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Home My WebLink AboutHANSON PREELECT12(2)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from O t 0 ^ throughOl ko 1o%- 1. ? of Recipient Committee: All committees — complete Parts 1, 2, 3, and 4. fficeholder, Candidate Controlled Committee 9(o( E] Primarily Formed Ballot Measure State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part 5) Q Sponsored to (Also Complete Part 6) ❑ General Purpose Committee Executed on O Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also complete Part 7) 3. Committee Information I LA COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NRko" QAsofly MAILING ADDRESS) (IF DIFFL'RENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS COVER PAGE Date Stamp Date of election if applicable: C Page I of t (Month, Day, Year) 12 CT 23 AM 7: 54 For Official Use only o1•LBAKE '�FiEL j CI i Y CLER 2. `Type of Statement: 15d Preelection Statement ❑ Quarterly Statement /// ❑�� Semi- annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER 1J4ak �AaL.4 MAILING ADDR SS 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 information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws ofthe State of California that the foregoing is true and correct., Executed on L By'�" ( Date Sign lure ofTreasurer or Assistant Treasurer to Executed on Date By SigfatureofControlilOfficeholdakCandidate, StateMeasure ProponentorResponsibleOfficerofSponsor Executed on Date By Signature ofControtling Officeholder, Candidate, State Measure Proponent Executed on Dare By Signature of Controling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275-3772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) ,;Atcts y IV.� �%,, IL -w t'%w 1 miA , 5 RESIDENTIAUBUSINESS ADDRESS (W. AND STREET) C rry STATE ZIP Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? OFFICE SOUGHT OR HELD ❑ YES ❑ NO COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVERPAGE -PART2 Page I of i ala BALLOT NO. OR LE ER 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 List 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 OF ICEHOLDER 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 460 (January/05) FPPC Toll -Free Helpline: 8661ASK -FPPC (86612753772) State of California Type or print in ink. Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. TRUCTIONS ON REVERSE SUMMARY PAGE Statement covers period CALIFORNIA • ' dw from "W• .- through t1t, • A. 1101-W Page 0 of SEE INS NAME OF FILER Collumn A Column B Contributions Received TOTALTHISPERIOD CALENDAR YEAR "OMATTACHED SCHEDULES) TOTALTO DATE 1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ $ 2. Loans Received ....................... ............................... schedule B, Line 3 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................••• Add Lines 3 +4 $ $ 00 - Expenditures Made _ - 6. Payments Made ......... $ .............. ............................... Schedule E. Line 4 $ • . Schedule H, Line 3 - 1\0 000 7. Loans Made...+.. ..�.�.`. t ..... ............................... 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 +7 $ - 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F. Line 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE . ............................... Add Lines e + 9 + 10 $ 7 0 0 ' $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 13. Cash Receipts .................... ............................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15. Cash Payments ................... ............................... Column A, Line 6 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. $ $ �I Son- 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding Debts ......................... Add line 2 +Line 9 in Column B above $ 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 filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). I.D. NUMBER 11115 'ci a Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6/30 7/1 to Date 20. Contributions Received $ '� $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (ff Subject to Voluntary Expenditure limit) Date of Election Total to Date (mm /dd/yy) $ 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 (8661275 -3772) Schedule E Payments Made Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER 1 kAS. a �,ou,�e ►►� �`I�c�3�R �Ah� S. Statement covers period v from w • I 0 �� .} , 01 through '^' Page T of CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. MBR member communications RAD radio airtime and production costs CMP CNS campaign paraphernalia/misc. campaign consultants MTG meetings and appearances RFD SAL returned contributions campaign workers' salaries CTB contribution (explain nonmonetary)` OFC PET office expenses petition circulating TEL t.v. or cable airtime and production costs CVC FIL civic donations candidate filing /ballot fees PHO phone banks TRC TRS candidate travel, lodging, and meals staff /spouse travel, lodging, and meals FIND fundraising events supporting /opposing others (explain)' POL POS polling and survey research postage, delivery and messenger services committees of the same candidate /sponsor W LEG independent expenditure legal defense PRO professional services (legal, accounting) OT VVEB transfregistration information technology costs (intemet, a -mail) LIT campaign literature and mailings PRT print ads NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) 3L. lKI"a4 x- 4, A� CODE OR DESCRIPTION OF PAYMENT L4 Lam$ " Payments that are contributions or independent expenditures must also be summarized on Schedule D. AMOUNT PAID 5oQ - SUBTOTAL$ p00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................... ............................... $ 0 0 - 2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column ( e).) ................................................ ...........................•••• $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK -FPPC (866/275 -3772)