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Home My WebLink AboutMAXWELL PREELECT12(2)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE fro Type or print in ink. Statement covers period 10 -1 -12 m through 10 -20 -12 Date Stamp Date of election if applicabl #: OCT 23 AM (O: 13 (Month, Day, Year) BAK RSA #LL i C! i Y C:LE 11 -6 -12 COVER PAGE Page 1 of 9 For Official Use Only 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 2. Type of Statement: Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure is Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee ❑ Semi - annual Statement ❑ Special Odd -Year Report 0 Recall 0 Controlled E] Termination Statement ❑ Supplemental Preelection (Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) Statement -Attach Form 495 ❑ General Purpose Committee (Also Complete Part 6) ❑ Amendment (Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1350691 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Maxwell for City Council Ward 2 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS Treasurer(s) NAME OF TREASURER Anthony Ansolabehere MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY MAILING 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. Executed on /0 _:? � — / C_�_ By Date re of Treasurer orAssista Executed on I n r 23 ' 1 Z By Date SicinaWofControllinaO*ehgMer.Candidog, State Measure Proponent or Responsible Officer of Sponsor Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 10 -1 -12 SUMMARYPAGE SEE INSTRUCTIONS ON REVERSE To calculate Column B, add 5850.00 through 10 -20 -12 Page 2 of 9 NAME OF FILER 7. Loans Made .............................. ............................... Schedule H, Line 3 0 0 I.D. NUMBER Maxwell for City Council Ward 2 8357.05 $ 10167.30 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 0 1350691 10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 0 Column A Column B Calendar Year Summary for Candidates Contributions Received 10167.30 TOTALTHISPERIOD CALENDARYEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTALTO DATE General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 5850.00 $ $ 13400.00 0 840.00 1/1 through 6/30 7/1 to Date 2. Loans Received ....................... ............................... Schedule e, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 5850.00 $ 14240.00 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 5850.00 $ 14240.00 Made $ $ Expenditures Made To calculate Column B, add 5850.00 6. Payments Made ........................ ............................... Schedule E, Line 4 $ 8357.05 $ 10167.30 7. Loans Made .............................. ............................... Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 8357.05 $ 10167.30 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 0 0 10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 0 0 11. TOTAL EXPENDITURES MADE .... ............................Add Lines 8 + 9 + 10 $ 8357.05 $ 10167.30 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 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. 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 $ 6579.75 To calculate Column B, add 5850.00 amounts in Column A to the corresponding amounts from Column B of your last 0 8357.05 report. Some amounts in Column A may be negative 4072.70 figures that should be subtracted from previous period amounts. If this is the first report being filed 0 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 0 0 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) *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 (866/275 -3772) SChPdi11P_ A Type or print in ink. SCHEDULE A Monetary ontributions Received Amounts may be rounaea ry to whole dollars. Statement covers period • ' from 10 -1 -12 • ' . 10 -20 -12 3 9 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Maxwell for City Council Ward 2 1350691 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR OR CONTRIBUTOR F AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Edward Hopple BIND ❑coM Retired 10 -2 -12 ❑ PTY ❑SCC WZI Inc ❑IND 10 -4 -12 ❑ PTY ❑ SCC Lloyd Plank BIND ❑COM Retired 10 -3 -12 ❑ PTY ❑ SCC Ken Vetter BIND Retired 10 -2 -12 ❑OTH ❑ PTY ❑ SCC Bakersfield Dodge ❑IND 10 -3 -12 BOTH ❑ PTY ❑ SCC SUBTOTAL$ 1050.00 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 $ 5850.00 2 5850.00 *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 (866/275 -3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 10 -1 -12 • 460 from 10 -20 -12 4 9 through Page