Loading...
HomeMy WebLinkAboutSMITH 460 PREELECT12(2) AMEND 10/26/12"'IRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) Type or print in Ink. Date Stamp Statement covers period Date of election If applicable: from ` �q/ I / � (7— (Month, Day, Year) 12 01 T 26 PM 3: 08 SEE INSTRUCTIONS ON REVERSE I through 101W/ 2012— 1. Type of Recipient Committee: Ail committees - Complete Parts 1, 2.3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee Q Political Party /Central Committee 3. Committee Information NAME (OR CANDIDATE'S NAME IF NO ❑ Primarily Formed Candidate/ Officeholder Committee (Also complete Part 7) I.D. NUMBER S3 :__m f TH F0F —CirY (2,G)(A VU - 29 ► z STREET ADDRESS (NO P.O. BOX) S (IF DIFFERENT) NO. AND STREET OR CITY STATE ZIP CODE AREA CODE /PHONE COVER PAGE Page of For Official Use Only t1ko/2atZ_ " i ELG i; "'Y CLERK 2. Type of Statement: ki6preeiection 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) r,o RL Tw IN -kapip Co NfA611I( N Treasurer(s) NAME OF TREASURER DE68E]i c MAILING ADDRESS [ CITY STATE ZIP CODE AREA CODEIPHONE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the t of k w dge the in ation contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is tru and corre Executed on BY ' 1 e re or lTreasurer Date Executed on L��12 By Date —Signature 61 Controlling State Measure Proponent or Responsible Officer of Sponsor Executed on BY Date By of Controlling ORceftolder, Carxfidate, Slate Measure Proponent Executed on BY Date Signature of Controlling Officetrolder, Carxlida te, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772) State of California Type or print in ink. COVER PAGE - PART 2 Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE & Sm a-H OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Wh PsFiEU) Q-1TV CoukCAL� RESIDENTIAL/BUSINESS AIJDRESS (NO. AND STREET) CITY 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 I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE Page Z of `k 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION I E] 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 ofhceholder(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 460 (January/05) FPPC Toll -Free Helpline: 8661ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement Summary Page OFF INSTRI Ir:TIr1NS nN RFVERSE NAME OF FILER ;06 SMIT14 R) Contributions Received 1. Monetary Contributions ............ ............................... Schedule A, Line 3 2. Loans Received ....................... ............................... schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 4. Nonmonetary Contributions ..... ............................... schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .•••••• ••••.• .............. Add Lines 3 +4 Expenditures Made 6. Payments Made ........................ ............................... schedule E, Line 4 7. Loans Made .............................. ............................... schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + g + 10 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 I, Line 4 15. Cash Payments ................... ............................... Column A, Line 8 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. Type or print in ink. Amounts may be rounded to whole dollars. 2-0 12- Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) $ U $ C2 �vy $ $ t3,4�4.3� O $ l3/44'q .316 O v $ j a �JU v t3,4�1.3�d $ 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 s in Column B above $ 2D'000 SUMMARY PAGE Statement covers period CALIFORNIA from lUl l /?.otZ FORM 4 through LVL / w/Zo Page of I.D. NUMBER Column B CALENDAR YEAR TOTALTO DATE $ 2-9.11,50 ?,Of 000 $ 49.,1 — $ 31519.52 O $ 31 X51°►. S2 y O $ 31 t5►q -5Z 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6130 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (N Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd /yy) I If $ I —I— If $ 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 A Type or print in ink. Amounts may be rounded Monetary Contributions Received to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER 9&,& Sm iTH FOP- CC(Y owzt' FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER DATE CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF - EMPLOYED, ENTER NAME OF BUSINESS) ❑IND \ r/� ❑COM V� 1�F& 1 ❑OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SCHEDULE A Statement covers period CALIFORNIA , p/ I/ l2.