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Home My WebLink AboutDICKERSON SEMIANN99(2) ecipient Committee Campaign Statement (Govem~lent Code Sections 84200-842t 6.5) SEE INSTRUCTIONS ON REVERSE Type or print in Ink. Stateme/nt co~(ere pedod ,rom '7/I f 9'S Data of election if ap plicable: (Month, Day, Year) Dele Stamp COVERPAGE Page J of ~ 1..Typ~f Recipient Committee: All Committees- Complete Parts 1, 2, 3, and ?. [~'"Officeholder, Candidate [] Primarily Formed Candidate/ Controlled Committee (Also Con. ere Part 4.) [] Ballot Measure Committee O Primarily Formed O Controlled O Sponsored (Also Complete Part 5) Officeholder Committee (Also Complete Part 6J [] General Purpose Committee 0 Sponsored O Broad Based 2. Type of Statement: oO~electio n Statement i-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Pre-election Statement - Attach Form 495 I.D. NUMBER 3. Committee Information ~ I 1 7__.1 STREET ADDRESS (NO PlO. BOX) CITY STATE ZIP COOE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR PlO. BOX AREA CODE/PHONE Treasurer(s) MAILING ADDRESS CITY NAME OF ASSISTANT TREA~BL~ER, IF ANY STATE ZIP CCOE AREA cODE/PHONE MAILING ADDRESS CiTY STATE ZIP COOE AREA COOEJPHONE OPTIONAL: FAX/E-MAIL ADORESS CITY STATE ZIP COOE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS FPPC From 4~0 For Technical Aesl~tance: 916~2-S660 State of California Recipient Committee Campaign Statement Cover Page-- Part 2 Type or print in ink. COVER PAGE-PART 2 Page 4. Officeholder or Candidate Controlled Committee Related Committees Not Included in this Statement: Llstany¢ommlttees not included In this consol/dated ~tatement that are controlled by you or which ere primarily formed to receive contributions or to make expenditures on behaff of your candidacy. CCMMITI-E E NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMIttEE? [] YES [] NO COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE 7. Verification 5. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER J~JRISDICTION I [] SUPPORT I [] OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, ii' any. NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO, IF ANY 6. Primarily Formed Committee List names of officeholder(s) or candidate(s) for which this committee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE Attach con~nuation sheets if necessary OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowle/~'~/t~e J~f~f~nation contained herein and in the attached schedules is true and complete. I cattily under p~nalty of perjury under the laws of the State of California that the fo~g/~ i~'/r~e/and correct. Executed on ,.,- [ , , By - DATE SIeNATURE OF CONTROLIJNG OFFICEHOLDER. CANOIDAIE. STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR Executed on By C^~E Executed on By FPPC Form 460 (~99) For Technical Asalatance: 916/322.5;660 State of CMifornie Campaign Disclosure Statement Summary Page Type or print in Ink. Amounts may be rounded to whole doller~. SEE INSTRUCTIONS ON REVERSE NAME OF F~.ER SUMMARy PAGr' ,,o,._ 7h/SS Contributions Received 1, Monetary Contributions ...................................................... Schedule A, Line 3 2. Loans Received ................................................................... Schedule B, Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines I + 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 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 1 3. Cash Receipts .............................................................. Column A, Line 3 above 14. Miscellaneous Increases to Cash ....................................... Schedule I, Line 4 1 5. 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 S, Pan t, Column (b) $ Cash Equivalents and Outstanding Debts 18, Cash Equivalents ..................................................... See inslruclion$ on reverse $ 19. Outstanding Debts ................................... Add L/ne 2 + Line 9 Sn Column C above $ Column A TOT~ T.S PE.~OO .~:~-~ l--r>-- S I.D. NUMBER Column B* Column C TOTAL PREVIOUS PERIOD TOTAL TO DATE Z_l,-7 z.3/:-- '._____~s 7z~C- 7 , · From previous statement Summary Page, Columa 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 Summary for Candidates in Both June and November Elections 20. Contributions Received ............ 21. Expendilures Made .................. FPPC Form 460 (8/99) For Technical Aesletence: 916/322-5660 Schedule ~ - Part 1 Lo.ils Received Type or print in ink. Amounts may be rounded to whole dollara. SEE INSTRUCTIONS ON REVERSE NAME OF FILER CATE RECEIVED E]Lender I-1Guarantor []Lender I~Guarantor CONTRIBUTOR CODE * [] IND [] COU [] OTH [] IND [] COM r-] OTH IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER OUE DATE/ INTEREST RATE DUE DATE INTEREST RATE DUE DATE SCHEDULE B - PART LENDER INFORMATION GUARANTOR INFORMATION Co) SUBTOTALS Schedule B - Part I Summary 1. Loans of $100 or more received this period. (Include all Loans Received - Part 1 (a) subtotals.) ................... $ 2. Amount received this 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.) I1 forgiven or paid by a third party, include this amount on Schedule A Summary, Line 2 ...................................................... $ 6. Total loans repaid, forgiven, or paid by a third party this period. (Add Lines 4 + 5.) ........................... TOTAL $ 7. Net change this period. (Subtract Line 6 from Line 3.) Enter the net here and on the Summary Page, Column A, Line 2 .......................................................... NET $ ["Cor~tributo~ C~odes IND - h~qvfduaJ COM- Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Aaaiatanc,a: 916/;322-5660 Schedule B - Part 2 Repayments Made on Loans Received, Loans Forgiven, and Loans Repaid by a Third Party SEE INSTRUCTIONS ON REVERSE NAME OF FILER DATE OF REPAYMENT DATE OF OR ORIGINAL LOAN Type or print in ink. Amounts msy be rounded to who/e dollars. St.t=,.e,n~cofers period FULL NAME OF LENDER INTEREST (c) SCHEDULE B - PART 2 RATE (IF CHANGED) AMOUNT REPAID OR FORGIVEN ON PRINCIPAL * IEXCLUDE PAYMENT OF INTEREST} OUTSTANDING INTEREST PRINCIPAL PAID Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ /~::::y~ ~--- TOTAL INTEREST PAID THIS PERIOD $ ~ * IMPORTANT: If any part of a loan is forgiven or repaid by a third party, also itemize the transaction on Schedule A, Enter the ~tin column (d) in the Schedule E I forgiveninCludingor paid.the name and address of the person forgiving the loan or the third party making the payment, and the amount Sumn~Schedute e~Summao/.3' Do not carry this total to the FPPC Form 460 (8/99) For Technical Asslstsnco: 916/322-5660 Schedule B - Part 3 Type or print in ink. SCHEDULE B- PART 3 Am~'~nts m'ey be rounded Annual Repo. of Outstanding Loans Received ,o.ho,..o..... ~om 7/I[~ ~ gEE INSTRUCTIONS ON REVERSE Pa~. of ~ NAME OF FILER / ~ LD. NUMBER FULL NAME OF LENDER ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL UNPAID INTEREST ~ f / Attach additional information on appropriately labeled continuation sheets. TO'aL $ '% 77--~ ,'"--- NOTE: This total should be ~he same amount as entered en fhe Sumn~ry Page, Colurn~ C, Line 2. FPPC Form 460 (~/99) For Technical Assistance: 916/322-5660