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HomeMy WebLinkAboutDICKERSON SEMIANN05(2) 4. Verification I have LB8d eU reesonable dlUgence In pre~'ng and reviewing this statement and to the best of my under penalty of pe~ury under uje liIW1 of State of California that the foregoing Is true and correct ')Jr-. Of Executed on -¡¡¡; , By _ Executed on.::1 By _ "'" ..,.,.... Executed on c;¡; By Executed on ~ 8y .·df........or AasWtñtr,..... - '.~.s-........ProponenIOt~OII'œtd ........,,~~,"""""",--..- ...,. _oI"-~,__-,,_ . ---v ,,,~_. FPI'C F......eo (JanUOfyI05) FPPC ToIl..free HtlpUne: 8611ASK-FPPC (1aeI275-3712) State of CaHfornll (~'1ormauon contained herein and In the attached schedules is true and complete. certify OPTIONAL: i OPTIONAL: FAX I E-MAIL ADDRESS FAX , E-MAIL ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE A ) MAILING ADDRESS a;y STATE f - ZIP CODE AREA CODE/PHONE Committee Information ~~c~SÑ~~) \ 3. seE INSTRUCTIONS ON REVERSE through - Typ Recipient Committee: All Comm'''''' - Com..... Pa.. 1. 2. 3, and 4. ot!iceholder, Candidate Controlled Commillee 0 Primarily Formed Ballot Measure o Stata Candidate Election Committee Committee o Recall 0 Controlled __-0) 0 Sponsored --_OJ o General Purpose Commlllee o Sponsored 0 Primarily FOI1T1\Id Candidate! o SmeU Conb'ibutor CommlUee Officeholder Commllloe o PoIlticaJPartylCentralCommlUee I-_P""I 1. 2. Type of Statement: o ~Statement ~IStatement o Termination Statement (Also file a Focm 410 Tennlnalion) o Amendment (Explain below) o auarterty Statement o SpecIal Odd-Year Report o Supplemental Preelection Statement - Attach Focm 495 from Oat. of .Iectlon If apPllcabl"lf06, rEB (Month, 07' Year) " C ,_" N¡~ n "" o U L ..' ~ 3 , t Page I For Official Use Only Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print In Ink. AM Date Stamp /1: CALIFORNIA 2001/02 FORM a mD FPPC F"'1!1. * (....UOfyI05) FPPC ToIl..free HelpAM: 88IIASK.f'PPt: (lMlZ7s..3772) S...."'_ CITY NAME OF TREASURER COM\4IT1EE NAME C'TY COMMITTEE ADDRESS srATE STREET ADDRESS srATE ZIP CODE CONTROllED COMMITrEE? DYES oNO (NO P.O. BOX AREA COOEJPHONE ZIP CODE .D. NUMBER AREA COOElPHONE Att,ch continuation sheets If nec....ry NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE COMMITTEE ADDRESS NAME: GF Tkš:AS"_I~R CCNTROLLED COMMITTEE? DYES oNO STREET ADDRESS (NO P.O, BOX) Primarily Formed Candidate/Officeholder Committee Ust nam.. 01 oIIfoelooldot(s¡ 01' -...¡o¡ "" """ch this r;omml_ /$ prlmarl y formed, R not Incl.-In lhIII.ta_ ""',.... con"""oII by you or.. prInwlty _ to "",aIn conlTlbutloM or make expendIturu on behall of your candidacy. COMMITTEE NAME .0. NUMBER 7. OFFICE SOUGHT OR HELD Identify the eontroUl"g officeholder, candidate, or stat. mea8ure proponent, If any. NAME OF OFFICEHOLDER. CANDIDATE, OR PROPONENT DISTRICT NO. IF IWf Recipient Committee Type or print In Ink. Campaign Statement Cover Page - Part 2 - 5, Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAMEM~ER~~ÜN NAME OF BALLOT MEASURE <23//2-( OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO, OR LETTER JURISDICTION o SUPPORT o OPPOSE COVER PAGE· FPPC Fonn _ (JonuaryI05) FPPC TolI-Freo Helpline: 8861ASK-FPÞc (866/275-3772) Schadula S, PM 2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents, ........... _..-.on...."'" 19. Outstanding Debts AddUne2+UnaS"CdumnSebova $ $ Current Cash Statement 12. Beginning Cash Balence 13. 14. 15. Schedule I, Line 4 Cash Payments Cokmn A. Line 8 above 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 " this Is a termination statement, Une 16 must be zero. 17. LOAN GUARANTEES RECEIVED $ $ Cash Receipts Misce"aneous Increases to Cash Previous Summllf)' Page, Une 16 Cohmn A. Line 3 above To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your lest report. Some amounts In - J 3- - Column A may be negative , C1::L, ~ llgureo that should be , subtracted (rom previous period amounts. If this Is the tInIt report being filed for this celendar year, only œny over the amounts from Unes 2, 7. and 9 (If any). f'1 z::- -Amounts in this secüon may be different from amounts reported in Column B. $ -ê-- ~ $ 10. Nonmonetary Adjustment 11. TOTAL EXPENOITURESMADE 7. 8. 9. SUBTOTAL CASH PAYMENTS Accrued Expenses (Unpaid Bills) Schedule E. Line 4 Schedule H, Un6 3 Add Lines 6 + 7 " Schedule F. Une 3 . Sch&du/ø C, L.ine 3 AddUnfl58+9+ 10 $ $ Date of E1ection (l1)fT1/ddlyy) $ Cumulative EXlMndltur.. Mad.