Statement covers period. Date of election if applicable: (Month. Day, Year) 1/1/2017 4I 1I Preelection Statement Committee.

Transcription

1 Recipient Campaign Statement Cover Paae COVER PAGE Date Stamp Date of election if applicable: LOS ANGELES CITY ETHICS COMMISSIO i'! (Month. Day, Year) from through 1. Type of Recipient : 1/1/2017 4I 1I All s- Complete Parts 1, 2, 3, and 4. 0 Officeholder, Candidate Controlled 0 Primarily Formed Ballot Measure Semi-annual Statement 0Recall 0Controlled 0Termination Statement (Also Complete P'arl 5) osponsored Osmall Contributor Primarily Formed Candidate/ Officeholder Treasurer(s) COMMITTEE NAME (OR CANDI'S NAME IF NO COMMITTEE) NAME OF TREASURER Speak UP - Supporting Nick Melvoin for School Board 2017 (Nonprofit 501(c)(4)) Katie Braude MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE CA STATE CITY STATE ZIP CODE AREA CODE/PHONE Pacific Palisades CA ( 310) NAME OF ASSISTANT TREASURER, IF ANY AREA CODE/PHONE (310) MAILING ADDRESS MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY 0Special Odd-Year Report (Also file a Form 410 Termination) 3. Information Pacific Palisades Oauarterly Statement (Also Complete Pari 7) 0 Political Party/Central CITY 11 0Amendment (Explain below) (Also Complete Part 6) 0 of -Fo_r_O_ff-ic-ia-1Use Only RECEIVED Preelection Statement 0Sponsored Page 1 2. Type of Statement: Ostate Candidate Election 0 General Purpose APR CALIFORNIA 2001/02 FORM ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ ADDRESS OPTIONAL: FAX/ ADDRESS (213) I jguard@kaufmanlegalgroup.com 4. Verification Executed on 1have 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 2:rwry }'nder the laws of the State of California that the foregoing is y~rre~ i l / Y / 13'DhE By SIGNATURE OF TREASURER OR ASSISTANT TREASURER By Executed on SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDI, OR STATE MEASURE PROPONENT FPPC Advice: advlce@fppc.ca.gov SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDI, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDI. STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF PROPONENT Executed on By Executed on ( ) By

2 Recipient Campaign Statement Cover Page-Part 2 COVER PAGE-PART 2 5. Officeholder or Candidate Controlled -NAME or:.o'mc'eholderor CANDI 6.Primarily Formed Ballot Measure NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP BALLOT NO. OR LETTER JURISDICTION I OsuPPORT L..!:::::.. OoPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHLOLDER, CANDI, OR PROPONENT Related s Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD tistrict N IF_A_N_Y NAME OF TREASURER CONTROLLED COMMITTEE? DYES ONo COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME NAME OF TREASURER CONTROLLED COMMITTEE? DYES DNO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 7. Primarily Formed Candidate/Officeholder Lisl names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDI Nick Me lvoin NAME OF OFFICEHOLDER OR CANDI NAME OF OFFICEHOLDER OR CANDI NAME OF OFFICEHOLDER OR CANDI OFFICE SOUGHT OR HELD Board of Education OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD!2JSUPPORT DoPPosE OsuPPORT OoPPosE IE;"'"""' PPOSE OFFICE SOUGHT OR HELD Attach continuation sheets if necessary DsuPPORT OoPPosE FPPC Advice: advlce@fppc.ca.gov (866/ )

