HomeMy WebLinkAboutGOH KAREN 460 TERMINATION STATEMENTRecipient Committee
Campaign Statement
Cover Page
Statement covers perlo l
from 07/01/22
SEE INSTRUCTIONS ON REVERSE Ithrough 12/15/22
1. Type of Recipient Committee: AgCemmmees- Complete Pans 1, 2.3. and 4.
m Rceholdec Candidate Controlled Committee
8 State Candidate Election Committee
0 Recall
Iwwcw,gennnsl
❑ Creneral Purpose Committee
(8) Sponsored
Small Contnbutor Committee
Political Party/Central Committee
3. Committee Information
Karen Colt for Mayor 2016
❑ Primarily Formed Ballot Measure
omminae
Controlled
Sponsored
ram cwi e"pan&
❑ Primarily Formed Candidate/
Officeholder Committee
(abeconands ano
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIPCODE
AREACOOEIPHONE
MAILING
ADDRESS (11 DIFFERENT) NO,
AND STREET OR PO. BOX
CITY
STATE
ZIP CODE
AREACODEPHONE
2: SR
2. Type of Statement:
❑
Preelection Statement
❑
Semi-annual Statement
IiJ
Termination Statement
(Also file a Form 410 Termination)
❑
Amendment (Explain below)
Page 1 of
❑ Ouartedy Statement
❑ Special Odd -Year Report
Treasurer(s)
NAME OF TREASURER
Shaven P. Kelly, CPA
MAILING ADDRESS
CITY
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY
STATE
ZIP CODE
AREA LODEIPHONE
OPTIONAL: FAX I E-MAILAOORESS
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 antl r the laws of the State of California that the foregoing is le end Correct.
ExecutM on ' I� ZZ By .Iveawr DrAedeMnl reaemer
Ezaculed on I�,�Z By NnaOn, ICoromnin eC Ca io.... Ie Memin, Pnoponexor Xan,ponvoseSponsor
ay egnalma of D-Woury minernod., L.And., elate Maeaue rworcnl
Executed on aN BY Ai ... of Convocing O1vxr1M,X Candidate men Meawre pintorem
FPP[ Form 460 (tan/2016))
FPPC Advice: advice@fppc.ca.gov (966/27S-3772)
www.fPPc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Karen Goh
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Mayor, City of Bakersfield
RESIDENTIAUBUSINESSADDRESS (NO.ANDSTREET) CITY STATE ZIP
Related Committees Not Included in this Statement: uwanycommittaea
not Included in this slatement mat are controlled try you or are primarily formed to receive
conMfiutlons or make expenditures on behalf of your candidacy.
COMMITTEE NAME I IQ NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEENDDRESS STREET ADDRESS (NO PO. BOX)
CITY STATE ZIP CODE AREACODEIPHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO PO. BOX)
COVER PAGE -
Page 2 of 8
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, 9 any.
NAME OF OFFICEHOLDER. CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee List name. of
ofacehoiderfs) or candidate(s) for which due committee is primarily formed.
NAME OF OFFICE HOLDER OR CANDI DATE
OFF ICE 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
El SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODEIPH0 E Attach continuation sheets Ifnecessary
FPPC Form 460 (Jan/2016)
FPPC Advice: advice afppc.ca.gov (a66/275-3772)
www.fPPc.ca.60v
Campaign Disclosure Statement Amounts may be rounded
to whole dollars. Statement covers period
Summary Page
from 07/Ol/22
12/15/22
Page 3 of 8
SEE INSTRUCTIONS ON REVERSE
through
I.D. NUMBER
NAME OF FILER
Karen Goh for Mayor 2016
1384218
A
Column B
Calendar Year Summary for Candidates
Contributions Received
ieColumn
iRTHI5 YEW0o
GALENDARVEAR
Running in Both the State Primary and
Im0MAc7AOIED SCHEDULES)
TOTUTODATE
General Elections
2200.00
$
28,750.00
1. Monetary Contributions ........ ........................... _......
.... .., schedule A, Line 3
$
111 mrown ergo Tit to dab
2. Loans Received ........................... ...._............ _.................
schedule e, Linea
20. ContributionsReceived
28000.00
$
28750.00
$ $
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines l+z
$
4. Nonmonetary Contributions.... ........................ _.....
....... schedule C, Llne3
21. Expenditures
28,000+00
28.750.00
Made $ 8
5. TOTAL CONTRIBUTIONS RECEIVED.... . .......
. ...... , ndd Cmed3+4
$
$
Expenditures Made
6. Payments Made... ..................... ............. ...........................
schedule E, Line
$
2$459.70
7. Loans Made ......... _......_............ _.__.............. .................
schedule N. Line
8. SUBTOTAL CASH PAYMENTS.._...................................
Add 16+7
$
28,459070
9. Accrued Expenses (Unpaid Bills) ...... ....... .............
..__._.....Schadwe F Lines
10, NonmonetaryAdjustment............._.........._______...............
