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Home My WebLink AboutGRAY SEMIANN21(1)Recipient Committee Campaign Statement 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. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Pad5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ d Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information L.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 AREA CODEIPHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX / E-MAIL ADDRESS Date Stamp Date of election if applicable: (Month, Day, Year) 2. Type of Statement: ❑ Preelection Statement Semi-annual Statement El Termination Statement (Also file a Form 410 Termination) El Amendment (Explain below) COVER PAGE i' Page 1 of 11 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER MATTHEW MARTIN MAILINGADDRESS CITY STATE ZIP CODE AREA CODEIPHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODEIPHONE OPTIONAL: FAX I E-MAIL 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 ejury under the laws of the State of California that the foregoing an c r t. 1 r^- Executed on ` � By Efate Signa L r `' rr Executed on c� Date By Signature df Cont ina " a Ider. contained herein and lij the attached schedules is true and complete. I or or Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (1an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov COVER PAGE Recipient Committee Date Stamp ® . Campaign Statement .. ' Cover Page Statement covers period Date of election if applicable: Page 1 of 11 7-1-2021 (Month, Day, Year) For Official Use Only from _____ SEE INSTRUCTIONS ON REVERSE through 12-31-2021 _ 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee 0 Recall O Controlled (Also Complete Partli) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Farmed Candidate/ 0 Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Pail 7) 3. Committee Information 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 AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX IE-MAIL ADDRESS 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER MATTHEW MARTIN MAILING ADDRESS CITY STATE ZIP CODE AREACODEfPHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I 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 By Date Signature of Treasurer or Assistant Treasurer Executed on By Date 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 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER COVER PAGE - PART 2 Page 2 of 11 ❑ SUPPORT ❑ OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Identify the. controlling officeholder, candidate, or state measure proponent, if any. 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. NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED CUMMI I rEEY ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NU Y.U. 130x) CITY STATE ZIP CODE AREA CODE/PHONE 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 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 SUMMARY PAGE to whole dollars. Statement covers period e - rY g Summary Page from 7-1-2021 ; - � ' through 12-31-2021 Page 3 of 11 SEE INSTRUCTIONS ON REVERSE _ ��._� -- I.D. NUMBER NAME OF FILER PATTY GRAY FOR CITY COUNCIL 2020 Contributions Received Column A Column B TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE 1. Monetary Contributions................................................... Schedule A, Line 3 $ 00.00 0.00 2. Loans Received...................................................... ......... Schedule B, Line 3 --- 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ 0.00 0.00 4, Nonmonetary Contributions.. ...................... .................... Schedule C; Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ......................... ..Add Lines 3 + 4 $ 0.00 Expenditures Made 6. Payments Made..... ........................................................... Schedule E, Line 4 $ 1250.00 .. T Loans Made .......................... .............................. ............. Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 1250.00 9. Accrued Expenses (Unpaid Bills Schedule F Line 3 0.00 _______-_________ 0.00 10. Nonmonetary Adjustment.........--............................................ Schedule C, Lines 11. TOTAL EXPENDITURES MADE...................................:Add Lines 8+9+10 $ 125000 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 e, Part 2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ -- -- $ 0.00 0.00 $ 0.00 0.00 $ 0.00 $ 2550.00 0.00 $ 2550.00 157.00 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 711 to Date 20, Contributions 0 0 $ Received $ - 21. Expenditures 0 0 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) Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (1an/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 period from 7-1-2021 SCHEDULE A 12-31-2021 Page 4 -of 11 SEE INSTRUCTIONS ON REVERSE through _ I.D. NUMBER NAME OF FILER 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ IND ❑ COM ❑ OTH [] PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC _ El IND COM ❑ OTH El PTY O scC [_1 IND ❑ COM ❑ OTH ❑ PTY ❑SCC ❑IND ❑ COM [� OTH ❑ PTY F1SCC 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 ........................... $ 0 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 0 *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 whole dollars. Statement covers period • . A Loans Received from 7-1-2021 �_ �� e' • through 12-31-2021 Page 5 of 11 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER PATTY GRAY FOR CITY COUNCIL 2020 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING BALANCE O AMOUNT RECEIVED THIS c AMOUNT PAID OR FORGIVEN OUTSTANDING BALANCE AT e INTEREST PAID THIS ORIGINAL AMOUNT OF 9 CUMULATIVE CONTRIBUTIONS OF LENDER (IF SELF-EMPLOYED. ENTER BEGINNING THIS PERIOD THIS PERIOD • CLOSE OF THIS PERIOD LOAN TO DATE (IF COMMITTEE. ALSO ENTER LD, NUMBER) NAME OF BUSINESS) PERIOD PERIOD M®..- --- "— CALENDAR YEAR __--____—__ _, ❑ PAII? RATE ❑ FORGIVEN PER ELECTION** DATE DUE DATE INCURRED t• ❑ IND ❑ COM ❑ OTH ❑PTY ❑ SCC. CALENDAR YEAR ❑ FAID $ ❑ FORGIVEN PER ELECTION** RATE $ — $ DATE DUE DATE INCURRED t ❑ IND ❑ COM El OTH ❑PTY ElSGC ❑PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION** RATE 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.) 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.).............................................................. NET $ Enter the net here and on the Summary Page, Column A, Line 2. 