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Home My WebLink AboutCOUCH SEMIANN98(2) 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 flied: [] 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 tries Statement ............ NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMIER IF .APPtlCABLE) RES40ENTIAL OR IUSlNE$$ ADDRESS (NO. AND STREET) CITY STATE COMMITTEE NAME COMMITTEE ADDRESS (NO, AND STREET) ziP cool 7805' Y-e rxe /Z,oee CITY STATE ZIP B~ lceeS p, e/j ~4~ NAME OF TREASURER PERIdAN~NT ADORISS O~ TIIA$1/RtR (NO. AND STREtT~ CITY STATE Zl~ CODE ~,a ketz$12, e /j Cn iII Verification Type or print In ink. AREA CODE/DAYTIME FHONE LD. NUIdlER ry z/5,o Statement covers period Date Stamp from through /2'/3//9~/ "' ..... ' NAME O(~ TRLAt4~R COIdldlTrll AD0~$S COVER PAGE - LONG FORM ""'~7or Official Use Only ,t~,t&TZ~-~,~,;'i'?~ot Included in this 5 tatement: u,,,rome, coe~tn/tteeS not i~l~d in t~ c~dtdat~ ~atement ~t ere c~trolled by y~ ~ any c~es of ~h you haw k~wle~ that a~ ~aH~ f~m~ to receive c~trt~l~ ~ to make ex~ures ~ N~ff ofy~r ca~idaq. C~M~E[ ~ME ~ I D NUMIER C~ROLLED (NO. AND STREET) CITY STATE COMMnTEE NAME AREA COODOAYTIME I~CNCE NAME Oe TREASURER COMMITTEE ZIP COO[ AREA COOrdOAYTINIE I.D. NUMBER CONTROLtED COMMITTEE? ] YEs [] z~c(N~ AREA CO~A~T~ME AREA COOe. JO~,YTIME PHOeff (NO. AND STI!iET) sTATE Information on appropriately labe/ed cont/nua tlon I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my know he information contained herein end in the attached schedules is Executed on At By DAT! CITY ANO STATE SIGNATURE 0f CANOIDATI/OfFICIHOLDER Executed on At By DATE CITY AND STATE SIGNATURE Ol CANDIDATE/OFfICEHOLDER fOR INFORMATION REQUIRED TO IE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT Of 1977. $f i INFORMATION MANUAL ~ CAMPAIGN DISCt__OSURI PROVISIONS OF THE POLITICAl REFORM ACT Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE Contributions Received 1. Monetary Contri butions ............................... Schedu/e A, Une 3 2, LOans Received ......................................... Schedule a, Une 7 3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I ,~ 2 4, Non-monetary Contributions ......................... schedu/e c, une 3 5. SUBTOTAL CONTRIBUTIONSi(Exdude Enforceable Promises) Add Unes 3 + 4 6. Enforceable Promises (Exclude Loon Guarantees, Line 18 below) ................... Schedtde D, Une 7 7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddLInesS · 6 Expenditures Made 8. Cash Payments (Other than LOans Made) ............ Schedule E, U~e S 9. LOans Made ............................................. Schedde H, Une 7 10. SUBTOTAL CASH PAYMENTS ............................ AddLines8 · 9 11. Accrued Expenses(Unpaid Bills) ........................ ScheduleF, UneS 12. TOTAL EXPENDITURES MADE ......................... AddUnes 10 · 11 'Current Cash Statement 13. Beginning Cash Balance .................. PrevtousSummary Pafe, Une I7 14. Cash Receipts ...................................... CdumnA, Une3above 15. Miscellaneous Increases to Cash ........................ Schedu/e ;, Une 4 16. Cash Payments .................................... ColurnnA, Une lOebova 17. ENDING CASH BALANCE ..... Add Lines 13,14 4 15, thensubtradUne 16 ff thtS b a tenninettOn ltaternent, Line 17 mult be zero. 18. LOAN GUARANTEES RECEIVED .............. Schedulea, PartI, Column(b) $ Cash Equivalents and Outstanding Debts 19. Cash Equivalents ................................ See l~ on reverie 20. Outstanding Debts ................. AddLine2, Line 111nColurnnCabove COlUmn A TOIAL THIS fiROld ATIACI~D SCHEDULES) __ s ~,~.o5' s 1o, Ii~ s s 1~, ii~ ~NOIM6 CAn't ~ALAN(I SHOIA. D NOT ~ A N~GATIVI~ AIV!4~d~ Statement covers period ,,o, Column B* TOTAL PREVIOUS PEIUOD (SEE NOTE IELO W) ,27, 7~c~ ,~7, 27, 2Z SUMMARY PAGE I.D. NUMBER COIUITln C TOTAL TO DATE (ADD C04. UMN$ A · l) 520 s 3 3, ~ 23, ~Zo s 3~, ~ 38 5, 5,LO s 33, * From previous Statement Summary Page, Column C. However, if this is the first reDoft filed for the calendar year. Column B should be blank ext. ept for Loins Received (Line 2), Enforceable Promises (Line 6), Loans Made (Line g), and Accrued Expenses (Line 11). Summary for Candidates in Both June and November Elections 1/1 through 6/30 7/1 to Date 21 ontrib tions Schedule A Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE FULL NAME AND ADDRESS OF CONTRIBUTOR DATE (if COMMITTEE IN ADDfil0N TO COMMITTEE'S NAME AND ADDRESS [NTERI.D. NUMEER RECEIVED · · Ot~ if NO I.D. NUMBER HAS IEEN ASSIGNED, ENTER TREASURER°$ NAME AND ADDRESS) OCCUPATION AND EMPLOYER (II~ SELf-EMPI. OYED, ENTER NAME OF IIU$1N[SS) Statement covers period ,,om thro..h AMOUNT RECEIVED THIS PERIOD I.D. NUMBER CUMULATIVE TO DATE CALENDAR YEAR '(JAN, 1 - DEC. 31) ~ ~ ! SUBTOTAL S/,ago 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 $ CUMULATIVE TO DATE OTHER (IF APPLICABLE) 7~2 5o Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink, Amounts may be rounded to whole dollars. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE FULL NAME AND ADDRESS OF CONTHIEUTOR DATE 0f C~M~EE, IN ADDff~ TO C~M~[E'$ ~ME AND AD~S$, E~ER I.D. N~R RECEIVED ~ IF ~ I.D. NUMI[R I$ IE[N ASkeD, E~ER T~ASU~R'$ ~ME AND OCCUPATION AND E MPLOYE R (HI: $ELF-EMIq. OYED, ENTER NAME O~ IU$1NES$) 2'~$'v,e,, a te /O~; e-/7 S, /,, ,, ~ Statement covers period ,,, thrOugh AMOUNT RECEIVED THIS PERIOD lo0 6'qO. SCHEDULE A (cont.) . ,~ ~.. . ', .<' ~ ~ ,,: ::. __ fP,,,. q I.D. NUMBER CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 3 1 ) CUMULATIVE TO DATE OTHER (IF APPLICABLE) SUBTOTAL $/m / q't~, ::: . : Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE FULL NAME AND ADDRESS OF CONTRIBUTOR DATE (IF COMMfT[EE, IN ADDITION 10 COMMITTEE°$ NAME AND ADDRESS, ENTER I,O. NUMBER RE CE I VE D OR. IF NO I.D, NUMIER HAS BEEN ASSIGNED, ENTER TREASURER*S NAME AND ADDRESS) OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME Of BUSINESS) SUBTOTAL Statement covers period ,,o., "'l'~lq~ .. ,.,o.o. l~l~,l'~ AMOUNT RECEIVED THIS PERIOD SCHEDULE A (conE.) CUMULATIVE TO DATE CALENDAR YEAR (JAN. I - DEC. 31) 18o CUMULATIVE TO DATE OTHER (IF APPLICABLE) s 2,o~o Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE DATE RECEIVED FULL NAME AND ADDRESS OF CONTRIBUTOR (It CO MMrI'I'EE, IN ADDITION TO COMMrlTE['$ NAME AND ADDRESS, ENTER I.D. NUMBER OR. IF NO I.D. NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'$ NAME ANO OCCUPATION AND EMPLOYER (IF SErF-EMPLOYED, ENTER NAME Of BUSINESS) D e ,, e/op ee t..1/,4/9s Statement covers period throu,,h AMOUNT RECEIVED THIS PERIOD SCHEDULE A (cont.) ~ .