HomeMy WebLinkAboutCOPE SEMIANN02(1)Recipient Committee
Campaign Statement
Cover Page
(Government Cede Sections 84200-84216.5)
SEE~NSTRUCTIONS ON REVERSE
Type or print in ink.
Date Stamp
Statement covers period
through
Date of election if a
(Month, Day, Year)
COVEI~ PAGE
For Officia~ Use Only
1. Type of Recipient Committee: All Committees - Complete Parts t, 2, 3, and 4.
[] Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee
O Recall
[] General Purpose Committee ~ Sponsored
O Small Contributor Committee
O Political Party/Central Committee
[] Ballot Measure Committee 0 Primarily Formed
0 Controlled
O Sponsored
(AIsc Complete Part E)
[] Primarily Formed Candidate/
Officeholder Committee
(Aisc Co.plate Pa~t 7)
2. Type of Statement:
[] Preelection Statement
~ Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Preelection
Statement - Attach Form 495
3. Committee Information
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Treasurer(s)
NA E OF TREASURER
NAME OF ASSISTANT TREASURER, IF ANY
MAiLiNG ADDRESS (IF DIFFERENT} NO. AND STREET OR PlO. ~OX MAILING ADDRESS
CITY STATE ZiP CODE AREA CODE/PHONE CiTY STATE ZiP CODE AREA CODE/PRONE
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 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 of the State of California that the foregoing is true and correct.
Executed on By
Executed on By
Executed on By
FPPC Toll-Free Helpllne: 8661ASK-FPPC
Stale of California
Recipient Committee
Campaign Statement
Cover Page-- Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Type or print in ink.
6. Ballot Measure Committee
NAMEOFBALLOTMEASURE
COVER PAGE - PART 2
Page o2.~ of L~
OFFICE BOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTiAL/BUSINESS ADDRESS (NO. AND STREET) CITY STA3E 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.
COMMI3-i'EE NAME
NAME OF TREASURER
COMMI~i'EE ADDRESS
ID. NUMBER
CONTROLLED COMMITrEE?
[] YES [] NO
STREET ADDRESS (NO P.O. BO)'
CITY STA~E ZIP CODE AREA COOEJPHONE
COMMIT~'EE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITFEE?
I [] YES [] NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STA~E ZIP CODE AREA CODE/PHONE
BALLOT NO. OR LETTER 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 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 OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
[] SUPPORT
r-]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 (June/01)
FPPC Toll-Free Helpllne: 866/ASK-FPPC
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
E OF FILER
Contributions Received
1. Monetary Contributions ........................................... ScheduleA, Line3
2. Loans Received ......................................................Schedule B, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + £
4. Nonmonetary Contributions .................................... Schedule C, Line3
5. TOTAL CONTRIBUTIONS RECEIVED ........................... AddLines3+4
Expenditures Made
6. Payments Made ....................................................... Schedule E, Line 4
7. Loans Made ........... , ................................................. Schedule H, Line 7
8. SUBTOTALCASHPAYMENTS .................................... AddLines6+ 7
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3
10. Nonmonetary Adjustment .......................................... Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from ~-- \-~-O~.-
through ~9 -.~) -0 ~
Column A Column B
TOTAL THiS PERIOD CALENDAR YEAR
lr/j.qg $
Current Cash Statement
12. Beginrlin~l Cash Balance ....................... Previous Sumrnary Page, Line16
13. Cash Receipts ...................................................ColumnA, Line3above
14. Miscellaneous Increases to Cash ........................... Schedule I, Line
15. Cash Payments .................................................. ColumnA, LineSabove
16. ENDINGCASHBALANCE .......... Add Lines 12+ 13+ 14, then subttact Line 15
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2
$
,
Cash Equivalents and Outstanding Debts
1 8. Cash Equivalents ........................................ See instructions on reverse
19. Outstanding Debts ......................... Add Line 2 + Line g in Column B above
SUMMARY PAGE
'.ge
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
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
20. Contributions
Received
21. Expenditures
Made
1/1 through 6/30 7/1 to Date
$ $
$ $
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
Date of Election Total to Date
(mm/dd/yy)
__J /
__J /
I__L__ $
I L__ $
I L__ $
I L__ $
*Since January 1, 2001. Amounts in this section may be
different from amounts reported in Column Iii.