0 0 0 (May be negative number) (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 *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. )I FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Nonrnonetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period from 7-1-2021 SCHEDULE C SEE INSTRUCTIONS ON REVERSE _�_� 12-31-2021 ._ through Page 6 of 11 NAME OF FILER I.D. NUMBER PATTY GRAY FOR CITY COUNCIL 2020 IF AN INDIVIDUAL, ENTER AMOUNT/ TIVE TO PER ELECTION DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF FAIR MARKET 7CAEND TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR CODE* (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE R YEAR (IF REQUIRED} (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS} DEC 31.) IND ❑ COM [� OTH [� PTY ❑ SCC ❑ IND ❑ COM ❑ OTH n PTY ❑ SCC El IND ❑ COM OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 0 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. 0 (Include all Schedule C subtotals.) ............................................. ......... ............. ................................... - ............ ..$ 2. Amount received this period — unitemized nonmonetary contributions of less than $100—................... ............ $ 0 3. Total nonmonetary contributions received this period. (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 SCHEDULED Summary of Expenditures Amounts may be rounded Statement covers period Supporting/Opposing Other to whole dollars. 7-1-2021 low 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. 1 -DEC, 31) (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 2500.00Contribution Contribution - ❑ Independent m Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent - — ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 2500,00 z z;, Schedule D Summary 2500.00 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.)... ....... - ........................... ............... $ 2. Unitemized contributions and independent expenditures made this period of under$100................................................................_................... $ 3. Total contributions and independent expenditures made this period. Add Lines 1 and 2. Do not enter on p p p ( the Summary Page.)....... Y 9 ).......... TOTAL.. $ 2500.00 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppe.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Payments Made INSTRUCTIONS ON REVERSE 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 RAID 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 $ U Schedule E Summary 0 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............... ......... ............ ............ ........ ................... ..... .............. ............ ... $ 2. Unitemized payments made this period of under $100........................ 90.00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)... ............................ .......... ................................ ...: $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 0 FPPC Form 460 (1an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEF Schedule F Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER PATTY GRAY FOR CITY COUNCIL 2020 CODES: If one of the following codes accurately describes the payment, you may enter the code. CMP campaign paraphernalia/misc. MBR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)* OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads Statement covers period from 7-1-2021� through 12-31-2021 Page 9 of 11 I.D. NUMBER Otherwise, describe the payment. 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, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER LD. NUMBER) DESCRIPTION OF PAYMENT BALANCE_ BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) 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 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 $ 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 on the 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 Page10 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 la OUTSTANDING (b) AMOUNT c REPAYMENT OR OUTSTANDING e Ifl 9 CUMULATIVE OF RECIPIENT OF sEIM EOFBUST D, ENTER BALANCE BEGINNINGTHIS LOANEDTHIS FORGIVENESS BALANCE HI Ct_OSEOFTHIS INTEREST RECEIVEDNAME UNTOF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) of suslNess> PERIOD THIS PERIOD FORIGINAL OAN TO DATE El PAID CALENDAR YEAR RATE Q FORGIVEN PER ELECTION* DATE DUE DATE INCURRED PAID CALENDAR YEAR $ RATE ❑ FORGIVEN PER ELECTION" DATE DUE DATE INCURRED 'Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be 0 $ 0 $ 0 $ 0 { reported on Schedule E. SUBTOTALS $ (Enter (e) on Schedule I, Line.3) Schedule H Summary 0 1. Loans made this period....................................................................................................................................................$ (Total Column (b) plus unitemized loans of less than $100.) 0 2. Payments received on loans.......... .............. - ................ ................. ................................ ................ $ - (Total Column (c) plus unitemized payments of less than $100.) 0 3. Net change this period. (Subtract Line 2 from Line 1.)............................................................................................NET $ _ (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a. negative number) *'If Required FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov o ' no*souus| "~..^~~~~..�� __—_ Miscellaneous Increases to Cash to whole dollars. Statement covers period from 7-1-2021 12-31-2021 through Page!,- of 11 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER PATTY GRAY FOR CITY COUNCIL 2020 DATE FULL NAME AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT AMOUNTOF RECEIVED ff COMMITTEE, ALSO ENTER LD, NUMBER) INCREASE TO CASH 08/03/2021 KERN COUNTY REPUBLICAN PARTY REFUND OF OVERPAYMENT 1250.00 Attach additional information onappropriately labeled continuation sheets. SUBTOTAL $ 1250,00 2. Uniternized increases to cash of under $100 this period. ..... ......... O —. $ _ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................... ....... ....... $ O 4.Total miscellaneous increases hncash this period. (Add Lines 1.2.and 3.Enter here and onthe 125080 Summary Page, Line 14]... ...................................... .......... —...... --- ......... ........................................ ..... TOTAL $ FprcForm 4sn(Jan/zo1s)) FPPC Advice: advice@fppcca-gov(8a6/z75-3ro}