3 Campaign Disclosure Statement Summary Page Amounts may be rounded from 1/1/20 17 through 4/1/20 17 SUMMARY PAGE Supporting Nick Me1voin for School Board 2017 (Nonprofit 50l(c) (4)) s Received 1. Monetary s Schedule A, Line 3 2. Loans Received Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines Nonmonetary s Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines ColumnA Total This Period (FROM ATTACHED SCHEDULES) $102, $0.00 $ 102, $102, Column B CALENDAR YEAR TOTAL TO $102, $0.00 $102, $102, Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. s Received 21. Expenditures Made 1/1 throuqh 6/30 7/1 to Date Expenditures Made 6. Payments Made Schedule E, Line 4 7. Loans Made Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines Accrued Expenses (Unpaid Bills) Schedule F, Line Nonmonetary Adjustment Schedule C, Line TOTAL EXPENDITURES MADE Add Lines $0.00 $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made * Date of Election (mmldd!yyyy) (If Subject to Voluntary Expenditure Limit) Total to Date Current Cash Statement 12. Beginning Cash Balance... Previous Summary Page, Line Cash Receipts... Column A, Line 3 above 14. Miscellaneous Increases to Cash Schedule I, Line Cash Payments Column A, Line 8 above 16. ENDING CASH BALANCE.. Add Lines , then subtract Line 15 If this is a termination statement, Line 16 must be zero. $102, $ $102, To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. tf this is the first report being filed for this calendar year. only carry over the amounts ~ i from Lines 2, 7, and 9 (~ 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 any). Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse 19. Outstanding Debts... Add Line 2+Line 9 in Column B above *Amounts in this section may be different from amounts reported in schedule B. FPPC Advice: advice@fppc.ca.gov (866/ )

4 Schedule A Monetary s Received _ Amounts may be rounded SCHEDULE A f~ ECE IVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I. D. NUMBER) CONTRIBUTOR CODE* IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO CALENDAR YEAR (JAN. 1-DEC. 31) PER ELECTION ro 03 / 28/ Megan Chernin Santa Monica, CA [2j1ND OcoM OaTH 0PTY CEO The LA Fund f o r Publi c Educat i on $ 1 00, $ 100, /28/20 17 Patricia Neu wirth Los Angele s, CA IND OcoM DoTH 0PTY sec Re t i red N/A $2, $2, Schedule A Summarv 1. Amount received this period -itemized monetary contributions. SUBTOTAL (Include all Schedule A subtotals.) Amount received this period -unitemized monetary contributions of less than $ Total monetary contributions received this period. $102, 500. ool $ 1 02, (Add Lines 1 and 2. Enter here on the Summary Page, Column A, Line 1.) TOTAL $ 1 02, *Contributor Codes IND- Individual COM- Recipient (other than PTY or SCC) OTH- Other (e.g., business entity) PTY- Political Party SCC- Small Contributor FPPC Advice: advice@fppc.ca.gov (866/ )

5 ScheduleD Summary of Expenditures Supporting/Opposing Other Candidates, Measures and s NAME Or FILER. Amounts may be rounded Speak UP- Supporting Nick Melvoin for School Board 2017 (Nonprofit 50l(c) (4)) from 1:-/:-1_/:-2:-0:-1:-7:- 4/1/201"1 through SCHEDULED CALIFORNIA 460 FORM Page 1.0. NUMBER 5 of 11 NAME OF CANDI, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE TYPE OF PAYMENT DESCRIPTION AMOUNT/FAIR MARKET VALUE CUMULATIVE TO CALENDAR YEAR (JAN. 1-DEC. 31) PER ELECTION TO 03/27/2017 Nick Melvoin Board of Education Other: Los Angeles Unified School District. District No: 4 D Nonmonetary r71 Independent ==-----== ~Expenditure [21Support Ooppose $ /30/2017 Nick Melvoin Board of Education Other: Los Angeles Unified School District. District No: 4 [21support 00ppose D Nonmonetary r7jindependent ~Expenditure $25.00 $125_00 01/30/2017 Parent Teacher Alliance, sponsored by California Charter Schools Association Advocates Independent Expenditure r71 Nonmonetary ~ 0 Independent ---=, == E:xpenditure [21support 00ppose Memo: $ $31, SUBTOTAL $7,0~0.231 Schedule D Summarv 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) $31,462 _11 2. Unitcmized contributions and independent expenditures made this period of under $ ~ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.)... TOTAL $31, FPPC Advice: advice@fppc.ca.gov (866/ )

