The URL can be used to link to this page

Home My WebLink About2016 07-01 thru 12-31 Nichols 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) fro Type or print In Ink. m Statement covers period Date of election if appli July 1, 2016 (Month, Day, Year) SEE INSTRUCTIONS ON REVERSE I through Dec 31, 2016 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee Q Recall 0 Controlled (Also Conri*te Part 5) O Sponsored General Purpose ❑ rpose Committee (Also compilers Part 6) Q Sponsored ® Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (AW Complete Part 7) 3. Committee Information COMMITTEE NAME (OR I.D. NUMBER NAME IF NO COMMITTEE) Committee to Elect Kim Nichols for Orange City Council 2014 CTGGCT AnnGCCC thin on onv% CITY STATE ZIP CODE AREA CODE/PHONE Orange CA 92869 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE Orange CA 92683 OPTIONAL: FAX / F-MAII Ann RFRS L1 ITY CLER - I AM 9: 34 Nov 4, 2014 2. Type of Statement: ❑ Preelection Statement ® Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Lynn A Nichols MAILING ADDRESS COVER PAGE Page 1 of 5 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 CITY STATE ZIP CODE AREA CODE/PHONE Orange CA 92869 NAME OF ASSISTANT TREASURER, IF ANY Not applicable MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the b et of my knowleAaeYifohnnation 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 fore( Executed on January 31, 2017 Date Executed on January 31, 2017 Date _._._ _...__. _. _ D%Dr Executed on Date gy Signature of Controling Officeholder, Candidate, State Measure Proponent Executed on Date By SlgnatureofControling Officeholder, Candiclarta, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Recipient Committee Type or print In Ink. COVER PAGE - PART 2 Campaign Statement om 0 1 Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Kimberlee C Nichols OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL MEMBER, ORANGE RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Orange, CA 92869 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 receive contributions or make expenditures on behalf of your candidacy. COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Page 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholders) or candidate(s) for which this committee /s 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 (January/05) FPPC Toll -Free Helpllne: 866/ASK•FPPC (866/275-3772) State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Kim Nichols for Orange City Council 2014 Type or print In Ink. Amounts may be rounded to whole dollars. SUMMARY PAGE Statement covers period from -July 1, 2016 _ through Dec 31, 2016 - Page 3 of 5 Contributions Received Column TOTALTHISPERIOD (FROM ATTACHED SCHEDULES) Column B CALENDARYEAR TOTAL TO DATE 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 0 $ 0 2. Loans Received ...................................................... Schedule B, Line 3 0 0 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2 $ 0 $ 0 4. Nonmonetary Contributions ............................... Schedule C, Line 3 0 0 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 0 $ 0 Expenditures Made 6. Payments Made....................................................... Schedule E, Line 4 $ 300.00 $ 648.48 7. Loans Made ............................................................. Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 300.00 $ 648.48 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 0 0 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE................................Add Lines 8 + 9 + 10 $ 300.00 $ 648.48 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 13. Cash Receipts ................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ..... ...... ......... Schedule /, Line 4 15. Cash Payments .................................................. Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions an reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ To calculate Column B, add 0 amounts in Column A to the 0 corresponding amounts from Column B of your last 300.()() report. Some amounts in Column A may be negative 911.18 fi, ures that should be subtracted from previous period amounts. If this is the first report being filed 0 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). I.D.NUMBER 1368342 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) $ IAmounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) T.. .. .....:..4 :— :...:. Amounts may be rounded Statement covers period Loans Received to whole dollars. July 1, 2016 4 from ®� 5EE INSTRUCTIONS ON REVERSE Dec 31, 2016 through 4IF Page NAME OF FILER I.D. NUMBER Committee to Elect Kim Nichols for Orange City Council 2014 1368342 FULL NAME, STREET ADDRESS AND ZIP CODE OFLENDER IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE AMOUNT O (c) AMOUNT PAID OUTSTANDING BALANCEAT e INTEREST ORIGINAL g CUMULATIVE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS NAMEOF BUSINESS) PERIOD THIS PERIOD PERIOD LOAN TO DATE Steven A Nichols Attorney ❑PAID CALENDARYEAR Rutan & Tucker $ 0 $ 10,000 0 10,000 10,000 Orange, CA 92869 r RATE $ $ PER ELECTION— ❑ FORGIVEN $ 10000.00 $ 0 $ 0 12/15/17 $ 0 8/15/14 t® IND El COM ❑ OTH ❑ PTY ❑ SCC $ DATE DUE DATE INCURRED Kimberlee C Nichols Restaurant Manager ❑PAID CALENDARYEAR Cyranos Caffe LLC $ 0 $ 3,254.41 0 % 100 $ 3,254.41 Urange, CA 92869 RATE $ PER ELECTION** ❑FORGIVEN $ 3254.41 $ 0 $ 0 12/15/17 $ 0 8/15/14 $ t® IND El COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED DATE DUE ❑ PAID CALENDARYEAR ❑ FORGIVEN RATE PERELECTION" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ $ DATE DUE DATE INCURRED SUBTOTALS $ 0 $ 0 $ 13,254.41 $ 0 Schedule B Summary 1. Loans received this period......................................................................... (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid orforgiven this period.............................................................. (Total Column (c) plus loans under$100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............................. Enter the net here and on the Summary Page, Column A, Line 2, 'Amounts forgiven or paid by another party also must be reported on Schedule A. If required. .................................. $ ..... I ............................ $ r❑ N ...................... NET $ 0 (Maybe a negative number) (cmer to) on Schedule E, Line 3) tContributor 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 460 (January/05) FPPC Tall -Free Heipline: 866/ASK-FPPC (866/275-3772) Schedule E Payments Made SEE INSTRUCTIONS owREVERSE Type mprint mink. Amounts may uorounded u,whole dollars. NAME opFILER Committee toElect Kim Nichols for Orange City Council 2O14 Statement covers period from July 1.2O1G CODES: If one of the following codes accurately describes the payment, you may enter the code, Otherwise, describe the payment 5 5 ��m__1368342 mVP campaign paraphemalia/misc, MBR member communications mAD radio airtime and production costs CINS campaign consultants Mm meetings and appearances mo returned contributions o/a contribution (explain mmmonetary)* opo office expenses SAL campaign workers' salaries n/c civic donations PEr petition circulating TEL 1xn,cable airtime and production costs pIL candidate nnno/maomfees n+o phone banks TmC candidate travel, lodging, and meals FND fundraising events poL polling and oum*v research Tms atan/spmvoetrave|. |ouoino, and meals mo independent expenditure aunpomnomvpnnino others (explain)* pmS vvmaoe, delivery and messenger services Tap transfer uomean committees of the same candidate/sponsor I eo legal defense PRO pm�smona|a*�ivae(|ooa|. accounting) voT voter registration LIT campaign memmeand mamnoe P�' print ads vwEa information technology costs (imemet.e-maiV NAME AND ADDRESS OF PAYEE (IFCOMMrT7EE, ALSO ENTERIM, NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID California Secretary of State Political Reform Division FIL 200.00 ° Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTODAL$ 20000 Schedule E Summary 1.Itemized payments made this period. (include all Schedule Euubbzta|sl-------....................................................................................... $ 200.80 2.Unbomizedpayments made this period of under $1OO.......... ...................................................... .............................................. ...................... $ 100.00 3.Total interest paid this period onloans. (Enter amount from Schedule B.Part 1.Column (e)l-------........................................................ $ O 4. Total payments made this period, (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ................. 1.1111. ..... TOTAL $ 300.00 FPPC Form wm(January/05) FPPCToll-Free *mvlino86mASK-Fppo(866/u75-m72)