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Home My WebLink AboutCOUCH SEMIANN10(2)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE COVER PAGE Type or print in ink. Date Stamp CALIFORNI Statement covers period Date of election if applicablf I I JAIN 3 1 PH 14: 28 Page of S from (Month, Day, Year) For Official Use Only through ~02 Type of Recipient Committee: AN Committees - Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also compete Part 5) 0 Sponsored ❑ General Purpose Committee (AlsocompielePar 6) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information 2. Type of Statement: ❑ Preelection Statement A,• Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) ❑ Quarterly Statement ❑ Special Odd-Year Report ❑ Supplemental Preelection Statement - Attach Form 495 I.D. NUMBS Treasurer(s) ~ Z 7 V15 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) N~/L i20J0 _'t VID Co ke V hog e ,17-y MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX / Y l///P' OPTIONAL: FAX / E-MAIL ADDRESS NAWou. TREASURER V A14- MAILIN ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. ~7~ Executed on , 6 / l / r BY Aatir4 Treasurer 0130 6gnak- of Treasurprdflkss Executed on I _ By Executed on Dale Executed on rate By Signature ofCon"ing Officeholder, Candidate, State Mem" Proponent FPPC Form 460 (Jenuary/06) FPPC Toll-Free Helpline: 86WASK-FPPC (8661276-3772) State of California By Signature of Controlling Officeholder, Canftate, State Measure Proponent Recipient Committee Campaign Statement Cover Page - Part 2 5. Officeholder or Candidate Controlled Committee Type or print in ink. NAME OF OFFICEHOLDER OR CANDIDATE ~OkGA-L- OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUM$E IF yPPLIILLE) C4 rY 1~'Ol~Ne,L w,~i~ -y. G rA, gx.Ieu> RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: Llstanycommittees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME NAME OF TREASU RER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE 6. Primarily Formed Ballot Measure Committee COVER PAGE - PART 2 Page of NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION I ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (January/06) FPPC Toll-Free Helpline_ 866/ASK-FPPC (86612763772) State of Callfomia Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Summary Page Amounts may be rounded Statement covers period to whole dollars. from 1411-11,70,10 014. Elm SEE INSTRUCTIONS ON REVERSE NAME OF FILER l!/D Go' kcEt through 1l• .3/ 10d0 Page of Contributions Received 1. Monetary Contributions schedule A, Line 3 2. Loans Received schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 4. Nonmonetary Contributions schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED AddLines 3+4 Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) $ Column B CALENDAR YEAR TOTALTO DATE $ l~ X00 $ •~DO Expenditures Made 6. Payments Made schedule E, Line 4 7. Loans Made Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines 6+ 7 9. Accrued Expenses (Unpaid Bills) schedule F Line 3 10. Nonmonetary Adjustment Schedule C, Line 3 11. TOTAL EXPENDITURES MADE Add Lines s + 9 + 10 $ ~.f . i $ f G , pZ 6 $ GG. $ $ Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 13. Cash Receipts Column A, Line 3 above 14. Miscellaneous Increases to Cash Schedule 1, Line 4 15. Cash Payments Column A, Line 8above 16. ENDING CASH BALANCE Add lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. $ sr. 017 v ~ $ 703• r To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents see instructions on reverse $ 19. Outstanding Debts Add Line 2 + Line 9 in Column B above $ I.D. NUMBER /312 -7y1 - 15-Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 1 21. Expenditures Made $ `lam Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' IN Subject to Volunmry Expenditure Limit) Date of Election Total to Date (mm/dd/yy) 1 J- 1 $ I $ Amounts in this section may be different from amounts reported in Column B. NiJ FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. 1-ma yr nLrK OT VV y > e Daac*- Statement covers period from ! /7 _Z0/0 through Page r of r i3~ 7Y/J CODES: If one of the following codes accurately describes the payment ou ma t th CIuP c i , y y en er e code. Oth erwise, d escribe the payment. CNS ampa gn paraphemalia/misc. campaign consultants NIBR member communications RAD radio airtime and production costs CTB contribution (explain nonmonetary)" MfG OFC meetings and appearances office expenses RFD returned contributions CVC civic donations PET petition circulating SAL campaign workers' salaries FIL candidate filing/ballot fees PHO phone banks TEL t.v. or cable airtime and production costs FND fundraising events POL polling and survey research TRC candidate travel, lodging, and meals IND LEG independent expenditure supporting/opposing others (explain)" legal defense POS postage, delivery and messenger services TRS TSF staff/spouse travel, lodging, and meals transfer between committees of the same candidate/s onsor LIT campaign literature and mailings PRO PRT professional services (legal, accounting) i VOT p voter registration pr nt ads WEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT L~~~o~t~ .dy rt.~ Gve 4C-7-1YE ~of3v G~~r~ Gv~ &AF " Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) 2. Unitemized payments made this period of under $100 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) SUBTOTAL$ G11Ql-rr jr s per- EoeleiveE loo - El-r-r-Tia'y /V/,*,&T y *Va ✓A'41,0 r WeZ-71W X AMOUNT PAID loge' $ o",14 $ $ TOTAL $ FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E (Continuation Sheet) Payments Made NAME OF FILER 'Z4lu) I!em'u Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from through CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW CNS campaign paraphemalia/misc. campaign consultants NW member communications RAD radio airtime and production costs CTB contribution (explain nonmonetary)• MiG OFC meetings and appearances office expenses RFD returned contributions ' CVC FIL civic donations candidate filing/ballot fees PET petition circulating SAL TEL campaign workers salaries t.v. or cable airtime and production costs FND fundraising events PHO FOL phone banks polling and survey research TRC TRS candidate travel, lodging, and meals IND LEG independent expenditure supporting/opposing others (explain)" legal defense POS postage, delivery and messenger services TSF staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor UT campaign literature and mailings PRO PRT professional services (legal, accounting) print ads VOT voter registration WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) T /1'l 4141T~ CODE OR DESCRIPTION OF PAYMENT raymems that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL I AMOUNT PAID SCHEDULE E (CONT.) Page S of I.D. NUMBER 1.32 -7yls FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772)