< i-; ,~ ::':; ~ ,~::-' ;,~ ::7 ~ CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 3 1 ) 40¥0 CUMULATIVE TO DATE OTHER (IF APPLICABLE) SUBTOTAL Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE DATE RECEIVED / 2/7/? FULL NAME AND ADDRESS OF CONTRIBUTOR (IF COMMrt~[[, f,N AODffK N TO COMMrr~EE'$ NAME AND ~DD~S$, ENTER I.D. ~ IF NO I.D. NUMIE~ ~S IEEN A$~NED, EffiER TREASUER'$ NAME AND ADD~SS) OCCUPATION AND EMPLOYER (IF SELl-EMPLOYED, ENTER NAME Of BUSINESS) Statement covers period ,rom AMOUNT RECEIVED THIS PERIOD SCHEDULE A (ConE.) : .............· ",I~,~. __ .-:>..,:. 7:.%::::. ~ I.D. NUMBER CUMULATIVE TO DATE CUMULATIVE TO DATE C, ALE NDAR YEAR OTH E R (JAN. I - DEC. 31) (IF APPLICABLE) / qa / q~ SUBTOTAL Schedule E Payments and Contributions (Other Than Loans) Made Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE CODES FOR CLASSIFYING EXPENDITURES Statement covers period from thro.0h/ / '1 SCHEDULE E Page ~ of NUMBER If one of the following codes accurately describes the expenditure, ou may enter the code and leave the "Description of Payment' co|umn blank. Refer to the back of Schedule E-Continuation Sheet for detailed explanations of Y;ach category. 'C'- MONETARY AND IN-KIND (NON-MONETARY) CONTRIBUTIONS TO OTHER CANDIDATES AND COMMITTEES INDEPENDENT EXPENDITURES LITERATURE '1" - NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION (if CO MMrtn~i, IN hOOrflON TO COMMIT~EE'S NAME ANO AIX)I~SS, IN~ER t.D. NUMIER OR, W NO I.D NUMIER HAS lIEN ASSIGNED, ENT[R TII~ASUI~R~ NAME AND ADDRESS) 'B' - BROADCAST ADVERTISING 'G' - 'N" - NEWSPAPER AND PERIODICAL ADVERTISING 'T' - °O" - OUTSIDE ADVERTISING "S" - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS 'P' ' 'F" - FUNDRAISING EVENTS GENERAL OPERATIONS AND OVERHEAD TRAVEL, ACCOMMODATIONS AND MEALS (MUST BE DESCRIBED) PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON UNE 4 OF THE SUMMARY SECTtON BELOW. CODE OR DESCRIPTION OF PAtMENT L Im rtant: Contributions and expenditures made out of campaign funds to or on behalf of other o~ic;holders, candidates, commmttees, or ballot measures must also be entered on the Allocation Page, Part I. Payments and Contributions Made Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................ ~ ......................... $ ... 2. Payments made this period of under $10 ize.) ....................................................................... $ 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. $ 4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ..................................... $ 5. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) ........... TOTAL $ AMOUNT PAID 251 SUBTOTAL 7,./ Schedule E (Continuation Sheet) Payments and Contributions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE 'C' - MONETARY AND IN-KIND (NON-MONETARY) °B' - CONTRIBUTIONS TO OTHER CANDIDATES °N' - AND COMMITTEES °O" - "1' - INDEPENDENT EXPENDITURES =S~ _ 't"- LITERATURE =F"- NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION (if COMMITrEE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS. ENTER I.D. NUMBER OR. If NO I.D: NUMBER HAS IEEN ASSIGNED, ElftER TREASURER'S NAME AND