6 ScheduleD Summary of Expenditures Supporting/Opposing Other Candidates, Measures and s NAME OF FILER Amounts may be rounded Speak UP - Supporting Ni ck Melvoin for School Board 2017 (Nonprofit 501(c) (4 )) from through 1_/_1_/_2_0_1_7_ 4/1/2017 SCHEDULED CALIFORNIA 460 FORM Page 6 of 11 J.D. NUMBER NAME OF CANDI, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LEITER AND JURISDICTION, OR COMMITIEE TYPE OF PAYMENT DESCRIPTION AMOUNT/FAIR MARKET VALUE CUMULATIVE TO CALENDAR YEAR (JAN. t-dec. 3t) PER ELECTION TO 02/13/2017 Parent Teacher All iance, sponsored by Cal i fornia Charter Schools Associ ation Advocates Independent Expenditure r71 Nonmonetary ~ D Independent ----== == Expenditure IZ.Jsupport ooppose Memo : $ $31, /28/2017 Parent Teacher Alliance, sponsored by California Charter School s Association Advocates I ndepe ndent Expenditure IZ.Jsupport r71 Nonmonetary ~Cont rib ution D Independent Expenditure Ooppose Memo : $ Staf f Time $31, /13/2017 Parent Teacher Alliance, sponsored by Californi a Charter Schools Association Advocates Independent Expenditure r71 Nonmonetary ~C o ntribution 0 Independent == == l Expenditure IZ.Jsupport 00ppose Memo : $ $31, SUBTOTAL $16, Schedule D Summarv 1. Itemized contributions and independent expenditures made this period. (Include all ScheduleD subtotals.) $:._3::..:::.. 1, Unitemized contributions and independent expenditures made this period of under $ Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $31, FPPC Advice: advice@fppc.ca.gov ( )

7 ScheduleD Summary of Expenditures Supporting/Opposing Other Candidates, Measures and s NAME OF FILER. Amounts may be rounded Speak UP- Supporting Nick Melvoin for School Board 2017 (Nonprofit 50l(c) (4)) from through 1/1/2017 4/1/2017 SCHEDULED CALIFORNIA 460 FORM Page 7 of 11 NAME OF CANDI, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE TYPE OF PAYMENT DESCRIPTION AMOUNT/FAIR MARKET VALUE CUMULATIVE TO CALENDAR YEAR (JAN. 1-DEC. 31) PER ELECTION TO 03/27/2017 Parent Teacher Alliance, sponsored by California Charter Schools Association Advocates Indepe ndent Expenditure 171 Nonmonetary IY...I D Independent =::: =::: Expenditure [Z] Support D Oppose Memo: $ $31, SUBTOTAL $8, Schedule D Summarv 1. Itemized contributions and independent expenditures made this period. (Include all ScheduleD subtotals.)... $.;._3_1.:..,_4_6_2_._1_1_ 2. Unitemized contributions and independent expenditures made this period of under $ Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $31, FPPC Advice: advice@fppc.ca.gov (866/ )

8 Schedule E Payments Made NAME OF FILER. Amounts may be rounded Speak UP - Supporting Nick Melvoin f or School Board 2017 (Nonprofi t 50l (c) (4 ) ) from 1_/_1_1_2_. 0_1_7_ through 4/1/2017 SCHEDULE E CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campri Qn paraphernalia/misc. ens campaiqn consultants etb contribution (explain nonmonetary) eve civic donations FIL candidate filin~/ballot fees FND fundraisinq events IND independent expenditure LEG leqal defense LIT campaiqn literature and mail i nr~s -- MBR member communications MTG meetin>ls and appearances OFC office expenses PET petition circulatinq PHO phone ban ks POL pollinq and su rvey research POS postaqe, delivery and messenqer services PRO professional services (leqal, accountinq) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaiqn workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodqinq, and meals TRS staff/spouse travel, lodqinq, and meals TSF transfer between committees of the same candidate/sponsor VOT voter reqistration WEB information technoloqv costs (Internet, ) NAME AND -ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMIHEFO, ALSO ENTER LD. NUMBER) J e ffrey Kho Lo s Ange l e s, CA J effrey Kho Los Angeles, CA I ND St a f f Time, Nick Melvoin, Supp o r t $ IND, Ni c k Melvoin, Suppor t $25.00 Speak UP Memo: $ , Parent Teacher Allia n ce, s p ons ored by Cal i f o r nia Charter CTB School s Association Advoc a t e s I ndependent Pacifi c Pa lisades, CA Expendi t u r e Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) $ Unitemi.:ed payments made this period of under $ Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) Total payments made this period. (Add Linos 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ FPPC Advice: advice@fppc.ca.gov (866/ )