FPPC Form 460 (June/01)
FPPC Toll-Free Helpiine: 8661ASK-FPPC
Schedule A Type or print in ink. SCHEDULE A
may Statement covers period ~ ~r~ I'; t
rVlonetary Contributions Received Am°tUontwshole dbo~larr°sU,nded
,rom O-I -O lali lira m
EEINSTRUCT'ONSONREVERSE throu.h ro- o-o [,...e "'/
I iF AN iNDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
DATE FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
RECEIVED (IF COMMITTEE, ALSO ENTER i.D. NUMBER) CODE ~ (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31 ) (IF REQUIRED)
OF I~USINE$S)
I~IND
r~cou
[~OTH
[] PTY
Oscc
DIED
I-ICOM
DOTH
[] PTY
~rscc
•IND
~cou
I-lOTH
[] PTY
[~scc
~IND
~COM
[~OTH
[] PTY
[] scc
[]IND
[~COM
r-~OTH
[] PTY
r~scc
SUBTOTALS
Schedule A Summary
1. Amount received this period - contributions of $100 or more.
(Include all Schedule A subtotals.) ........................................................................................................
2. Amount received this period - unitemized 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
*Contributor Codes
IND - Individual
COM- Recipient Committee
(other than PTY or SCC)
OTH - Other
PTY - Political Party
SCC- Small Contributor Committee
FPPC Form 460 (Junel01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule B - Part 1
Loans Received
SEEINSTRUCTIONS ON REVERSE
NAME OF FILER
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
JIF COMMITTEE, ALSO ENTER I.D. NUM{3ER)
tl--~ INn [] COM [] OTH [] P3Y [] SCC
t[] ~ND [] COM [] OTH [] PTY [] SCC
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
Type or print in ink.
Amounts may be rounded
to whole dollars.
(m)
OUTSTANDING
BALANCE
Statement covers period
,rom D -17-D
(bt
AMOUNT
(¢)
AMOUNT PAID
OUTS'r(,~N) DiNG
BALANCE AT
(el
INTEREST
SCHEDULEB-PART1
Page ~_~ of_~
I.D. NUMBER
(f) (gt
ORIGINAL CUMULATIVE
1'[~ IND [] COM [] OTH [] PTY [] SCC
(IF SEU=-EMPLOYED, ENTER
NAME OF BUSINESS)
BEGINNING THIS
PERIO0
RECEIVED THIS
PERIOD
OR FORGIVEN
THIS PERIOD *
[] PAID
$
[]FORGIVEN
$
[] PAID
$
[]FORGIVEN
$
[] PAID
$
CLOSE OF THtS
PERIOD
DATE DUE
t
DATE DUE
DATE DUE
PAID THIS
PERIOD
RATE
RATE
AMOUNTOF
LOAN
DATErNCURRED
DATE INCURRED
DATE INCURRED
~NTRIBUTIONS
TO DATE
CALENDARYEAR
$
CALENDARYEAR
$
PER ELEC33ON **
$
CALENDARYEAR
PER ELECTION
SUBTOTALS $ $ $ $
Schedule B Summary
1. Loans received this period .................................................................................................................... $
(Total Column (bt plus unitemized loans 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.)
(Enle~ (et on
Schedule E, Line 3}
*Amounts forgiven or paid by}
another party also must be
reported on Schedule A.
