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Home My WebLink AboutSULLIVAN SEMIANN10(2)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 7.1.10 through 12.31.10 1. Type of Recipient Committee: All 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 Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored 0 Small Contributor Committee Q Political Party/Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information 1 I.D. NUMBER 950347 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Jacquie Sullivan for City Council MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS By 4. Verification 1 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. n A i Executed on Date Executed on 41 Date Executed on Date Executed on Date By Date of election if applicable: (Month, Day, Year) Date Stamp 011 JAW 31 PH 3: 3 2. Type of Statement: ❑ Preelection Statement ® Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE Page_ of L For Official Use Only ❑ Quarterly Statement ❑ Special Odd-Year Report ❑ Supplemental Preelection Statement -Attach Form 495 Treasurer(s) NAME OF TREASURER Tracey Mitchell-Reynolds MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/2754772) State of California • Recipient Committee Type or print in ink. COVER PAGE -PART 2 Campaign Statement • CALIFORNIA 460 Cover Page - Part 2 Page 2 of _ 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Jl~~ullivan OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Ward 6 RESIDENTIAUBUSINESS Related Committees Not Included in this Statement: List any committees 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 I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) 6. Primarily Formed Ballot Measure Committee 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 '.A I i JIHIC Llr UuUt HKLA UUUL1VHUNL Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275.3772) State of California SCHEDULE B- PART 1 5chedule B - Part 1 Amouunt nts may be e rounded Statement covers period Loans Received to whole dollars. 7 1 10 • • ' . . from h 12.31.10 h P f SEE INSTRUCTIONS ON REVERSE t roug age o NAME OF FILER I.D. NUMBER Ja Sullivan 950347 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER a OUTSTANDING (b) AMOUNT (c) AMOUNT PAID (d) OUTSTANDING (e) INTEREST V) ORIGINAL (9) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS (If COMMITTEE, ALSO ENTER I.D. NUMBER) , NAMEOFBUSINESS) PERIOD PERIOD THIS PERIOD* PERT PERIOD LOAN TO DATE Jackie Sullivan Self ❑ PAID CALENDARYEAR Real Estate ❑ FORGIVEN RATE PERELECTION** 1300 0 8/19/08 $ $ $ $ $ to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR ❑ FORGIVEN RATE PER ELECTION a a $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR $ $ % $ $ ❑ FORGIVEN RATE PER ELECTION $ $ 8 S S t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ Schedule B Summary 1. Loans received this period (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. If required. $ $ NET $ 0 0 0 (May be a negabve number) (tmer (e) on Schedule E, Lune 3) tContributor Codes IND-Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772) Schedule F Type or print in ink. Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SFF INS TRHrTIONS ON REVERSE Statement covers period from 7.1.10 SCHEDULE F through 12.31.10 I Page of q NAME OF FILER I.D. NUMBER Jackie Sullivan 950347 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/misc. NUR member communications RAD radio airtime and production costs CNS campaign consultants WG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals PD independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration Lrr campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR CODEOR (a) OUTSTANDING (b) AMOUNT INCURRED (c) AMOUNT PAID (d) OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Western Pacific Research LIT,PRO,RAD,SAK 34155.53 6424.49 0 40580.02 1 1 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 34155.53 $ 6424.49 $ 0 $ 40580.02 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) INCURRED TOTALS $ PAID TOTALS $ 6424.49 0 NET $ 6424.49 May be a negative number FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772)