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HomeMy WebLinkAboutBENHAM SEMIANN01(1) ecipient Committee Campaign Statement (Government Code Seclions 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Typa or print In ink. Statement corm pedod t/o t / o I from .,rou.h b/5o/o t Date of election if applicable: (Month, Day, Year) Date Stamp JtIL 23 J CITY COVER PAGE Pag~ ~' of For Official Use Ortly 1. Type of Recipient Committee: A, Committees- Complete Pads 1, 2, 3, and 7. ~ Officeholder, Candidate Controlled Committee (Also Complete part 4.) [] Ballot Measure Committee O Primarily Formed O 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 COMMITTEE NAME STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP COOE AREA CODEA'HONE MAILING ADORESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP COOE AREA CODE./PHONE OPTIONAL: FAX / E-MAIL ADORESS 2. Type of Statement: [] Pre-election Statement  S emi-annual Statement Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Pre-election Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER MAILING ADDRESS CllY STATE ZIP COOE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAIUNG ADDRESS CiTY STATE ZIP CCOE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADORESS FPPC Form 460 (8/99) For Technical Asslatanc®: 916~3;~2.5650 State 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 CANDIDA'( E OFFICE SOUGHT CR HELD (INCLUDE LOCATION AND DISTRICT NUMBER iF APPLICABLE) RESIDENTIAL/~tJSINESS STATE ZIP Related Committees Not Included in this Statement: Llltanycomrnlllee9 not Included In thll consolidated stalemen! that are controlled by you or which are primarily formed lo receive contrlbullonl or to make expendlture9 on behalf of your candidacy. COMMITTEE NAME /I.D. NUMBER NAME CX® TREASURER CONTROl_LED COMMI~I'EE? [] YES [] NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP COOE 5. Ballot Measure Committee NAME OF BALLOT MEASURE ~ALLOT NO, OR LETTER I JURISDICTION I [] SUPPORT [] OPPOSE Identt(y the conf,'oiling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT AREA cODE/PHONE OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY 6. Primarily Formed Committee Lt,t n,,,e~ of o~c,hotdo,~) or c,ndldaf,(,) for which this committee Is prlnmrll¥ formed. NAME OF OFFICEHOLDER OR CANDIDATE FFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD OFFICE SouGHT OR HELD NAME OF OFFICEHOLDER OR CANDIDATE []SUPPORT []OPPOSE []SUPPORT [] Attach continuation sheets if necessary 7. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of rny knowledge the informatioR contained herein and in the attached schedules is t~ue and complete. I certify under penalty of perjury under the laws o~e~tat.e of California that the foregoing is true and correct. By SleN,~V/R~ ~; ~O.~OtUN~ O~iCEHO~OE,. C,,[~O^~. S,^TE ,~SOn~ P,O~ON~N~ O" nESPONS DATE DATE By By Executed on Executed on FPPC Form 460 (8/99) ForTechnlc&l Aselitance: 916~322-5660 State of Californle 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 Schedule A, Line 3 1. Monetary Contributions ...................................................... 2. Loans Received ................................................................... Schedule B, Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines f + 2 4. Nonmonetary Contributions ............................................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add L/nes 3 + 4, Column A ~O~^L ~,S P~OO Z.~, x-t oo ,oo 4 oo, oo 0 fl4,4-~0, O0 Statement covers period through [P/~0 /0} Column S* SUMMARY PAGE I.D. NUMBER Column C TOTAL TO DATE $ $. $ $ $ $ Expenditures Made Schedule E, Line 4 6. Payments Made .................................................................... Schedule H, Line 7 7. Loans Made .......................................................................... 8. SUBTOTAL CASH PAYMENTS ................................................Add Lines 6 + 7 9. Accrded Expenses (Unpaid Bills) ............................................ Schedule F. Line 3 10. Nonmonetary Adjustment ....................................................... ScheduleC, Line3 11. TOTAL EXPENDITURES MADE ......................................... Add Lines a + 9 + ~0 0 s ~,%IL~,i~ S $ $ $' Current Cash Statement 12. Beginning Cash Balance ................................ Previous Summary Page, Line ~6 13. Cash Receipts .............................................................. Column A, Line 3 above 14. Miscellaneous Increases to Cash ....................................... Schedule I, Line 4 Column A, Line 8 above 15. Cash Payments ............................................................ 16. ENDING CASH BALANCE .............. Add Lines 12 + t3 + ~4, then subtract Line 15 Il this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................... Schedule B. Pad I. Column (b) $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ..................................................... See inslruclions on reverse $ 19. Outstanding Debts ................................... Add Line 2 + Line 9 in Column C above $ Z4, 4o'o, s IG, ~o q'a,. 5Lo . LO * F~omrom previous statement Summary Page, Column C. However, if this ' I isthefirstrepodfiledforthecalendaryear, Column B should be blank I except for Loans Received (Line 2), Loans Made (Line 7}, and Accrued Expenses (One 9). Summary for Candidates in Both June and November Elections 111 through 6/30 711 to Dale 20. Contributions Received ............$ 21. Expenditures Made .................. FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule A Type or print in ink. SCHEDULE A through L~/~/0{ I Page ~ ~ IND '~w~ ~~2 ~¢¢~ ~ ~COM ~O SUBTOTAL $-~ c'l 00.003 Schedule A Summary 1. Amount received this period - contributions of $100 or more. (Include all Schedule A subtotals.) ....................................................................................................... $ ~../-)r, I C'.YO, ~ 2. Amount received this period - unitemized contributions of less than $100 ......................................... $ ~.~©. OO 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1 .) ................... TOTAL $ 7..~'~/-J-00,00 'Contributor Codes IND-Indivtdual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: 916~322-5660 SCHEDULE A (CONT.) Type or print In ink. Schedule A (Continuation Sheet) Amounts may be rounded I Statementcoversperiod Monetary Contributions Received towholedollars. NAME OF FILER FULL NAME. MAILING ADDRESS AND ZIP cODE OF CONTRIBUTOR DATE (IF COMMI~TEE, ALSO ENTER t+O. NUMBERI RECEIVED CODE IND COM [] OTH [] COM [] OTH [] COM [] OTH IND COM [] OTH [] COM [] OTH ~4ND [] COM [] OTH IF AN INDIVIDUAL, ENTER AMOUNT OCCUPATION AND EMPLOYER RECEIVED THIS ~\00 ~ [, ooo ~r~gto¥cd SUBTOTAL $ ~-~4 CUMULATIVE TO DATE CALENDAR yEAR (JAN 1 - DEC 31) CUMULATIVE TO DATE OTHER (IF APPLICABLE) I*Cont~butor Codes iND -Indlvidual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: 916522-5660 · Schedule A (Continuation Sheet) Typ, or print in Ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may De rounoea Statement covers period NAME OF FILER I.D. NUMBER DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIB~OR CONTRIB~OR ~CUPATION AND EMPLOYER RECEIVED ~IS CALENDAR YEAR · OTHER RECEIVED flF ~EE. ~O E~ER I.O. N~ER) CODE * (IF SE~%I~L~R N~E "ER~O (JAN I- DEC 31) 0F APPLIC~LE) ~/(~JOJ ~, DCOM SUBTOTAL 'Contflbuto~ Codes IND - Individual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical AImlstance: 9f 6/322-5660 Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) towholedollere, from \/0 ~ / O I tkrough I'~l'~.d.~fO( IPege "~ of FLAME OF FIkE~J I,~.~UI,~. ~U~B~fi IF AN INDIVIDUAL, ENTER AMOUNT CUMU~TiVE TO DATE CUMU~TIVE TO DATE DA~E FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIB~OR ~CUPATION AND EMPLOYER RECEIVED ~iS CALENDAR YEAR OTHER RECE~D (IFC~EE, A~OE~ERI.D.