HomeMy WebLinkAboutROWLES SEMIANN98(2) OH fficeholder, Candidate,
and Controlled Committee
Campaign Statement - Long Form
Type or print in Ink.
(Government Code Sections 84200-84216 3)
SEE INSTRUCTIONS ON REVERSE
(beet one of the following boxes to Indicate the type of statement bolng flied: Pre-election Statement
Supplemental Pre-election Statement (Attach a completed Form 495 to this statement,)
' Special Odd-Year Campaign Report
' Semi-lnnuel Statement
= Termination Statement (Attach a completed Form 4 15 to this statement.)
I :)ffic holder Candidate, and Controlled Committee
Inclu:]ed in tt~is Statement
ARI, A CODE/OAYTIME PHONE
LD, NUMIER
AR~A CODE/DAYTIME PHONE
~ 3 ~C) E IIYI
COMMI~EE NAME '
STATE ZIP
~A~ ~SS ~ T~R
C~ STATE Z~ C~l I A~A C~AYT~E ~E
~cS~CeH, ~ q3,~q L~bS~s* ~
iII Verification
Statement covers period Date Stamp
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II
COVER PAGE - LONG FORM
·;, , .~:: ( >. ~': ~:, ';~ s~ '
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For Official U~e Only
uther Committees qot Included in this 5 tatement: cm,.yothe,
commil~ees not Included In this consollda ted sla lament that are controlled by you and any
coma/frees of which you have knowledge that are primarily formed to receive contributions
or to make expenditures on bahaft of your cand/dacy.
COMMrFrEE NAME i.O. NUMBER
NAME O~ TREASUI~R CONTILED COMMrrrEll
] Y.s [] No
COMMIT/E! ADI~IS (NO. AND STREET)
CITY STATE Zlt COO[ AREA C00E/DAYTIM[ PfiON!
COMMITTEE NAME I I,O, NUMIER
NAME O~ TR[ASUPZR CONTROllED COMMITlEE1
] Y,s [] No
. .
COMMfirtrEE AOORESS (NO. AND STMtET)
CITY STATE ZIP CODE AREA COOl/DAYTIME PItON!
Attach additional information on appropriately labeled continua lion sheets,
An officehoMer or candidate who controls a committee must also ver~y the campaign statement. I have used all reasonable diligence and to the best Of~knowledge the treasurer has used all
reasonable diligence In preparing this statement. I have reviewed the statement and to the best of my k nowledge the in ,,, u, ntair~ ,,; := · d in the attached schedules is true and
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Executed on At By ~ ~
DATE CITY AND STALE SIGNATURE O~ CANDIDATE/OFFICEHOlDER
Executed on At By
OAT! CITY AND STATE SIGNATURt 0t CANDIOATE~OtFI(IHOLD| R
FOR INFORMATION RIQUm;D TO If PROVll)If) TO YOU PURSUANT TO ttlr INFORMATION PRACTKES ACT or 1971, ~IF INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PRgvI_$tQN$,I~t TH.[ pgtlJK:~t_ ,RIFORM~A~
State of California Fair Political Practices Commission
Campaign Disclosure Statement
Summary Page
Type or print In Ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
Contril~utions Received
Hddtr
CObJan A
TOTAL THIS RERIOO
~ROM AttACHED $(HEDULES)
1. Monetary Contributions ............................... Schedule A, line
2. Loans Received ......................................... Schedule e, line
3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I ·
4. Non°monetary Contributions ......................... Schedule C, Line
5. SUBTOTAL CONTRIBUTIONS:(Exdude Enforceable Promises) Add l ines 3 ,,
6. Enforceable Promtse$
(Exdude Lo~n Guarantees, line 18 below) ................... Schedule D, Une
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnesS ·
Expenditures Made
B. Cash Payments (Other than Loans Made) ............ .Schedule E, Une
9. Loans Made ............................................. Schedule H, Une
10. SUBTOTAL CASH PAYMENTS ............................ AddLines8 .~
11. Accrued Expenses (Unpaid Bills) .................... Schedule F, line
12. TOTAL EXPENDITURES MADE ....................... AddUnes lO · 11
Current Cash Statement
13. Beginning Cash Balance .................. Previous Summary Page, Line I7
14. Cash Receipts ...................................... ColumnA, UneJabove
1S. Miscellaneous Increases to Cash ........................ Schedule CUne
16. Cash Payments ................................... CotumnA, line lOebova
17. ENDING CASH BALANCE ..... AddLines 13 · 14 , 1S. then subtrad LIne 16
ff this Is a termination statement, Une 17 must be zero.
18. LOAN GUARANTEES RECEIVED .............. Sthedule ~, Part~, Column(b)
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................ See Insfrudlons on reverse
20. Outstanding Debts ................. AddLine 2 · LIne lf lnColumnCabove
']qS.51
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5.
ENDIN~ CASH IALAN4:[ SHOUt.{)
NOT II A NEGATIVE AMOUNT
Statement covers period
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through
SUMMARY PAGE
I D
· .N
0503
Column B* Column C
TOTAL PREVIOUS PERIOD TOTAL TO DATE
(SEE NOTE IELOW) (ADDCIXUMN$ A · I)
s ~cY'~,C~ s
_~00
· From previous Statement Summary Page, Column C. However, If I
this is the first report flied for the calendar year, Column B should be
blank e,cept for Loam Received (Line 2), Enforceable Promises (Line
6), Loans Made (Line 9), end Accrued Expenses (Line 11).
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/I to Date
21 ontrib tions
22. ~apo~end!!.u.r.e! S
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
.12anaqj ~2nc,\~s ~r Ci ~3 Ebunr', t- O&~E~ Vto~ct~f OrEcourt?
CODES FOR CLASSIFYING EXPENDITURES
Statement covers period
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through t~lSIlq8
SCHEDULE E
_ ~ Page 3 of q
I.D. NUMBER
!f 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) "B ' -
CONTRIBUTIONS TO OTHER CANDIDATES ' N' -
ANDCOMMITTEES 'O' -
'1' - INDEPENDENT EXPENDITURES 'S' -
°L'- LITERATURE 'F'-
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
[tE COMMITTIE, IN AOD ITION rO COMMITTEE 'S NAME AND ADDRESS, ENTER ID NUMIER O1~ II NO I.D
NUMBER HAS lIEN ASSIGNED. ENTER TREASURER'S NAME AND ADDRESS)
e~
~
ADVERTISING
NEWSPAPER AND PERIODICAL ADVERTISING
OUTSIDE ADVERTISING
SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS
FUNDRAISING EVENTS
'G' -- GENERAL OPERATIONS AND OVERHEAD
'T" - TRAVEL, ACCOMMODATIONS AND MEALS
(MUST BE DE SCRIBED)
"P" - 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 LINE 4 OF THE SUMMARY iECTION BELOW.
CODE OR DESCRIPTION OF PAfMENT AMOUNT PAID
Chopr, be-r ~Ccmr~
SUBTOTAL $
E:br',a-h. bn
Y.D. ~X ~
o~ant: Contributions ~nd expenditures made out of campaign funds to or on behalf of other
o~ehol~en, candidates, committees, or ballot measures must also be entered ?n the Allocation Page, Pa~ I. ,,
Payments and Contributions Made Summa~
1. Payments made this period of $'100 or more. (Inclu : ......................... $
2. Payments made this peri~ of under $100. (Do not itemize.) ....................................................................... $
3. Total interest paid this peri~ on outstanding loans. (Enter amount from Schedule B, Pa~ 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 I_inps 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8) ........... TOTAL $
500 .oo
leo.co
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qqs.s/
Schedule I
Miscellaneous Increases to Cash
Type Or print in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
DATE
RECEIVED (IF COMMITTEll, IN ADDITION TO COMMITIE['S NAME AND ADDRE ~S, ENTIR I D NUMilER
O4~ If NO I.D. NUMIER HAS BEEN ASSIGNED, ENIER IR~ASURER*$ NAME AND ADDRESS)
Statement covers period
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DESCRIPTION OF RECEIPT
SCHEDULE I
I.D. NUMBER
q o5o3
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