HomeMy WebLinkAboutDICKERSON SEMIANNUAL11(1)Recipient Committee
Campaign Statement
Cover Page
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Type or print In Ink
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SEE INSTRUCTbNS ON REVERSE Ithrough 61. 1!
1. lypeJot
Recipient Committee: Aa Commlthew- complete Parte 1, 2, a, am♦
[j{/OMoaholdar, CaMleate ControPod Canmaee Pdmarly Formed Ballot Measure
Q BIab GMldate Election Committee Cammtitee
Q Recall Q Cpntroged
(AIn DanpNNPma
Q Sponsumd
❑ Oenena Purpose Commiee
Pue, warwro
Q Sponsored
0 Primarily Fomted Candhlatel
Q Sm00 ConblbulorCammtitee
OMcahower Committee
Q Pdehzi Pady/Central Committee
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3. Committee Information
uta of eleodon If applicable:
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NAAIE OF ASSISTANT ROMUR . IF ANY
NO ORESS IIF MFREREm NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA COO&PHONE
OPTIONAL: FAX I EMAIL ftuu Eye
CITY STATE ZIP CODE AREA COOEIPHONE
OPTIONAL. FAX I E-MAIL ADDRESS
I new, used all reasonable tlifgeno, In preparing and reviewnt, MIs slatement and to91e beet of myarmwledge the
underpenelyofperjuryu,dermal I PaleofCalMamle that Me foregotig is Into and Correct.
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Recipient Committee Type or print In Ink COVER PAGE - PART 2
Campaign Statement • 1
Cover Page — Part 2
Page of
S. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHooER OR CANDIDATE NRLIEOFBALLOTMEASURE
Nlrbv _Ot "XBTM /21
OFFICE 8000HT OR HffLD(INCLUDE LOCATION ON ADISTRICT NUMBER IF APPLN;ABLEI BALLOTNO.ORLETTER JURISDICTION nSUPPORT
OPP0.4E
REBIDENTIAl1BUMNESS ADDRESS (NO. AND STREET) ! F ` (A SfAIE ZIP
/ NAME OF OFFILEHOL➢ER, CAI-UIMTE. OR PROPONEM
Related Committees Not Included in this Statement: Ilstmy ammateee
net hlclutleh M fh, spMMnt fhatare cmbeeaC by you or •re pMnarhy rams to recelea
cmmeffiene or make espen,Tfrm On hehef a four cans y.
COuun`TEENAuE I.D. NUMBER
NAME OF TREASLRERCONTROLIID CDMWTfEEt
p YES ❑ NO
COMMIITEEADDPESS STREETADDREES MO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
COMMRTEENAME LO. NUMBER
NAMEOFTREASURER CONTROLL®COMMITLEEI
O YES ❑ NO
COMMIITEEADOPE8.4 STREErAcusess (NO P.O. BOX)
OFFICE SOUGHT OR HELD DMTRICT NO. IF ANY
7. Primarily Formed CandidatelOfecehoider Committee Llat.nnw or
ofAn%fWd r(,N w aaf&Ws) Tor "h fhs ammlfa k InhO Nly romeLL
MIME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
Q SUPPoRT
ElOPPOSE
NANE 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 CANWDATE
OFFICE SOUGHT OR HELD
SUPPORT
OPPOSE
CRY SWTE ZIP CODE AREA CODEPHONE Aeach conf rustlon shell If neeems y -
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Loans R Amounts may be rounded S element c I For
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NAME OF FlLER
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FULL"MRSTREETADDRESSANDZIPCOCE
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MTEDUE
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3
SUBTOTALS $ S $ $
-�..�-...o •. wnnnary
1. Loansrecelvedthis period ........................
...........................................
(Total Column (b) plus unitemized loans of less than $100100.)
2. Loans paid or forgiven this period ..............................................................
ficirgve n
(total Column (c) plus loans under $100 paid arforgiven.)
(include loans paid by a third parry that are also Itemized on Schedule A.)
3. Net change this period. (Subtract Lina 2 from Line 1.) ................
Enter the net here and on the Summary Page, Column A, Line 2.
AmMrsquted.ounb b "m ar Pent by amlhar party aid' muel be -"r4d on Shcpdule A.
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11
7
SdadEeElEny
1Cordibulor Was
$ ... —
IND- Ird idual r
........
COM- Reelpled Commivalt
(ot er than PTY or SCC)
0TH -.Other (e.g., business entity)
NET $
PLY-Polllloel Party
SCC-SmetCanbOutorCommMee
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11
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13
Campaign Disclosure Statement
Type or print In Ink
SUMMARY PAGE
statement ..TeIF pesos
Summary tie Pa Amounts may be rounded
sullen.
o whole
A gill
11
from
IdDli Page
SEE INSTRUCTIONS ON REVERSE
through
of79
NAME OFRER
,�_1'
,ra-t �GQ_ P {r Q\
CcN`1r�/11'��Q�C—
1.0.
1 t2I
Contributions ReceivedColumnA
Column
Calendar Year Summary for Candidates
iO11"a'pp10p
pmoxenu�menmhgt
CNE�0""`''""
io a.roava
Running in Both the State Prima and
1.
'�
G1:IteregEleptlonSry
Monetary Contrbutions........................................... sardwAlNB3
E
E
2. Loans Received...................................................... schedlx & urea a
to enough arse 711 to Date
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Aedtaraf.2
S
'®—
g
20. Conhibuflons
ReceNea
4. Nonmonetery Contributions .................................... saradec. urs
EE
21. Expendeuma
5. TOTALCONTRIBUTIONS RECEIVED ........................... Adfuna9.4
$�—
E
Meas S �
Expenditures Made
Expenditure Limit Summary for State
8. Payments Made ....................................................... sardwe E,lNe4
E
19'
E
Candidates
7. Loans Made............................................................. SunhJU Rume3
e. SUBTOTALCASH PAYMENTS .................................... AMUnu a.7
E
4�)•
S
12. Cumulative Expenditures Made•
msrmamwa.mnayenesmumn
9. Accrued Expenses (Unpaid Bills)...............................Sone Furs
Date ofElection Total to Dab
10. Nonmonelery, Adjustment .......................................... saadda C,,,o 3
(mnVdd/yy)
11. TOTAL EXPENDITURES MADE................................Amuua 8. a. 10
$
^O—
E
—J—J_ $
$
Current Cash Statement
12. Beginning Cash Balance ....................... n.dmrsimm.ryP.p.,lmefe
$
To calculate Column B. add
13. Cash Receipts ................................................... Ca4mnAur3aeom
amount in Column A to the
14. Miscellaneous lnceema to Cash ........................... 3rAedas t, lmae
corresponding amounts
from Column S of your last
•Amountsd this section may be digemnllem amounts
reported In Column B.
15. Cash Payments .................................................. CammoAfAr seeds
report Some amounts In
Column A may be negative
18. ENDiNGCASHBALANCE .......... Addunee f2. f3. u, dao au4tr f U m
E
Sgures that should be
It Mia Is a ferminaadn summand, Line 18 must to z
subtracted from previous -•
arrouMe. If due Is
period period
tlr Erol neon being Std
17, LOAN GUARANTEES RECEIVED ...........................
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (it
,
Cash Equivalents and Outstanding Debts
78. Cash Equivalents ........................................ see dadrctlem an nmr»
E
any).
19. Outstanding Debts ......................... Aduu1e2+Ur*9ln Cmum9aaore
S
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FPPC Form 4811(.1anuary/0S)
FPPC TolWme Helpline: SSSIASK- PPC PIAIWOTb 772)