9 Schedule E Payments Made Amounts may be rounded from 1:-/-:-1:-/-:-2::-0::-1:-7::- 4/1/2017 through SCHEDULE E NAME OF FILER Speak UP - Supporti ng Nick Me 1voin for School Boar d 2017 (Nonprofit 50 1 (c) (4) ) CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaiqn paraphernalia/misc. CNS campaiqn consultants CTB contribution (explain nonmonetary)' eve civic donations I'll. candidate filinqiballot fees FND fundraisinq events IND independent expenditure LEG leqal defense LIT campaiqn literature and mailinqs NAME AND ADDRESS OF PAYEE (IF COMMITIEE, ALSO ENTER I. D. NUMBER) MBR member communications MTG meetinqs and appearances OFC office expenses PET petition circulatinq PHO phone banks POL pollinq and survey research POS postaqe, delivery and messenqer services PRO professional services (leqal, accountinq) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaiqn workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodqinq, and meals TRS staff/spouse travel, lodqinq, and meals TSF transfer between committees of the same candidate/sponsor VOT voter reqistration WEB information technoloqy costs (Internet, e mail) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Speak UP Pacific Pal i sades, CA CTB Memo : $ St aff Time, Parent Teacher Alliance, s p o nsor ed by Ca liforni a Charter Schoo l s Associ a t ion Advocat es Independen t Expend i ture Comm i ttee Speak UP Pacific Pa l isades, CA CTB Memo : $ St aff Ti me, Parent Teacher Allianc e, sponsored by Californi a Cha r t er Schools Associat i on Advocates Inde p e nd e n t Expenditure Speak UP Pacific Pa l i sades, CA CTB Memo : $ Staff Ti me, Parent Teacher Alliance, s ponsored by Ca l ifornia Charter Schools Association Advocates Independent Expenditur e Co mmitt ee Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $0.00 Schedule E Summary Unitemized payments made this period of under $ Itemized payments made this period. (Include all Schedule E subtotals.) Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) $ Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ FPPC Advice: advice@fppc.ca.gov ( n2)

10 Schedule E Payments Made. Amounts may be rounded NAME OF FILER Speak UP- Supporting Nick Melvoin for School Board 2017 (Nonprofit 501(c) (4)) from 1_/_1_/_2_0_1_"_7 through 4/1/2017 SCHEDULE E CALIFORNIA 460 FORM Page 1 0 of 11 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campai!=ln paraphernalia/misc. CNS campai!=jn consultants CTB contribution (explain nonmonetary)* eve civic donations FIL candidale filinq/ballot fees FND fundraisinq events IND independent expenditure LEG leqal defense LIT campaiqn literature and mailinqs NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) ~ -.. MBR member communications MTG meetinr~s and appearances OFC office expenses PET petition circulatinq PHO phone banks POL pollinq and survey research POS postaqe, delivery and messen!=ler services PRO professional services (leqal, accountinq) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel. lodqinq. and meals TRS staff/spouse travel, lodqinq, and meals TSF transfer between committees of the same candidate/sponsor VOT voter reqistration WEB information technolo!=lv costs (Internet, ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Speak UP Pacific Palisades, CA CTB Memo: $ , Parent Teacher Alliance, sponsored by Californi a Charter Schools Association Advocates Independent Expenditure *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)... j_12_5. 0_0_ 2. Unitemized payments made this period of under $ Total interest paid this period on loans. (Enter amount from Schedule 8, Part 1, Column (e).)... $ Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)... TOTAL $ FPPC Advice: advice@fppc.ca.gov ( )

11 Notes and Memos FORMISCHEDULE REFERENCE NUMBER (IF APPLICABLE) TEXT F4 60 Al l memoe d ent r i es were contribu t i o n s ma de by s ponso r.