~BER) CODE * 0FSELF*E~E~Ys~ERN~E PERIOD (JAN1-DEC31) (IFAPPLICABLE) ~.L. ~ ~ ~SSo~ mIND m ou +/~/cl ~H ~ ~ SUBTOTALS ~,000,00 ~ I*Contributor Codes IND - Individual CUM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: g16,1322-5660 Schedule A (Continuation Sheet) Type or print In ink. SCHEDULE A (CONT.) Monetary Contributions Received ~moumsmeyoerounueo S[&;~,,,,=,,;c,,~ei:,perlod · · NAME OF FILER M ~/FO/O~ DCOM ~ 500 SUBTOTALS ~ ,'~-~ 0 {'Conl~bM~r Codas ] IND-Indlvtduel COM - Recipient Commlffee OTH - Other FPPC Form 460 (8/99) ForTechnlcsl Assistance: 916~22-5660 Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT.) ~JoJJetary Contributions Received Amounts may be roundedto whole dollars, fromS[a;"'"eh~ ~.,,v~;; perlodi/o I /~} j j;L~ ~IAME OF FILER M If AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE DATE FULL NAME, MAILING ADDR ESS AND ZIP CODE OF CONI~(IBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED 11dis CALENDAR YEAR OTHER RECEIVED {IF COM~EE. ALSO ENTER LO. h",lt m E R) CODE * (IF SELF-EMP~.OYED, EmER NN~E PERIOD (JAN 1 * DEC 31 ) (IF APPLICAI~LE) OF EUSIN~$S) LD.,UJ O f ~ C.z O~D yt v~(YJ~V~ ~ L..o~v~ ~ E]IND , ~ood 4 ~a~ OIND ~ ~J~ ~U~ DIND SUBTOTAL S 1 ) ~, oO L ['Contributor Codes IND - Individual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: 916~22-5660 Schedule A (Continuation Sheet) Typ, or print In Ink. SCHEDULE A (CONT.) Monetary Contributions Received Amountsmayberounded to,.,o,,,,o,,.r,. ,rom I i !il through ~/'~/0) I Page IO of I '~ NAME OF FILERII.D.NI.D. NUMBER ' IF AN INOIViDUAL, ENTER AMOUNT DUMULATIYE TO DATE CUMULATIVE TO DATE DATE FULL NAME. MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR OTHER REOE~VED 0F COMMITTEE, AL~O ENTE~ I.O..UMBER) CODE * 0 F SELF-EM~LOYEO, ENTER N~ME PERIOD I JAN 1. DEC 31) (IF APPLICABLE) OF 8USII~ESS) ~/o':/o~ noou DOTH SUBTOTALS J~o00,O0 *Contributor Codes IND - I~Mdual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Aseletence: 916/322-5660 Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT.) Monetary fJontriDutions Received .~moums may Be rounaea s;.;,=..=,,; covers period ,rom i/o /o NAME OF FILER~ I.O.N~LO. NUMBER IF AN INDIVIDUAL ENTER ~U~ CUMU~TIVE TO DATE CUMU~TIVE TO DATE DATE FULL NAME. MAILING ADDR ESS AND ZIP C~E OF CONTRIB~OR CONTRIB~OR ~CUPATION AND EMPLOYER RECEIVED ~IS CALENDAR YEAR OTHER RECEIVED ~F~EE, A~OE~ERI.D. ~n) CODE * ~FSELF-~OYEO, E~ER N~E PERIOD (JAN I - DEC 31) (IF APPLICABLE) OF BUSINESS) COCa) ~l~N~,~ ~OTH ~/io/o] ~ - DCOM NO, ~lO~ ~U SUBTOTAL $ I~ f~O0,O0 'Conlributor Codes IND - Individual COM - Recipient Committee OTH - Olher FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT.) Monetary Contributions Received ~.mounrsmayoeroun~eo S~,,~,,;.c~,v.=i&perlod ~AME OF FILER~I.D. NUMBER DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CON~IB~OR CON~IB~OR ~CUPATION AND EMPLOYER RECEIVED ~IS CALENDAR YEAR OTHER SUBTOTAL $ ,~, ~00, *C(mtflbutor Codes IND - Individual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE Type or print in Ink. Amounts may be rounded to whole dollars. through SCHEDULE D Page NAME OF FILER DATE I.D. NUMBER CANDIDATE AND OFFICE, MEASURE AND JURISDICTION, OR COMMITTEE ~-~'bpport [] Oppose [] Support [] Oppose TYPE OF PAYMENT ~/'Monetaw Cofltdbution [] Non-Monetary [] Independent Expenditure [] Monetary Coflthbution [] No~Monetary C<~t~bution [] Independent Expend'~ure [] Monetary Contributfon [] Ncn-M~etary Contribution [] Independent Expenditure DESCRIPTION OF NONMONETARY CONTRIBUTION (IF REQUIRED) AMOUNT THIS PERIOD [] Suppo~ [] Oppose SUBTOTAL $ ~l, O00 CUMULATIVEAMOUNT Calendar Year $ Other $ Calendar Year $ Other Calendar Year $ Other $ Schedule D Summary 1. Contributions and independent expenditures made this period o! $100 or more. (Include all Schedule D subtotals.) ........................................ 