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Home My WebLink AboutDICKERSON SEMIANN00(2) ecipient Committee Campaign Statement (Government Code Sections 84200-84216.5) Type or print in ink. SEE INSTRUCTIONS ON REVERSE through 1, Type of Recipient Committee: Att Committees- Complete Pads 1, 2, 3, end 7. [~fficeholder, Candidate [] Primarily Formed Candidate/ Controlled Committee (Also Complete Part 4.) [] BalJot Measure Committee O Primarily Formed 0 Controlled 0 Sponsored Officeholder Committee (AI~ complete Part 6J [] General Purpose Committee O Sponsored O Broad Based I LD. NUMBER 3. Committee Information ~ ~.~ ii ~.-( COMMITTEE NAME ~ ( STREET ADORESS {NO RO. BOX) CITY STATE ZIP COOE ,~ AREA CODFJ~HONE MAILING ADORESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP COOE AREA CODFJPHONE OPTIONAL: FAX / E-MAIL AI3ORE SS Date of election if applicable: (Month, Day, Year) Date St;m~ FEB --2 Pt'! t2: 5,~ (ERSFiE! D CITY CLER 2. Type of Statement: []/~e-election Statement [~' Semi-annual Statement COVER PAGE [] Termination Statement [] Amendment (Explain below) Treasurer(s) [] Quarterly Statement MAILING ADDRESS [] Special Odd-Year Report [] Supplemental Pre-election Statement - Attach Form 495 STATE ZIP CODE AR A CODFJPHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADORESS Ci~Y STATE ZIP COOE AREA COOFJPHONE OPTIONAl.: FAX IE-MAiL AOO~ESS FPPC Form 460 (8/99) For Technical Assistance: g!6/3~2.$$60 State of California Recipient Committee Campaign Statement Cover Page -- Part 2 Type or print in ink. COVER Page '~' of '~ 4. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE / , RESlDENTIAL~USINESS ADDRESS (NO. AND STREET) CITY STATE ZI~, / Related Committees Not Included in this Statement: Llstanycommlrteea not included In this consolidated statement that are controlled by you or which are primarily formed to receive contributions or re make expenditures on behalf of your candidacy. COMMI~IE E NAME /I.D. NUMBER CONTROCLED COMMITTEE? NAME OF TREASURER I~ YES [--1 NO COMMITI~E ADDRESS STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE AREACODE/PHONE 5. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LET[ER IJURISDICTION I [] SUPPORT I[] OPPOSE Identify the controlling officeholder, candidate, or slate measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE sOUGHT OR HELD I DISTRICT NO. IF ANY 6. Primarily Formed Committee Llstnamesofofficeholder(s) orcandldare(s) for which this commlffee Is pr#rmrlly formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD NAME OF OFFICEHOLDER OR CANDIDATE r-]SUPPORT []OPPOSE [] SUPPOR¢¢ []OPPOSE Attach continuation sheets if necessary Verification 7. enable dili ence in preparing and reviewing th s statement and to the best.e~ rrN I ~/~vledge the information contained herein and in the attached schedules I have used all teas g ............ , ok^ ~'~te of California/theft) (fpregoing is true and correct. ~s true and complete I certify under penalty el perjury under me ~uwa u, t.,~ ,-,.,~ "]"-/7-// Executed Da By DATE Executed on. By DATE SIGNATURE O¢ CONTROLUI~ OFFICEHO~.O~R, CANOIDATE, STATE MEASURE PROPONENT SIGNATURE OF CONTROU.IH~ OFFICEHOLDER. CANOIDATE, STATE MEASURE P~OPCNENT FPPC Feint 460 (8/99) For Technical Assletance: 916/322-5660 State of California CamPaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Amounts may be rounded to whole dollars. through SUMMARY PAGE I.D. NU,',~CC~ NAME~RLER Contributions Received 1. Monetary Contributions ...................................................... 2. Loans Received ................................................................... 3. SUBTOTAL CASH CONTRIBUTIONS ................................... AddS.rhea t + 4. Nonmonetary Contributions ............................................... Schedule C, Line 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + Column A ,/ $ Column B' Column C Expenditures Made 6. Payments Made .................................................................... Schedule E, Line 4 Schedule H, Line 7 7. Loans Made .......................................................................... 8. SUBTOTAL CASH PAYMENTS ................................................ Add Lines S + ? 9. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, Line 3 10. Nonmonetary Adjustment ....................................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ......................................... Add Lines a + 9 + 10 $ $ Current Cash Statement 12. Beginning Cash Balance ................................ Previous Summary Page, Line t6 $ 1 3. Cash Receipts .............................................................. Column A, Line 3 above 14. Miscellaneous Increases to Cash ....................................... Schedule I, Line 4 Column A, Line 8 ebove 15. Cash Payments ............................................................ 16. ENDING CASH BALANCE .............. Add Lines 12 + 13 + 14, then subtract Line 15 $ If this Is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................... Schedule B, Part I, Column $ Cash Equivalents and Outstanding Debts See instructions on reverse $ 18. Cash Equivalents ..................................................... 19. Outstanding Debts ................................... AddLine2+LlneginColumnCebove $ · From previous statement Summary Page, Column C. However, if this is tim first repod filed for the calendar year, Column B should be blank except for Loans Received (Line 2), Loans Made (Line 7), and Accrued Expenses (Une 9). Summary for Candidates in Both June and November Elections 111 through 6J30 711 to Date 20. 21. / Contributions Received ............ Expenditures Made .................. FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 :hc~dule B - Part 3 ~nual Report of Outstanding Loans Received ~ ,,., / '/__=~ .. -: ,: · ~ J ii ii II I 4 ttach additional inforroation on appropriately labeled continuation sheets. TOTAL $ /~_~ ~~~ NOTE: T'nl; total ~ukl be the ~me amount as entered For Te~hnlrml A~el~tm~e: 9t~2-56G0 THE LAW OFFICES OF MARK DICKERSON · ]~LFNGIA. GA FEB "2 pY P: 55 ~-..~c~x/'~a'~ Ihh,,,Ih,,ll,lh,,,,,llhh,hh,hh,hh,,hh,hhl,,hi