HomeMy WebLinkAboutROWLES SEMIANN98(2) fficeholder, Candidate,
and Controlled Committee
Campaign Statement - Long Form
(Government Code Sections 84200-84216 3)
SEE INSTRUCTIONS ON REVERSE
Check one of the following boxes to Indicate the type of statement being filed:
BPre-eledton Statement
Supplemental Pre-electton Statement (Attach e completed Form 495 to this statement,)
' Special Odd-Year Campaign Rel~ort
q,v Semi-annual Statement
= Termination Statement (Attach · completed Form 41S to this statement.)
~)ffic holder Candidate, and Controlled Committee
Inclu:~ed in tries Statement
COMMITTEll ~AME
STATE
Verificflion
ZIP CODE
Type or print in Ink.
Statement covers period
.ore ~ltlq~
,h,o.g. PIst
Date of alealign If applicable:
(Month, Day, Year)
Ii
COVER PAGE - LONG FORM
Other Committees ~ot Included in this $tatement:
NAMI O; TREASURER
AREA CODE/t)AYTIAE PHONE COMMnlll ADDRESS {NO, ANO STill!T)
(zcyS) 3 s- qoza,
,.O, NUMIER CITY STATE
ARIA CODE/DAYTIME PHONE NAME Of TREASURIR
COMMrrIEE ADI)RISS (NO. AND STRIVEn
CITY STATE
(ONTROtUD COMMITtEES
] ,S [] ,,O
I)P CO0[ AREA (OOf.4MYTNdt PHONI
I.O. NUMIER
CONTROllED C0MMrTTE! t
n YEs [] ,o
It CGIX AI~.A CQIX4)AYTIME PHONI
Attach additional information on appropriately labeled continuation xheeb.
! have used all reasonable diligence in preparing this statement, I have reviewed the statement and to the best of knowledge the Information contained herein and In the attached schedules is
;':2::.'; .;.;'
7~A~[ , CITY AND STAID S!G~R[ 0t TREASURER
An officeholder or candidate who controls a committee must also verily the campal n statement. I have used all reasonable diligence and to the best of my knowledge the treasurer has used all
reesonlble diligence in preparing this statement. I have reviewed the statement e,n~to the best of .my k. nowledg~ th h ,,at~ conSeine herein and i the attached schedules is true and
,,., ,,. ,...,o.., .. :;
Executed On. .AtE At crrv
DATE CffY ANO STALE S!6NAIURE Of CANOIOAS!/OIfiCIItOtDEII
Executed on At By ' '
DAlE (fly AtlO SlAtE ~IGNAIUR! 0l CAND!OAEI~OIEI(!ItOtD! R
FOR INfORMATION REOUIRi~ TO ST PR0vlnrD TO Yn!l PUR~I/ANI TO Till INFDRMATIr)N PRA('TI(E t Aft O! 1971. t, lr INSfORMATION MANUA[ ON CAMPAIGN DIS(:IOq~IJRE PROVI$1ON~ O; _I_HE PO{,IT~At~EIORM_~A.~
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
Contrib~ions I~eceived
1. Monetary Contributions ............................... Schedule A, line 3
2. Loans Received ......................................... Schedule a, Line 7
3. SUBTOTALCASH CONTRIBUTIONS ...................... AddUnes f, 2
4. Non-monetary Contributions ......................... Schedule C, Line 3
5. SUBTOTAL CONTRIBUTIONS:(hdude/nforceab/e Promises) AddUnes 3 ,, 4
6. Enforceable Promises
fE, tlude Loan Guarantees, Unefe below) ................... Schedule D, Une 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnes5 · 6
· Expenditures Made
8. Cash Payments (Other than Loans Made) ............~hedule ~, line S
g. Loans Made .............................................Schedule., LIne 7
10. SUBTOTALCASH PAYMENTS ............................AddUnesa · 9
11. Accrued Expenses (Unpaid Bills) ......................Schedule F. LIne S
12. TOTAL EXPENDITURES MADi: ................... AddUneg 10 · l I
Current Cash Statement
13. Beginning Cash Balance .................. Prevlous Summary Page, line f7
14. Cash Receipts ......................................column A, Une J above
15. Miscellaneous Increases to Cash ........................Schedule I, LIne 4
16. Cash Payments ....................................ColumnA, LIne fOabove
17. ENDING CASH BALANCE ..... Addlines I3 , 14 ~ 15, fhensubtrad LIne 16
If thll 11 1 lermlnmflon llmtement, Line 17 mull be zero.
