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Home My WebLink About2017 07-01 thru 12-31 Nichols 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from July 1, 2017 through Dec 31, 2017 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 0 Recall 0 Controlled (Also Complete Part5) 0 Sponsored ❑ General Purpose Committee (A/soComplete Part 6) 0 Sponsored ® Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also complete Part7) 3. Committee Information I.D. NUMBER 1368342 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Kim Nichols for Orange City Council 2014 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Orange CA 92869 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX P. O. Box 6069 CITY STATE ZIP CODE AREA CODE/PHONE Orange CA 92683 OPTIONAL: FAX / E-MAIL ADDRESS 47verincation I have used all reasonable diligence in preparing and reviewing this statement under penalty of perjury under the laws of the State of California that the foregc Executed on January 31, 2018 Date Executed on January 31, 2018 Date Executed on Date Date Stamp lit W CITY CLERK Date of election if appli (Month, Day, Year) 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 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 ;chedules is true and complete. I certify CL_ . 3ponsor By Signature ofControlling Officeholder, Candidate, State Measure Proponent Executed an By Date Signature ofControllkV Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Type or print in ink. COVER PAGE - PART2 Recipient Committee Campaign Statement Im 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 RESIDENTIALJBUSINESS 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. COMMITTEE NAME I I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME 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 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 officehokier(s) or candidate(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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of Califomia Campaign Disclosure Statement Type or print in ink. SUMMARYIPAGE Summary Page Amounts may be rounded to whole dollars. Statement covers period 4 from - July 1, 2017_ SEE INSTRUCTIONS ON REVERSE through Dec 31, 2017 page -e 3 of 5 NAME OF FILER I.D.NUMBER Committee to Elect Kim Nichols for Orange City Council 2014 1368342 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTODATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 0 $ 0 2. Loans Received ...................................................... Schedule B, Line 3 0 0 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2 $ 0 $ 0 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 0 $ 0 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ....................................................... Schedule E, Line 4 $ 100.00 $ 654.00 Candidates 7. Loans Made ............................................................. Schedule H, Line 3 0- 0 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6 + 7 $ 100.00 $ 654.00 22. Cumulative Expenditures Made* (if Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 100.00 $ 654.00 $ Current Cash Statement $ 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 357.18 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above 0 amounts in Column A to the 14. Miscellaneous Increases to Cash ........................... Schedule /, Line 4 corresponding amounts from Column B of your last *Amounts in this section may be different from amounts reported in Column B. 15. Cash Payments .................................................. Column A, Line 8 above 100.00 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 257.18 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ 0 for this calendar year, only - Garry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if any). 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) '`' --'---'— Schedule 5 Part 1 Amounts Loans Received to whole dollars. July 1, 2017 0 from — 0. Dec 31, 2017 4 5— SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Committee to Elect Kim Nichols for Orange City Council 2014 1368342 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE (b) AMOUNT (c) A MOUNTPAID (d) OUTSTANDING BALANCEAT (0) INTEREST M ORIGINAL CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEG1PN'N1,NG THIS RECEIVED THIS PERIOD 0 R FORGIVEN CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS NAMEOFBUSINESS) _E,_OD THIS PERIOD PERIOD PERIOD LOAN TO DATE Steven A Nichols Attorney E] PAID CALENDARYEAR PTY n SCC DATE DUE DATE INCURRED Kimberlee C Nichols Restaurant Manager r-1 PAID CALENDARYEAR [3 FORGIVEN PER ELECTION Orange, (;A 92869 RAT E PAID CALENDARYEAR E] FORGIVEN PERELECTION� RATE Schedule B Summary 1. Loans received this period .................. ........ ........... ....................... .................................. (Total Column Udplus unibennizedloans ofless than $1UO] 2. Loans paid cvforgiven this period ....................................................................................... (Total Column (c)plus loans under $1UOpaid orforokmnj (include loans paid bva third party that are also itemized onSchedule &) 3. Net change this period. (Subtract Line 2from Line 1.)............... Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven mpaid uyanother party also must uereported nnSchedule A. ** If required. ... ..... ... $ r4l � � O -------------' NET $ (Maybe a negative number) Schedule E, Line m tContributor Codes ` !NO -individual COM-Recipient Committee (other than PTYor8CC) OTH-Other (e.g, business entity) PTY-RddicaPooy scC-Small Contributor Committee FPPC Form 460(Januan105) Schedule E Payments Made SEE INSTRUCTIONS owREVERSE Type or print mink. Amounts may berounded to whole dollars. NAME OF FILER Committee bzElect Kim Nichols for Orange City[bunoi|2014 Statement covers period from July 1, 2017 sm, 1368342 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign panaphema|iahmisc, MBR member communications RAID radio airtime and production costs Q«S campaign consultants K0G meetings and appearances RFD returned contributions cnB contribution (explain nonmonotary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL /� or cable airtime and production costs FL candidate fi|ing/bo|htfneo PHO phone banks TRC candidate travel, lodging, and meals FIND fundraising events POL polling and survey research TR8 staff/epouoeuave|. lodging, and meals W independent expenditure supporting/opposing others (explain)* POG pmetage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (|eQo|. aonuunUnQ) VQT voter registration UT campaign literature and mailings PFT print ads WEB information technology costs (intemet.e-moi|) NAME AND ADDRESS uFPAYEE (IFoommnTEE.ALSO ruTEn/oNUMBER) CODE on DESCRIPTION OF PAYMENT UNT41011111,1m�� ° Payments that are contributions m,independent expenditures must also be summarized on Schedule D. SUBTQTAL$ Schedule E Summary 1.Itemized payments made this period. (Include all Schedule EoUbtota|n]............................................................. ...................... ......................... $ U 2.Unitemizedpayments made this period of under $1UO........................................................................... .................. ..................... ..................... $ 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.) ....... _ .................. . TOTAL $ 100.00 FPpuForm 460(Jonuarym5) FPPCToll-Free Help|ine:V6WhuSK-FPPC<8U6127s-3773