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HomeMy WebLinkAboutPRICE SEMIANN99(1) fficeholder, Candidate, and Controlled Committee Campaign Statement -- Long Form Type or print in ink. (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Check one of the following boxes to indicate the type of statement being filed: [] Pre-election Statement ~ Supplemental Pre-election Statement (Attach a completed Form 49S to this statement) Special Odd-Year Campaign Report iSemi-annual Statement Termination Statement (Attach a completed Form 41S to this statement.) I ~)fficeholder Candidate. and Controlled Committee Included in t~is Statement ZIP CODE AREA CODE~DAYTIM[ PHONE LD. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE M:XIGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER if APPLtCAIILE) REMDEIfflAL OR BUSINESS ADDRESS (NO AND STREET) CITY STATE COMMITTEE NAME ' COMMITTEE AODR~SS III COVER PAGE - LONG FORM from / ' through ~' j~' ~ ~ 9~ ~L 19 P~ Z: 2 3 Dateofe~ionfapplica~A~RSFIELD C)TY CLER~ pa~ / (MMth, Day, Year) ~ For Official Use Only NAME OF IEASURER COMMITTEE ADDRESS Other Committees ~iot Included in this Statement: cm,nyot~er committees not included in this consolidated Statement that are controlled by you and any committees of which you have knowledge that are primarily formed to receive contributEore or to make expenditures on behalf of your candidacy. COMMITTEE NAME ] I D. NUMBER CONTROLLED COIVIMITTEr ) (NO. AND STREET) crrf STATE ZIP CODE AREA CODEJDAYTIME Iq4ONE CITY NAME OF TREASURER ~ERMANEI~I ADDRESS OF TREASURER CITY Verification (NO. AND STREET) STATE (NO AND STREET) ZiP CODE AREA CODE/DAYTIME PHONE STATE Ztt CODE AREA CODFJDAYTIME PHONE C0MMITIEE NAME II D NUMIER NAME OF TREASURER CONTROLLED COMMITlEE? ] yes [] ND COMMITTEE ADDRESS (NO AND STI~ET) CITY STATE ZIP CODE AREA CODE/DAYTIME tt-K)NE Attach additional information on appropriately labeled continuation sheets. I have used atl reasonable diligence in preparing this statement. I have reviewed the 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 7-//--~? At ~,~,~j"_~/~_~ /~-, By ~/~-~ ~'~'"~<~ DATE .~'/ CITY AN~STAIE SIGNATURE Of TREASURER An officeholder or (l~Mate who controls · comml~ee must also varify the campaign statement, t have used all reasonable diligence and to the ~ of my k nowledge the treasurer has used all '=;;;';'"" '"" "" ,,,..., ,, ,,.... Executed on A~ ~' By DATE CITY AND $IATE SIGNA 1 U~E OF CANDIDAT E/O~ ~ ICE HO[ DE ~ E~eculed on A~ By FOR iNFORMATION RETIRED TO BE PROVIDED TO YOU PURSUANT TO 1HE INFORMATION P~I(ES A~ Of I~77, SEE INFORMATIO~ANUAL ON CAMPAIGN DiSCtOSUR[ P~OVISIONS Of 1HE POLITICAt REFORM AC1 Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from /'/' ?~ SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE Contributions Received 1. Monetary Contributions ............................... Schedule A, LIne 3 $ 2. Loans Received ......................................... Schedule e, Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I · 2 $ 4. Non-monetary Contri butions ................... schedule c, Line 3 5. SUBTOTAL CONTRiBUTIONS:(Exclude Enforceable Promises) Add Unes 3 6. Enforceable Promises (Exclude Loan Guarantees, Line 18 below) ................... Schedule D, Une 7 7. TOTAL CONTRIBUTIONS RECEIVED .................... AddUnesS, 6 $ Expenditures Made 8. Cash Payments (Other than Loans Made) ............ Schedule E, Une 9. Loans Made ............................................. Schedule H, Une 10. SUBTOTAL CASH PAYMENTS ............................ AddLines8. 11. Accrued Expenses (Unpaid Bills) ........................ Schedule F, Une 12. TOTAL EXPENDITURES MADE ......................... AddUnes I0 · II Current Cash Statement 13. Beginning Cash Balance .................. Previous Summary Page, Line 17 14. Cash Receipts ...................................... ColumnA, Line3alx)ve 15. Miscellaneous Increases to Cash ........................ schedule I, Line 16. Cash Payments .................................... CotumnA, Line lOebova 17. ENDING CASH BALANCE ..... Add Lines 13 + 14 ~ 15, then subtract Ltne 16 ff this Lf a termination statement, Line 17 must be zero. 18. LOAN GUARANTEES RECEIVE D .............. Schedule e, Pan I, Column (b) S Cash Equivalents and Outstanding Debts 19. Cash Equivalents ................................ See instructions on reverse Colurrtn A TOTAL THIS I~RIOD ffRO M AllACHED $4:HEDUL[S) through Col urfir} Bt TOTAL PREVIOUS PERIOD (SEE NOTE IELOVV) Page ~L of '~' I.D. NUMBER ~dOd~ / COlumn C TOTAL TODATE (ADD C0tUMN$ A · l) * From previous Statement Summary Page, Column C. However, if this is the first report filed for the calendar year, Column B should be blank except for LOam Received (Line 2), Enforceable Promises (Line 6), Loans Made (Line 9). and Accrued Expenses (Line 11), Summary for Candidates in Both June and November Elections 1/1 through 6/30 7/1 to Date 21 ontrib tions 22. ~ap3e?d!!.Ur.e! S 20. Outstanding Debts ................. AddLine 2 ~, Line I l in Column Cabova S Schedule E Payments and Contributions (Other Than Loans) Made Type or pdnt tn ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE CODES FOR CLASSIFYING EXPENDITURES Statement covers period from / -/- 9 ~,__ through SCHEDULE E Page -~ of ~z- : I,D. NUMBER If one of the following codes accurately describes the expenditure, u may enter the code and leave the "Description of Payment' co|u mn blank. Refer to the back of Schedule E-Continuation Sheet for detailed explanations otY~e;ch category. 'C' - MONETARY AND IN-KIND (NON-MONETARY) 'B' - CONTRIBUTIONS TO OTHER CANDIDATES ' N' - AND COMMITTEES ,Oo _ '1' - INDEPENDENT EXPENDITURES- 'S*- 'L'- LITERATURE 'F'- BROADCAST ADVERTISING 'G" - NEWSPAPER AND PERIODICAL ADVERTISING 'T' - OUTSIDE ADVERTISING SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS *P° ' FUNDRAISING EVENTS NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION (W COIdMIIT~E, IN ADOITION TO CO4dMITTEE'$ NAME ANO ADDliS$, ENTER I.O. NUMI~R OR. I~ NO t.D, NUMIIR HAS lIEN ASSIGNED, ENTER TREAf~REIr$ NAME AND ADORESS) GENERAL OPERATIONS AND OVERHEAD TRAVEL, ACCOMMODATIONS AND MEALS (MUST BE DESCRIED) PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW. CODE OR DESCRIPTION OF PAtMENT SUBTOTAL $ Im ant: Contributions and ex .t~. nditures made out of campai n funds to or on behalf of other ordered: canal/dates, committees, or ballot measures must ;~; be entered on the Allocation Page, Part L Payments and Contributions Made Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................ 2. Payments made this period of under $100. (Do not itemize.) ....................................................................... $ 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. 4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ..................................... $ AMOUNT PAID ,5"_,c:,/', c c S. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8) ........... TOTAL Schedule E (Continuation Sheet) Payments and Contributions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITFEE "C* - MONETARY AND IN-KIND (NON-MONETARY) 'B' - CONTRIBUTIONS TO OTHER CANDIDATES 'N' - AND COMMITTEES 'O' - "t' - INDEPENDENT EXPENDITURES 'S'- "L'- LITERATURE i NAME AND ADDRESS OF PAYEE. CREDITOR, OR RECIPIENT OF CONTRIBUTION (if COMMITtrEE, IN AI)OfTION TO COMMII*r~r$ NAME AND ADDRESS, ENTER I.D. NUMIER OR, I~ NO I.D. MUMMR HA$ IEEN Ae~gGNED. ElklfER TREAf~4~RER'S NAME AND Type or prIM In IM. Amountt may be rounded to whole dollars. Statement covers period from / _/_ c~ ~ through ~ ' "-~ ' ~ ~' CODES FOR CLASSIFYING EXPENDITURES BROADCAST ADVERTISING °G' - NEWSPAPER AND PERIODICAL ADVERTISING *T' - OUTSIDE ADVERTISING SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS FUNDRAISING EVENTS SCHEDULE E (cont,) __ ~ PI~, ~ Of "~' I.D. NUMBER - 'j.,., GENERAL OPERATIONS AND OVERHEAD TRAVEL, ACCOMMODATIONS AND MEALS (MUST BE DESCRIBED) PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES .. CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID SUBTOTAL Schedule I Miscellaneous Increases to Cash Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from /-/- ~;~; SCHEDULE I SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE DATE FULL NAME AND ADDRESS OF SOURCE RECEIVE D (~; COMMITTEL IN ADDftlON TO COMMITTEE"~ NAME AND ADDRESS, ENTER I.D. NUhIIER O~ If NO I,ID, NUMIER NA$ IEEN AS~.IGNEDo ENTER TREASURER'$ NAME AND ADDRESS) DESCRIPTION OF RECEIPT Attach additional information on appropriately labeled continuation sheets, Miscellaneous Increases to Cash Summary 1, Increases to cash of $100 or more this period ............................................................. $ 2. Increases to cash under $100 this period. (Do not itemize.) ................................................ $ 3. Total ofall interest received this period on loans made to others. (Schedule H, Part ll(b).) ....................$ 4, Total miscellaneous increases to cash this period, (Add Lines 1, 2, and 3, Enter here and on the Summary Page, Line 15,) ....................................................................... TOTAL $ SUBTOTAL I.D. NUMBER .~ z~</~ / AMOUNT OF INCREASE TO CASH