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Home My WebLink AboutROWLES AMEND97(3) ),mendment to Typ. o. p,...,ok ::ampaign Disclosure Statement ' ~iB fo~m must be used to a mend statements filed pursuant to Government code Sections 8a2OO-ga21 $.5. and muBt be filed with all l lag officers who ~ece ved the statement being amended. NOTE Do not use this fo~m to amend a Statement of Organization, Form 10. Candidate Intenbon FO m S0 . or a Campaign Bank Account. Form 502 Use the actual Form 410. 501 of 502. respectively, to make I! Amendment In~m Name of Filer (see ~r,poHantlnfo~matlononrevene.) NAME OF FILER ~ I.D. NUMRER MAILINGADDRE SS:/OF FILER , I (NO. AND STREET) STATE ZIP CODE AREA CO~AYTI~E PHONE NUMAR ~ RMANE NT ADDRESS OF TREASURER: (Ir APPL~E) (NO.AND STREET) . , STATE ZIP CODE AREA CODE~AYTIME PHONE NUMBER AMENDMENT For Of facial Use Only SOANNED A. The following informatiorLamends campaign disclosure statement, Form No. qO.C) , ..ec .do. ql B. The amended information affects Items on the: [] Cover Page [] AIIocatk~ Pe~e [~ Summery P&ge [] [] C Descr be the changes below, Inclucle in Clet~il all information you wish to become a part. of your official campaign statement. HeBse attach a cover page, summary page ~nd/or appropriate scbeclule(~) ~o thi~ Form 405 if necessary for clarification. Include adclfbonal information on eppropri* atel¥ labelecl continuation sheets. (Number of sheets at~ached ) I Verification (see Impo. ant have u~d all rea~nable d~ genoa In preperi~ this ~etement. I hive reviewed the statement and to the ~st of my k n~ledge the inf~mabon contained h~retn~nd in the iffKhed Khedules is ~e~r. cad,ate, state milture pro~ a I~n~a~ (~ml~ee fes~wlb~ ~cer ver~at~: I have u~d all TRainable diligence and to the ~ of my k n~ledge the treasurer ha~ u~d all rel~na~e dil*ge~e in prepa~ing this ~etement I have ~eviewed the ~atement end to the ~st of my kn~ledge ~ion (on~ein ts true and complete. I (e~ify u~er ~n~hy ~f ~rjury under the ~w~ ~ the ~tate ~f ~if~rni~ th~t the f~eg~in~ is t~ue ~nd ~re~ ' State of California Fatr Polltkal Pflctlces Commission Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Amount~ may be rounded to whole dollars. ,rom through SUMMARY PAGE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE ContributiOns Received 1. Monetary Contributions ............................... Schedule A, tiM.9 s 2. Loans Received ......................................... Schedule e, Une 7 3. SUBTOTALCASHCONTRIBUTIONS ...................... Ac~Unesl *2 $ 4. Non-monetary Contributions ......................... Schedule C, Line 3 5. SUBTOTAL CONTRIBUTlONS:(Exdudu Enfor~eable Promlses) Add Unes .9 ,,4 S 6. Enforceable Promises fExclude Loln Guarantee$, Llne l m below) ................... $chedule D, Une 7 7. TOTALCONTRIBUTIONS RECEIVED ..................... Add Unes S * 6 $ Expenditures Made 8. CashPayments(OtherthanLoansMade) ............ ~chedule E, Une $ $ 9. Loans Made ......................... .................... Schedule H, Une 7 10. SUBTOTALCASH PAYMENTS ............................ AddUnesa * 9 $ 11. Accrued Expenses (Unpaid Bills) ........................ Schedule F, une $ 12. TOTAL EXPENDITURES MAD[: ......................... AddUnes tO * tt $ Current Cash Statement 13. Beginning Cash Balance .................. ~revlousSumrnaryP,ge,~Jne 17 $ 14. Cash Receipts ...................................... co/utah A Une 3 above '15. MiKellaneous Increases to Cesh ........................ Schedule t, Une 4 16. Cash Payments ....................................Co/umnA, Une lOibove 17. ENDING CASH BALANCE ..... AddLInej 1.9 * 14 ~* tS, thensubtractUne 16 $ If this Is a termlna IIon ~ti tement, L/ne 17 must be zero. Column A $ $ Column TOT^t ,~v~OUS Column C TOTAL 10 DATE 18. LOANGUARANTEESRECEIVED .............. Schedule a,~'a~ l, Colurnnfb) S ::ash Equivalents and Outstanding Debts 19. CashEqulvalents ................................ ~eeJns~.uct/onsonreverse S 20. Outstanding Debts ................. AddUne.9 qYBq. q s 21. ~ontribqtions ,ice,via .... s 22. ~.xp~nditures Maoe ....... $ I/1 th.rough 6/30 711 to Date Summary for Candidates in Both June and November Elections I · From previous Statement Summary Page, Column C. However, if [ this is the first reDort flied for the calendar year, Column B should be [ blink eKcept for Loins Received (Line 2), Enforceable Promises (Line [ 6), Loans Made (Line 9), and Accrued Expenses (Line 11). / J Schedule E Payments and Contributions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE Type or print in Ink. Amounts may be rounded to whole dollars. Stetement Covers period ,,om IlzlCtq through tJ~ ! ~).] qI~ SCHEDULE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER G unoil CODES FOR CLASSIFYING EXPENDITURES 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' - INOEPENDENTEXPENDITURES . °L'- LITERATURE 'g'- BROADCAST ADVERTISING 'N'- NEVVSpAPE R AND PERIODICAL ADVERTISING 'O' - OUTSIDE ADVERTISING °S°- SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS 'F'- FUNDRAISING EVENTS 'G'- GE NE RAL OPERATIONS AND OVERHEAD 'T'- TRAVEL, ACCOMMODATIONS AND MEALS (MUST aE DESCRIBED) 'P"- PROFESSIONALMANAGEMENTANDCONSULTING SERVICES NAME AND ADDRESS OF PAYEE, CREDITOR. OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E. (i~ eom MF~I'i L i, AODfTiO~ rO COMMIe1 ir.$ N&M! AND AOOLl~r $$. i~m[R iD. NUM II:R OR. ~F NO I.D. REPORT ONLY TH E LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW. CODE OR DESCRIPTION OF PAtMENT AMOUNT PAID 8xu(ers q /d Oen cn I I q Important: Contributions and expenditures made out of campaign funds to or on behalf of other ~ffi~eh~der~ cand~dates~ c~mm~t~ee$~ ~r ba~t measure~ must a~s~ ~e en~ tered~n the A~cati~n~Pa~e~ ~art ~. SUBTOTAL Payments and Contributions Made Summary 1. Payments made this period of $100or more. (Include all Schedule E subtotals.) ............. ~I.0.~L)~,~(~..~./~. ~. ~./:'..~..O/...~. .l.?~'~0 -- 90 ~.(~ ~. Payments made this period of under $100. (Do not itemize.) ....................................................................... $ ~ L 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.) ..................................... S ~ L Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) ........... TOTAL $ ~)~' ~ Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE DATE FULL NAME AND A~DRE $S OF SOURCE Type or print In Ink. Amounts may be roundod to whole dollars. Statement covers period from V lqq through DESCRIPTION OF RECEIPT 'SCHEDULEI Page_ of LD. NUMBER q 03 AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL Miscellaneous Increases to Cash Summary I. Increases to cash of $100 or more this period. L Increases to cash under $100 this period. (Do not itemize.) ................................................. 1. Total of all interest received this period on loans made to others. (Schedule H, Part II Cb).) .................... 1. Total miscellaneous increases to cash this period. (Add Lines 1,2, and 3. Enter here and on the Summary Page, Line 15.) ....................................................................... TOTAL