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OVER PAGE
Typa
er
in ink
1 CI ITYD
applicabl
5 84218 94200
Statement
Irom
covers
patlatl
Date of election II
7 S 4 P
Alt lo 4
Page
of Ony
2009 01 07 2009 19 09
2
a 3 l
i
through
An
COmPIet a cmamm
Type
of Statement CuaMtly
Statement
Committee
Election Committee
pdmarlly FOrmetl
Committee
PrealecOOn Salamenl
Semiannual Statement
Q ControAed Q Sponawetl
AAacuAmele Perce
Special
TermineOOn Statement
Also
Report SupplamentalPreelec0on
Ageph Statement FOrrn 495
OtldYear
Tarmne9on
Purpose
COmminae
Amentlment
Explain below
Committee Information
L0 NUMBER
1309990
Treasurer
NAME nF TPEASURER
Rothman for
Mayor
Klnde Durkee
MAILING ADOPESS
1212 5
STREET ADORE58 INO P BO O I
LITT
Victory
BI
STATE ZIP COOE AREA COOEIPMONE
Burbank
ZIP CODE
AREA
CA
TREg6URER
IF ANT
91502
COOEIPHONE
NAME OF ASSISTANT
Pomona
MAILING gDDRE66
CA
IF pIFFERENT NO ANO
STREET
91766
OR P BOX O
1212 S Vlctary BI
CITY
6TATE
21P LODE
CIN
6TgTE
21P
CODE
AREA CODFJPHONE
Burbank
OPTIONAL
FA
CA
6M411 ADDRE39
81502
MAIL E ADORE66
Veriflcatlon
I have used ell reasonable tllllgence In prepatlng and reviewing this statement antl to the oi bes my knowledge the Informal undarpenaly of periuryuntleriha laws oRhe State of Callfomla that Naforegoing is true and colred
9 Exacal
an
hmntelnetl herel
2009 22 09
2009 22 09
m o
sY
Kinds Durkee
N tumr e R Avel
Exealad on
By
Elliott Rothman
amemconemaro sw
aimre cm r
Exeomee
an
ev
suia eammate rwmr marememomunsolll sie Memun Pmponem
Exewled
on
IB u
BY
elaMaoun EBrewrealLmeWap OaceMmr Cer4aau S Pmpomm
FPPC Ferm 480 tJanuary 05 A6 FPPC TPII Nelpline 88 WFPPC iBBLZTSBTR Free Stets pl Cellbrnla
Type
or
in ink
of
Officeholder
or
Primarily
Elliot Rothman
OFFICE SOUGHT OR HELD LOCATION AND DISTRICT NUMBER IF APPLICABLE INCLUDE OR BALLOTNO LETTER
JURISDICTION
SUPPORT
oPPOSE
Mayor City
t2i2
of Pomona
NO
AND
STREET
CITY
STATE
ZIP
ICtOry t BI
Burbank
CA
J150Q
Itlentify
the
or
state measure
proponent if
any
t Li aAy ommirceea
to
are
on
controlled by you
behal oI your
contribu0ons
make
expendifwes
receive
DISTRICT NO IF ANV
COMMITTEE NAME
LD NUMBER
NAME OF TREASURER
CONTROLLED COMMmEE
TES NO
Primarily
List
names
s ceholtler o
s candidate
primarily
formed
COMMITTEEADDRESS
STREETAWRESS
NO
PO
BOX
OPPOSE
CITT STATE ZIP CODE AREA COpEIPHONE
COMMITTEE NAME
SUPPORT OPPOSE
NAME OF TREASDRER
CONTROLLEDCOMMITTEE
VES
SUPPORT
OPPOSE
NO
COMMITTEEADDRESS
STREETADORESS
NO PO BOX
CITY
STALE
ZIP CODE
necessary i
Helpllne
FPPC 666IABK
Januaryl06 3 1 6 8662
State of California
Campaign
Disclosure Statement
TYPe
or
in ink Statement
covers
SUMMARY PAGE
Summary Page
period
from
0112009 07 2DD9 19 D9
3
NUMBER
tNOUgh
Page
I n
Of
1309990
ColumnB
Contributions RBCeiVed
1 2 3
4
esl rmomarrnweoscnew
ooeTe croru
raa AtenoAa
Monetary
Contributions
5cnedure A maa
00 0
00 0 00 0
g
scnedwe e mea
Aae
00 0 00 0 00 0
00 0
z ripest
00 0
20 Contributions Receivetl 5
Nonmonetary
Contributions
00 0
00 0
p1
Expendltures
Matle
TOTALCONTRIBUTIONS RECEIVED
Expendltures Made
6 7 8 9 tL
Payments Matle
Loans Made
srnedwe E Linea
46 1704
35 4423 00 0
35 4423
Expenditure
Candidates
Limit
Summary
for Slate
sonaewe n uaea
Aad ones 6
00 0 48 1704 00 0
00 0
g
33 Cumulative
Expentlitures
Matle
SUBTOTALCASH PAYMENTS
iinez
OD O 00 0
g
Date of Election
Total to Date
Nonmonetary AtljustmenL
