The URL can be used to link to this page

Home My WebLink AboutDICKERSON SEMIANN10(1)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in Ink Stateme co ra period from n TZIA>t through & F-z-o to 1. Typ"f Recipient Committee: AN Cormnatees _ ce n i a Parts 1, 2, 3, and 4. [Oficeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (A1so CorrPWt Parts) O Sponsored M1W Connote Pere 6m ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee Q Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAMI - -1,rT,.rr ¢ce h-1 ❑ Primarily Formed Candidate/ Officeholder Committee ~ C-#bbe Pot n I.D. NUMBER $31 I z Date of election If applicable; (Month, Day, Year) , Date Stamp I1fEB-4 AX10:4 2. Type of Statement: Sem ❑ ,Oelectlon Statement Semi-annual Statement ❑ Termination Statement (Also fie a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) IM COVER PAGE CALIFORN FORM 'A 4.1 Page --I- of For Official Use Only ❑ Quarterly Statement ❑ Special Odd-Year Report ❑ Supplemental Preelection Statement - Attach Form 495 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the under penalty of perjury under the of the State of California that the foregoing is true and correct. Executed on By Executed on i By .e ~r w sk new Da* and in the attached schedules is true and complete. I certify Executed on By Gals Sookm ofCwbx4N 5K-e et,Cendda Stara Meamm Proponent Exerted on D.re By Signaaaa of Conhoinq g6odndder. Carditlare, Shls I/naaa PrapanerN FPPC Form 460 (January/05) FPPC Toll-Free Helpline: a661ASK-FPPC (6661275~1772) Stab of California Type or print in ink COVER PAGE - PART 2 Recipient Committee Campaign Statement • i CALIFOPMA FORM Cover Page - Part 2 Page of _ S. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Kant '1c)►~Q~~-1 g?jl 12 I OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Related Committees Not Included in this Statement Lw any committees not Included in this statement that are controlled by you or are prfmafly formed to receive conMbudons or make expenditures on behalf of yaw candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? I ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA COOE/PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER i 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. IF ANY 7. Primarily Formed Candidate/Officeholder Committee ust 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 ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 160 (JanuaryMS) FPPC Toll-Free Hipline: WWASK-FPPC (66=75JT72) Stab of CaMmia Campaign Disclosure Statement Summary Page Type or print In Ink. Amounts may be rounded to whole dollars. Statement a ve tperiod from , I to SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER t1-{.mss- Cohan A Column a Calendar Year Summary for Candidates Contributions Received TOTALT111SPOCOW CALerx YEM (FTM ATTACHM SCFEDULM TOWTOUAM Running in Both the State Primary and General Elections 1. Monetary Contributions Sdiedure A. Line 3 $ $ 111 through 6130 711 to Date 2. Loans Received Sdredde B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines r + 2 $ $ 20. Contributions Received $ $ 4. Nonmonetary Contributions Sdiedure C, Line 3 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ..................AddLima3+4 $ $ Made $ - Expenditures Made 6. Payments Made Schedule E, Line 4 $ 7. Loans Made Sdredre H, Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) Sch dae F Line 3 -1&-- 10. Nonmonetary Adjustment Sdodule C. Line 3 11. TOTAL EXPENDITURES MADE Add Lines 6 + 9 + 10 $ ' a a $ $ Current Cash Statement 12. Beginning Cash Balance PreviowSurtrmeryPage, Line 16 $ 13. Cash Receipts Column A, Line 3 above 14. Miscellaneous Increases to Cash Scnedu►e Lime 4 15. Cash Payments Cdumn A, Line 6 above 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, Own subWad Line 15 $ ' if this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED SCh dlde 8, Part 2 $ -1cl'_ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See kat ucoons on reverse s 19. Outstanding Debts Add Line 2 +Lkw 9 in column e above $ f f 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 first report being fled for this calendar year, only carry over the amounts from Lines 2, 7, and 9 if any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* IM subiedto lrokeAwry Em-Will- UrrAl Date of Election Total to Date (mm/dd/yy) I _ I $ I -lam $ Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661273-3772) SCHEDULEB-PART1 ryps or pnrtt in mR. Schedule B -Part 1 Amounts may be rounded statement v rs period i -ALIFORNIA , , `2o10 Loans Received to whole dollars. from -1 ri FORM pap of through SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER n C'Y -1`c 2- FULL NAME. STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING BALANCE b AMOUNT RECEIVED THIS (al AMOUNTPAID ANCMG BALANCEAT • INTEREST PAID THIS ORIGINAL AMOUNT OF 9 CUMULATIVE CONTRIBUTIONS OF LENDER IF - couwRTEE ALSO ENTERLD.M1M8Bi) (IF ggFEMPLOYED, ENTER wwEoFSUSINESS) BEGINNING THIS PER OD PERIOD OR FORGIVEN THIS PERIOD' CLOSE OF THIS PERIOD AN LO TO DATE \ ~~T C] PAID CALENDAR YEAR % R C~ RATE - ❑ FORGIVEN PERELECTION ~ s S t❑ IND COM ❑ OTH ❑ PTY ❑ SCC S / S s DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR % S S $ i ' E] FORGIVEN RATE PER ELECTION" s s s s s DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR S i % S S ❑ FORGIVEN RATE PER ELECTION- $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC S S 3 DATE DUE DATE INCURRED SUBTOTALS ~ $ $ Schedule B Summary 1. Loans received this period $ (Total Column (b) plus unitemized loans of less 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. --e-- (May boa MOO- Moo" (Enter (e) on Sdbdk/e E. Line 3) tContributor Codes IND-Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee 'Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772)