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HomeMy WebLinkAboutDICKERSON SEMIANN02(1) c- ipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216,5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. St. t em ent c.)~ve?s period from . I1 / 1. Typ~ Recipient Committee: AII Committees - Complete Pa~ls l, 2, 3. and4. {~'Officeholder, Candidate Controlled Committee [] Ballot Measure Committee O State Candidate Election Committee O Primadly Formed (D Controlled O Sponsored [] Primarily Formed Candidate/ Officeholder Committee (~) Recall [] General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee 3. Committee Information ILb' NUMB~-~ii/ ~_..( COMMITTEE NAME (OR CANDIDATE'S NAME IF NO,COMMITTEE) j Date of election if (Month, Day, Year) Date Stamp 02 COVER PAGE Page / of~:~__._ For Olficlal Use Only 2. Type of Statement: ~] Pre~lection Statement L~emi-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER MAILING ADDRESS NAME OF ASSISTANT TREAS~IER. IF ANY STREET ADDRESS (NO P.O. BOX) MAILING ADDRESS (IF I~IFFERENT) NO. AND STREET OR P.O. SOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZiP CODE AREA C'ODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS 4. I have used all reasonable diligence in preparing and reviewing this statement and to the best of my know edg~ythe/t~rmi~on contained herein and in the is true and complete. I Verification certify under penalty of perjury u~.der/the laws of the State of California that the foregoing is true and correct. ,,//ii ~/ attached schedules Executed on / o -z - By Executed on Date Executed on ny By Sig~atureof C~l~O~ficehoider, Candldate, Stat® Measu~ePropomml FPPC Form 460 (June/01) FPPC Toll-Free Helpllne: 866/ASK-FPPC Recipient Committee Campaign Statement Cover Page-- Part 2 Type or print in ink. COVERPAGE-PART2 Page ~ of ~ 5. Officeholder or Candidate Controlled Committee OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STAT ZIP Related Committees Not included in this Statement: List any committees not included in this statement that are controlled by you or ere primarily formed to receive contributions or make expenditures on behaff of your candidecy. COMMITTEE NAME I.D. NUMBER NAM E OF TREASURER CONTROLLED COMMITTEE? [] YES [] NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX CITY STA3E ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITrEE? [] YES [] NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX CITY STALE ZIP CODE AREA CODE/PHONE 6. Ballot Measure Committee NAMEOFBALLOTMEASURE BALLOT NO. OR LE3q'ER JURISDICTION []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. IE ANY 7. Primarily Formed 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 ;r-"l SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD I-~ SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE Attach continuation sheets if necessary FPPC Form 460 (June/01) FPPC Toll-Free Helpllne: 866/ASK-FPPC State of California Campaign Disclosure Statement Summary Page SEEINSTRUCTiONS ON REVERSE Typo or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER Contributions Received 1. Monetary Contributions ........................................... Schedule A. Line 3 2. Loans Received ...................................................... Schedule B. Line 7 3. SUBTOTALCASH CONTRIBUTIONS ............ : ............ AddLines I +2 4. Nonmonetary Contributions ................ . ................... ScheduleC. Line 3 5. TOTAL CONTRIBUTIONS RECEIVE[3 ......... : ................. AddLines 3 + 4 Statement/co/v/ers period from /,////(~ ~-- Column A Column B TOTN. THIS PERIOD CALENOAR YEAR (FRO~I ATTACHED SCHEDULES) TOTALTO DATE $ $ ~.~ Expenditures Made 6. Payments Made ......... ~...._.: ..................................... ScheduleE, Line4 $ 7. Loans Made ............................................................. Schedule H. Line 7 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 9, Accrued Expenses (Unpaid Bills) ............................... Schedu/eF, Line3 10. Nonmonetary Adjustment .......................................... Schedule C. Line 3 11. TOTAL EXPENDITURES MADE ................................ AddLInes8+9+10 Current Cash Statement 12. Beginning Cash Balance ....................... PreviousSummaryPage. Line 16 13. Cash Receipts ........................................... :.;::..' 'CotumnALin¢A~ve 14. Miscellaneous Ir~c_r,e, ases to Cash ............sc~ule L Line 15 Cash Payment~';~' :,~A~?A ~n ~,~ , ~ ColumnA Llne8above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13+ 14. then subtract Line 15 If this is a termination statement, Line 16 must be zero. 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 fimt report being tiled for this calendar year. only carry over the amounts fmm Unes 2, 7, and 9 (if any). 17. LOAN GUARANTEES RECEIVED ........................... s~edu/ee. Pe~t2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructkms on reverse 19. Outstanding Debts ......................... AddLine2+Llne9inColumnBabove SUMMARY PAGE Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contributions Received Expenditures Made 1/1 through 6/30 7/1 to Date Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' Date of Election Total to Date (mm/dd/yy) __J / $ __l / $ __J / $ __! /.__ $ __L__J $ *Since January 1. 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Tofi-Free Helpline: 8661ASK-FPPC · Schedule B- Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement c~ve7 period from through ~//'~/~) ~---- NAME OF FILER FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMM[TFEE. ALSO ENTER I.D. NUMBER) IF AN INDIVIDUAL, ENTER t[] IND [] COM [--I OTH r-I PTY [] SCC t[] IND [] COM [] OTH [] PTY [] SCC OCCUPATION AND EMPLOYER (IF SELF~MPLOYED, ENTER NAM~ OF BUSINESS) Amounts may be rounded to whole dollars. (b) AMOUNT RECEIVED THIS PERIOD (c) AMOUNT PAID OR FORGIVEN THIS PERIOD * []PAID $ [] FORGIVEN $ [] PAID $ [] FORGIVEN $ []PAID $ [] FORGIVEN $ OUTST(,~N) DING BALANCE AT CLOSE OF THIS PERIOD $ DATE DUE DATE DUE (e) INTEREST PAID THIS PERIOD RATE RATE Page SCHEDULE B - PART 1 I.D. NUMBER ORIGINAL CUMULATIVE AMOUNTOF CONTRIBUTIONS LOAN TO DATE (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD DATE INCURRED DATE INCURRED CALENDAR YEAR $ PER ELEC'RON ** $ $ $ $ t[] IND [] COM [] OTH [] PTY [] SCC DATEDUE DATE INCURRED SUBTOTALS $ $ $ $ ,~, Schedule B Summary (E.,~(.)o~ 1. Loans received th s per od ....... $ ~ (Total Column (b) plus unitemized leans leas 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.) ................................................ NET $ Enter the net here and on the Summary Page, Column A, Line 2. It Contributor Codes IND-Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee/ *Amounts forgiven or paid by~ another party also must be reported on Schedule A. "" If required, j FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Information on appropriately labeled continuafion sheets. TOTAL $ /~ NOTE: ~Ns CO~nn C, LIM R ~ F~ ~ ~ MARK DICKERSON USA USA