HomeMy WebLinkAboutSALVAGGIO SEMIANN97(1) fficeholder, Candidate,
and Controlled Committee
Campaign Statement -- Long Form
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print In ink.
Check one of the following boxes to indkate the type of ~tetemant being filed:
[] ere-election Statement
[] Supplemental Pre-election Statement (Attach a completed Form 495 to this ~tatement.)
Special Odd-Year Campaign Report
Semi-annual Statement
Termination Statement (Attach · completed Form 415 to this statement.)
Officeholder..Candidate, and Controlled Committee
Included in this Statement
NAME OF TREASURER
III V~rifiatio~
Date Stamp
COVER PAGE - LONG FORM
throug , !Ill o, .,. / ~
Deteofelectk)nfflipIdltable: ,.,,~ .... '.. ~ Page of
(Month, Day, Year) ~J.~ ,:~ ........ ~ For Official ~
II Other Committees Not Included in this Statement: un,.yo~,
comm/~ees of which you have knowledge that ere pdmar#y formed to receive contr/but/om
or to make exaonditures on behalf of your candidacy.
c(xvwrreE N~ME I ,.O. NUMeE,
I
[] ,Es [] .o
COMMOq'EE A~SS ~O. AND STt~T)
Afl, ch edditlm~l Information o~ epFopriately lehel~d contlouatlo~ Jheet~.
I have u~d all reasonable diligence in preparing this statoment, t have reviewed the statement end to th~ ~ Of my knowledge the infor~tion contained herein and in the attached Khedules is
true and comp~wte. ~ertify~nde~pen~tyofpegu~yVndorthe~e~fthe~tateofCa~if~rniath~tthef~reg~ingist~ndc~rrect ,
An officehold~T M candidate who cont~oili i committe~ ms~t ebo verify th~ c~mpaign stotem~flt. I have u~d ell reasonebt~ diligence and to the ~ of my knowledge the treasurer has used all
reasonable diligence in preparing this statement. I have reviewed the statement and to the hast of my k nowl~dge the informat~)n contein~ herein and in the attached schedules is true and
complete. I certify under I~nalty of perjury under tj~e laws of the State of California ~h~t the foregoing is true and correct. ;~/~./
Ex.cut. on /. ,,
E~ecut~d on. At By
DATE C/TY AK STATE SK~TLIR~ OF C~NO#)ATUOF Fff~ENOL DER
Executed on At By
gATE OTY ANe STATE
FOR INF(~MATK)N REQ4Jh~EO TO lie P~4OVIDfD TO YOU P~JRSUAIfr TO THE INFONVlATIOFd P(qACTICE S ACT OF 1977, SE i INFO4U~ATK)N MANyA~ OFd CAMPA~N D~SCLOSURE PROYISK)N$ OF THf POL~L RE FORM ACT
State of Caflfornia Flit Political Practices Commission
campaign Disclosure Statement
Summary Page
Ty~ ~ I~lnt In ink.
Amounts may be m~mded
SEE INSTRUCTIONS ON REVERSE
Se.eemeflt myers pedod
from ~
NAMLOF OFFICEHOLDRR OR CANDIDATE AND CONTROLLED COMMITTEE
Contributions Received ~ Column A Column B*
1. Monetary Contributions ............................... ~ A, Une $
2. Loans Received ......................................... Sched~ a, Une 7
3. SUBTOTALCASHCONTRIBUTIONS ...................... AddUnest *2
4. Non-monetary Contributions ......................... ~hedu/e CUne 3
5. SUBTOTAL CONTRIBUTIONSi(Exdude Enfo~cee~e e~m~es) ~dUnes3 + a
6. Enforceable Promises
(Exdude Loan G~arer~eet;, Ltne M below) ................... 50~,d~e D, Une 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddU~s5 + 6
Expenditures Made
8. Cash Payments (Other then Loans Mede) ............ ~ E, U,w S
9. Loans Mede ............................................. Schedu/e H, U~e 7
10. SUBTOTAL CASH PAYMENTS ............................ addunese · 9
1 1. Accrued Expenses (Unpaid Bills) ........................ ~ R b~e ~
12. TOTAL EXPENDITURES MADE ......................... ~,ddUnes t0 * ;!
Current Cash Statement
13. Beginning Cash Balance .................. I~evlou~SumetatyP~,~Jr~;7
14. Cash Receipts ...................................... Ce/m~n A Une $ a~we
15. Miscellaneous Increases to Cash ........................ ~edu~e I. Une a
16. Cash Payments .................................... Co~umnAUnelOebo~e
17. ENDING CASH BALANCE ..... AddUnesU*14+IS, thensub~actUne~6
If fff~ ls a letmlna#on ~tetement, l. ine 17 mmt be zem.
18. LOAN GUARANTEES RECEIVED .............. s~heo~te ;, Peril, Column~)
SUMMARY PAGE
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................ Seel~omo~mveme $
20. Outstanding Debts ................. AddLIne2 ~,LlneffinColumnCa~ove S
Column C
TOTAL TO DATE
s
'/ I'"G ~
s /~
/ ,
* F~ pr~i~i $teteme~ $umml~ Pa~, C~umn C. N~e~r.
th~ a~ fi~ rt~ fl~ f~ t~ ~ndar ~lr. C~umn a Ihould
I ~lnk e~ ~ L~m R~elv~ (LI~ 2), Enf~ceable ~i~
Summery for Candidates in Both June and
November Elections
111 through ~10 711 to Date
21. ;ontribqtiom /L,//./~ /L///~
Kecmvea .... S . .
22. ~p~nditures A] /~ ~ /~
MaDe ....... ~ ....
Schedule A Tv,, o~ ~.lnt inl,k. SCHEDULE A
HOLDER OR ~DIDATE AND CONTROLLED COMMI~EE I.D. NUMBER
FULL ~E AND ADDRESS OF C~TRIBUTOR ~CUPATION AND EMPLOYER AMOUNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE
Monetary
SEE INSTRUCTIONS ON REVERSE
C. O Ll ~ ct '
DATE
RECEIVED
SUBTOTAL $ (~)~ (~
Monetary Contributions Summary
1. Amount received this period -- contributions of $100 or more.
(Include all Schedule A subtotals.) ....................................................................................................
2. Amount received this period -- contributions of less than $100.
(Do not itemize.) .......................................................................................................................
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ........................................ TOTAL
Schedule A (Continuation Sheet) Ty~,~m~ln~,k. SCHEDULEA(cont.)
Monetary Contributions Received towhole doll,rs.
from ~
NAME OF OFFICEHOLDER OR C~NDIDATE AND CONTROLLED COMMITTEE I.D. NUMRER
FULl NAME AND ADDRES~ ~F CO~UTOR KCUPATION AND EMPLOYER AMOUNT CUMU~TIVE TO DATE CUMU~T~VE TO DATE
DATE (w C~M~E[, ~ A~ TO C~M~E'$ ~ME AND ~0~$$, E~ER I.O N~R (~ SELF ~M~OYED, E~ER RECEIVED THIS ~LE NDAR YEAR OTH E R
RECEIVE D ~ IF ~ LD. NUMI~M ~S I~(N ASkeD, EmER TREA~R'$ ~ME A~ A~$S) ~ME m I~SS) PER~D (JAN* 1 - DEC* 31 ) (IF APPLI~BLE )
SUBTOTAL
Schedule E
Payments and Contributions
(Other Than Loans) Made
SEE INSTRUCTIONS ON REVERSE
NAME OF OFficEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
,,- ////¢7
through ' ~/~/~; ~
SCHEDULE E
pape ~...~'
C~'/'CODES FOR CLASSIFYING EXPENDITURES
I.D. NUMBER
If one of the following codes accurately describes the expenditure,you may enter the code and leave the 'Description of Payment' column blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations of each category.
'C'- MONETARYANDIN-KIND(NON-MONETARY) 'B'- BROADCASTADVERTISING 'G'- GENERALOPERATIONSANDOVERHEAD
CONTRIBUTIONSTOOTHERCANDIDATES 'N'- NEW~PAPERANDPERIODICALADVERTISING °T'- TRAVEL, ACCOMMODATIONSANDMEALS
AND COMMITTEES 'O'- OUTSIDE ADVERTISING (MUST BE DESCRIBED)
'1~ - INDEPENDENTEXPENDITURES 'S' - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOORSOLICITATiONS °P' - PROFESSIONAL MANAGEMENTANDCONSULTING
'L°- LITERATURE 'F'- FUNDRAISINGEVENTS SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
~F caeaMm~E, m A~OmO~ TO CO~Un'rEE'S ~r~ME A~ ADD.SS, EmE~ ~.D. N~lER ~ · ~ I.D. RE ~RT ONLY TH E LUMP SUM OF SUCH PAYMEN~ ON LINE 4 OF TH E SUM~Y SE~ION BE LOW.
CODE OR DESCRIPT~N OF PAYMENT A~UNT PAID
oe,~! ee//~. C 9~/~.) ~5 C,Ooa/e~-. tg~,.,~..
