CandidatesCampaign Contribution Disclosure Report Please review all the rules for Campaign Contributions in the Election Manual including IX. Other Campaign Rules and XI. Challenges to the Election. Below are two key rules to keep in mind when completing the Campaign Contribution Disclosure Report (CCDR). IX. G. Candidates (including prospective candidates) shall not seek or receive financial support or any other form of support (including, without limitation, endorsements, services, or materials) for his or her candidacy from any labor organization or employer, regardless of the relationship between that labor organization or employer to UTLA. Candidates shall not seek or receive financial support, or any other direct or indirect support of any kind (except an individual’s own volunteered personal time) from anyone who is not a member of UTLA, a friend or family member of the candidate. Violation of this rule shall render a candidate ineligible to run for or hold office for a period of one year. Candidates must report any and all financial or material support pursuant to Section H of these rules (“Campaign Contribution Disclosure Reports”). IX. H. 5. Originals of the Campaign Contribution Distribution Reports shall be retained for four years after the end of the election and shall be made available to any UTLA member for review at UTLA’s offices, upon request. The Campaign Contribution Disclosure Reports of candidates and committees shall be published in summary form on the UTLA Elections website. Who should file this report This statement covers all contributions and expenses incurred for the 2022-2023 UTLA General Election campaign including carryover funds from the previous UTLA Election, up to the vote count day. A separate report must be submitted for any run-off or re-run elections. Even if a candidate is reporting as a Political Committee, the individual candidate must submit a Disclosure Report even if it shows 0 contributions and 0 expenses. If a candidate contributed money to their Political Committee but raised that money through private fund raising, those contributions must be reported on their individual Disclosure Report. Report Start Date of Statement (required) End Date of Statement (required) Filing As An individual that does not have Political CommitteeAn individual Disclosure Report for a candidate who is part of a Political CommitteeAn individual with a Political Committee only supporting one candidateA slate of candidates supported by one Political Committee Registered as a political committee? You must first complete the Political Committee Registration Form listing the participating candidates and the office sought. Name of Candidate or Committee (required) If Committee, Name of Individual Completing This Form For a Committee Office or Offices Being Sought (required) Non-LAUSD Email (required) Street Address (required) City (required) State (required) Zip Code (required) Phone Number (required) Attachment Prefer to send a single document instead of using the form below? If so, attach your document here and skip to "I DECLARE..." section at the bottom. If not, proceed with each section below. Document 5mb limit. DOC, DOCX, PDF, or XLS. Income All contributions must come from UTLA Members, family, or friends. This requirement was not in place during the previous election. I. Carryover Funds Description Amount Total from the previous election that will be used in this election, if any II. Monetary Contributions For each row, include the name and relationship for individual contributor giving $25.00 or more. If an individual makes several donations, list the total amount of all their donations. Address and contact information must be available upon request from the Elections Committee. If candidates are part of a Political Committee and make contributions to the Political Committee, list each candidate’s name and the amount they contributed. If an individual candidate fundraises to pay for their contribution to their Political Committee, they must show those contributions on their individual Campaign Contribution Disclosure Report. NEW FOR 2022-2023: You must include the name and their relationship on the same line. Example: John Doe (UTLA Member) ... $25 Jane Doe (Friend) ... $50 Name + Relationship (UTLA Member, Family, or Friend) Amount III. Fundraisers NEW FOR 2022-2023: You must include the date of event and name of host on the same line. Example: 9/1/2022 John Doe (UTLA Member) ... $250 10/1/2022 Jane Doe (Friend) ... $500 Date of Event + Name of Host + Relationship (UTLA Member, Family, or Friend) Amount Expenses List all the expenses you incurred during your campaign, including any estimates of any bills yet received. Examples: the cost for a website or other electronic media, printing, postage and mailing costs, mileage to visit schools, reception costs for food, drinks, paper goods, entertainment, stickers, and buttons, etc. Item Name Amount Non-Monetary Contributions For each fair market value item is over $25.00: include a description of the contribution, name of contributor, and their relationship to the candidate or Political Committee. Allowed examples: paper goods, flyers, food or drink, photography, etc. Not allowed examples: sharing phone lists of UTLA members from another organization, sharing chapter chair or cluster phone lists. NEW FOR 2022-2023: You must include the description of contribution, name of contributor, and their relationship on the same line. Example: Website (John Doe, UTLA Member) ... $500 Photography (Jane Doe, Friend) ... $250 Description of Contribution + Name + Relationship (UTLA Member, Family, or Friend) Amount Totals The following is automatically calculated based on the number(s) in the "amount" columns of the respective sections above. Total Income __________ Total Expenses __________ Total Non-Monetary __________ I certify that all contributions, except the carry over funds, came from UTLA members, family, or friends. I also declare the above assignment information to be true to the best of my knowledge. (Required) Checking this box represents your e-signature I, __________, affirm under penalty of perjury that all of the information provided by me in this form is correct to the best of my knowledge. __________ Signature of Candidate __________ Date Signed This form goes to Tara Thomas of the UTLA Elections Committee, who can also be reached at tthomas@utla.net or 3303 Wilshire Blvd., 10th floor, Los Angeles, CA 90010 or 1–213–637–5165. Δ