Loading...
HomeMy WebLinkAboutDICKERSON SEMIANN13(1)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 64216.5) Type or print in ink. Stateme co ers period from ! i 70 ( 3 SEE INSTRUCTIONS ON REVERSE I through I �b ?S13 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. fficeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also Compbte Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 8�1,1z1 COMMITTED NAME (OR CI m N�COMMITTEE_ ) i STREET ADDRESS (NO P.O. BOX) CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E -MAIL ADDRESS Date Stamp Date of election if applicable: (Month, Day, Year) I I 2. Type of Statement: ❑ Z ction Statement nual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER Page 1 of _ For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER 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 dirtgenc in preparing and reviewing this statement and to the best of my knowledge the info under penalty of perjury under the aws of thl§ate of California that the foregoing is true and correct. J' Executed on BY ��G►��11 Executed on I BY Si D Signature of and in the attAched schedules is true and complete. I certify Executed on BY Date Signature of Controang Olfioeholder, Candidate. State Measure Proponent Executed on BY Date SignadxeorContrdlingOfficetwlder Cardidate.Staie Measure Proponent FPPC Form 460 (January/OS) FPPC Toll -Free Helpline: 866IASK -FPPC (8661275 -3772) State of California Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or,Candidate Controlled' Committee NAME OF OFFICEHOL ER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Type or print in ink. RESIDENTIAL/BUSINESS ADDIR Related Committees Not Included in this Statement: ustanycommimes not included in this statement that are eontrolfed by you or are primarily formed to receive contributions or make expenditures on behalf of your canrlfdecy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITfEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page 71 of BALLOT NO. OR LETTER ( JURISDICTION I ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, N any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate /Officeholder Committee ust names of ofliceholdWs) or eandidaWs) for which this committee is p4marily 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 160 (Januaryles) FPPC Toll -Free Wpline: 886/ASK -FPPC (866W541772) State of California Campaign Disclosure Statement Summary Page RFF INSTm ICTInNS ON REVERSE NAME OF FILER Type or print in ink. Amounts may be rounded to whole dollars. CONN SUMMARY PAGE Statement poverp period from ( 3 through .� l Page of I.D. NUMBER_ n _ Column B CALENDAR YEAR TOTALTO DATE Q $ $ R<0 ' Expenditures Made 6. Payments Made ........................ ............................... schedule E Line 4 $ $ 7. Loans Made .............................. ............................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ _Z� $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3j�' —� 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ l ? $ 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 4D- 15. Cash Payments ................... ............................... column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 . $ K this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule e, Part 2 $ '"G;" I Cash Equivalents and Outstanding Debts -2 %S 18. Cash Equivalents ......... ............................... See irmnxtions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 43 ( 1 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6130 7/1 to Date 20. Contributions Received $ $ 21. Expenditures ��. Made $ kst' -� $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' . (t►SuWeettovduMryExwatumLimit) Date of Election (mm/dvia Total to Date 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpiine: 866/ASK -FPPC (866/275-3772) Column A Contributions Received TOTAL THS PERIOD MIOMATTACFEDS04EDULES) I --, 1. Monetary Contributions ............ ............................... 2. Loans Received ....................... ............................... 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Schedule A, Line 3 schedule s, Line 3 Add Lines 1 + 2 $ $� 4. Nonmonetary Contributions ..... ............................... 5. TOTAL CONTRIBUTIONS RECEIVED ••••.• ••.••.••......•..•••• Schedule C, Line 3 Add Lines 3 +4 4" — _ $ CONN SUMMARY PAGE Statement poverp period from ( 3 through .� l Page of I.D. NUMBER_ n _ Column B CALENDAR YEAR TOTALTO DATE Q $ $ R<0 ' Expenditures Made 6. Payments Made ........................ ............................... schedule E Line 4 $ $ 7. Loans Made .............................. ............................