of NAME OF FILER I.D. NUMBER Maxwell for City Council Ward 2 1350691 DATE ZIP DE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) Gil's Welding ❑IND 10 -3 -12 ❑ PTY ❑ SCC Diane Lake BIND None 10 -4 -12 ❑ OTH ❑ PTY ❑ SCC William Lazzerini OIND Owner 10 -4 -12 E] OTH ❑ PTY ❑ SCC Bob Hampton OIND Owner 10 -17 -12 ❑ OTH ❑ PTY ❑ SCC William Malloy OIND Attorney 10 -12 -12 E] OTH ❑ PTY ❑ SCC SUBTOTAL$ 3550.00 `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 (866/275 -3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 10 -1 -12 4 ' from 10 -20 -12 5 8 through Page of NAME OF FILER I.D. NUMBER Maxwell for City Council Ward 2 1350691 DATE FULL NAME STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Juliana's Garden LLC ❑IND 10 -5 -12 PTY ❑ SCC Mesa Marin LLC ❑IND 10 -5 -12 OOTH ❑ PTY ❑ SCC Hubbell & Assoc F1 IND 10 -11 -12 00TH ❑ PTY ❑ SCC Joseph Drew 2] IND Senior Vice President 10 -7 -12 ❑OTH ❑ PTY ❑ SCC Rayburn Dezember ❑� IND Retired 10 -6 -12 ❑OTH ❑ PTY ❑ SCC SUBTOTAL$ 1050.00 *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 (866/275 -3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 10 -1 -12 FORM 460 from 10 -20 -12 6 9 through Page of NAME OF FILER I.D. NUMBER Maxwell for City Council Ward 2 1350691 DATE FULL NAME STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 31) IF REQUIRED ( ) OF BUSINESS) Independent Oil Producers ❑IND 10 -12 -12 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 200.00 '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) SCHEDULEB -PART1 Schedule B — Part 1 ' "_ _, ayb' .`'n Amounts may be rounded Statement covers period P � . Loans Received to whole dollars. 10 -1 -12 .. • from 10 -20 -12 9 SEE INSTRUCTIONS ON REVERSE through page Of NAME OF FILER I.D. NUMBER Maxwell for City Council Ward 2 1350691 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER , a OUTSTANDING (b) AMOUNT (c) AMOUNT AID (d) OUTSTANDING (e) INTEREST ( ) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAMEOFBUSINESS) PERIOD PERIOD THIS PERIOD" PERIOD PERIOD LOAN TO DATE Terry Maxwell Resturant Owner ❑ PAID CALENDAR YEAR RATE $ 840.00 $ 0.00 $ $ 8 -15 -12 $ DATE DUE DATE INCURRED tg IND ❑ COM ❑ OTH ❑ PTV ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PERELECTION— RATE DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION ** RATE DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0$ $ 840.00 $ 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. ............. $ ........ $ 0 L ....... NET $ 0 (May be a negative number) (Enter (e)on Schedule E, Line 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: 866 1ASK -FPPC (866/275 -3772) Schedule E Type or print in ink. Amounts may be rounded Payments Made to whole dollars. RFF INSTRUCTIONS ON REVERSE Statement covers period from 10 -1 -12 through 10 -20 -12 Page 8 of 9 NAME OF FILER W. NUMtltK Maxwell for City Council Ward 2 1350691 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CtvP campaign paraphernalia /misc. MBR member communications RAID radio airtime and production costs CNS campaign consultants MTG 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 ND 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 LIT campaign literature and mailings PRT print 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 AMOUNTPAID DB & Co. Brian Todd Capitol Promotions ` Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 8062.05 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. $ 8262.05 P Y P ( ) ............................................................................... ............................... 95.00 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 Summa Page, Column A, Line 6. TOTAL $ 8357.05 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule E (Continuation Sheet) Payments Made cFF InICTRI ICTIONS ON REVERSE NAME OF FILER Maxwell for City Council Ward 2 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 10 -1 -12 through 10 -20 -12 SCHEDULE E (CONT.) Page 9 of 9 I.D. NUMBER 1350691 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphernalia /misc. NBR member communications RAD radio airtime and production costs CNS campaign consultants MTG 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 W 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 I rr -nninn litarnhirP and mailinas PRT print 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 AMOUNT PAID County of Kern POL 200.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 200.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)