* (1f lubfect to VcIIunt.ty Expend(bIni LImIt) Total to Date Expenditures Made 8. Payments Made Loans Made $ $ $ $ 22, ExpendRure Limit Candidates Summary for State ,. 2. 3. 4. 5. Monetary Contributions Loens Received .......... SUBTOTAL CASH CONTRIBUTIONS Nonmonetary Contributions .............. TOTAL CONTRIBUTIONS RECEIVED Contributions Received L G.NM1~~? - - - - C~umnA CowmnB 'OTAI,THlSPERIOO CALENDARYeAR (FROMAT'TAOiEDsctEDULES) TOTliLTOOATE Schedule A, Une $ r~OO -:- $ '..Q- Schedule B. Line 3 . Add/.kle'V2 $ 13~ S Schedule C, Line 3 .A- AddLlnes3+4 S L~=- _ $ 21. 20. Expenditures Made Contributions Received $ s through 6130 7J1 to Date C, S J.3ro~ I C $-A- I.D. NUMBER <g3j I 2., Calendar Year Summary for Candidates Running In Both the State Primary and General Elections '1 SEe iNSTRUCTIONS ON REVERSE NAME OF FILER Campaign Disclosure Statement Summary Page lNw-L 'Þ \ Type or print In Ink. Amounts may be rounded to whole dollars. through from Statement Schedule A Type or print in ink. Monetary Contributions Received Amounts may be rounded to whole dollars. from SEe INSTRUCTIONS ON REVERSE through NAME OF FILER N~ 'ù\ck~ ,.0. NUMBER \~'DS <231 I Z DATE FULL NAME, STREET ADDRESS AND ZIP CODe OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOtNT I CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE. AlSO ENTER 1.0. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPlOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) OJfl~ 6 ~v\ "-"L \::x.Nf:S¡; OIND ~LLdL I~-:- tßèð~ -e- ZŒ' DSCC DIND DCOM DOTH DPTY DSCC -- DIND DCOM DOTH DPTY DSCC DIND DCOM DOTH DPTY DSCC DIND DCOM DOTH DPTY DSCC SUBTOTAL $ Schedule A Summary ·Contributor Codes 1. Amount received this period - contributions of $1 00 or more_ btb--:- IND -Individual (Include all Schedule A subtotals.) '-'00 n.nnnnnnnnn. 00-00.-00 -00000000 00.000000' 0000.000000. $ COM - Recipient Conmittee (other than PTY or sec) 2 _ Amount received this period - unitemized contributions of less than $1 00 00 00' 00 00 _00000000.00 $ .8- QTH - Other PTY - Political Party 3. Total monetary contributions received this period. r--' see - Small Contributor Comrrittee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ 3cù FPPC Fonn 460 (JunolO1) FPPC Toll-Free Helpline: 8661ASK-FPPC 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 onother party also must be reported on Sc:hedule A. - « reqUred. FPPC Farm 480 (JonuorylO5) FPPC TolI-Free IWlpllne: 8I6IASK.fPPC (8681275-3n2) Loans paid or forgiven this period .................................... (Total Column (c) plus loans under $1 00 paid or forgiven.) (Include loans paid by a third party that are also Itemized Dn Schedule A.) NET $ -è-- - ~ (MI;y".~1II.ITIber1 2. Schedule B SUmmary 1. Loansreœlved this period ................................................... (Total Column (b) pfus unltemlzed loans of less than $100.) $ $ .:e- tContribulor Codes IND -individual COM - Recipient Committee (other than PTY or sce) OTH - Other (e.g., business entily) PTY-PoIiticaIPariIy SCC - Small ConlributorCommittee DATE DUE = $ 3Z.A'ìL~ - (EnW(B)on Sc:MduIt E. Lft 3) SUBTOTALS $ $ to IND DOOM o OTH 0 PTY o SCC · o PAlO .- o FORGIVEN · DATE INCURRED CALENOAA YEAR · PER elECTION" · . _% .", . to IND o COM ODTH OPTY o SCC . · o PAID .- o FORGIVEN · DATE""" . DATE INCURRED CALENDARYEM · PeR ELEC1lON ** _% .". SEE INSTRUCTIONS ON REVERSE NAME OF FILER Ní¥2-~D\ (~0 ~e.... FULL NAME. STREET ADDRESS AND ZIP CODE If!' AN INDIVIDUAL, eNTER ~ OF lENDER OCCUPATION AND EMPLOYER BALANCe (FCOMMm"æ.ALSOENTERI.D NJMBER) (lFsaF-EMPLOYED.ENTER BEGINNING THIS , NAME Of BUSINESS) µ~N .Ç){c.b~ þ;L-GJ.~ ~,1tS ~~ É' .Ecl-~ '. ~,,-'lS:.. ?>~47Z t~ 0 COM 0 OTH 0 PTY 0 SCC LdP--ihlV\ «-WE- (b) (el C AMOlM'" AMOUNT PAID RECEIVED THIS OR FORGIVEN PERIOD .....!!::!!§..PERIOD· o PAID · è- s o FORGIVEN · -G- I '3>49z.. DATE DUE s _% RAre --'é- ,. INTEREST PAID THIS PERIOD s ~1?: ORIGINAL AMOUNT OF lOAN PER ELECTION" .:&- '" CUMUlATIIIE CONTRIBUTIONS TO DATE CALENDARYEAR Schedule B - Part 1 Loans Received Type or print in ink. Amounts may be rounded to whole dollars. through from ~.- - P098 ---2 of ~ to. NUMBER ~117.-/ '- k- CD: L\'M uça- - , ~~{'--J\ '. \to\ \;Û~- \l)l c kf¿S.J 21 (lob S'Q(2'---( «(L ~- T;IJ() I v0<- "',,~ (/f-- -TiJ-j¡S M' ¡/(lvL'T. , .' 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