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Home My WebLink AboutHOLLON PREELEC99(1)Recipient Committee Campaign Statement (Government Code Sec'do~s 84200..84216.5) SEEINSTRUCTIONSONREVERSE Type o~ print in ink. 1. Type of Recipient Committee: ~Ji Committees- Complete Pints 1, 2, 3, and 7. ~ Officeholder, Candidate Controlled Committee (Also Complete Part 4.) [] Ballot Measure Committee O Primarily Formed 0 Controlled O Sponsored (Also Complete part 5.) [] Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 6.) [] General Purpose Committee O Sponsored O Broad Based 3. Committee Information COMMI'I-fEE N~ME ILO. NUMBER Date of ejection if applicable: (Mon63, Day, Year) Dale Stamp 10C ' 17_ 11:16 .RSFiEL. D Ct~¥ uLE 2. Type of Statement: ~,~,P re-election Statement [] Semi-annual Statement [] Termination Statement [] Amendment (Explain below) COVER PAGE Fo~ Official Use Onty' [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Pre-election Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY STATE ZIP COOE AREA CODE/PHONE NAME OF ASSISTANT TREASURER. IF ANY STREET ADORESS (NO P.O. BOX) CITY STATE ZIP COOE AREA CODE/PHONE MAILING ADORESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP COOE AREA COOE/PHONE OPTIONAl.: FAX / E-MAIL ADDRESS FPPC Fo;m 460 (8/99) For Technical Assistance: 91rd3~2-5660 Slate of California Recipient Committee Campaign Statement Cover Page-- Part 2 Type or print in ink. COVER PAGE * PART 2 4. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE CITY ~TAT.E ZIP R®lat~d Committ~$ Hot Included in thi~ Statement: uet~¥coram~ not ~clud~ In ~ls c~fldat~ s~t~t ~.t ~ con~l~ by ~ ~ whl~ ~e ~maaly D~s O ~ cFrY STATE ZiP COOE 7. Verification 5. Ballot Measure Committee NAME OF BALLOT MEASURE D oPPos~ Identify the conbolling officeholder, candidate, or state measure proponent, if any. 6. Primarily Formed Committee Ust names ofofllceholder(s) or candidate(e) for which Ibis committee la prfnm~fly formed. Attach continuation sheets if necessary OFFICE ~ OR HELD [] su.~ [] oPPosE [] SUPPORT 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 tree and correct. Executed o~ DATE Executed on DATE By ~ / By, FPP(:: From 4~0 (w) For Tec~niMI A~Mt~ce: ~1rd322~660 State el CMIfomll Campaign Disclosure Statement Summary Page Type or print in Ink. Amounts may be rounded to whole dollars. E;UMMARY PAIl F Contributions Received 1. Monetary Contributions ...................................................... ScheduleA, Line 3 2. Loans Received ................................................................... Schedule 8. Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines t + 2 4. Nonmonetary Contributions ............................................... Schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 Column A $ Column B* $ $ Column C TOTAl. TO OATE (COLUMNS A * B) $ $ Expenditures Made 6. Payments Made .................................................................... Schedule E, Line 4 7. Loans Made .......................................................................... Schedule H, Line 7 8. SUBTOTAL CASH PAYMENTS ................................................ Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, Line 3 10. Nonmonetary Adjustment ....................................................... Schedule C. Line 3 11. TOTAL EXPENDITURES MADE ......................................... Add Lines 8 + 9 + 10 Current Cash Statement 12. Beginning Cash Balance ................................ Previous Summary Page. Line 16 13. Cash Receipts .............................................................. Column A, Line 3 above 14. Miscellaneous Increases to Cash ....................................... Schedule I, Line 4 15. Cash Payments ............................................................ column A. Line 8 above 16. ENDING CASH BALANCE .............. Add Lines 12 + 13 + 14. then subtract Line 15 Il this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................... Schedule B, Pan 1, Column (U) Cash Equivalents and Outstanding Debts 18. Cash Equivalents ..................................................... See instructions on reverse 19. Oulstanding Debts ................................... AddLIne2+LlneginColumnCabove $ $ 20. * From previous statement Summary Page, Column C. However, if this is the first report filed for the calendar year, Column B should be blank except for Loans Received (Line 2), Loans Made (Line 7), and Accrued Expenses (Line g). Summary for Candidates in Both June and November Elections 1/1 through 6/30 7/1 to Date Contributions Received ............ $ Expenditures Made ..................$ FPPC Form 460 (8/9g) For Technlcsl Aselstsnce: 916/822-5660 Schedule A Typ~ or print in ink. SCHEDULE A Monetary Contributions Receivedto whole dollara, from ~ IND ~ COM ~ OTH ~IND ~ COM ~ OTH ~IND ~ COM ~ OTH ~IND ~ COM ~ OTH ~IND ~ COM ~ OTH SUBTOTALS Schedule A Summary 1. Amount received this pedod - contributions of $100 or more. (Include all Schedule A subtotals.) ....................................................................................................... 2. Amount received this pedod - unitemized contributions of less than $100 ......................................... 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ................... TOTAL ['Con~butor Codes IND - Individual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: 916/~22-5660 Schedule B - Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER DATE RECEIVED Type or print in ink. Amounts may be rounded covers period SCHEDULE B - PART to whole dollers. FUt. L NAME, MAILING ADDRESS AND ZIP CODE OF LENDER OR GUARANTOR CONTRIBUTOF CODE * IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER LENDER INFORMATION (~,) I.D. NUMBER GUARANTOR INFORMATION [] Lender [] Guarantor Lender [] Guarantor r"]Lende¢ []Guarantor [-I IND [] COM [] OTH [] IND [] coM [] OTH []IND [] COM [] OTH DUE DATE INTEREST RATE SUBTOTAL $ OF LOAN TO DATE CALENDAR YEAR $ $ ALENDAR YEAR OTHER CALENDAR YEAR $ OTHER $ GUARANTEED TO DATE CALENDAR YEAR $ OTHER $ CALENDAR YEAR Schedule B - Part I Summary t. Loans of $100 or more received this period. (include all Loans Received - Part t (a) subtotaJs.) ................... $ 2. Amount received lhis period - unitemized loans of less than $100 ................................................................... $ 3. Total loans received this period. (Add Lines 1 and 2.) ....................................................................... TOTAL $ Schedule B - Part 2 Summary 4. Loans of $100 or more repaid, forgiven, or paid by a third party this period. (include all Part 2 (c) subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) ............................. $ 5. Loans under $100 repaid, forgiven, or paid by a third party. (Do not itemize.) I! forgiven or paid by a third party, include this amount on Schedule A Summary, Line 2 ...................................................... $ COM - Recip/erff Corem/Ires 6. Total loans repaid, forgiven, or paid by a third party this pedod. (Add Lines 4 + 5.) ........................... TOTAL $ OTH- Other 7. Net change this pedod. (Subtract Line 6 from Line 3.) Enter the net here and on the Summary Page, Column A, Line 2 .......................................................... NET $ ~ ~ a n~live nu~. FPPC Form 460 (8/99) For Technicel Assistance: 916A~22-5660 Schedule B - Part 2 Repayments Made on Loans Received, Loans Forgiven, and Loans Repaid by a Third Party SEEINSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole do#ars. S~,;=.,~.[ covers period through '/~*~--//~)~ q~ SCHEDULE B - PART 2 NAME OF FILER DATE OF REPAYMENT OR FORGIVENESS DATE OF ORIGINAL LOAN FULL NAME OF LENDER INTEREST RATE (c) AMOUNT REPAID OR FORGIVEN ON PRINCIPAL* I.D. NUMRER OUTSTANOING PRINCIPAL (d) INTEREST PAID Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ ~ TOTAL INTEREST PAID THIS PERIOD $ ~.~ * IMPORTANT: If any part of a loan is forgiven or repaid by a third par~, also itemize the transaction on Schedule A, Enterthe amountin column (a~) in the Schedule E I including the name and address of the person forgiving the loan or the third party making the payment, and the amount Summa~ U'ne 3. Do not ca~rr~ this total to the forgiven or paid. Schedule B SummarX. FPPC: Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule B - Part 3 Type or print in Ink. SCHEDULE E - PART 3 Attach additional information on appropriately labeled continuation sheets. TOTAL NOTE: This total should be the same amount as entered on the Summary Pa~e, Column C, Line 2, FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule C Typ. or print in ink. SCHEDULE C Amounts may be rounded Nonmonetary Contributions Received towhole doller~. ~' '~ from SEE INSTRUCTIONS ON REVERSE NAME OF FILER DATE RECEIVED FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR CODE * I--lIND [] COM [] OTH [] IND [] COM [] OTH l-liND [] COM [] OTH IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF GOODS OR SERVICES [] IND [] COM [] OTH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ AMOUNT/ FAIR MARKET VALUE CUMULATIVE TO DATE CUMULATIVE TO DATE OTHER CALENDAR YEAR (JAN 1 o DEC 31) (IF APPUCABI. E) Schedule C Summary received this period - nonmonetary contributions of $100 or more. 1. Amount (Include all Schedule C subtotals.) ................................................................................................................... $ 2. Amount received this period - unitemized nonmonetary contributions of less than $100 ................................ $ _,,'(~'" 3. Total nonmonetary contributions received this period. (Add Lines I and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ................... TOTAL ['Co~tflbuto~ Codes IND - Individual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: g16/322-5660 Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUC~ONS ON REVERSE Type or print in Ink. Amounts may be rounded to whola dollars. through SCHg:DULE D .,.,? DATE CANDIDATE AND O~FICE, MEASURE AND JURISDICTION, OR COMMITTEE [] Support [] Oppose [] Support [] Oppose TYPE OF PAYMENT [] rotary [] ~/ [] [] Ex~rd~a DESCRIPTION OF NONMONETARY CONTRIBUTION (IF REQUIRED) AMOUNT THIS PERIOD I.D. NUMBER CUMULATIVE AMOUNT Calendar Year $ Other Calendar Year $ Other $ Calendar Year S Other SUBTOTAL $ Schedule D Summary 1. Contributions and independent expenditures made this period of $100 or more. (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 the Summary Page.) ........ TOTAL FPPC Form 460 (8/99) For Technical Assistance: 916/~22-5660 Schedule D ~,UIII. IIIUULIUI! .~!!~'~LI SCHEDULE D iCONT Summary of Expenditures T~p* or print In Ink. Amounts may be rounded S~.;.~...;,,~ ~,,,v=,~, ~.~;~; ~ _=.__ _ :. Supporting/Opposing Other ,o whole dollars, fr°m ~-~/- ~ ~? ~ Candidates, Measures and Committees th r o ugh / ~) --//~'~ '-- ~/~ [ i.PDa. NgNu~/BE~R of /~ NAMEOF RLER DESCRIPTION OF NONMONETARY OATE CANDIDATE AND OFFICE, TYPE OF PAYMENT CONTRIBUTION AMOUNT THIS PERIOD CUMULATIVE AMOUNT MEASURE AND JURISDICTION. OR COMMITTEE {IF REOUIRED) [] Monetary Calendar Yea; ConbibutJon Contributio~ Other [] Independent [] Su~po;t [] Oppose Exper~ture $ [] Moneta~ Calendar Year Cont~bufion [] Monetary Calendar Year Co~bibu~on Contfibu~on Other [] suppo~ [] Opp~e Ex~r~e s [] Monelmy Celendar Year Contribution [] No~Monet~y SUBTOTAL FPPC Form 460 (8/99) For Technical Assistance: 916/~22-5660 Schedule E Payments Made SEE INSTRUC~ON? ON REVERSE NAME OF FILER Type or print in ink. Amounts may be rounded to whole doller~. CODES: If one of the following codes accurately describes the payment, you may enter the code. Othenvise, describe the payment. C'MP campeign perapherna/la/misc. CNS csrnp~gn consultants CTB c(mt~oufion (explain nonmoneta~y)- CVC civic donations FND ftmdraising ever~ts IND Indepe~t expendilurs suppo~ng/opposing others (explain)* LIT can~aignliterature and mailings