2. Unitemized contributions and independent expendilures 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 Asstatance: 916~22-$660 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. from through SCHEDULEE pog, I% of NAME OF FILER I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphe malieJmisc. CNS campaign consultants CTB contribution (explain nonmonetary)' CVC civic donations FND fundraising events IND independent expenditure suppoding/oppnsing others (explain)' LIT campaign lilemtum and mailings MTG meetings and appearanses OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO prolessional services (legal, accounting) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers salades TEL t.v. or cable airtirne and produclion costs TRC candidate bevel, lodging and meals (explain) TRS staff/spouse travel, lodging and meals (explain) TSF transtar between committees of the same candidate/sponsor VOT voter mgistmlJon WEB informatioo technology costs (interest, e-mail) NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * Paymen~ that are conbibuflons or In.pendent expenditures must also be summarized on Schedule D. SUBTOTALS Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................................................................................... $ '~,-/d'¢'! .'~! ~ 2. Unitemized payments made this period of under $100 ........................................................................................................................................ $ ~J'~-', ~-/~ 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) ....................................................... $ (~ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ......................... TOTAL $ ~',~J ~. i¢J FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule'E (Continuation Sheet) Payments Made Type or print tn ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF RLER Statement covere period through LO/:~ /~[ SCHEDULE E (GONI.i Page t~ of ~'~f~ I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. CNS campaign consullants CTB contribution (explain nonmonetary)* CVC civic donations FND fundraising events IND Independent expenditure supporting/opposing others (explain)* LIT campaign literature end mailings MTG msalings and appearances DFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging end meals (explain) TRS stall/spouse traveyodging and meals (explain) TSF transfer between committees of the same candidate/sponsor VDT voter registration WEB info,'marion technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, A~O ENTER ID. NUMBER) . Bu, Sq *Pay~thatarecontrlbutlenaerln~tex~ureamustalso~s~mar~donScheduleD, SUBTOTAL ~ ~,~.~ FPPC Fo~ 460 (~9) For Technical Assistance= 91~22-5660 Schedule E (Continuation Sheet) Payments Made SEE iNSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ~/0~ /0[ NAME OF RLER CODES: If one of the following codes accurately describes the payment, you may enter the code. OthenNise, describe the payment. CMP campaign paraphemalia/misc, CNS campaign consultants CTB contribution (explain nonmonetary)° CVC civic donaUons FND fondralstng events IND independent expenditure supporting/opposing others (explain)' LIT campaign literature and mailings MTG mee6ngs and appearances aFC office expenses PET peliflon circulating PHO phone banks PaL polling and survey research POS postage, deliven/and messenger services PRO professional son/ices (legal, accounting) PRT print ads RAD radioaidimeand ,roductioncosts SCHEDULEE(CONT.) I,D. NUMSER RFD returned contdbufious SAL campaign workers salades TEL t.v. or cable aidime and production costs TRC candidate travel, lodging and meals (explain) TRS staff/sponso travel, lodging and meals (explain) TSF transfer between committees of the same candidate/sponsor VaT voter registtatiou WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COM~II'Cr EE, AL~O ENTER ] O, NUMBER) , ID~ Payments that ere contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$~,ZZ.~.I~ 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. ~:--;--~,~t covers period from )/I /O ~ through C//~O/~ I SCHEDULEI SEE INSTRUCTIONS ON REVERSE Page J~- of I ~ NAM E OF FILER I.D. NUMBER DATE FULL NAME AND ADDRESS OF SOURCE DESCRIP~ON OF RECEIPT AMOUNT OF RECEIVED (~F COOl. EL. A~O ENTER I,O. N~BER) INCREASE TO CASH A~ach additional info~ation 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 Technics! Assistance: 916/322-5660