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Home My WebLink AboutSMITH SEMIANN97(2) 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 indicate the type of statement being filed: [] Pre-ejection Statement [~ Supplemental Pre-election Statement CA. ach a completed Form ag5 tO this statement.) ArSpecial Odd-Year Campaign Report Semi-annual Statement ruination Statement (At~ach a corn plated Form at S to this statement.) ceholder, Candidate, and Controlled Committee included in this Statement Statement covers period from ! I ~ 1 r / through~ / ~ f Date of election ff applicable: (Month. Day. Year) II Date Stamp COVER PAGE - LONG FORM For Official Use Only ~'~ ~) fi ( ~i)~ ~.~.~ ~-q f L~ ! . Attac~addRIonal fnforrna.on on appropHatel¥1aboledcontlnuatlons~eet~. III Verification reachable diligence in pre,ring this ~atement. I have revi~ the ~atement and to the ~ of my kn~dgez~e information conta~ her~n and in the a~ached ~h~ul~ is have true and complY. I ce~i~ under ~na~ of ~rju~ under the ta~ of the State of ~lifomia that the for~oi~ istrue~r~. // A~offlce~lt~ltew~cont~oIslcomm~elmu~lllover~ecam~Ig~liml~. I have u~d all rea~nable diligence and to the ~ of my kn~l~ge the treasurer has u~ all reasonable dilige~e in pre,ring this ~atement. I have reviewed the ~atement and to the ~ of my kn~l~ge the infor~tion contaiaed h~rein and in the a~ached schedules is true and complete. I ce~i~ under ~nal~ of ~rju~ under the ta~ of the State of California that the foregoing is true arid corr,. [ ~ ~ ~ eATE C~ AND STATE SIGNATURE OF ~NDIOATE/OFF~E~DER Executed on, At By Executed on At By State of California Fair Political Practices Commission COMMITTEE ADDRESS (NO, AND STREET) C/TY STATE ZIP CODE AI~EA CODEJOAY TIME ~ Other Committees i aot Included in this Statement: u~anyo~, cornm/ttees not included in this consolidated rtatement that are contro#ed by you and any comm/t~ees of which you have knowledge that are primariiy formed to receive contribution~ o~ to make expenditures on behalf of your candldacy. Campaign Disclosure Statement Summary Page Type or print In inl(. Amounts may be rounded to whole dollars. SEE iNSTRUCTIONS ON REVERSE through NAM~OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEEF-~ Contributions Received Column 1. Monetary Contributions ............................... Sc~e~u~ A, Line ~. Loans Received ......................................... s~h~o~ule a, une 7 3. SUBTOTALCASHCONTRiBUTiONS ...................... ,~dd unes ; +2 $ _. _~__ 4. Non-moneta ry Contributions ......................... 5. SUBTOTAL CONTRIBUTlONSi(Exdude Enforceabte Promises) add Lines3 6. Enforceable Promises (Exdude Loan Guarantees, Line 18 below) ................... $chedu/e D, 7. TOTAL CONTRIBUTIONS RECEIVED ..................... ,~ddLinesS. 6 $ ~ Expenditures Made 8. CashPayments(OtherthanLoansMade) ............ Schedule£,UneS $ ~,00 9. Loans Made ............................................. .~d~dute H, Line 7 10. SUBTOTAL CASH PAYMENTS ............................ AddLines8 1 1. Accrued Expenses (Unpaid Bills) ........................ 12. TOTAL EXPENDITURES MADE ......................... Column B* SUMMARY PAGE I.D. NUMBER Column C s _ OO ~T lie A NtGATiVE AMOUNT -- -- ~-- 18. LOAN GUARANTEE5 RECEIVED .............. ~hedulee, Part~,¢olumn(N Cash Equivalents and Ou~tanding Debts 19. Cash [quivalents ~,t~m~ons~ve~ ~ ~ 22. [~p~nditures ................................ 