COVER PAGE

Recipient Committee
460
Date Stamp
Campaign Statement CALIFORNIA
FORM
Cover Page
(Government Code Sections 84200-84216.5) E-Filed
07/31/2017
Statement covers period Date of election if applicable: 11:38:49 Page 1 of 8
(Month, Day, Year)
from 01/01/2017 Filing ID: For Official Use Only
165543684

SEE INSTRUCTIONS ON REVERSE 06/30/2017 06/05/2018

through

1. Type of Recipient Committee: All Committees Complete Parts 1, 2, 3, and 4. 2. Type of Statement:
X Officeholder, Candidate Controlled Committee Primarily Formed Ballot Measure Preelection Statement Quarterly Statement
State Candidate Election Committee Committee X Semi-annual Statement Special Odd-Year Report
Recall Controlled Termination Statement Supplemental Preelection
(Also Complete Part 5) Sponsored (Also file a Form 410 Termination) Statement - Attach Form 495
(Also Complete Part 6)
General Purpose Committee Amendment (Explain below)
Sponsored Primarily Formed Candidate/
Small Contributor Committee Officeholder Committee
(Also Complete Part 7)
Political Party/Central Committee

I.D. NUMBER
3. Committee Information Treasurer(s)
1396687
COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) NAME OF TREASURER
Moon for Sheriff 2018 Rita Copeland
MAILING ADDRESS

STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Sacramento CA 95841 (916)348-9100
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY

Sacramento CA 95841 (916)348-9100

MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS

CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE

OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS

(916)348-9111 / [email protected]

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 07/31/2017 By Rita Copeland

Date Signature of Treasurer or Assistant Treasurer

Executed on 07/31/2017 By Shannan Moon

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: [email protected] (866/275-3772)
www.fppc.ca.gov
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 COVER PAGE - PART 2
Recipient Committee
Campaign Statement
Cover Page Part 2
CALIFORNIA
FORM 460
Page 2 of 8

5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee

NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE

Shannan Moon
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION SUPPORT
Sheriff: Nevada County OPPOSE

RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP

Identify the controlling officeholder, candidate, or state measure proponent, if any.
Grass Valley CA 95949
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT

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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
contributions or make expenditures on behalf of your candidacy.

COMMITTEE NAME I.D. NUMBER

7. Primarily Formed Candidate/Officeholder Committee List names of

NAME OF TREASURER CONTROLLED COMMITTEE?
officeholder(s) or candidate(s) for which this committee is primarily formed.
YES NO
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) SUPPORT
OPPOSE

CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
SUPPORT
OPPOSE
COMMITTEE NAME I.D. NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
SUPPORT
OPPOSE

NAME OF TREASURER CONTROLLED COMMITTEE?

NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
SUPPORT
YES NO
OPPOSE
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)

CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary

FPPC Form 460 (Jan/2016)

FPPC Advice: [email protected] (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Campaign Disclosure Statement Amounts may be rounded
SUMMARY PAGE

460
Statement covers period
Summary Page to whole dollars. CALIFORNIA
from 01/01/2017 FORM

through 06/30/2017 Page 3 of 8

SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER

Moon for Sheriff 2018 1396687

Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTAL THIS PERIOD CALENDAR YEAR
Running in Both the State Primary and
(FROM ATTACHED SCHEDULES) TOTAL TO DATE
General Elections
1. Monetary Contributions ........................................... Schedule A, Line 3 $ 2,463.00 $ 2,463.00
1/1 through 6/30 7/1 to Date
2. Loans Received ...................................................... Schedule B, Line 3 3,500.00 3,500.00
5,963.00 5,963.00 20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ $
Received $ $
4. Nonmonetary Contributions .................................... Schedule C, Line 3 0.00 0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 5,963.00 $ 5,963.00 Made $ $

Expenditures Made Expenditure Limit Summary for State

6. Payments Made ....................................................... Schedule E, Line 4 $ 2,597.86 $ 2,597.86 Candidates
7. Loans Made ............................................................. Schedule H, Line 3 0.00 0.00
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 2,597.86 $ 2,597.86 (If Subject to Voluntary Expenditure Limit)

9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 280.85 280.85 Date of Election Total to Date
(mm/dd/yy)
10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0.00 0.00

11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 2,878.71 $ 2,878.71 / / $

Current Cash Statement / / $

12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 0.00
To calculate Column B, add
13. Cash Receipts ................................................... Column A, Line 3 above 5,963.00 amounts in Column A to the
corresponding amounts *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4 0.00 from Column B of your last reported in Column B.
2,597.86 report. Some amounts in
15. Cash Payments .................................................. Column A, Line 8 above
Column A may be negative
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 3,365.14 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
0.00 for this calendar year, only
17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $
carry over the amounts
from Lines 2, 7, and 9 (if
Cash Equivalents and Outstanding Debts any).
18. Cash Equivalents ........................................ See instructions on reverse $ 0.00

19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 3,780.85
FPPC Form 460 (Jan/2016)
FPPC Advice: [email protected] (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A SCHEDULE A
Amounts may be rounded
Monetary Contributions Received
460
Statement covers period
to whole dollars. CALIFORNIA
from 01/01/2017 FORM

through 06/30/2017 Page 4 of 8

SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER

Moon for Sheriff 2018 1396687

IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION

DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED)
OF BUSINESS)