** If required. J
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. {May be anegatlvenumber)
It Contributor Codes
IND-Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC- Small Contributor Committee
FPPC Form 460 (June/01)
FPPC Tall-Free Helpline: 666/ASK-FPPC
SCHEDULEB-PART2
Schedule B- Part 2 Type or print in ink. p~gl, e ~? i i i~d~kl~d
Amounts may be rounded Statement covers period
Loan Guarantors to whole dollars, from ~ -- [ '7-~)~.-- '
SEE INSTRUCTIONS ON REVERSE through ~O -~ "~
NAME OF FILER I.D. NUMBER
FULL NAME, STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT BALANCE
ZiP CODE OF GUARANTOR CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED CUMU~TIVE ~TSTANDING
(IF CO~I~EE, ALSO ENTER ID NUMBER) CODE (IF SE~-EMPLOYE~, ENTER THIS PERIOD TO BATE TO DATE
~IND LENDER CALENDAR YEAR
~COU
/ ~OTH DAm PER ELEC~ON
(IF REQUIRED)
~ PTY
~SCC
~ COM
PER ELEC~ON
~ OT~ DATE (IF REQUIREO)
~ PTY
~SCC
CALEND~ YEAR
~IND LENDER
~ COM
~OTH (IF R~QU~RED)
~ PTY
~ SCC
C~ENDAR YEAR
~IND LENDER
~OTH DATE (IF REQUIRED)
~ PTY
~scc
Enter c~
SUBTOTAL $ SummafyPage,Lice17~k/
FPPC Form 460 (June/D1)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule C
Nonmonetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND
ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE. ALSO ENTER ID. NUMBER}
CONTRIBUTOR
CODE *
[~]IND
[-~COM
~]OTH
~]PTY
I-lSCC
I-lIND
[~COM
[~OTH
[~] PTY
clscc
DIND
~lCOM
I~OTH
DPTY
E]scc
r-lIND
r~COM
~]OTH
[]PTY
[]SCC
Type or print in ink.
Amounts may be rounded
to whole dollars.
IFAN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF OUSINESS)
Stat~,,,e,,~ covers period
from ~
through
DESCRIPTION OF
GOODS OR SERVICES
AMOUN~
FAIR MARKET
VALUE
Page 7
LD. NUMBER
CUMULATIVE TO
DATE
CALENDAR YEAR
(JAN 1-DEC 31)
SCHEDULE C,
PER ELECTION
TO DATE
(IF REQUIRED)
Attach additional information on appropriately labeled continuation sheets.
SUBTOTAL $
Schedule C Summary
1. Amount received this period - nonmonetary contributions of $100 or more.
(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 $
· *Contributor Codes
IND- Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other
PTY- Political Party
SCC - Small Contributor Commiltee
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 8661ASK-FPPC
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEEINSTRUCTiONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars,
Statement covers period
SCHEDULE D
NAME OF FILER
DATE
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDtCTION,
OR COMMI~FEE
[] Suppo~ [] Oppose
[] SuppoH [] Oppose
[] Suppo~ [] Oppose
TYPE OF PAYMENT
[] Monetary
Contribution
[] Nonmonetary
Contribution
[] Independent
Expenditure
[] Monetary
Contribution
[] Nonmonetary
Contribution
[] Independent
Expenditure
[] Monetary
Contnbution
[] Nonmonetary
Contribution
[] Independent
Expenditu~ e
DESCRIPTION
(IF REQUIRED)
AMOUNT THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN 1-DEC. 31)
PER ELECTION
TODATE
(iF REQUIRED)
SUBTOTAL $
Schedule D Summary
1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) .............................................. $
2. Unitemized contributions and independent expenditures made this period of under $100 ...................................................................................... $
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .............. TOTAL $
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule E
Payments Made
SEE iNSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
through
Page
SCHEDULE F
LD. NUMBER
CODES: if one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CM° campaign paraphemalia/misc. MBR membercommunications RAD radio airtime and production costs
CNS campaign consultants
C'I~ contribution (explain nonmonetary)*
CVC civic donations
F]L candidate filing/ballot iees
FND fundraising events
IND independent expenditure supporting/opposing others (explain)*
LEG legal defense
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
FRO professional services (legal, accounting)
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
UT campaign literature and mailings FRq- pdnt ads WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I O NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
S or independent expenditures must also be summarized on Schedule D.