Schedule c. One s
11. TOTAL EXPENDITURES MADE__.....__ ....................
Add Lines 8+9+10
$
28,459.70
Current Cash Statement
12. Beginning Cash Balance _____._...._......... PNNAos summand, Eage, Line 14
$ 459.70
28.000.00
13. Cash Receipts ............ -.............. .............................. caumn A,leme3above
14, Miscellaneous Increases to Cash ...................... ..... schedule i. Line a
15. Cash Payments ................ ............... Column A, Line eabove
28,459.70
16. ENDING CASH BALANCE ...._......... .Addunes 12+13+ 14, then subrrenune 15
$ 0.00
If this a a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................ _............. schedule e, Part2 $
18. Cash Equivalents_ ................................._......__. Seefinducransobneaenee $
19. Outstanding Debts ................. Add Line 2+ Line a in Column a above $ 0'00
$ 21L814470
8
To calculate Column B,
add amounts in Column
A to the conesponding
amounts from Column B
of your last report. Some
amounts in Column A may
be negative figures that
should be subtracted foul
previous period amounts. If
this is the first report being
filed for this calendar year,
only tarty over the amounts
from Lines 2, 7, and 9 (if
any).
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made`
et sub ectovelumm, Eap.ndi Limit)
Date of Election Total to Date
(mmlddi
'Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (lan/2016))
FPPC Advice: advice@fppc.ca.see (866/275-3772)
www.fppc.ca.eov
e.-1....a..te A Amounts may be rounded SCHEDULE A
to whole dollars.
Monetary Contributions Received
Statement covem period
'' • 1
hom g7/O1/22
• -
12/15/22
Page 4 of 8
through
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
NAME OF FILER
1384218
Karen Gob for Mayor 2016
FULL NAME. STREET ADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
CONTRIBUTOR
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
(IF COMMITTEE. PLED ENTER IU. HUMBEP)
CODE
EMPLOYED. ENTER NAME
yFSELE� OF 9L.INESEI
PERIOD
(JAN, 1-DEC. 31)
(IF REQUIRED)
11/28/22
Farhad& Fatemah Bashhtash
MIND
Owner
4,900.00'
❑ PTY
❑ SCc
11/28/22
Kevin McCarthy for Congress
❑ IND
N/A
4,900.00'
m COM
❑ scc
11/28/22
Centric Health
0IND
N/A
4,900.00'
❑ DOM
❑ PTY
❑ SOO
11/28/22
Diane Lake
mIND
Homemaker
4,900.00-
❑ DOM
❑ PTY
❑ SCC
11/28/22
California Water Service
❑IND
N/A
4,900.00'
❑ PTY
❑ SCC
SUBTOTAL$ 24,500.00
Schedule A Summary •Contdbmor Codes
IND—Individual
1. Amount received this period — itemized monetary contributions. 28,000.00 DOM —Recipient Committee
(Include all Schedule A subtotals.) .......................... ............ ........................................ ...........................$ (other than PTY or SOD)
OTH — Other (e.g.. business entity)
2. Amount received this period — unitemized monetary contributions of lass than $100 ...................... .....$ PTV — Political Party
SCC— Small Contributor Committee
3. Total monetary contributions received this period. 28,000.00
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ FPPC Form 460 (Jan/2016))
FPPC Advice: a deice@fppc.ca.gov (866/275-3772)
www.fPPc.ra.gov
�* �4 pa )e 5 of 8
Schedule A (Continuation Sheet) Amounts may be rounded
SCHEDULE (CONT)
Monetary Contributions Received towhot. dollar..
8tatementcoversperiod
e.
from 07/01/22
e
through 12/15/22
Page 5 of 8
NAME OF FILER
D. NUMBER
Karen Gain for Mayor 2016
1384218
FULL NAME, STREETADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
CONTRIBUTOR
OCCUPATION AND EMPLOYER
RECEIVED THIS
OALENDARYEAR
TO DATE
RECEIVED
(IF COMMinEE ALSO ENTER I.O. NUMBER)
CODE
(IF SELF-EMPLOYED. DF VEN;ER NAME)
NEss
PERIOD
(JAN.t - DEC. 31)
(IF REOUmED)
11/28/22
Barbara Grimm -Marshall
®IND
Owner
3,500.00'
P.
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTV
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTV
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTV
SCC
SUBTOTAL $ 3,500.00
'Contnbnur Codes
IND - Individual
COM - Recipient Committee
(other than PTV or SCC)
OTH - Other (e,g., business entity)
PTV - Political Party
SCC - Small Contributor Committee
- Dr( jvl . CQ✓7Frl G(/l. �"O �0�� (!0/h/Dd.£ [r,
+ra,v4s rrefd - 40 2zl(p i*-G"Pr"-1.tL-1— -10
rL pa> loan.