06/09/2017 Jeffrey T. Burget X IND Retired 1,000.00 1,000.00

Nevada City, CA 95959 n/a
COM
OTH
PTY
SCC
06/29/2017 Marlene Dresbach X IND Appraiser 100.00 100.00
Grass Valley, CA 95949 COM Marlene Dresbach
OTH
PTY
SCC
06/08/2017 W.E. Mullis X IND Retired 500.00 500.00
Grass Valley, CA 95949 n/a
COM
OTH
PTY
SCC
06/08/2017 Marcia L. Salter X IND Auditor Controller 100.00 100.00
Grass Valley, CA 95945 County of Nevada
COM
OTH
PTY
SCC
06/08/2017 Christina L. Toft X IND Teacher 100.00 100.00
Auburn, CA 95602 Pleasant Ridge School
COM District
OTH
PTY
SCC

SUBTOTAL $ 1,800.00

Schedule A Summary *Contributor Codes

1. Amount received this period itemized monetary contributions. IND Individual
COM Recipient Committee
(Include all Schedule A subtotals.) ........................................................................................................ $ 1,900.00
(other than PTY or SCC)
OTH Other (e.g., business entity)
2. Amount received this period unitemized monetary contributions of less than $100 ............................. $ 563.00
PTY Political Party
3. Total monetary contributions received this period. SCC Small Contributor Committee
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ 2,463.00

FPPC Form 460 (Jan/2016)

FPPC Advice: [email protected] (866/275-3772)
www.fppc.ca.gov
www.netfile.com
Schedule A (Continuation Sheet) SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may be rounded Statement covers period
to whole dollars.
from 01/01/2017
CALIFORNIA
FORM 460
through 06/30/2017 Page 5 of 8

NAME OF FILER I.D. NUMBER

Moon for Sheriff 2018 1396687

IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION

DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED)
OF BUSINESS)
06/29/2017 Sandy Wick X IND Retired 100.00 100.00
Grass Valley, CA 95945 n/a
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 $ 100.00

*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: [email protected] (866/275-3772)
www.fppc.ca.gov
www.netfile.com
 SCHEDULE B - PART 1
Schedule B Part 1
460
Amounts may be rounded Statement covers period
CALIFORNIA
Loans Received to whole dollars.
from 01/01/2017 FORM

through 06/30/2017 Page 6 of 8

SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER

Moon for Sheriff 2018 1396687

(a) (b) (c) (d) (e) (f) (g)
FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING OUTSTANDING
AMOUNT AMOUNT PAID INTEREST ORIGINAL CUMULATIVE
OF LENDER OCCUPATION AND EMPLOYER BALANCE BALANCE AT
RECEIVED THIS OR FORGIVEN PAID THIS AMOUNT OF CONTRIBUTIONS
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF-EMPLOYED, ENTER BEGINNING THIS CLOSE OF THIS
NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD * PERIOD PERIOD LOAN TO DATE
Shannan Moon Candidate PAID CALENDAR YEAR
Grass Valley, CA 95949 n/a
$ 0.00 $ 3,500.00 0.00 % $ 3,500.00 $ 3,500.00
RATE
FORGIVEN PER ELECTION **

$ 0.00 $ 3,500.00 $ 0.00 11/22/2017 $ 0.00 05/22/2017 $

DATE DUE DATE INCURRED
X IND COM OTH PTY SCC

PAID CALENDAR YEAR

$ $ % $ $
RATE
FORGIVEN PER ELECTION **

$ $ $ $ $
IND COM OTH PTY SCC DATE DUE DATE INCURRED

PAID CALENDAR YEAR

$ $ % $ $
RATE
FORGIVEN PER ELECTION **

$ $ $ $ $
IND COM OTH PTY SCC DATE DUE DATE INCURRED

SUBTOTALS $ 3,500.00 $ 0.00 $ 3,500.00 $ 0.00

(Enter (e) on
Schedule B Summary Schedule E, Line 3)

1. Loans received this period .................................................................................................................... $ 3,500.00

(Total Column (b) plus unitemized loans of less than $100.) Contributor Codes
IND Individual
2. Loans paid or forgiven this period ......................................................................................................... $ 0.00 COM Recipient Committee
(Total Column (c) plus loans under $100 paid or forgiven.) (other than PTY or SCC)
(Include loans paid by a third party that are also itemized on Schedule A.) OTH Other (e.g., business entity)
PTY Political Party
SCC Small Contributor Committee
3. Net change this period. (Subtract Line 2 from Line 1.) ............................................................... NET $ 3,500.00
(May be a negative number)
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. FPPC Form 460 (Jan/2016)
FPPC Advice: [email protected] (866/275-3772)
www.fppc.ca.gov
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 SCHEDULE E
Schedule E
460
Statement covers period
Amounts may be rounded CALIFORNIA
Payments Made to whole dollars. 01/01/2017 FORM
from

through 06/30/2017 Page 7 of 8

SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER

Moon for Sheriff 2018 1396687

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 PAYEE

(IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID

Christopher Kelly FND 100.00

Nevada City, CA 95959

River City Business Services PRO 446.11

Sacramento, CA 95841

Robins, McNamara & Perkins CNS 2,000.00

Nevada City, CA 95959

* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,546.11

Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ 2,546.11

2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ 51.75

3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ 0.00

4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ 2,597.86

FPPC Form 460 (Jan/2016)

FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
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 SCHEDULE F
Schedule F
Accrued Expenses (Unpaid Bills)
Amounts may be rounded
to whole dollars.
from
Statement covers period
01/01/2017
CALIFORNIA
FORM 460
through 06/30/2017
Page 8 of 8
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER

Moon for Sheriff 2018 1396687

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)

(a) (b) (c) (d)

NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD
River City Business Services PRO 0.00 280.85 0.00 280.85
Sacramento, CA 95841

* Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0.00$ 280.85 $ 0.00 $ 280.85
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 $ 280.85

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 $ 0.00

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 $ 280.85
May be a negative number

FPPC Form 460 (Jan/2016)

FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
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