20. Ou~l~nd~ ~ ................. ~ Um ~ ~ urrent Cash Statement 13. Beginning Cash Balance .................. PrevlousSummao, Page, Line rr S ~a. ~sh R~eip~ ............................... : ...... C~umnA u~ 3 a~ 15. Mi~ellaneous Increases to Cash ........................ ~e 16. ~sh Paymen~ .................................... C~umnA, U~lOa~ 17. ENDING ~SH BA~NCE ..... A~LI~J ff this ~ a ~[~ff~ ~atement, ~ From previous Statement Summary Page, Column C. However, if this is the first report filed for the calendar year, Column a should be blank e~cept for Loans Received (Line 2), Enforceable Promises (Line 6), Loans Mede (Line 9), and Accrued Expenses (Line 11 ). Summary for Candidates in Both June and November EJections Schedule E Payments and Con ribu.tions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period_ NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE CODES FOR C~$SIF¥~G £XP~NDITURES SCHEDULE I.D. NUMBER If one of the following codes accurately describes the expenditure,you may enter the code and leave the "Description of Payment' column blank. Refer to the back of Schedule E-Continuation Sheet for detailed explanations of each category. 'C'- MONETARYANDIN-KIND(NONoMONETA~tY) "B'- RROADCASTADVERTISING "G'- GENERALOPERATiONSANDOVERHEAD CONTRIRUTIONSTOOTHERCANDIDATES 'N'~ NEWSPAPERANDPERIODICALADVERTISING 'T'- TRAVEL, ACCOMMODATIONSANDMEALS AND COMMITTEES #O'- OUTSIDE ADVERTISING {MUST BE DESCRIBED) ~1' - INDEPENDENTEXPENDITURES ~S'- SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOORSOLICITATIONS "P'- PROFESSIONALMANAGEMENTANDCONSULTING SERVICES ~L~ LITERATURE ~F"- FUNORAISINGEVENTS NAME AND ADDRESS OF PAYEE, CREDITOR. OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E. (IF COMM~TEE. rkl ADD I1q~fl TO COM M~/'i'EE*5 NAME AND ADDRESS. ENTER I.O. NUMBER OR, Er NO I.D. RE PORT ONLY THE LU M P SUM OF SUCH PAYM E NTS ON LIN E 4 OF TH E SUM MARY SECTION RE LOW. NUMBE~ HAS BEEN ASS~NED, Eflfft~R YaJEA SU RI R'S NAM~ AND ADDRESS) CODE OR DESCRIPTION OF PA~'MENT AMOUNT PAID Important: Contributions and exp_enditures made out of campaign funds to or on behalf of other ~iceh~ders~candidate$~c~mm~ttees~rba~tmeasure$musta~$~beentered~ntheA~cati~nPage~Par~. : SUBTOTAL Payments and Contributions Made 5umrnary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ...................................................... 2. Payments made this period of under $ I00. (Do not itemize.) ....................................................................... 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part It, Column (d).) .............................. 4. Total accrued expenses paid this period. (Do not Itemize. Enter amount from Schedule F, Line 4.) ..................................... 5. Total paymentsmadethisperiod. (Add Lines 1,2,3, and4. Enter hereand on the Summary Page, ColumnA, Line8.) ........... TOTAL Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE Statement covers period Attach additional information on appropriately labeled continuation sheets. Miscellaneous increases to Cash Summary i. increases to cash of $ 100 or more this period ............................................................. 2. Increasestocash under $100thisperiod. (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 NAME OF OFF~CEHOLOER OR CANOIOATE ANO CONTROLLEO COMMITTEE DATE RECE~VEO FULL NAME AND ADDRESS OF SOURCE OESCR~PTION OF RECEIPT SUBTOTAL SCHEDULE o, c/ LO. NUMBER AMOUNT OF INCREASE TO CASH Type or print in ink. Amounts may be rounded to whole dollars. through