- FORM • from through IC�1Zo1 w(Z Page of —` I.D. NUMBER s z AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD I (JAN. 1 - DEC. 31) (IF REQUIRED) t/ 4.00 SUBTOTAL $ I / �0 O Schedule A Summary •Contributor Codes 1. Amount received this period — itemized monetary contributions. IND - Individual COM — Recipient Committee (Include all Schedule A subtotals.) ......................................................................... ............................... $ (other than PTY or SCC) OTH —Other (e.g., business entity) 2. Amount received this period — unitemlzed monetary Contributions of less than $100 ............................. $ PTY — Political Party 3. Total monetary contributions received this period. SCC - Small Contributor committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK -FPPC (8661275 -3772) XV E.r* Cjt,.r(-P1 eMT 10 N 5 AITA- A- Ilvl," i t etoD CvvPfi wb 10/1 I Mz - 1017,01 2011 la- W* to Amount Received Total Contribut this Receive Date Address City Stati zip Code period to date Received First Last Occu ation Guinn Construction IND IND IND IND IND IND 100 100 100 250 100 100 100 250 10/9/201 Geor a Martin 10/9/201 Lawrence & Esth Brandon 10/9/201 anice Becker Becker 10/9/201 ohn & olene ld Smith rcial Total 800 SCHEDULE B - PART 1 Type or Prue m mom. Schedule B — Part 1 Amounts may be rounded Statement covers period ' CALIFORNIA , Loans Received to whole dollars. `C / (/ZO(Z from • • - ,01w1 WI Z (0 Cl through Page of SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER SAT 'PO - CITY C� v L 2s� iz 13 sSZ (d) let IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT (�) OUTSTANDING INTEREST FULL NAME, STREET ADDRESS AND ZIP CODE AMOUNT PAID BALANCEAT OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS PAID THIS lg) ORIGINAL CUMULATIVE AMOUNT OF CONTRIBUTIONS OF LENDER (IF SELF - EMPLOYED, ENTER BEGINNING THIS OR FORGIVEN CLOSE OF THIS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAMEOFBUSINESS) PERIOD THIS PERIOD PERIOD LOAN TO DATE ❑ PAID CALENDAR YEAR SYYII I CIVIL V'41MEEcl U u,1OUc� D % �,ano s $ : C] FORGIVEN : PER ELECTION- �N�SS (�/� >NE�. ATE CCX)O V 0 zo I'Z- $ 0 ZO 12_ s Z-OL� t IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $20 $ $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION' RATE S S $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN RATE PER ELECTION" t❑ IND [] COM El OTH El PTY [] SCC S f S S DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ (Enter (e) on Schedule B Summary Schedule E, Line 3) 1. Loans received this period ..................................................................................... ............................... $ (Total Column (b) plus unitemized loans of less than $100.) U 2. Loans paid or forgiven this period .......................................................................... ............................... $ U (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 $ U Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number) `Amounts forgiven or paid by another party also must be reported on Schedule A. If required. 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 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) i Schedule C Nonmonetary Contributions Received SEE Type or print in ink. SCHEDULE Amounts may be rounded Statement covers period � to whole dollars. _ • from � , t 1 -0q_ through L01 ?fO jZpl2 Page of MME OF FILER IF AN INDIVIDUAL, ENTER AMOUNT/ FULL NAME, STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF FAIR MARKET DATE * OCCUPATION AND EMPLOYER GOODS OR SERVICES ZIP CODE OF CONTRIBUTOR CODE (IFSELF- EMPLOYED, ENTER VALUE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) ❑IND O,G NtkNff, c sas s ❑coM wlt8129 EIPTY c ❑ IND ❑COM ❑OTH ❑ PTY ❑SCC ❑ IND ❑COM ❑OTH ❑ PTY ❑ SCC ❑ IND ❑COM ❑OTH ❑ PTY ❑ SCC Attarh additional information on appropriately labeled continuation sheets. SUBTOTAL $ 5'()p Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.) ............................................................ ............................... 2. Amount received this period — unitemized nonmonetary contributions of less than $100 .......... 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ......... ....................... $ s()U ....................... $ rJ OU I.D. NUMBER �3A <6sS-2 CUMULATIVE TO I PER ELECTION DATE TO DATE CALENDAR YEAR (IF REQUIRED) (JAN 1 - DEC 31) 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC —Small Contributor Committee ............ TOTAL S FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule E Payments Made RFF wsTRl ICTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER � o� Sm1T�i r (Z CITY COUNGL- 2oI7- Statement covers period from L t_l_Z0'Z through SCHEDULE E Page J of -` I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL TEL campaign workers' salaries t.v. or cable airtime and production costs CVC civic donations PET PHO petition circulating phone banks TRC candidate travel, lodging, and meals FIL candidate filing /ballot fees POL polling and survey research TRS staff /spouse travel, lodging, and meals FND W fundraising events independent expenditure supporting/opposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor LEG legal defense PRO professional services (legal, accounting) VOT WEB voter registration information technology costs (internet, e-mail) LIT campaign literature and mailings PRT print ads NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 13.40,_5Y Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ......................................... ............................... 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.) .... ... ............................... $ t 3,4g9.3� ... ............................... $ t:J ............................... $ Z ................ TOTAL $ 3Is FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772) . t� ?E (4uD CAvepNN Wilw(l .. l o I 2v wZ