HomeMy WebLinkAboutSCRIVNER SEMIANN10(4)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink. Date Stamp
201111 Statement covers period Date of election if applicable: ZOI FP-9-
7/1/10 (Month, Day, Year)
from
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 Pan 5) O Sponsored
(Also Compete Part 6)
❑ General Purpose Committee
Q Sponsored
Q Small Contributor Committee
Q Political Party/Central Committee
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Pan 7)
2. Type of Statement:
❑ Preelection Statement
® Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
COVER PAGE
of 5
For Official Use Only
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement -Attach Form 495
3. Committee Information
;OMMITTEE NAME (OR CANDIDAIt'S n
Scrivner for Supervisor 2014
STREET ADDRESS (NO P.O. BOX)
OPTIONAL: FAX / E-MAIL ADDRESS 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 ntained 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 s~ J
r~ i k BY S~gnatureafT arAs ' reasurer '
Executed on oat.
Executed on BY
Date SignatrseofCoNro9irrgOl6oetwlder,Carrdidate,State Me or Responsible Ot6cerofSponsor
Executed on Date BY Signalise of CormobV 016ceholder. CardKkte, State Measure Proponent
Sign6iaueorConootlingOr6«0older. Candidate. StateMeauaeProponent FPPC Form 460 (January/05)
Executed on Oat. BY
FPPC Toll-Free Helptine: 8661ASK-FPPC (8661275-3772)
State of California
I.D. NUMBER
1334335
Type or print in ink.
Recipient Committee
Campaign Statement
Cover Page - Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Zack Scrivner
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLIUMSL.)
Kern County Supervisor, 2nd District
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
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.
NAME
I.D. NUMBER
NAME OF TREASURER
CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEENAME
I.D. NUMBER
NAME OF TREASURER
CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
Page 2 of 5
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO.OR LETTER 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
R HELD
❑ SUPPORT
7
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
R HELD
OFFICESOUGHT
❑ 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/05)
FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772)
State of California
Campaign Disclosure Statement Type or print in ink.
Amounts may be rounded
Summary Page to whole dollars.
c - oMlcocr-
SUMMARY PAGE
• 1
Statement covers period CALIFORNIA
7/1/10 •
from
through 12/31/10 Page 3 of 5
NAME OF FILER
Scrivner for Suaervisor 2010
Column A
Contributions Received
TOTALTHISPERrOO
ES
)
(FRO M ATTACHM SCHEDUL
600.00
1.
Monetary Contributions
Schedule A, Line 3
$
0.00
2.
Loans Received
Schedule B, Line 3
600.00
3
SUBTOTAL CASH CONTRIBUTIONS Add lines 1 +2
$
.
0.00
4.
Nonmonetary Contributions
Schedule C, Line 3
s 3 + 4
Add Li
$ 600.00
5.
TOTAL CONTRIBUTIONS RECEIVED
ne
Column B
CAU NDARYEAR
TOTALTO DATE
600.00
0.00
600.00
0.00
$
$ 600.00
Expenditures Made
6. Payments Made
Schedule E, Line 4 $
7. Loans Made
Schedule H. Line 3
8. SUBTOTALCASH PAYMENTS
Add Lines 6+7 $
9. Accrued Expenses (Unpaid Bills
Schedule F, Line 3
10. Nonmonetary Adjustment
Schedule C, Linea
11. TOTAL EXPENDITURES MADE
Add Lines 8 + 9 + 10 $
Current Cash Statement
12. Beginning Cash Balance Previous SummaryPage, Line 16 $
13. Cash Receipts Column A, Line 3above
14. Miscellaneous Increases to Cash Schedule Line 4
15. Cash Payments Column A, Line 8 above
16. ENDING CASH BALANCE Add lines 12 + 13 + 14, then subtract Line 15 $
If this is a termination statement, line 16 must be zero.
596.32 $
0.00
596.32 $
0.00
. 0.00
596.32 $
0.00
600.00
0.00
596.32
3.68
17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $
0.00
Cash Equivalents and Outstanding Debts
18. Cash Equivalents See instructions on reverse $
19. Outstanding Debts Add Line 2 +Line 9 in Column B above $
0.00
0.00
596.32
0.00
596.32
0.00
0.00
596.32
I.D. NUMBER
1334335
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 711 to Date
20. Contributions
Received $ $
21. Expenditures
Made $ $
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made`
IN Subject to Voluntary Expenditure Limh)
Date of Election Total to Date
(mm/dd/yy)
-J--/ $
_l ---J $
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).
`Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)
Type or print in ink.
SCHEDULE A
Schedule A
Amounts may be rounded
Statement covers period
' •
460
Monetary Contributions Received
to whole dollars.
7/1/10 .
from
through 12/31/10 Page 4
of 5
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
NAME OF FILER
1334335
Scrivner for Supervisor 2014
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
CONTRIBUTOR OC
ON AND EMPLOYER
AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED THIS CALENDAR YEAR TO DATE
(IF REQUIRED)
DATE
RECEIVED (IFCOMMRlEE.ALSO ENTER I.D.NUMBER)
CODE it OF SELF-EMPLOYED, ENTER NAME
PERIOD (JAN. 1 -DEC. 31)
OF BUSINESS)
Mary Jane Wilson
® IND
❑COM Executive
500.00 500.00
500.00
12/20/10
FJPTY
❑SCC
❑ IND
Scrivner for Supervisor 2010
ZCOM Transfer
100.00 100.00
11/24/10
❑ PTY
,
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTALS 600.00
Schedule A Summary
1. Amount received this period - itemized monetary contributions.
(Include all Schedule A subtotals.) $
2. Amount received this period - unitemized monetary contributions of less than $100 $
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $
600.00
0.00
600 00
'Contributor 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: 866/ASK-FPPC (8661275-3772)
Schedule E Type or print in ink.
Amounts may be rounded
Payments Made to whole dollars.
ccc 1 -ol 1!` InAlc np l RFX/FRCP
Statement covers period
from 7/1/10
through
12/31/10
NAME OF FILER
Scrivner for Supervisor 2014
Page 5 of 5
I.D. NUMBER
1334335
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
t
i
MBR
member communications
RAD
on cos
s
radio airtime and product
CLIP
CNS
campaign paraphemalia/misc.
campaign consultants
MTG
meetings and appearances
RFD
SAL
returned contributions
campaign workers' salaries
CTB
contribution (explain nonmonetary)'
OFC
office expenses
TB
t.v. or cable airtime and production costs
CVC
civic donations
PET
POD
petition circulating
phone banks
.
TRC
candidate travel, lodging, and meals
l
FL
IL
candidate file llot fees
POL
polling and survey research
TRS
s
staff/spouse travel, lodging, and mea
mmittees of the same candidate/sponsor
FND
tZ
fundraising events
endent expenditure supporting/opposing others (explain)'
inde
POS
postage, delivery and messenger services
OTSF T
tra
voter regist n co
LEG
p
legal defense
PRO
professional services (legal, accounting)
WEB
information technology costs (intemet, e-mail)
LIT
campaign literature and mailings
PRT
print ads
NAME AND ADDRESS OF PAYEE
OF COMMI I I Also ENTER I.O. NUMBER)
Minuteman Press
Subvendor: U.S. Postal Service $532.54
CODE OR
POS
' Payments that are contributions or independent expenditures must also be summarized on Schedule D.
SUBTOTALS
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.) TOTAL $
DESCRIPTION OF PAYMENT
AMOUNT PAID
532.54
532.54
532.54
63.78
0.00
596.32
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772)