SUBTOTALS
Schedule E Summary
1. Payments made this period of $100 or more. (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.) ............................. TOTAL $
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 8661ASK-FPPC
Schedule F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
St&;.eih,=nt covers period
from 2-\7-0A
through ~
SCHEDULEF
LO. NUMBER
CODES: If one of the following codes accurately describes the
~ campaign paraphernatia/misc, k/E~R
CNS campaign consultants
CTB contribution (explain nonmonetary)'
CVC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND independent expenditure supporting/opposing others (explain)*
payment, you may enter the code. Otherwise, describe the payment.
member communications
M]'G meetings and appearances
DFC office expenses
PET petition cimulating
PHO phone banks
FOL polling and survey reseamh
POS postage, delivery and messenger services
RAD radio aidime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting) VDT voter registration
UT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
(a) (b) (c) (d)
NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING
(IF COMMITTEE, ALSO ENTER LO. NUMBER) DESCR)PTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ON E} OF THIS PERIOD
summarized on Schedule D. SUBTOTALS $ $ $ $
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $
2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on
accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................. PAID TOTALS $
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 8661ASK-FPPC
Schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
SEE ~NSTRUCTIONS ON REVERSE
NAME OF F~LER
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
,rom
SCHEDULE G
I.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
campaign paraphernalia/misc.
CNS campaign consultants
CTB contribution (explain nonmonetary)*
CVC civic donations
candidate tiling/ballot fees
fundraising events
independent expenditure supporling/opposing others (explain)'
LEG legal defense
UT campaign literature and mailings
MBR member communications
MI'G meetings and appearances
OFC office expenses
PET petition circulating
R-lO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
Ff:{T print ads
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
RAD radio aiHime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airttme and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMI~FEE, ALSO ENTER ID NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Attach additional information on appropriately labeled continuation sheets. TOTAL* $
· Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or
independent contractor as reported on Schedule E. FPPC Form 460 (June/01)
FPPC Tog-Free Helpline: 866/ASK-FPPC
Schedule H
Loans Made to Others*
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
,,om
SCHEDULE H
I.D. NUMBER
FULL NAME, STREET ADDRESS AND ZIP CODE
OF RECIPIENT
(IF COMMI~FEE, ALSO ENTER I.D. NUMBER)
IF AN INDIVIDUAL, ENTER (a) ~b)
OUTSTANDING AMOUNT
OCCUPATION AND EMPLOYER BALANCE
(IF SELF-EMPLOYED, ENTER BEGINNING THIS LOANED THIS
NAME OF BUSINESS) PERIOD PERIOD
$
SUBTOTALS $
*Loans that are CORtr;bUtions to another candidate or committee
must also be summarized on Schedule D. Loans forgiven must
also be reported on Schedule E.
(¢) OUTsT[d~DING
REPAYMENT OR BALANCE AT
FORGIVENESS CLOSE OF'
TH~S PERIOD*
[] PAID
$
[] FORGIVEN
$
DATE DUE
[] PAID
$
[] FORGIVEN
DATE DUE
(e)
INTEREST
RECEIVED
ORIGINAL
AMOUNTOF
LOAN
DATEINCURRED
CUMULATIVE
LOANS
TO DATE
CALENDAR YEAR
$
PER ELEC~ON~
$
CALENDAR YEAR
$
PER ELECTION **
$
Schedule H Summary
1. Loans made this period .......................................................................................................................... $
(Tota Co umn (b) p us un tem zed Dans ess than $100.)
2. Payments received on loans ..........................................................................................................................$
(Total Column (c) plus unitemized payments less than $100.)
3. Net change this period. (Subtract Line 2 from Line 1.) ........................................................................................ NET $
(Enter the net here and on the Summary Page, Column A, Line 7.)
(Emer (e) on
Schedule I, Line 3)
**If Required
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
SCHEDULEI
I.D. NUMBER
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE, ALSO ENTER I.O NUMBER)
DESCRIPTION OF RECEIPT
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
AMOUNT OF
INCREASE TO CASH
Schedule I Summary
1. Increases to cash of $100 or more this period ........................................................................................................... $
2. Unitemized increases to cash under $100 this period ............................................................................................... $
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ........................................................................................................................... TOTAL $
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC