 2nd Pre-election Statement COVER PAGE Recipient Committee Date Stamp CALIFORNIA t Campaign Statement �,; FORM Cover Page Statement covers period Date of election If applicable T•,, Page 1 of 7 from 9/25/16 (Month,Day,Year) I "- < i�I, n For Official use only SEE INSTRUCTIONS ON REVERSE through 10/22/16 11/8/16 1. Type of Recipient Committee: Alt Committees–COMPlete Part t,z 3,end 4. 2. Type of Statement: ❑ Officeholder,Candidate Controlled Committee 0 Primarily Formed Ballot Measure la Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report 0 Recall 0 Controlled ❑ Termination Statement (Aso Csmple Pars) O Sponsored (Also file a Fonn 410 Termination) (Aan Cemp.Ye Prr6) ❑ General Purpose Committee ❑ Amendment(Explain below) • Sponsored ❑ Primarily Formed Candidate/ • Small Contributor Committee Officeholder Committee • Political Party/Central Committee (ASO COmpsa PW 1/ 3. Committee Information I.D.NUMBER Treasurers) # 1389886 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Committee Opposed To Encinitas Measure T Bruce Ehlers Encinitas CA 92024 760-944-9482 CITY STATE ZIP CODE AREACODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY Encinitas CA 92024 760-946-6668 Elizabeth Ehlers MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX CITY STATE ZIP CODE AREA CODEIPHONE CITY STATE ZIP CODE AREACODE/PHONE Encinitas CA 92024 760-946-6668 Encinitas CA 92024 760-944-9482 OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL'. FAX E-MAIL ADDRESS Info @EncinitasSaveOurCity.com email @ehlers-online.com 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 and corre� Executed on 10/27/2016 By Date igneture W Treasurer or Assistant Treasurer Executed on 10/27/2016 By T Date —3B^sure al Dote ling ce Wtler, anal ate,State easumwwonent or Responsible car^ Sponsor Executed on ate BY ignmure of ConVollin 5111eeholder,Candidate,Sw0easur.Pmponent Executed on pate By Signature of Conlrolling OMCaholtler,Candidate,State Measure Proponent FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/2753772) Ww Jppc.ca.gov COVER PAGE-PART 2 Recipient Committee CALIFORNIA , Campaign Statement FORM Cover Page — Part 2 Page 2 of 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Measure T OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑ SUPPORT T I City of Encinitas 0 OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP Identify the controlling officeholder,candidate,or state measure proponent,if any. NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Included in this Statement: Listanycommittees not included in this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO,IF ANY contributions ormake expenditures on behalf of your candidacy. COMMITTEE NAME I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7• Primarily Formed Candidate/Officeholder Committee ust names of officeholder(s)or candidatels)for which this committee Is primarily formed. [I YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEE NAME I.D.NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD El YES ❑ NO ❑ OPPOSE ❑ COMMITTEE ADDRESS STREETADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREACODE/PHONE Affach continuation sheets if Necessary 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 CALIFORNIA Summary Page from 9/25/16 FORM 460 throe h 10/22/16 Page 3 of 7 SEE INSTRUCTIONS ON REVERSE 9 NAME OF FILER I.D.NUMBER Committee Opposed To Encinitas Measure T # 1389886 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 2,705.00 9,923.00 General Elections 1. Monetary Contributions................................................... schedule A,Line $ 0 $ 0 ill through e/30 7/1 to Date 2, Loans Received................................................................ Schedule s,Line 3 20. Contributions 2,705.00 9,923.00 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lined+2 $ S Received $ N/A $ N/A 4. Nonmonetary Contributions............................................ Schedule C,Linea D 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 $ 2,705.00 $ 9,923.00 Made $ N/A S N/A Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ Schedule E.Line 4 $ 2,099.77 $ 6,524.61 Candidates 7. Loans Made....................................................................... Schedule H.Line 3 0 0 2,099.77 6,524.61 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS......... ................................ Add Lines s+7 $ $ (H aMDpot to Veluntrry Expenditure Limit) 9. Accrued Expenses(Unpaid Bills)..........................................Schedule F,Line 3 0 0 Date of Election Total to Date 10, Nonmonetary Adjustment...........................111...1.....................Schedule a Linea 0 0 (mm/ddtyy) 11. TOTAL EXPENDITURES MADE........................................Add Lines 8+9+10 $ 2,099.77 $ 6,524.61 _ 1 1 $ N/A Current Cash Statement $ N/A 12, Beginning Cash Balance............................ Previous Summary Page,Line 16 $ 2,793.16 To calculate Column B, 13. Cash Receipts........................................................... Column A,Line3above 2,705.00 add amounts in Column A to the corresponding *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash.................................. Schedule 1,Line 4 0 amounts from Column B reported in Column B. 77 of your last report. Some 099, 15. Cash Payments......................................................... Column A,Line Eabove 2,099,77 in Column Amay 16. ENDING CASH BALANCE ..................Add Lines 12+13+14,then subtract Line 15 $ 3,398.39 be negative figures that should be subtracted from If this is a temrnafion statement,Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED................................ Schedule s,Part 2 $ 0 filed for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts any) Lines 2,7,and 9(if, 18. Cash Equivalents................................................ See instructions on reverse $ 0 19. Outstanding Debts.............................. Add Line 2+Line g in Column a above $ 0 FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov, Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period a , from 9/25/16 e • • through 10/22/16 Page 4 of 7 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Committee Opposed To Encinitas Measure T # 1389886 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE,ALSO ENTER I.o.NUMBER) CODE ' OCCUPATION AND EMPLOYER RECEIVEDTHIS CALENDAR YEAR TO DATE IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN,1-DEC.31) (IF REQUIRED) OF BUSINESS) Mary Fleener-Therrio 000M Writer/Illustrator, 9/2512016 309 Ocean View Ave $200.00 $200.00 El FantagraphicBooks, lnc. Encinitas, CA 92024 ❑PTY ❑SCC IND Thomas L. Basacchi O 9/28/2016 ❑COM Retired $100.00 $100.00 2542 Manchester Ave. ❑oTH Cardiff by the Sea, CA 92007 ❑PTY ❑SCC 01ND Jean-Bernard Minster COM 9128/2016 1202 Melba Rd ❑OTH Professor, UCSD $250.00 $250.00 Encinitas, CA 92024 ❑PTY ❑SCC IND Rachel Workinger B 9/30/2016 216713th St ❑COM Homemaker/Caregiver $250.00 $250.00 ❑OTH Encinitas, CA 92024 ❑PTY ❑SCC Lisa Chestnut OIND 10/1/2016 553 Neptune ❑COM Project Director, Burton❑OTH Studio $100.00 $100.00 Encinitas, CA 92024 ❑PTY ❑SCC SUBTOTALS 900.00 Schedule A Summary 'Contributor Codes 1. Amount received this period-itemized monetary contributions. IND-Individual (Include all Schedule A subtotals.) $ 2,500.00 COM-Recipient committee ......................................................................................................... (other than PTY or SCC) 2. Amount received this period-unitemized monetary contributions of less than $100 ...........................$ 205.00 orH-other(e.g.,business entity) p ry PTY—Political Parry 3. Total monetary contributions received this period. SCC-Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 2,705.00 FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA 4601 from 9/25/16 FORM through 10122116 Page 5 of 7 NAME OF FILER I.D.NUMBER Committee Opposed To Encinitas Measure T # 1389886 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED REETA D COMMITTEE, ND ZIPCNDEOF CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN,I-DEC.31) (IF REQUIRED) OF BUSINESS) IND Ralph Borrelli JO Retired 10/1/2016 135 Via Del Cerrito El OTH $100.00 $100.00 Encinitas, CA 92024 ❑PTY ❑SCC Kenneth Selzer Ia IND Physician,Accretive 10/1/2016 481 Hillcrest Dr ❑COM Health Encinitas,CA 92024 $250.00 $250.00 El El ❑ScC Dan Graboi BIND Owner/Scientist 10/1/2016 1314 Desert Rose Way opTH Engineer, Carlsbad $250.00 $250.00 Encinitas,CA 92024 ❑PTY Scientific ❑SCC Chris Brumfield RIND Homemaker 10/142016 375 Fulvia St ❑COM $250.00 $250.00 ❑OTH Encinitas,CA 92024 ❑PTY ❑SCC III IND Brian Stearns ElCO VP, Inception Sciences 10/14/2016 157 Beechtree Dr ❑OTH $250.00 $250.00 ❑OTH Encinitas, CA 92024 [1 PITY ❑SCC SUBTOTAL$ 1,100.00 'Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH—Other(e.g.,business entity) PTY—Political Party SCC—Small Contributor Committee FPPC Form 466(Jan/2016) FPPC Advice:advice@fppc.w.gov(866/275-3772) www.fppc.ca.gov Schedule A(Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA from 9/25/16 FORM • , through 10/22/16 Page 6 of 7 NAME OF FILER I.D.NUMBER Committee Opposed To Encinitas Measure T # 1389886 DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED OF ETDCOMMITTEE ALSO ENTER C NUMBER)DE OF CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED.ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED) OF BUSINESS) JZ IND Kevin Mulvey ❑COM Director of Recruiting, 10/1212016 624 Hymettus Ave ❑OTH Mulvey International $250.00 $250.00 Encinitas, CA 92024 ❑PTY p SCc Linda Durham OIND Retired 10/20/2016 850 Summerhill Ct ❑COM $250.00 $500.00 ❑OTH Encinitas, CA 92024 ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC SUBTOTAL$ 500.00 'Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH—Other(e.g.,business entity) PTY—Political Party FPPC Form 460(Jan/2016) SCC—Small Contributor Committee FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded Statement covers period SCHEDULE E to whole dollars. • I , Payments Made from 9/25116 FORM SEE INSTRUCTIONS ON REVERSE through 10/22/16 Page 7 of 7 NAME OF FILER I.D.NUMBER Committee Opposed To Encinitas Measure T # 1389886 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misa 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 FIND 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 candidatelsponsor 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 (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID VPG 2240 Encinitas Blvd, Ste F LIT $540.00 Encinitas, CA 92024 The Coast News 315 S Coast Hwy 101,#W PRT $800.00 Encinitas,CA 92024 Airgas Helium gas for demonstration event balloons, tank 1415 Grand Ave rental and deposit(deposit to be returned) $605.19 San Marcos, CA 92078 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ $1,945.19 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ $1,945.19 2. Unitemized payments made this period of under$100................................................................................ $154.56 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 $ $2,099.77 FPPC Form 460(Jan/2016) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov