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HomeMy WebLinkAboutGRAY SEMIANN21Recipient Committee Date Stamp I COVER PAGE Campaign Statement CALIFORNIA ' • i Cover Page FORM SEE INSTRUCTIONS ON REVERSE Statement covers period from 7-1-2021 through 12-31-2021 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ State Candidate Election Committee 0 Recall ,Also Complete Part {; ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO CC PATTY GRAY FOR CITY COUNCIL 2020 ❑ Primarily Formed Ballot Measure Committee 0 Controlled ❑ Sponsored ;:Also Complete Par{ 5, El Primarily Formed Candidate/ Officeholder Committee (Also Complete Pad,') I.D. NUMBER STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX / E-MAIL ADDRESS Date of election if (Month, Day, Page 1 of 11 0* 3 For Official Use Only . u' I; i CLERK 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 MATTHEW MARTIN ❑ }Quarterly Statement ❑ Special Odd -Year Report MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER. IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best# my knowledge the certify under penalty of eriury unider the laws of the State of California that the foregoing ' an c r I. Executed on l gy ete - Signr Executed on Date By Sinnathirar contained herein and its the attached schedules is true and complete. I or or Executed on By — Y Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (!an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Date Stamp COVER PAGE Campaign Statement imm Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7-1-2021 through 12-31-2021 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. Z Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) ❑ General Purpose Committee O Sponsored O Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Comptele Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) PATTY GRAY FOR CITY COUNCIL 2020 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Date of election if applicable: Page I of 11 (Month, Day, Year) For Official Use Only 2. Type of Statement: ❑ © ❑ Preelection Statement Semi-annual Statement Termination Statement ❑ (Also file a Form 410 Termination) Amendment (Explain below) ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER MATTHEW MARTIN MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 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 true and correct.. Executed on 1/31/2022 B Date y Signature of Treasurer or Assistant Treasurer Executed on g Date y Signature of Controlling Officeholder. Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure. Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL/BUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP 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) COVER PAGE - PART 2 Page 2 of 11 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 officeholder(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 CITY STATE ZIP CODE AREA CODE/PHONE Attach 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 to whole dollars. Summary Page Statement covers period from 7-1-2021 SUMMARY PAGE 12-31-2021 Page 3 of 11 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER PATTY GRAY FOR CITY COUNCIL 2020 Contributions Received Column A TOTAL THIS PERIOD Column B Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions.... . ...... ...... ................. ............. . schedule A, Line 3 $ 0.00 $ 0.00 0.00 0.Q0 111 through 6/30 7t1 to Date 2. Loans Received. ............... ...................... ............. .......... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS- ........................... Add tines 1 +2 0.00 $ 0.00 $ 20. Contributions 0 0 Received $ $ 4. Nonmonetary Contributions ............................................ Schedule c, Line 3 0.00 0.00 21. Expenditures 0 0 0.00 5. TOTAL CONTRIBUTIONS RECEIVED ........ ....... .............. .-Add Lines 3+4 $ $ 0.00 Made $ $ Expenditures Made 6. Payments Made... ............... ...... ........ .............. ... Schedule E, Line 4 $ 1250.00 7. Loans Made....................................................................... Schedule H, Line 3 0.00 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 1250.00 9. Accrued Expenses (Unpaid Bills) -- ........ ... ..... -............. Schedule F Line 3 0.00 10. Nonmonetary Adjustment......................................................... Schedule c, Line 3 0.00 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 1250.00 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 4469.13 13. Cash Receipts........................................................... column A, Line 3 above 0 14. Miscellaneous Increases to Cash ......... ..... -- .......... ...... Schedule 1, Line 4 1250.00 15. Cash Payments .................. ........... ................ ....... . Column A, Line 8 above 2500.00 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 3219.13 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0 19. Outstanding Debts .............................. Add Linen + Line 9 in Column B above $ 0 $ 2550.00 0.00 $ 2550.00 1.57.00 0.00 $ 2707.00 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. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 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) *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers from 7-1-2021 SCHEDULE A through 12-31-2021 Page 4 of 1.1 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER PATTY GRAY FOR CITY COUNCIL 2020 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 CALENDAR YEAR TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ Schedule A Summary 1. Amount received this period — itemized monetary contributions. 0 (Include all Schedule A subtotals.).. ...................................................... ................. .............................. $ — 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 3. Total monetary contributions received this period. 0 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)...................... TOTAL $ _ 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 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 Schedule B — Part 1 to who dollars. ^ Statement covers period Loans Received 7-1-2021 - • - from through 12-31-2021 Page 5 of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I . NUMBER PATTY GRAY FOR CITY COUNCIL 2020 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a(b) OUTSTANDING AMOUNT c AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL g CUMULATIVE OF LENDER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED. ENTER. BEGINNINGTHIS PERIOD THIS PERIOD * CLO HIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD PERIOD ❑ .PAID CALENDAR YEAR $ S A $ g RATE ❑ FORGIVEN PER ELECTION** $ S $ $ $ DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR S S h 5 S ❑ FORGIVEN PER ELECTION** RATE S S S t ❑ IND ❑ COM ❑ OTH ❑PTY ❑SCC $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION** RATE g $ S S $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0 $ 0 $ 0 $ 0 Schedule B Summary 1. Loans received this period ........................ ......................$ (Total Column (b) plus unitemized loans of less than $100.) 0 2. Loans paid or forgiven this period.........................................................................................................$ — (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 0 1 Net change this period. (Subtract Line 2 from Line 1.).............................................................. NET $ Enter the net here and on the Summary Page, Column A, Line 2. IMay be a negative number) *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. (Enter (e) 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 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE PATTY GRAY FOR CITY COUNCIL 2020 Amounts may be rounded to whole dollars. Statement covers period from 7-1-2021 through 12-31-2021 SCHEDULE C Page 6 of 11 I.D. NUMBER IF AN INDIVIDUAL, ENTER CUMULATIVE TO FULL NAME, STREET ADDRESS AND AMOUNT/ PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF DATE ZIP CODE OF CONTRIBUTOR * FAIR MARKET TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR (IF REQUIRED) NAME OF BUSINESS) (JAN 1 - DEC 31) 5cneauie c Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)... ...........$ 0 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ................ ..........$ 0 3. Total nonmonetary contributions received this period. 0 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.).....................TOTAL $ _ *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 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D SCHEDULE D Summary of Expenditures Amounts may be rounded Statement covers period - to whole dollars. s Supporting/Opposing Other 7-1-2021 0 -'� • Candidates, Measures and Committees from through 12-31-2021 Page 7 of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER PATTY GRAY FOR CITY COUNCIL 2020 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED} PERIOD CALENDAR YEAR TO DATE OR COMMITTEE {JAN. 7- DEC. 89} (IF REQUIRED) 7/03/2021 Kern County Republican Party ® Monetary 1250.00 1250.00 Contribution Contribution ❑ Independent ® Support ❑ Oppose Expenditure 7/16/2021 Kern County Republican Party Monetary 1250.00 2500.00 Contribution Contribution ❑ Independent ® Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 2500.00 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ...................... .............................. $ 2500.00 2. Unitemized contributions and independent expenditures made this period of under$100.................................................................................... $ 0 3. Total contributions and independent expenditures made this period. Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL.. $ 2500.00 P P P ( rY 9 } .....,.... FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Payments Made QFF INRTRI Ir'.TIrINS nm RFl/FRRF AME OF FILER PATTY GRAY FOR CITY COUNCIL 2020 Amounts may be rounded to whole dollars. Statement covers period from 7-1-2021 through 12-31-2021 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 8 of 11 I.D. NUMBER CMP campaign paraphernalia/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 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 FND 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 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, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 0 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)................................................................................. 2. Unitemized payments made this period of under$100................. ........._................................................................................... 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)................................................. 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)............ ............................ $ 0 90.00 .......................... $ 0 ............... TOTAL $ 0 FPPC Form 460 (Jan/2016)) FPPCAdvice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEF Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FILER PATTY GRAY FOR CITY COUNCIL 2020 Amounts may be rounded to whole dollars. Statement covers period from 7-1-2021 through 12-31-2021 Page 9 of 11 I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/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 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 FND 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 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, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0 $ 0 $ 0 $ 0 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ...... ....................................INCURRED TOTALS $ 0 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.)..................... PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 0 onthe Summary Page, Column A, Line 9.)................................................................................................................................................................................... NET $ May be a negative number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule H Loans Made to Others* Amounts may be rounded to whole dollars. Statement covers period from 7-1-2021 SCHEDULE H through 12-31-2021 Page 10 of 11 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER PATTY GRAY FOR CITY COUNCIL 2020 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING (b) AMOUNT c REPAYMENT OR e OUTSTANDING M ORIGINAL g CUMULATIVE OF RECIPIENT (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS LOANED THIS FORGIVENESS BALANCE AT CLOSE OF THIS INTEREST RECEIVED AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PrRinn PERIOD THIS PERIOD* PERIOD LOAN TO DATE ❑ PAID CALENDARYEAR S $ $ $ ❑ FORGIVEN RATE PER ELECTION** $ $ $ $ $ DATE DUE DATE INCURRED $ IS *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. SUBTOTALS $0 ij PAID CALENDAR YEAR S S $ $ RATE ❑ FORGIVEN PER ELECTION** $ 5 S DATE DUE DATE INCURRED $0 Is Is (inter (e) on Schedule 1, Line 3) Schedule H Summary 0 1. Loans made this period....................................................................................................................................................$ — (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans............................................................................................................................................$ (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. Subtract Line 2 from Line 1. 0 9 p ().......................................................................................,....NET $ _ (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number) **If Required FPPC Form 460 (1an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Srharl� Ila 1 SCHEDULEI to whole dollars. Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE Statement covers period from 7-1-2021 through 12-31-2021 A • - A , FORM FOU Page 11 of 11 NAME OF FILER PATTY GRAY FOR CITY COUNCIL 2020 I.D. NUMBER DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH 08/03/2021 KERN COUNTY REPUBLICAN PARTY REFUND OF OVERPAYMENT 1250.00 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 1250.00 c e u e I Summary 1. Itemized increases to cash this period..........:..........................:.....................................................:.,.................:..... $ 1250.00 2. Unitemized increases to cash of under $100 this period.................................................................................................$ 0 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).).......................................$ 0 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the 1250.00 Summary Page, Line 14.).................... ................................................. ....................................................... TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov