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Home My WebLink AboutCOUCH SEMIANN99(2) ecipient Committee Campaign Statement (Govemmeat Code SeclJeas 84200-84216.5) COVER PAGE Type or print in ink. SEE INSIRUCTIONS ON REVERSE 1. Type of Recipient Committee: A. Commi.eN- ComCete Parts 1, 2, 3, and 7. Date of election if applicable: (Month, Day, Year) Date Stamp 2. Type of Statement: For Officlst Use Only j~ Officeholder, Candidate Controlled Committee (Aisc Comptete Part 4.) [] Ballot Measure Committee O Primarily Formed O Controlled O Sponsored (Also Complete Part 5.) [] Primarily Formed Candidate/ Officeholder Committee (Al~o Complete Part 6J [] General Purpose Committee O Sponsored O Broad Based [] Pre-election Statement ~ Semi-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Pre-election Statement - Attach Form 495 3. Committee Information COMMITTEE NAME STREET ADDRESS (NO RO. BOX) CITY STATE ZIP COOE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR I~O. BOX CITY STATE ZIP CCOE AREACODE/PHONE AREA CODE/PHONE Treasurer(s) NAME OF I~EASURER AREACODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP COOE AREA CODE/PRONE OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS FPPC Form 460 (8/99) For TechnlcM Assistance: 916/3~2-5660 S~ate of California ReCipient Committee Campaign Statement Cover Page -- Part 2 Type or print in ink. COVER PAGE o PART 2 Page ~k~ of 4. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DIS~:~ICT NUMBER IF APPLICABLE) Related Committees Not Included in this Statement: LIst any commlttees not Included In this consolidated stetement the t are con.oiled by you or which ere primarily formed to receive contributions or to make expenditures on beheff of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE NAM E OF OFFICEHOLDER OR CANDIDATE NAM E OF OFFICEHOLDER OR CANDIDATE Attach continuation sheets if necessary OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE OFFICE SOUGHT OR HELD [] SUPPORT State of California campaign Disclosure Statement Summary Page Type or print In Ink. Amounts may be rounded to whole dollars. SEE iNSTRUCTIONS ON REVERSE NAME OF FILER Contributions Received 1. Monetary Contributions ...................................................... Schedule A. Line 3 $ 2. Loans Received ................................................................... Schedule B, 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 $ 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 Bi~ls} ............................................ Schedule F, Line 3 10. Nonmonelary Adjustment ....................................................... ScheduleC, Line3 11. TOTAL EXPENDITURES MADE ......................................... AddLInes8+9+ 10 $ Column A TOTAL THrS PERIOO .~?,/ from throug Page SUMMARY PAGE I.D. NUMBER Column B* Column C TOTAL PREVIOUS PERIOO TOTAL TO {)ATE -o - $ 39¥ · .0 ° -0 ° -oo o0o $ 'TSt 9 $ (. 3 7& -O° -O' - O' *0' 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 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................... Schedule e, Part 1, Column (b) $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ..................................................... See instructions on reverse 19. Outstanding Debts ................................... Add LIne 2 + Line g in Column C above 39,/ * From previous statement Summan/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 (Une 9), Summary for Candidates in Both June and November Elections 1/1 through 6/30 7/1 lo Date 20. Contributions Received ............ $ 21. Expenditures Made .................. FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule A Typ. or print in ink. SCHEDULE A Amounts may De rounder] S:-;.,~,=i~ covers ~r;~,d I Monetary Contributions Receivedto whole dollars, from 7///g~ i~~I~ ~AME OF RLER I.D. NUMBER IF AN INDIVIDU~, ENTER AMOUNT CUMU~TIVE TO DA~ CUMU~TIVE TO DATE OATE FULL NAME, MAIMNG ADDRESS AND ZIP CODE OF CON~IB~OR CONTRIB~OR ~CUPATION AND EMPLOYER RECEIVED ~IS CALENDAR ~AR O~ER RECEI~D (~F C~EE. A~O ENTER I.D. NU~ER) CO~E * (IF SE~-~OYEO, EN~R ~ PER~D (JAN. 1 - DEC. 31 ) (IF APPLIC~LE) ~ BUSINESS) ~IND ~ COM ~ OTH ~IND DcoM ~ OTH ~IND ~ COM ~ OTH ~IND ~ COM ~ OTH DIND D COM ~ OTH SUBTOTALS Schedule A Summary 1. Amount received this period - contributions of $100 or more. (Include all Schedule A subtotals.) ....................................................................................................... $ 2. Amount received this period - 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 $ *Contributor Codes ,NO-Individual COM - Recipient Commiltee FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule E Type or print in ink. Payments Made Amounts may Pe rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Statement covers period through /~/~'/¢~? Page ~' of {~ CODES: If one of the following codes accurately describes the payment, you may enter the code. OthenNise, describe the payment. DFC office expenses PET petition circulating PHO phonebanks PaL polling and suwey research POS postage, deliver7 and messenger services PRO professional san/ices (legal, acccunting) PRT pdnt ads I.D. NUMBER RFD returned cont~buti(:~3s SAL campaign workers salades TEL {.v. orcab~e a/d/me and production costs TRC candidate travel, lodging and meals (explair0 TRS staff/spouse travel, lodging and meals (explain) TSF bansfer between committees of Ihe same c~andidate/spon$or VDT voter registra~on MTG meetingsandappearances RAD radioairtJmeandproductioncosls WEB ~nforrnat~ontechrmlogycosts(~nternet, e_n~) NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMM3TT~E E, AL~O ENTER ID. NUMBER) COOE OR DESCRIPT3ON OF PAYMENT AMOUNT PAID re co ts or independent expenditures must also be summarized an Schedule D. SUBTOTAL Schedule E Summary 1. Payments made this pedod of $100 or more. (Include all Schedule E subtotals.) ............................................................................................... $ 3/'7° 2. Unitemized payments made this pedod of under $100 .................................................. ......................... $ ;t o. 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) ....................................... $ -? - 4. Tolal payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6 ) ............. TOTAL $ ~'~'~ FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule I Typa or print in ink. SCHEDULE Miscellaneous Increases to Cash Am~'u~t~s-m'-a~'b~'~-ded to whole dolla,a, from SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER DATE FULL NAME AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT AMOUNT OF RECEIVED pF COMMITTEE, ALSO EN?ER I+D, NUMBER) INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule I 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