FPPC Form 460 (lan/2016))
FPPC Advice: advice@fppr...Bov (866/275-3772)
www.fppaca.8ov
SCHEDULE B - PART 1
Schedule B — Part 1 ee noCaon;..:
Statement covers period
e .
Loans Received
o-em 07rov22
.
through 12/15/22
Peg. S of a
SEE INSTRUCTIONS ON REVERSE
I.O. NUMBER
NAME OF FILER
Karen Gob for Mayor 2016
1384216
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTERis)
OUTSTANDING
AMOUNT
AMOUNT PAID
OUTSTANDING
T
INTEREST
ORIGINAL
B
CUMULATIVE
OFLENDER
OCCUPATION AND EMPLOYER
BALANCE
RECEIVED THIS
OR FORD IVEN
BALANCEAT
PAIDTHIS
AMOUNTOF
ONTRIBUTIONS
OF COMMITTEE ALSO ENTER LD. NOMeem
(IF SELF-EMPLOYED ENTER
BEGINN ING TH IS
PERIOD
THISPERIOD-
CLOSEOFTHIS
PERIOD
PERIOD
LOAN
TO DATE
NAME OF BUSwesal
PERIOD
CALTRUK R
® PAID
Karen Gob
Mayor
$ 28,000.00
0 %
f 4,715.00
$
® FORGIVEN
PER ELFCTION"
52,715.00
f
$ 24,715.00
N/A
.00
8/11/16
$
$
$
DATE DUE
DATE INCURRED
1C) IND ❑ COM ❑ OTH ❑ PTV ❑ SCC
PAID
CALENDAR YEA0.
—%
$
❑FORGIVEN
PER ELECTION"
NniE
$
DATE OUE
DATE INCURRED
1[I IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
El PAID
CALENDAR YEAR
$
_%
$
FORGIVEN
RATE
PER ELECTION"
$
3
$
DATE DUE
DATE INCURRED
11] IND ❑ COM ❑ OTH ❑ PTV ❑ SCC
SUBTOTALS $ $ 52,715.00 $ $
Schedule B Summary
1. Loans received this period..........................................................................
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven 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.
IeNur --is E L...,r
$
0.00
$
52,715.00
tCOntEbUtOr Codes
IND - Individual
COM - Recipient Committee
(other than STY or SCC)
NET $
(52,715,00)
OTH- Other (e.g. business entity)
PTY - Political Party
SCC - Small Contributor Committee
(M.ve..AA. ....Rn
FPPC Form 460 (lam/2016))
FPPC Advice: advlce@fppc.ca.gov (966/275-3772)
W..fppc.o.gov
Schedule E Amounts may be Founded Statements
to whole dollars.
Payments Made I from 07/01/22
Karen Gob for Mayor 2016
through 12/15/22 I Page 7 of 8
1384218
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CMP
campaign paraphemalialmisc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)'
OFC
once expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition Emulating
TEL
tv. or cable airtime and production costs
FIL
candidate filing/ballot fees
PRO
phone banks
TRC
candidate travel, lotlging, and meals
FND
fundraising events
POL
polling and survey research
TRS
sta9lspouse travel, lodging, and meals
IND
independent expenditure supportinglopposing others (explain)'
POS
postage, delivery and messenger services
TSF
transfer between committees of the same cantlidate/sponsor
LEG
legal defense
PRO
professional Services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (Internet, a -mail)
NAME AND ADDRESS OF PAYEE
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
(IF COMMI TFs ALSQ ENTER I. D. NUMBER)
Wren Kelly CPAs
Accounting
323.00
Tri Counties Bank
Bank charges
40.00
Karen Goh
Loan repayment
28,000.00
' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 28,363.00
Schedule E Summary
28,459.70
1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $
2. Unitemized payments made this period of under$100.......................................................................................................................................... $
Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. 0-
Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 28,459.70
FPPC Form asp (Jan/2016))
FPPC Advice: advice@fppc.ca.Sov (966/275-3772)
www.fppc.ca.dov
Schedule E
(Continuation Sheet)
Payments Made
Amounts may be rounded
to whole dollars.
07/01/22
from
SCHEDULE
SEE INSTRUCTIONS ON REVERSE through 12/15/22 Page 8 of 8
NAME OF FILER LD. NUMBER
Karen Gob for Mayor 2016 1384218
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CMP
campaign pampherriga/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)'
OFC
once expenses
SAL
campaign workers'salaries
CVC
civic dommons
PET
petition circulating
TEL
L. or cable airtime and production costs
FILL
candidate fling@allot fees
RHO
phone banks
TRIO
candidate travel, lodging, and meals
FND
f michan ing events
ROL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
independent expenditure suppoonglopposing others (explain)'
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, email)
NAME AND ADDRESS OF PAYEE
(IF COMMniEE ALSO ENTER tO. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Karen Gob for Mayor 2020
TSF
96.70
' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 96.70
FPPC Form 460 Jan 2016
FPPC Advice: advice@fppc.ca.6ov (8661275-3772)
www.f ri c.ca.Bov