scnedmeo uaea
to g
mmldtllyy
48 1704
35 4423
Beginning
Cash
Balance
Previous
summary Page
une to
13 17665
To calculate Column B atltl
13 Cash Receipts
00 0
1 unea
OD D
48 1704
5
corresponding
amounts
Payments
Add ones
65 15980
previous
terminatlon statement
scnedure a Portz
00 0
If this Is the first report being flletl for this calendar year only carry over the amounts
perlotl
amounts
Cash
18 19
Cash
8
5
00 0
DD D
arum y
Linea z
and g
ir
Outstanding
Helpllne
FPPC 8661ASK
3 53 186612
Schedule D
scHEIwLEU
Summary
of
Expenditures
Type
or
print in ink
Statement
covers
U PP ortin 9
period
from
2009 01 07
Page 4
of
2009 19 through 09
OF FILER
D I NUMBER
Rothman For
Mayor
NAME OF CANDIDATE OFFICE AND DISTRICT OR MEASURE NUMBER OR LETTER AND JURISDICTION
ORCOMMITTEE
1309990
CUMUTATIVETO DATE PER ELECTION
PATE
ttPE Of PAYMENT
DESCRIPTION IF REDUIRFD
AMOUNT THIS
PERIOD
TO DATE IF REQUIRED
Jason Rothman
Monetary
Conldbutian
00 1000 G2009
00 1000
2009 02 09
Nonmonetary
Contribution
1000
Support
Oppose
Nonmonetary
Contribution
Support
Oppose
Nonmonetary
Contribution
ExpendlWre
SUBTOTAL
00 1000
Schedule D
Summary
ex P enditures
00 1000 0 00 1000
independent expenditures
ex P enditures
the Summa ry Pa 9 e
TOTAL
Januaryl0fi
SCHEDULEE
Type
Amounts
or
in ink
may be rounded
Statement
from
covers
period
to whole dollars
0112009 07 D9f19f2gD9 5
O
6
IhrOYgh
Pdg
LD
O1
NUMBER
Rothman For
Mayor
of the
1309990
CODES
QvP CNS
CTB
If
one
following
codes
accurately describes
the
NiER
payment
protluction
costs
campaign pamphemalialmisc
campaign
consultants
member communications
antl appearances
fi PG CFC
returned contdbulians
offce expenses
CVC
FlL FND IW
civic donations
cantlitlate
PcT
fees
petition circulating
phone
banks and survey research and messenger services
SAL TEL
TRC TRS
protluclion
costs
ballot filing
events
funtlraising
Prp POL
oNers
lodging
polling
explain
FOS
TSF
wndldatelsponsor
LEG
LfT
legal defense
cempaiBn
Illereture antl
FRO
VOT
VvEB
registration
mallings
HZf
Informetlon
technology
casts
Internet email
NAME ANO
eureai rlrcomrnmeeals
CODE
OR
DESCRIPTION OF PAYMENT
AMOUNT PALO
Associates
Victory
61
CA
PRO 91502
64 202
Burbank
Associates
Victory
BI
PRO CA
Fair CMP 91502
84 101
Burbank Los
Angeles County
1 110 W McKinley Av
Pomona s n Paym
that are contributions
00 400
CA
or
91768
must also be summarizetl
on
intlepentlent expenditures
Schetlule D
SUBTOTALS
48 704
Schedule E
1 Itemized
a
Summary
menu made this
eriod
48 1704 0
2 Unitemized
loans
Enteramount from 12
Add Lines
Line 6
TOTAL
48 1704
January105
Schee E
Type
or
in ink
coNT1 E ED scI
Statement
nom
covers
period
I
through
pag9
of
FILER
D NDMBER
Rothman For
Mayor
of the
1309990
CODES
CNP CMS CTB CVC
FIL FND Ifs
If
one
following
codes
accurately
describes the
MBF2 MrG
payment
meetings
member communications
office expenses
production
costs
relumed contrbutions
explain nonmonetary
OFC
Pd
dvic tlanations
petition circulating
TEL
TRC
production
costs
FiJ
POL
phone banks
palling and survey research postage tlelivery and messenger services
fundraising
events
TRS
TSF
and meals
same
POS
PRO
PRr
candidafelsponsor
LEG
Lfr
legal defense
VOT
WEB
ads
intemet a mail
AMOONT PAID
I n
PgYEE NpM9ERt
CODE
OR
DESCRIPTION OF PgYMENT
Sequoia
Glen CA
Pomona
91766
ID 1321232
are Paymentstha
on
Schedulo D
SUBTOTAL
00 1000