HomeMy WebLinkAboutMAGGARD SEMIANN98(2) BCSD fficeholder, Candidate,
and Controlled Committee
Campaign Statement -- Long Form
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Check one of the following boxes to indicate the type of statement being filed: [] Pre-election Statement
_El Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.)
Special Odd-Year Campaign Report
'_~Semi-annual Statement
Included in tl~is Statement
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPtlCAILE)
RESIDENTIAL OR BUSINESS ADDRESS (NO. ANd STREET) ' '% '[ [L' [ J
~t'! P/'*,--Xoru,-,,,.,,,.
Type or print in ink.
III
CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE
COMMITTEE NAME ,.D. NUNleER
COMMI11E[ ADDRESS ~ JNO, AND STREET)
"tqt7 'P,a,l,~-_.4--,,. h--,z.,,,-c
CITy STATE ZIP CODE AREA CODE/DAYTIME fiIONE
/-
NAME OF TREASURER
PERMANEHT ADDRESS DE TREASURER {NO. AND STREET)
CIIY STATE ZIP CODE AREA CODE/~AYTIME PHONE
Verification
Statement covers period Date Stamp
f,om Ju~,/
through
Date of e~d~n
{Month, Day, Year) :: C~'( b'-~ ....
For Official Use Only
~'~o~re'~-~mtrnrfi~es~:~e"a'm"~ls'1tatement': u. ,ny ome,
comm/ttee/not included in this comolidated statement that are controlled by you led any
comm~ees of which you haw know!edge that are primarily formed to receive contribution
or to make expenditures on behalf of your candidacy,
COMMITTEE NAME fi~l
NAME OF TREASURER
COMMITTEE ADDRESS (NO. AND STREET)
ZiP CODE
CITY STATE
COMMITTEE NAME
NAME OF TREASURER
(NO, AND STREET)
COMMITTEE ADDRESS
II.D. NUMIER
CONTROLLED COMMITTIlt
] ','Es [] No
JI.D. NUMIER
CONTROLtED COMMrlTEET
]-YES [] NO
CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE
Attach additional information on appropriately labeled continuation sheets.
I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the information contained herein and in the attached schedules is
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,....,.,o. .,
city AND STATE '/ SIGNATURE OF T SURER
An officeholder or candidate who controls a committee must also verify the campaign statement, I have used all reasonable diligence and to the best of my knowledge the treasurer has used all
reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the information contained herein and in the attached schedules is true and
complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and corred.
Executed on By
DATE CITY AND STATE
Executed on At By
DATE CITy AND STATE
Executed on At By
DATE CITY AND STATE
SIGNATURE OF CANDIDATE/OFFICEHOLDER
SIGNATURE OF CANDIDATE/OFFICEHOLDER
FOR INFORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISJON$ OF THE POLITICAL REFORM ACT
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
'NAMEOFOFFICEHOLDERORCANDIDATEANDCONTROLLEDCOMMiTTEE
Contributions Received '
1. Monetary Contributions ............................... Schedu~eA, Line3 $
2. Loans Received
......................................... Schedule B, Line 7
3 SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I ,, 2 $
4. Non-monetary Contri butions ......................... Schedule c, une 3
5. SUBTOTAL CONTRIBUTlONS!(Exdude Enforceeble promlses) Add Unes 3 ,,4 $
6. Enforceable Promises
(Exclude Loan Guarantees, Line 18 below) ................... Schedule D, Line 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnesS · 6 S
· Expenditures Made
8. Cash Payments (Other than L. oans Made) ............ Schedule E, Une S S
9. Loans Made Schedule H, Une 7
10, SUBTOTAL CASH PAYMENTS ............................ AddLtnesa, 9 S
11. Accrued Expenses (Unpaid Bills) ........................ Schedule F, Une S
12, TOTAL EXPENDITURES MADE ........................ AddUnes I0 · I1 $
Current Cash Statement
13. Beginning Cash Balance .................. Prevlous Summary page, rim 17 $
14. Cash Receipts ...................................... ColumnA, Line3above
15, Miscellaneous Increases to Cash ........................ Schedule I, Line 4
16, Cash Payments .................................... ColumnA, Line 10above
17, ENDING CASH BALANCE ..... AddLines f3
ff this is a termination statement, Line 17 must be zero,
18. LOAN GUARANTEES RECEIVED .............. Schedule B, Patti, Column (b) $
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................ see instructtom on reverse $
20. Outstanding Debts C>~-~ c~6~., L-o/~,~t:_-> 6-i~-~(o
................. Add Li~e 2 , Une f f ln Column C above $
Type or print In ink. SUMMARY PAGE
Amounts may be rounded Statement covers period
to .hole de.a,,.
from -~ _ ~ _ c~, ':::~: : .,:,
I,D,
Column A Column B· Column C
IOIAL ~ ~NOD TOTAL ~S FE~ TOTAL TO DA~
-0 -- --o-
ENDIN~ CASH IAI. ANCE SHOULD
NOr I!~ A NEGATIVE AMOUNT
* From previous Statement Summary Page, Column C. However, if
this is the first report filed for the calendar year, Column B should be
blank except for Loam Received (Line 2), Enforceable Promises (Line
6), Loam Made (Line 9), and Accrued Expenses (Line 11 ).
Summary for Candidates in Both June and
November Elections
21, ontrib tions
111 through 6/30 711 to Date
--~ ~ -e~
Schedule B --Part III
Annual Report of Outstanding Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
FULL NAME OF LENDER ORIGINAL DATE OF LOAN
Attach additional information on appropriately labeled continuation sheets.
Type or print in ink.
Amounts may be rounded
to whole dollars.
AMOUNT OF ORIGINAL LOAN
TOTAL
Statement covers period
from I - ~ ~:~ ~
through
UNPAID PRINCIPAL
tit oo
NOTE: This totalshouldbe
the same amount as entered
on the Summary Page,
Column C, Line 2,
SCHEDULE B - Part III
Page__
I.D. NUMBER
UNPAID INTEREST