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HomeMy WebLinkAboutMCDERMOTT TERMINATE 0HOfficeholder, Candidate, and Controlled Committee Campaign Statement -- Long Form Type or print in ink. (Government Code Sections 84200-8421S.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 · completed Form 49S to this statement.) ~] Special Odd-Year Campeign Report .~._Semi-annual Statement ~Terminatio~ Statement (Attach a completed Form 415 to this statement.) I Officeholder,Candidate, and Controlled Committee Included in this Statement N~ME OF OFFICEHOldER OR CANUTE * NAME OF TREASURER~ COVER PAGE - LONG FoRM Date Stamp Statement covers period FILE Date of electloft If epplicalde: II Other Committees ~1ot Included in this Statement: comakers not included in this como~ldated statement ~t a~ c~l~ ~ III Verification , I have usod all reasonable diligence In preperiug this statement. I have reviewed the statement and to the best of my ~rto~e the informatib'~eontaiq~,herei)fend in the attached schedules is true and complete ~certifyunderpen~ty~f~uryq4~derthe~avYs~theStat~fcp~if~rniathatthef~reg~ing~s~de~td~br~ect. k ~ ~ , /~ .~ DATE -- ~:~T¥ A"D STATE .... SJG/~II'ATUF~ O~ TREASUR~ An officeholder or andldite who ~ontroll e committee must cleo verify the campeign statement. I heve used eli reasonable diligence and tp.~ hest of my knowledge the treasurer has used aft 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. ~certifyunderpena~ty~fperjuryunde~the~awSoftheStata~fCaiif~rniathatthef~reg~ingistrueand~:~`(~ect. ~ t~ ~ Executed on "~ "~ "c~ At ~r-~ p~ ~ By ~ ~ ~q~ DATE C~TT AND STATE SIGNATURE OF CANDIDATE/Of F ICEHOlDER Executed on At By DATE C~ry AND STATE SIGNATURE OF CANDIDATE~OF FICEHOLDE# Executed on At By DATE OTy AND STATE SIGNATURE OF CANDIDATE/OFFICE HOLDS R FOR ~NFORMATION REQUIRED TO BE PROWOEO TO YOU eURSUAm TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISC LOSURE PROVtS~OHS OF mE potmcAt REFORM ACT Campaign Disclosure Statement Summary Page Type or pdnt in Ink. Amounts may be rmanded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDEr[OR CANDIDATE AND CONTROLLED COMMITTEE $. Monetary Contributions ...................... ScbeduleA, Une$ S 2. Loans Received ......................................... Schedule e, £~ ? 3. SUBTOTALCASHCONTRIBUTIONS ...................... Add Uoas ~ +2 $ 4. Non-moneta ry Contributions ......................... ScMdule C, Une 3 5. SUBTOTAL CONTRIBUTlONSi(ExdudeEnfo~eablePromlses) AddUnes3 +4 6. Enforceable Promises (Exclude Loan Guarentee$, Llne l R below) ................... $cheo~e D, Lloa 7 7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnes5 * 6 Expenditures Made 8. Cash Payments (Other than ~oans Made) ............ Schedule E, Uoa S 9. Loans Made ............................................. Schedule H, Une 7 t0. SUBTOTALCASH PAYMENTq ............................ AddLtnese + 9 11. Accrued Expenses (Unpaid Bills) ................... Schedule F, Une 12. TOTAL EXPENDITURES MADE ......................... AddLines I0 Current Cash Statement 13. Beginning Cash Balance .................. FreviousSummery Page, £1ne 14. Cash Receipts ...................................... Column A, L/he ~1 above 15. MiKellaneous Increases to Cash ........................ S~ed~le ~, Une a 16. Cash Payments .................................... ColumnA, Line 10above 17. ENDING CASH BALANCE ..... AddLine; 13 + 14 + I5, thensubtraCtUne 16 S If this Js a termlnation statement, Une 17 rnust be zero. Column A $ 18. LOAN GUARANTEES RECEIVED .............. ScheduleB, Partl, Columnlb) S Cash Equivalents and Outstanding Debts 19. Cash Equivalents ................................ See instructlons on reverse $ 20. Outstanding Debts ................. AddLine2 + Une IlinCMumnCabove S through SUMMARY PAGE * From previous Statement Summary Page, Column C. However, if this is the fi~t report filed for the calendar year. Column R should be blank em:ept for Loans Received (Line 2), Enforceable Promises (Line 6), Loam Made (Line 9), end Accrued Expenses (Line 11 ). . Summary for Ca.ndidates in Both June and November Elect;ons 111 through Ed30 711 to Date 21. [:ontribqtions Kecelvea .... S 22. Exoenditures Made ....... S Allocation Page -- Part I Contributions and Independent Expenditures Made From Campaign Funds SEE INSTRUCTIONS ON REVERSE Type o~ print In ink. Amounts may be rounded to whole dofiars. ' Statement covers period through List each contribution and independent exDenditure of $ I00 or more made from campaign funds to other committees or to support or oppose other candidates or ballot measures. DATE CHECK ONE NAME OF OFFICEHOLDER, CANDIDATE, COMMITTEE, OR MEASURE Suppert Oppose ALLOCATION - PART I I,D. NUMBER *See reverse regarding independent expenditures. ALLOCATION -- PARTI SUMMARY IND. CUMULATIVE TO DATE EXP* AMOUNT CALENDAR YEAR (JAN. 1 ~ DEC. 3 I) CUMULATIVE TO DATE OTHER (IF APPLICABLE) SUBTOTAL S ~ ~ Attach additional information on appropriately labeled continuation sheets. 1. Contributions and independent expenditures of $100 or more made this period from campaign funds. (Include all Allocation Page -- Part I subtotals.) ......................................................................................... 2. Contributions and independent expenditures under $100 made this period from campaign funds. (Do not itemize.) ........................................................................................................................... 3. Total contributions and independent expenditures made this period from campaign funds. (Do not carry this total to the Summary Page.) ..................................................................................TOTAL .Schedule E Payments and Contributions (Other Than Loans) Made Type or print In ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE -- CODES FOR CLASSIFYING EXPENDITURES SCHEDULE E Statement covers pedod I.D. NUMBER cK OT ~cneaule t-continuation ~neet for oetaileo explanations or each category. 'C'- MONETARY AND IN-KIND (NON-MONETARY) CONTRIBUTIONS TO OTHER CANDIDATES AND COMMITTEES '1' - INDEPENDENTEXPENDITURSS "L'- LITERATURE 'B'- BROADCAST ADVERTISING 'N'- NEWSPAPER AND PERIODICAL ADVERTISING 'O' - OUTSIDE ADVERTISING 'S'- SURVEYS, SIGNATURE GATHE RING, DOOR-TO-DOOR SOLICITATIONS 'F' - FUNDRAISING EVENTS 'G'- GENERAL OPERATIONS AND OVERHEAD, 'T'- TRAVE L, ACCOMMODATIONS AND MEALS (MUST BE DESCRIBED) 'P'- PROFESSIONAL MANAGE MENT AND CONSULTING SERVICES NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON UNE 4 OF THE SUMMARY SECTION BELOW. CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID 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.) ..................................... 5. Total payments made this period. (Add Lines 1,2,3, and4. Enter here and on the Summary Page, ColumnA, LineS.) ........... TOTAL Important: Contributions and exp_enditures mede out of campaign funds to or on behalf of other ~i?eh~ders~ ca .nd~i~d-ate-s~ c~mmlttees` ~r ba~t measures must a~s~ be entered ~n the A~cati~n Page~ PartL SUBTOTAL