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ _Z� $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3j�' —� 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ l ? $ 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 4D- 15. Cash Payments ................... ............................... column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 . $ K this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule e, Part 2 $ '"G;" I Cash Equivalents and Outstanding Debts -2 %S 18. Cash Equivalents ......... ............................... See irmnxtions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 43 ( 1 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6130 7/1 to Date 20. Contributions Received $ $ 21. Expenditures ��. Made $ kst' -� $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' . (t►SuWeettovduMryExwatumLimit) Date of Election (mm/dvia Total to Date 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpiine: 866/ASK -FPPC (866/275-3772) Schedule A Monetary Contributions Received Type or print In ink. SCHEDULE A- Amounts maybe rounded F ement ov period to whole dollars. t f -Z� ,� • 1 V Schedule A Summary Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) .................. ............................... ...... ............................... $e 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 S 'K�_b '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 (866WS -3772) through Page 4 of L SEE INSTRUCTIONS ON REVERSE _=J NAME OF FFIIILLE%R%, I.D. NUMBER ^� F^' ��' � � � ©� C_'- "tea'.' .7-�1 �M �'' � (� i • 1 l L L� � �' C� DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED OFCTADDREALSOENTERI.D.Nua3EOl CODE * OF SELF - EMPLOYED. EWER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) WD OCOM J t�I OTH ❑ D2��lbZ oSCC . ❑IND ❑COM ❑OTH ❑ PTY ❑SCC ❑IND ❑COM ❑ OTH ❑ PTY []SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑SCC ❑ IND ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS . Schedule A Summary Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) .................. ............................... ...... ............................... $e 2. Amount received this period — unitemized monetary contributions of less than $100 ......................... 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A. Line 1.) ................ TOTAL S 'K�_b 'Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK -FPPC (866WS -3772) Schedule E Type or print in ink. Statemen co rs period Amounts may be rounded CALIFORNIA • ' Paymerft Made to whole dollars. from �, Z��� • • rou h '�� P --6' of SEE INSTRUCTIONS ON REVERSE g NAME OF FILER ( I.D. NUMBER 4�r� cwt I ���► l CODES: If one of the following codes accurately describes the_ payment, you may enter the code. Otherwise, describe the payment. CW campaign parephemalialmisc. NW member communications - RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetaryp OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TM candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)` POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE EN pF COINMnTEE. ALSO TER I.D. NUMBER] CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID � � �`�'� " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 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.) ... .. ............................... $ S .. ............................... $- ................................. $_ .................... TOTAL $ Z v FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK -FPPC (8661275.3772) 'de B - Part 1 PAKal /ed EE INSTRUCTIONS ON REVERSE Typs.or print Is ink. 8CHEDULE 8 - PART 1 Amounts may be rounded Statement c ve period to whole doAsrs. • from �.rnueh ace of " �! NAME OF FILER I.D. NQU�M�B' ER' a r A i j' �- ✓� l Z FULL NAME, STREET ADDRESS AND 21P CODE OF LENDER IF AN INDMDUAL, ENTER OCCUPATI49A4X EMPLOYER ANDiNG BALANCE AMOUNT RECEIVED THIS AMOUNTIVE aNO qT IN7ERESS r PAID THIS ORIGINAL AMOUNTOF CUMULATIVE CONTRIBUTIONS tFu+rTEE ALSOevretLaNUat1� OR �E+rER BEGINNING THIS PERIOD THIS PERIOD CLOSE OF THIS PERIOD LOAN TODATE °PAW , C7' ❑ scc - s s UE s IlArEINCUNIED s ❑ PAID CALENDARYEAR s s x s s (3 FORGIVEN nnrE PER ELECTION *� tp IND ❑ COM ❑ oTH ° PTY ❑ scc s s a s s 13 PAID CALENDARYEAR s• s +� $ s [j FORGIVEN RATE PERELECTION" to #0 . [3 COM 13 OTH ❑ PTY 13 WC : $ s . DATE QUE s —�— . W►TE Ukx1RR� . s SUBTOTALS : S i 3 Schedule B Summary 1. Loans received this period .... ............................... .. . .. .. ... ... . , $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid orforgiven this period ......................:............................................... ............................... $ (Total Colurrin (c) plus loans under $100 paid orforgiven,) (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 repot on Schedule A. it required. –0-'� ............................. NET .:.. @rrw.�.orin,Nw�mu1 3tieduleE.LNs3) •.tConMbutor Cbdes AND- IndivitidW COM - Recent Committee (other then PTY pr SCC) OTH - 00w (e.g„ business entity) PTY - Pdtlbal Party SCC Small Contributor Committee J FPP :• Form 480 (January/05) FPPC Toll -Free Helpiine: S88/ASM -FPPC (886/275 -3772) 339c0e C enenAnr.n4RAR�AAAAAAAftiIAli';, 1;5,1 U Sn U Sn bberty Freedom justice FOREVER v FOREVER ., FOREVER ifr� l�il��v�l