18. LOAN GUARANTEES RECEIVED .............. Schedule I~, Part l, Column(b)S
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................See Instrudlons on reverse$
20. Outstanding Debts ................. AddSine 2 , line If lnColumnCabove $
Type or print In Ink.
Amounts may be rounded
to whole dollars.
Column A
TOTAL Ttl$ PIRIOI)
ffROM ATTACHED S(}tEDULES)
Statement ¢overl period
,,0,. -71 lq ',2
,h,o... 191 1
SUMMARY PAGE
I.D. NUMBER
q ,o O'g
Column B* Column C
TOTAL PRIVIOU$ PERIOD TOTAL 10 DATE
BEt NOTE IILOW~
s t 55qL q 5
* From previous Statement Summary Page, Column C. However, If
this is the lint report filed for the calendar leer, Column B should be
blank except for Loans Received (LIne 2), Enforceable Promises (Ltne
6), Loans Made (Line g), and AcCrut~l Expensel (Line t 1).
Summary for Candidates in Both June and
November Elections
111 through 6/30 711 to Date
21. ontrib lions
Schedule E
Payments and Contributions
(Other Than Loans) Made
Type or pHnl In ink.
AreomitS mly be rounded
to whole dollars,
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
CODES FOR CLASSIFYING EXPENDITURES
Statement covers period
,,ore
SCHEDULE E
If one of the following codes accurately describes the expenditure, ou 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 Y;ach category.
"C' - MONETARY AND IN-KIND (NON-MONETARY}
CONTRIBUTIONS TO OTHER CANDIDATES
AND COMMITFEES
"1' - INDEPENDENT EXPENDITURES
"L"- LITERATURE
NAME ANDADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
(ff COMMfiTII, IN ADDITION TO COMMITTII'S NAM[ AND At)OR[ $'L 1 NTIR I P NUMI[ R OR, If NO I D
NUMIIR HAS It[N A~e~IGNED. IN11ER TRIAe, URER'S NAME ANt) At)DRlSq, i)
"g' = BROADCAST ADVERTISING
"N" - NEWSPAPER AND PERIODICAL ADVERTISING
°O' - OUTSIDE ADVERTISING
"S" - SURVEYS. SIGNATURE GATHERING. DOOR-TO-DOOR SOLICITATIONS
'F" - FUNDRAISING EVENTS
'G' - GENERAL OPERATIONS AND OVERHEAD
°T" - TRAVEL, ACCOMMODATIONS AND MEALS
(MUST BE DESCRIBED)
'P' - PROFESSIONAL MANAGEMENT AND CONSULTING
SERVICES
IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
REPORT ONLY Tile LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW.
CODE
G
OR DESCRIPTION OF PAtMENT
ca:u n3 clna9 ce, s
"Ira' ~rfant;' contribUtion; ~n'd ;xeenditures n~ade out of campaign funds to or on behalf of other
o~i~eholders, candidates, comm#ttees, or ballot measures must also be entered on the Allocation Page Part I.
Payments and Contributions Made Summary
|. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................ : ......................... $
2. Payments made this period of under $100. (Do not itemize.) ....................................................................... $
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. $
4. Tota ize. Enter amount from Schedule F, Line 4.) ..................................... $
5, Total payments mad~thi~pnrind: (Add lin,~ t, 7, !, and 4, Enter here nnd nn theSummary Pagn, Cohm~n A, Line B) ........... TOTAL $
AMOUNT PAID
SUeTOTAL $
Schedule l
Miscellaneous Increases to Cash
SEE INSIRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
DATE FULL NAME AND ADDRESS OF SOURCE
RECEIVED lit COMMITTEI[, IN ADDITION TO COMMII'/EE'S NAME AND ADDRESS, ENTIR I t) NUMRER
OR, Ir NO I.O. NUMIER HAS IEEN ASSIGNED, ENIER TREASUR[R'S NAM[ AND ADDRESS)
Type or print In Ink.
Amounts may be rounded
to whole dollars.
Statement covers period
,,o.
,.,o.., IDISt/q
DESCRIPTION OF RECEIPT
SCHEDULE I
Page q d ,q ,,q
I.D, NUMBER
q30503
AMOUNT OF
INCREASE TO CASH
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