MTG maetingsandappearences OFC o~se expenses PET petition circulating PHO phone benks POL polling and survey research POS Postage, detive~j and meSSenger services PRO profeseiock~l services (legal. accounting) PRT p~nt ads RAD radio airfime and prnduction costs SCHEDULEr I,D. NUMBER RFD returned con~s SAL campaignworkers sala~es TEL t.v. or cable airlima and production casts TRC candidate travel, lodging and meals (explain) TRS slaff/spouse travel, lodging and meals (explain) TSF transfer behveen carr~nittees of the same candidate/sponsor VOT voter registration WEB infommtion techrmlogycasts (intemet, e.majlI NAME AND ADDRESS OF PAYEE OR CREDITOR (~ COMMt ~FEE, ALSO ENTER I.D. Nt~M~ERI CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID ~ or ~P~;~de,,;.expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Payments made this pedod of $100 or mom. (Include all Schedule E subtotals.) ............................................................................................... 2. Unitemized payments made this period of under $100 ........................................................................................................................................ 3. Total interest paid this pedod on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) ....................................................... 4. Total payments made this pedod. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ......................... TOTAL FPPC Form 460 (8/9g) For Technical Aeeletsn~e: 916~322-5660 Schedule E (Continuation Sheet) Payments Made Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF RLER from ~"--//~ ~ through CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaignparaphemaiia/misc. DFC office expenses RFD ;etumedcontdbutions PET pefilJofl circulating PHO phofle banks POL polling and survey research POS poslage, delivery and messenger sar-~fcas PRO profesaicxtai services (legal, accounting) PRT print ads SCHEDULE E (CONT.} CNS campaign consultants CTB cofltributiofl (explain no~mofletary) * CVC ck4c doflalJofls FND fundraislng evenls IND independent exT)enditum ~ng/ef:)posing olhers (explain)* LIT campaign lJteralure and mailings MTG men'~ngs end appearances PAD radio airtime and productiofl costs WEB informationtechno~ of/? I.D. NUMBER SAL campaign workers salaries TEL Lv. or cable airtime and production costs TRC candidate travel, lodging end meals (explain) TRS staff/spouse travel, lodging and meals (explain) TSF transfer between committees of the same candidate/sponsor VDT voter registralion NAME AND ADDRESS OF PAYEE OR CREDITOR {IF COM~ TTEE. ALSO ENTER ID. NUMBER) CODE OR DESCRIPTIONOF PAYMENT AMOUNT PAID ;;.,~,~,-; ex~C,;~uree must also be summarized on Schedule D. SUBTOTAL ~ FPPC Form 460 (8/99) For Technical Assistance: 916,~22-5660 Schedule F Accrued Expenses (Unpaid Bills) Type or print in ink. Amount~ may be rount~ed to whole dollar~ SEE INSTRUCTIONS ON REVERSE NAME OF FILER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP carnpaigr~paraphemalia/misc. DFC oft3ceexpensas RFD retumedcontfibuaons CNS campalg~ consultants CTB con~bution(exp~nonmonetaryI- CVC civic donations FND fundralsing events IND independent expenditure supporting/opposing others (explain)* LIT campaign ~teratureand mail/ngs MTG mee~ngs and appoamnces PET pel~tion circulating PHO phone banks POL polling and survey research POS postage, delive~ and messanger services PRO professional se rvfses (legal, accounting ) PRT pdnt ads SCHEDULEF I.D. NUMBER SAL campaign workers saiades TEL t.¥, or cabJe airtime and pr~Juct~ cos~s TRC candidate travel, lodging and meals (explain) TRS staff/spouse travel, Indging and meals (explain) TSF transfer between commiilees of the same candidate/sponsor VDT vOterre~stretfon *Paymentsthatareeontrlbuti(msorindependentexpendituresm RAD radio airtirne and prnduction costs WEB informado~technologycosts(intemet, e.mail NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR ia) lb) lc) id) OUTSTAND{NG AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRtPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (^LSD REPOR'r ON E) OF THIS PERtOO SUBTOTALS $ $ $ Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column lb) subtotals for accrued expenses of $1 O0 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column lc) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $I00.) ................................. 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 ~ FPPC Form 460 For Technical Assistance: 916/322-5660 Schedule F (Continuation Sheet) Accrued Expenses (Unpaid Bills) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period NAMEOFFILER SCHEDULE F (CONT.) I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. DFC office e~oenses PET pe~on circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO profeselonal services (legal, accounf~ng) PRT print ads RAD radio airlime and production costs CMP campaign paraphernalia/misc. CNS campaign consultants CTB ceetributioe (explain noemonetary)* CVC civic donafioes FND (tmdreising events IND indepef~denl expenditure supporlJng/opposing oCqe rs (explain)' LIT campaign literelure and mailings MTG meelings and appearances * Payments that are contributions or independent expenditures must also be summarized on Schedule D. RFD returned co~tfibulJo~s SAL campaignworkers sela~ies TEL t.v. or cable aiftime and production costs TRC caodidate travel, lodging aDd meals {explain) TRS staff/spouse travel, lodging aDd meals (explain) TSF transfer between committees of the same candidate/sponsor VDT voter registratio~ WEB information technology costs (intemet, e-mail) (a) (b) (c) (d) NAME AND ADDRESS OF PAYEE OR 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 SUBTOTALS $ $ $ $ FPPC Form 460 (8/99) For Technical Aeaistsnce: 916/322-5660 Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This CommiE=c) SEE INSTRUCTIONS ON REVERSE NAME OF FILER NAME OF AGENT OR INDEPENDENT CONTRACTOR Type or print in ink. Amounts may be rounded to whofe dolfer~. covers period SCHEDULE I.D. NUMSER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campa~gnpara~misc. DFC officae~penses RFD retun3edconldbuflons CNS campaign consulfents CT~ contdbu~on {explein nonmunetary~- CVC civic donations FND tondra~ng events IND independe~ expenditure supporting/opposing others (explain)* LIT campaign lifera~ure andmailings PET palJfion circulating PHC phone banks POL polling and survey research POS Poslage, de~veryandmessengersen~ces PRO profesaionai sewices (legal, accounting) PRT pdn~ads MTG meelings and appearances RAD radio atdime and production costs SAL campaign wonders salaries TEL t.v. o~ cable ai~rne and production costs TRC candidate travel, lodging and meais (explain) TRS slaff/spousetravel, tod~ngandmeais(expleth) TSF transfer between committees o! the same candidate/sponsor VDT vofer r~{ion WEB information technology costs (intemet, e.mail} * Payment~ that are contributions or Independent expenditures must afeo be summarized on Sch~,d ,-D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE. ALSO ENTER LD* NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAiD Attach additional information nn Rnrlrnrtri;f=lt/ I~h,~lanf ,w~n~i,~, ,~h~,~ ~;.~+~ eats. To'rAI.* $ ~ ° Do not IJ~= =fa to any other schedu(e or to the Summary Page. This to~almaynot equal the amount paid to the agent orindependent contractor as reported on Schedule E. FPPC Form 460 (8f99} For Technical Assistance: 916/322-5660 Schedule H - Part 1 Loans Made to Others* Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULEH-PART1 SEE INSTRUCTIONS ON REVERSE NAME OF FILER NAME AND ADDRESS OF RECIPIENT INTEREST RATE DUE DATE AMOUNT DATE OF LOAN (~F COMM/T~EE, ALSO ENTER 1.0. NUIV;~ER) *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. SUBTOTAL $ Schedule H - Part I Summary 1. Loans of $100 or more made this period. (Include all Loans Made - Part I subtotals.) ............................................... 2. Unitemized loans under $100 made this period ............................................................................................................. 3. Total loans made this period. (Add Lines 1 and 2.) .......................................................................................... TOTAL Schedule H - Part 2 Summary 4. Payments received on loans of $i00 or more. (include ail loan payments received and ail loans of $100 or more forgiven by this committee - Part 2 (a) subtotals. If forgiven, also itemize on Schedule E.) ................................................................................................................... $ 5. Unitemized payments received on loans under $100. (Including a forgiveness.) ............................................................................................................................................ $ 6. Total loan payments received this period. (Add Lines 4 and 5.) ........................................................................................................................................ TOTALS 7. Net change this period. (Subtract Line 6 from Line 3. Enter the net here and on the Summary Page, Column A, Line 7.) ................................................................ NET $ May ;~e a negative number FPPC Form 460 (8/99) For Technical Aaslstsnce: 916/322-5660 Schedule H - Part 2 Repayments on Loans Made to Others and Loans Forgiven Type or print in ink. Amounts may be rounded to whole doltare. SEE INSTRUCTIONS ON REVERSE NAME OF FILER DATE OF ORIGINAL LOAN DATE OF INTEREST REPAYMENT OR FULL NAME OF RECIPIENT OF LOAN RATE FORGIVENESS {iF CHANGED) ^~ouNT ;~.Ai~ OR FORGIVEN ON PRINCIPAL* EXCLUDE RECEIPT OF INTERES*I Atfach additional information on appropriately labeled continuation sheets. SUBTOTAL $ ~ * IMPORTANT: If any part of a loan is forgiven, also itemize the forgiveness on Schedule E. If a repayment is received from a third part~, enter the name and address of third parry in the 'FULL NAME OF RECIPIENT OF LOAN" column above, along with the name of the recipient of the loan. OUTSTANDING INTEREST PRINCIPAL RECEIVED Enter the amount in column (b) in the Schedule I Summary, Line 3. Do not cany this total to the Schedule H Summaq4 FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 SCHEDULE H-PART3 Schedule H - Part 3Amou..Ty'a o, pti., i. inl~may b~ rounded s"-""~'" c°wr' ~'"'~ ~i i~ Annual Report of Outstanding Loans Made towho~do.ere, from ~'~'/--/~ g t,,ro,,,!,h SEE INSTRUCTIONS ON REVERSE NAME OF FILER FULL NAME OF RECIPIENT OF LOAN ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL Attach additional information on appropriately labeled continuation sheets. TOTAL NOTE: This totalshouldbe the same amount as entered on the Summary Page, Column C, Line 7. FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule I Miscellaneous Increases to Cash Type or print in ink. Amounts may be rounded to whole dollars. period SCHEDULEI SEE INSTRUCTIONS ON REVERSE Page / (~ ' °f /(~ NAME OF FILER I.D. NUMBER DATE FULL NAME AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT AMOUNT OF RECEIVEO (IF CO~t~&fl~r EE. ALSO ENTER I.D. NUMBER} INCREA,¢~E TO CASH Attach addJtionai information on appropriately iabeied contt)3uab'on sheets. SUBTOTAL Schedule ! Summary 1. Increases to cash of $100 or more this period ........................................................................................................... 2. Unitemized increases to cash under $100 this period ............................................................................................... 3. Total of all interest received this period on loans made to others. (Schedule H, Part 2 (b).) ................................. 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ........................................................................................................................... TOTAL FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660