Im, .~o~ant/ ¢ontri ,bu. t. ions and exp. enditures made out of campaign funds to or on behalf of other
~ffiCen~er~` ~andi~ates~ c~mmlttees~ ~r be~t measures mu~t a~s~ be entered ~n the A~cati~n Pa~e~ Part ~* SUBTOTAL
Payments and Contributions Made Summary
1. Payments made this period of $100or more. (Inctudeall Schedule E subtotals.) ............................ : .........................
2. Payments made this period of under $100. (Do not itemize.) .......................................................................
:1. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Co)utah (d).) ..............................
4. Total accrued expenses paid this period. (Do not itamiza. Entaramount from schadula F, Line4.) ...................................
S. Total payments made this period. (Add Lines 1,2,3, and4. Enter here and on the Summary Page, ColumnA, LineS.) ........... TOTAL
Schedule I
Miscellaneous Increases to Cash
Type or print in ink.
Amounts rely be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
DATE ' * ' FULL NAME AND ADDRES~)It/S*OURCE
Statement covers period
th.,,,.,,
DESCRIPTION OF RECEIPT
SCHEDULE I
I.D. NUMBER
AMOUNT OF
INCREASE TO CASH
Attach additional information on appropriately labeled continuation sheets.
Miscellaneous Increases to Cash Summary
1. Increases to cash of $100 or more this period .............................................................
2. Increases to cash under $100 this period. (Do not itemize.) .................................................
3. Total of all interest received this period on loans made to others. (Schedule H, Part II Cb).) ....................
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 15.) ....................................................................... TOTAL
SUBTOTAL S %~)~-__.
Officeholder, Candidate,
and Controlled Committee
Campaign Statement -- Long Form
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type oz print In ink.
Check one of the following boxes to indicate the type of statement being filed: [] Pre-election St atement
[] Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.)
Special Odd*Year Campaign Report
Semi-annual Statement
Termination Statement (Attach · completed Form 415 to this ~tatement.)
Officeholder. Candidate, and Controlled Committee
Included in this Statement
FILE
Date of election If
(Month, Day, Year)
Date Stamp
COVER PAGE - LONG FORM
For Off~
Other Committees I )t Included in this Statement: Ust any other
r-i .s [] .o
COMMrT'rE ( A[~4~ SS (NO. AND STKELr'0
III
NAME OF T/REASURER
Verification
Attach addltJonal lnformatlo~ O~ appropriately labeled continua don sheets.
have used all reasonable diligence in preparing this Statement. I have reviewed the ~titement and to the be~t of my knowledge the Information contained herein and in the attached schedules is
t~"e ~ndc~: ~e#rt~ i~rde~ ~n&~ty~f~ ~/~r~/~r~/~d~th~ ~&v~th~&ii~rni~th~tth~ f~reg~g~s~`f~ndc~r~ec~ /)~ ',
An offlcebo~er ~ M ~ldat~ who ~ontrol~ I (om m~ee muff ~ I~ ver~y ~ um~ Ign s~teme~. I have u~ all re·tunable dilige nee and to the ~ of my k n~l~ge the treasurer has used a II
reachable dilige~e in pre.ring tM~ ~atement. ~ have reviewed the ~atement and to the ~ of my kn~l~ge the information cOntained herein and in the a~Khed ~hedules is true and
corn plate. I ~e~i~ under ~nal~ of ~rj u~ under ~e la~ of the State of California that the foregoing is true · nd corr~ / __
Ex~ed on At By
Sch ed ule I Type ot print in Ink. SCHEDULE I
Miscellaneous Increases to Cash Amountsmayb~rounded
to whole dollars. Statement covers period
NAME OF OFFICEHOLDER OR CANplDATE AND CONTROLLED COMMITTEE I.D. NUMBER
DATE ~ 'FULL NAME AND ADDRESS O~SOURCE
RECEIVE O 0F C~M~EL m A~ I0 C~M~[(3 ~ME ANO ADD.SS, ENTER I.D. NUMIER DESCRIPTION OF RECEIPT AMOUNT OF
Attach additional information on appropriately labeled continuation sheets.
Miscellaneous Increases to Cash Summary
1. Increases to cash of $100 or more this period .............................................................$
2. Increases to cash under $100 this period. (Do not itemize.) ................................................. $
3. Total of all interest received this period on loans made to others. (Schedule H, Part II (b).) .................... $
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 15.) ........................................................................ TOTAL $
SUBTOTAL $
Sched u le E Type o~ print In ink. SCHEDULE E
Payments and Contributions
(Other Than Loans) Made
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE
COMMITTEE
C~
CODES FOR CLASSIFYING EXPENDITURES
I.D. NUMBER
If one of the following codes accurately describes the expenditure,you may enter the code and leave the ~Description of Payment' column blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations of each category.
'C'- MONETARY AND IN-KIND (NON-MONETARY)
CONTRIBUTIONS TO OTHER CANDIDATES
AND COMMITTEES
'1' - INDEPENDENTEXPENDITURES
°L' - LITERATURE
'B'- BROADCAST ADVERTISING
'N'- NEWSPAPER AND PERIODICAL ADVERTISING
'O'- OUTSIDE ADVERTISING
'S'- SURVEYS, SIG NATURE GATHERING. DOOR-TO4X)OR SOL~ClTATIONS
'F' - FUNDRAISING EVENTS
GENERAL OPERATIONS AND OVERHEAD
TRAVEL, ACCOMMODATIONS AND MEALS
(MUST BE DESCRIBED)
'P*-- PROFESSIONAL MANAGE MENT AN D CONS ULTiNG
SERVICES
NAME AND ADDRE SS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE TH E PAYMENT OF ACCRUED EXPENSES ON SCH E DULE E.
(~F COMMn~E[. ee AOO~ON TO C~M~EE'S ~ME AND AD.SS, EmER I.D. NUMIER R IF ~ I.D. RE ~RT ONLY TH E LUMP SUM OF SUCH PAYME N~ ON LINE 4 OF THE SUM ~RY SE~ION BE LOW.
y. Jo ,.Jv. _, I_ /r2 -
I?f~o~an. t: Contributions and expenditures made out of campaign funds to or on behalf of other
o ~cen~de~candidates~c~mm~ttees~rba~tmeasuresmusta~s~beentered~ntheA~cati~nPage~Part~ ~
SUBTOTAL
'ayments and Contributions Made Summary
· Paymentsmadethis period of $100or more. (Include all Schedule E subtotals.) ............................ : ......................... $
!. Payments made this period of under $ 100, (Do not itemize.) ....................................................................... $
~. Total interest paid this period on outstanding loans· (Enter amount from Schedule B, Part II, Column (d).) .............................. $
· . Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ..................................... $
· Total payments made this period. (AddLines 1,2,3, and4. Enter here and on the Summary Page, ColumnA, Line8.) ........... TOTAL $
'"'~- 0 "'"'-
"--0 -'-
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLI~ER OR CANDIDATE AND CONTROLLED COMMITTEE
Contributions Received ~
1. Monetary Contributions ............................... Sd~edu/e A Uno 3
2. Loans Received ......................................... :;<hedule a, Uno 7
3. SUBTOTALCASH CONTRIBUTIONS ...................... AddUoa$ ! + 2
4. Non-monetary Contributlons ......................... S~he~e C, Uno 3
5. SUBTOTAL CONTRIBUTlONSi(Exdude Enforceable ~tomlses) AddUnes3 * a
6. Enforceable Promises
(Exclude Loan Guarantees, Uno ! m below) ................... Schedule D, Line 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnesS,
· Expenditures Made
8. Cash Payments (Other than Loans Made) ............ sd~edu/e E, L/ne
9. Loans Made ............................................. Schedu/e H, Uoa
10. SUBTOTAL CASH PAYMENTS ............................ ,add.Unesa, 9
11. Accrued Expenses (Unpaid Bills) ........................Schedu/e F, Uno S
12. TOTAL EXPENDITURES MAD): ......................... AddUneslO * ~
Current Cash Statement
13. Beginning Cash Balance .................. I'revlousSummaryt'age, une~?
14. Cash Receipts ...................................... ColumnA, Une3above
15. Mi~ellaneous Increases to Cash ........................ .;cheduleI, LIne4
16. Cash Payments .................................... Co.~umnA, UoalOabo~e
17. ENDING CASH BALANCE ..... Ad~Llnes 13, 14 · IS, then subtrKtUne 16
18. LOAN GUARANTEES RECEIVED .............. $cheduleB, Partl, Column(bJ
Cash Equivalents and Outstanding Debts
lg. Cash Equivalents ................................See lmtruct/oru on reverse $
20. Outstanding Debts ................. AddUne 2 ,~ Line ll lnColumnCabove
Type m' I~lnt In Ink.
Amount~ rely be rmanded
to whole dollars.
SUMMARY PAGE
I.D. NUMBER
Column C
S
* From previous Statement Summary Page, Column C. However, if
this is tho first rei~ort filed for the calendar year Column B should be
blink except for Loans Received (Line 2), Enforceable Promises (Line
~), Loins Made (Line 9), and Accrued Expenses (Line 11).
Summary for Ca.ndidates in Both June and
November Elect~ons