HomeMy WebLinkAboutSMITH SEMIANN98(2) f,'iceh older, Candid ate, Ty.~ o, pri.t i. t.k.
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
[] Supplemental Pre-election Statement (Attach a completed FOrm 495 tothis statement.)
"J Special Odd-Year Campaign Report
"] Semi-annual Statement
Termination Statement Attach a corn Form ' a_t{rment.)
RE$tOENTIAL OR IUSlNESS ADDRESS (NO. AI~D STREET)
CITY ZIP CODE AREA CODE/DAYTiME PHONE
COMMITTEE NAME I.D. NUMBER
COMMITTEE ADDRESS (NO. AND STREET)
I ZIP CODE AREA COD~/DAYTIME PHONE
N ME OF TREAS;E, B~,G ~'~7/
Statement covers period, Date Stamp
from
through
Date of eledion if aPPlicabtr-:
(Month, Day, Year)
~COVER PAGE - LONG FORM
Page / of q
For Official Use Only
NAME 0f TREASURER
COMMITTEE ADDRESS
~,~,'~:~t,~ihi~t~;%;)Ot Included in this Statement: u~anyott~r
committees not included in this consolida ted statement that are controlled by you and any
cornre/trees of which you have knowledge that are primarily formed to receive contributions
or to make expenditures on behaff of your candidacy.
COMMITTEE NAME I I O. NUMBFR
CONTROLLED COMMITTEE 1
(NO, AND STREET)
CfirY STATE
ZIP CODE AREA CODFJDAYTIME PHONE
I,D NUMIER
CONTROLLED COMMITfEE?
] YEs D ,o
COMMITTEE NAME
NAME OIt TREASURER
COMMITTEE ADDRESS
(NO. AND STREET)
PERMANENT ADDRESS Of TREASURER (NO. AND STREET) CITY STATE
III Verification "
l have u~d all reamnable diligence in preparing this statement I have reviewed the statement and to the N~ of myk --'~ getheinformetjonco ~ined~reinandinthea~achedschedulesis
~n offkehoM~r m (l~iate w~ (~trols I (omm~ee must Ilso ver~y t~ {ampl~n s~temem. I have u~ Ill rea~nable dil gen~e ~o the ~ of my knNl~ge the treasurer has us~
easonable di 'ge~e m preMrin9 th~s statement. t have review~ the statement and to the ~ of my knowl~ge the information ~ontamed herei0 and in the a~ached schedules i$ true and
corn plate. I ce~i~ under ~nal~ of ~du~ unde~ the laws of the State 9f Califo ia that the foregoing is true end corred:: / ~ ,
~NATURE ~
Executed on At By
DATE (~Y A~ STA~E SIGNATURE OF ~NDIDATE~FF~E~R
E~uted on At By
DATE CffY AND STATE ~IGNAIURE Ol
FOR INFORMATION RETIRED TO eE PROVID[D TO YOU PURSUANT TO THE INFORMAT~ ~I(E~ A~ OF 197~. SEE INFORMATION MANUAL ~ CAM?AIGN DI~(LO~URE PROVISItS ~ ~Hi P~ITI(At REFORM
ZIP CODE AREA CODE/DAYTIME PHONE
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
Contributions Received
1. Monetary Contri butions ............................... Schedule A, Line 3
2. Loans Received ......................................... Schedule 9, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I, 2
4. Non-monetary Contributions ......................... Schedule c, Line 3
5. SUBTOTAL CONTRIBUTIONS.(Exdude Enforceable Promises) Add Unes 3 ~ 4
6. Enforceable Promises
(Exclude LOon Guarantees, Line 18 below) ................... Schedule D, Une 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnesS, 6
Expenditures Made
8. Cash Payments (Other than Loans Made)
9. Loans Made .............................................
10. SUBTOTAL CASH PAYMENTS ............................
Schedule E, Une
Schedule H, Line
Add Lines 8 ,,
11. Accrued Expenses (Unpaid Bills) .......................ScheduleF, Une5
12. TOTAL EXPENDITURES MADE .........................AddUnes 10 · 11
Current Cash Statement
13. Beginning Cash Balance .................. PrevlousSumman/Page, Line 17
14. Cash Receipts ......................................ColumnA, Line3above
15. Miscellaneous Increases to Cash ........................Schedule I, Line 4
16. Cash Payments ....................................ColumnA, Line lOebova
17. ENDING CASH BALANCE ..... AddLines 13,14,15, thensubtrldUne 16
ff this is a termination statement, Line 17 must be zero.
18. LOAN GUARANTEES RECEIVED .............. Schedule e, Part1, Column(b) $
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................See instructions on rever~e S
20. Outstanding Debts ................. AddLine2 ~ Line 11 inColumnCabove
Type Or print in ink.
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS
eRO M AT/ACHED SCHEDULES)
S
E ~ ~ ~ $~D
~T I[ A NE~TIVE AM~
Statement covers period
Column B*
TOTAL PREVIOUS PERIOD
(~EE NOTE BELOW)
SUMMARY PAGE
I.D. NUMBER
Column C
TOTAL TO DATE
(ADD COLUMNS A + B)
s LeO ~' ' / ~ ~
_ s ~,
* 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), Loans Made (Line 9), and Accrued Expenses (Line 11 ).
Summary for Candidates in Both June and
November Elections
111 through 6/30 7/1 tO Date
21. ontrib tions
22. Ex nditures
Schedule I
Miscellaneous Increases to Cash
Type or print in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
DATE FULL NAME AND ADDRESS OF SOURCE
RECEIVE D (IF COMMflr1EI~, IN ADDITION 10 COMMITTEE'S NAME AND ADDRESS, ENTER I.D. NUMBER
O41,, tF NO |.D- NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS)
Statement covers period
i ~
through / 2"'5/' ~/
DESCRIPTION OF RECEIPT
SCHEDULE I
. "~. ~:., .
: . ~ :::: ·:. ~. ":.<.: .-',.:
. . .: ~ :~:::.~ ~'.~ ?-
Page
I.D. NUMBER
(~-LI -^, A
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
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 /L_~ ~
CODES FOR CLASSIFYING EXPENDITURES
SCHEDULE E
,,ore ....... :;l:;
through/~ ,P~ ~ U Page of ~/
ID. NUMBER
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 ~;fY~ach category.
MONETARY AND IN-KIND (NON-MONETARY) ' B" -
CONTRIBUTIONS TO OTHER CANDIDATES · N ' -
AND COMMITTEES =O' -
INDEPENDENT EXPENDITURES ·S' -
LITERATURE *F~ _
BROADCAST ADVERTISING 'G' '-
NEWSPAPER AND PERIODICAL ADVERTISING 'T' -
OUTSIDE ADVERTISING
SURVEYS. SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS 'P" '
FUNDRAISING EVENTS
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
(IF COMMITTEE, IN ADDITION 10 COMMrrl'EE'S NAME AND ADDRESS, ENIER I.D. NUMIER OR, IF NO I.D.
NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS)
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 LINE 4 OF THE SUMMARY SECTION BELOW,
CODE OR DESCRIPTION OF PAtMENT AMOUNT PAID
C.- i/1 ,
Important: Contributions and exp. enditures made out of campaign funds to or on behalf of other .....
officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Part I. SUBTOTAL $
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 $100· (Do not itemize.) ....................................................................... $
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 $ .
/i/n.s<
BA~ERSF;;Z LD CtT'r' CLERK
Bakersfield City Clerks Office
1501 Truxtun Ave
Bakersfield, CA 93301