ADDRESS) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period ,,o. t,.o.0, CODES FOR CLASSIFYING EXPENDITURES BROADCAST ADVERTISING NEWSPAPER AND PERIODICAL ADVERTISING OUTSIDE ADVERTISING SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS FUNDRAISING EVENTS CODE OR A/ L 0 -p- _ GENERAL OPERATIONS AND OVERHEAD TRAVEL, ACCOMMODATIONS AND MEALS (MUST BE DESCRIBED). PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES : DESCRIPTION OF PAYMENT AMOUNT PAID 375 SUBTOTAL Schedule E (Continuation Sheet) Payments and Contributions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE "C' - MONETARY AND IN-KIND (NON-MONETARY) 'B" - CONTRIBUTIONS TO OTHER CANDIDATES 'N' - AND COMMITTEES 'O' - '1' - INDEPENDENT EXPENDITURES 'S" - "L'- LITERATURE 'F'- NAME AND ADDRESS OF PAYEE. CREDITOR, OR RECIPIENT OF CONTRIBUTION (if COMMITrEE, IN ADDITION TO COMMITtEE'$ NAME ANO ADDRESS.. ENTER t.O. NUMBER OIL tf NO LD. NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'$ NAME AND ADDRESS) Reed ? ~ ~ Type or print in ink. Amounts may be rounded to whole dollars, Statement covers period ,.ore /4/ff CODES FOR CLASSIFYING EXPENDITURES BROADCAST ADVERTISING "G' '- NEWSPAPER AND PERIODICAL ADVERTISING 'T' - OUTSIDE ADVERTISING -p- _ SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS FUNDRAISING EVENTS CODE OR N P SCHEDULE E (cont.) Page I.D. NUMBER GENERAL OPERATIONS AND OVERHEAD TRAVEL, ACCOMMODATIONS AND MEALS (MUST BE DESCRIBED) PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES DESCRIPTION OF PAYMENT AMOUNT PAiD SUBTOTAL $ ~, ~ ~..~ Schedule E (Continuation Sheet) Payments and Contributions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE D. ,, ,~/ C- ~ ~-. F~ ,e -,js o ~ D,, ~,~/ "C" - MONETARY AND IN-KIND (NON-MONETARY) 'B' - CONTRIBUTIONS TO OTHER CANDIDATES "N' - AND COMMITTEES 'O' - *1' -- INDEPENDENT EXPENDITURES 'S' - 'L'- LITERATURE "F'- l NAME AND ADDRESS OF PAYEE, CREDITOR. OR RECIPIENT OF CONTRIBUTION (IF COMMITTEE. IN ADO[lION TO COMMrt1E['c, NAME AND ADDR[5.S. EN1~R I,D. NUMBER 0t~ |r NO I.D, NUMBER HAS 8EEN ASSIGNED, ENdE'ER TREASURER'S NAME AND ADDRESS) /4. L~ ,~. R. T 5. Type or print in ink. Amounts may be rounded to whole dollars, Statement covers period CODES FOR CLASSIFYING EXPENDITURES BROADCAST ADVERTISING *G' -- NEW$PAPER AND PERIODICAL ADVERTISING "T' - OUTSIDE ADVERTISING SURVEYS, SIGNATURE GATHERING, DOOR-TO*DOOR SOLiCiTATIONS FUNDRAISING EVENTS CODE OR F SCHEDULE E (cont.) I.D. NUMBER GENERAL OPERATIONS AND OVERHEAD TRAVEL, ACCOMMODATIONS AND MEALS (MUST BE DESCRIBED) PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES DESCRIPTION OF PAYMENT AMOUNT PAID lee /, q3o SUBTOTAL Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE DATE FULL NAME AND ADDRESS OF SOURCE RECEIVE D (JF COMMII'T/~E, IN ADDITION TO COMMITfEE'S NAME AND ADDRESS, ENTER LD. NUMBER O~ IF NO I.D. NUMBER HAS BEEN ASSIGNED, il~rER TREASURER'S NAME AND ADDRESS) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from throu.. DESCRIPTION OF RECEIPT SCHEDULE ',:::::.:.: ,:::! ':i":':::':.?:::::!:~:"">""""':::.~:'~ ::.':::~:~:~:~.!=:!!':::~'~E~, .~ :: :'! ~::: :~i !3: ~::~ :~!/. !!~ !.:: ~.,'.:, :~i :-~,,. ~%. ~] I.D. NUMBER AMOUNT OF INCREASE TO CASH · 720. 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 /, ,yZg~. I '/ZZ "" /