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Home My WebLink AboutSMITH 460 PREELECT12(2) AMEND 1/2/13Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 84218.5) fro Type or print In Ink. Statement covers period m 10/1/2012 SEE INSTRUCTIONS ON REVERSE I through 10/20/2012 1. Type of Recipient Committee: AN CommMbaa — Complsb Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Ado cornplara Pat 5) Q Sponsored (Ado Campdb Part 6) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee Q Political Party/Central Committee 3. Committee Information COMMITTEE Bob Smith for Council 2012 ❑ Primarily Formed Candidate/ Officeholder Committee (Also Compile Part n I.D. NUMBER MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement under penalty of perjury under the laws of the State of California that the foregc Executed on 13JQ , Dab Executed on ( Month, Day, Year) Dab Executed on Dare Executed on 11/6/2012 Dab the best BY COVER PAGE Date Stamp Treasurer(s) NAME OF TREASURER Debbie Camp MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS the irf6t Cation contained herein agld in the attached schedules is true and complete. I certify By SgrraaeotConuollrgoaanadsr, CwddWe, srrsMom" ftWwt BY swoon otca roong oacw4wer. Cadidab. Stab Manaus PioparM FPPC Form I60 (Janwry/05) FPPC ToNfne HdpNne: IWASK+M (INIGI 7EJ77Z) Sbb of Callbmis Type or print in Ink. COVER PAGE - PART 2 Recipient Committee CALIFORNIA ' Campaign Statement FOR Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Bob Smith OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Bakersfield City Council, Ward 4 RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: ust any committees not Included in this statement that are controlled by you or are pdmadly formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME NAME OF TREASURER COMMITTEEADDRESS STREET ADDRESS (NO P.O. I.D. NUMBER ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION I ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of of icaho/der(s) or candidates) 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 N necessary FPPC Form 460 (January" FPPC TojWme Help6ne: 6661ASK -FPPC (8661276 -3772) Stab of ca0bmie Campaign Disclosure Statement Type or print In InL Amounts may be rounded Summary Page to whole dollars. statement covers period from 1011/2012 PAGE Expenditures Made 6. Payments Made schedule E, Line 4 $ 12,368.45 $ 30,403.59 ........................ ............................... 7. Loans Made .............................. ............................... Schedule H, Line 3 0 0 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 12,368.45 $ 30,403.59 9. Accrued Expenses (Unpaid Bills) ............................... schedule F Line 3 0 0 10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 0 0 11. TOTAL EXPENDITURES MADE . ............................... Add Lines e + 9 + 10 $ 12,368.45 $ 30,403.59 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Pap, Line 16 $ 29,314.86 13. Cash Receipts ....... column A, Line 3 above 1,800 ............. ............................... 14. Miscellaneous Increases to Cash ........................... schedule ►, Line 4 0 15. Cash Payments ................... ............................... Column A, Line a above 12,368.45 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract tine 15 $ 18, 746.41 N this is a termination statement Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule S, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ............ ............................ see instructions on reverse $ 19. Outstanding Debts ......................... Add tine 2 + Line 9 in column 8 above $ 20,000 To ..fate 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` fir ftWd to Vokwftry Eq -xft- LkW" Date of Election Total to Date (mm/dd/yy) I $ 1 _lam $ "Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: SWASK -FPPC (866/275 -3772) through 10/20/2012 page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Bob Smith for Council 2012 1348852 Coiwnn B Calendar Year Summary for Candidates Contributions Received TOColumnA TALTHa9PERIOD CALEPDARYEAR Running in Both the State Prima and 9 Primary �FROMATTACHEDSCHIawiESt TOTA�TOOATe General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 1,800 $ $ 29,150 1/1 through 6130 7/1 to Date 2. Loans Received ....................... ............................... schedule e, Line 3 0 20,000 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines +2 $ 1,800 $ 49,150 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 500 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED .•.•.. .••• .............••••AddLin"3 +4 $ 2,300 $ Made $ $ Expenditures Made 6. Payments Made schedule E, Line 4 $ 12,368.45 $ 30,403.59 ........................ ............................... 7. Loans Made .............................. ............................... Schedule H, Line 3 0 0 8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 12,368.45 $ 30,403.59 9. Accrued Expenses (Unpaid Bills) ............................... schedule F Line 3 0 0 10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 0 0 11. TOTAL EXPENDITURES MADE . ............................... Add Lines e + 9 + 10 $ 12,368.45 $ 30,403.59 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Pap, Line 16 $ 29,314.86 13. Cash Receipts ....... column A, Line 3 above 1,800 ............. ............................... 14. Miscellaneous Increases to Cash ........................... schedule ►, Line 4 0 15. Cash Payments ................... ............................... Column A, Line a above 12,368.45 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract tine 15 $ 18, 746.41 N this is a termination statement Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule S, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ............ ............................ see instructions on reverse $ 19. Outstanding Debts ......................... Add tine 2 + Line 9 in column 8 above $ 20,000 To ..fate 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` fir ftWd to Vokwftry Eq -xft- LkW" Date of Election Total to Date (mm/dd/yy) I $ 1 _lam $ "Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: SWASK -FPPC (866/275 -3772) Srhedule A Type or print In Ink. SCHEDULE A Amounts may be rounded Monetary Contributions Received to Whole dollars. Statement covers period CALIFORNiA 10/1/2012 from • through 10/20/2012 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Bob Smith for Council 2012 1348852 �� FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED pFCO rrrEE,usoErrtEa�o.ru +l CODE " (FsELF-EMPLOYEO.ENTERNAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF MANJEW See Attachment ❑COM 1,800 VAR ❑ OTH ❑ PTY ❑SCC ❑IND ❑COM [10TH ❑ PTY ❑SCC ❑ IND ❑ COM ❑ OTH ❑ PTY []SCC ❑IND ❑ COM ❑ OTH ❑ PTY []SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS 1,800 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ......................................................................... ............................... $ 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ 1,800 0 1,800 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 (January105) FPPC TON -Free Helpi ne:11MASK -FPPC (8861275-3772) ROMO Tv 10/1/'74017 - ��;; nn ,A C' lv /gypl2v rZ Amount Received Total Contribut this Receive Date Received First Last Occu ation Address Ci IND l 1 SCHEDULE B - PART 1 Iype ur profit oil mw. Schedule B — Part 1 Amounts may be rounded statement covers period , CALIFORNIA , Loans Received to whole dollars. 10/1/2012 from a • • REVERSE through 10/20/2012 Page of SEE INSTRUCTIONS ON I.D. NUMBER NAME OF FILER 1348852 Bob Smith for Council 2012 ZI FULL NAME, STREET ADDRESS AND P CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER le) OUTSTANDING AMOUNT AMOUNTPA {D BALANCE RECEIVED THIS OUTSTANDING BALANCEAT lei INTEREST PAID THIS Iff 191 ORIGINAL CUMULATIVE AMOUNT OF CONTRIBUTIONS OF LENDER (IF SELF -R P Y®. ENTER BEGINNING THIS PERIOD OR FORGIVEN* THIS PERIOD CLOSE OF THIS PERIOD LOAN TO DATE (IF coMMiTTEE- Also ENTER I.D. NUMBER) NAIVEof OUST EW PERIOD ❑ PAID CALENDAR YEAR Bob Smith Civil Engineer, : 0 = 20,000 0 20,000 $ 20,000 Business Owner % RATE $ PER ELECTION" ❑FORGIVEN 20,000 O $ 0 12/2012 0 0712012 = 20,000 s $ s DATE INCURRED DATE DUE t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR It $ ❑ FORGIVEN RATE PER ELECTION" S S S S S DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION" S S 2 DATE DUE $ $ DATE INCURRED to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ $ $ $ 20,000 (Enter (9)- ScheddN E, Une 3) l4tr_hedule R 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.) ,�T E. (May be a negative numW 3. Net change this period. (Subtract Line 2 from Line 1.) .............................. ............................... Enter the net here and on the Summary Page, Column A, Line 2. I lil tContributor Codes IND — Individual COM — Recipient Committee (other then 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. 1 FPPC Form 460 (January/06) ** If regw�• FPPC Toll -Free Helpllne. 666/ASK -FPPC (8661276 -3772) Q0.tighA1lift r Type or print in ink. SCHEDULE C Amounts may oe rounaea Nonmonetary Contributions Received to whole dollars. Statement covers period • - , from 10/1/2012 • - 10/20/2012 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Bob Smith for Council 2012 1348852 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR FAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR (F COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) (IF REQUIRED) NAME OF BUSINESS) Managed Care Systems Office Space 500 500 10/19/12 ❑PTM ❑SCC ❑IND ❑COM ❑0TH ❑PTY ❑SCC ❑IND ❑COM ❑OTH ❑PTY ❑SCC ❑IND ❑COM ❑0TH El PTY []SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 500 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.) ...................... TOTAL $ 500 0 r� *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 FPPC Form 460 iJonuory/06) FPPC Toll-Free Helpline: 86WASK -FPPC (8661275~4772) SCA60uLs e:-;-- PMMyX- o q"KOZL6"O ('�1 iA AW �a �, 1 I L1 2012 I PMV, dF ^IAmE et. FILAL C306 WITH F0i- L'o(ANCl L Zo tZ 3gg8sZ FL candidate fifing/ballot fees PHD phone banks TRC candidate travel, lodging, and meals FPD fundraising events POL polling and survey research TRS staf ispouse travel, lodging, and meals W independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor LEG legal defense PRD professional services (legal, accounting) VOT voter registration LJr campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail) * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 12,165.63 Schedule E Summary 1. Itemized payments made this period. (include all Schedule E subtotals.) ......... $ 12,165.63 ........................................................ ............................... 2. Unitemized payments made this period of under $100 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ................................................ ............................... $ 0 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 12,165.63 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 666/ASK -FPPC (86612753772) Name of Payee I ► V !.c/ Pa ee Address !.� v Ci State zip Description Amount 420.00 tempSery Mailer 1,156.02 Total