The URL can be used to link to this page

Home My WebLink AboutTAKII 460 ;ecipient Committee Campaign Statement Cover Page (Government Code Sections 84200*84216.5) SEEINSTRUCTIONS ON REVERSE Type or print in ink, Date Stamp Statement c,~vers period ,rom through ~-~0 Date of(Month, election Day, if Year) applicable: COVER PAGE Page ), of J For Official Use Only 1. Type of Recipient Committee: All Committees- Complete Parts 1, 2, 3, and 4. ~" Officeholder, Candidate Controlled Committee O State Candidate Election Committee 0 Recall [] General PurposeCommittee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee [] Ballot Measure Committee 0 Primarily Formed 0 Controlled 0 Sponsored [] Primarily Formed Candidate/ Officeholder Committee 2. Type of Statement: [] Preelection Statement ~ Semi-annual Statement ~/Terminafion Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Preelection Statement - Attach Form 495 3.' Committee Information ll.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) CI ZiP CODE ARE CODE/PHONE M~ILING'ADDRESS (IF DIFFEREF~T) NO. AND STREET OR P.O. BOX Treasurer(s) NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTION : FAX I E-MAIL ADDRESS OPTIONAL: FAX I 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 perjuPj under the laws of the State of California that the foregoing is true and correct. Execuled on ~ '"~' ~ ~ Date x.utedo. Date Executed on Executed on By Dale FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Recipient Committee Campaign Statement Cover Page-- Part 2 Type or print in ink. 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESlOENTIAL/BUSINESS ADDRESS (NO. AND STREtT) ' 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.D. NUMBER NAME OF TREASURER CONTROLLED COMMITrEE? I [] YES [] NO COMMI~rEE ADDRESS STREET ADDRESS (NO RD. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMll'~EE NAME I.D, NUMBER NAME OF TREASURER ;ONTROLLED COMM)~fEE? [] YES [] NO COMM[~'EE ADDRESS STREET ADDRESS (NO P.O. BO)I CITY STATE ZIP CODE AREA CODFJPHeNE COVER PAGE - PART 2 6. Ballot Measure Committee Page ~-~ of ¢ NAME OF BALLOT MEASURE BALLOT NO. OR LE~rER JURISOICTION [] 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. IE 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 [] 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 (JunW01) FPPC Toll. Free Halpllne: 866/ASK4:PPC State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from //-/- d~-- through SUMMARY PAGE Page..~ of~ NAME OF FILER Contributions Received 1. Monetary Contributions ........................................... Schedule A, Line 3 2. Loans Received ...................................................... Schedule B, Line 7 ~- 3. SUBTOTAL CASH CONTRIBUTIONS ......................... AddLines1+2 $ 't~ 4. Nonmonetary Contributions ....................................ScheduleC, Line3 ~ 5. TOTAL CONTRIBUTIONS RECEIVED ........................... AddLines3+4 $ ~ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 7. Loans Made ............................................................. Schedule H, Line 7 8. SUBTOTAL CASH PAYMENTS .................................... AddLines6+ 7 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITU RES MADE ................................ Add L/nes 8 + 9 + 10 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summaq/Page, Line 16 13. Cash Receipts ................................................... ColumnA, Line3above 14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4 15. Cash Payments .................................................. ColumnA, Line8above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 If this is a ten'nination statement, Line 16 must be zero. Column A TOTAL THIS PERIOD 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ ~ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ S~e instructions on reverse 19. Outstanding Debts ......................... AddLine2+LlneginColumneabove Column B CALENOAR YEAR TOTAL TO DATE $ ~ $ ~ 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 shoutd be subtracted from previous period amounts. If this is the first report being flied 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 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* Date of Election Total to Date (mm/dd/yy) / /.__ $ __l___J.__ $ I I.__ $ --/---J.-- $ __1 I.__ $ __1 I $ *Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from /--/- 0 ~'''' SCHEDULE E ,h,oughp.g, ¥ NAME OF FILER I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CM:' campaign paraphemaliaJmisc. CNS campaign consultants c'rB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)° LEG legal defense UT campaign literature and mailings MBR member communications M'rG meetings and appearances OFC office expenses PEr petition cimulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) FRT pdnt ads RAD radio airlime and production costs RFD returned contributions SAL campaign workers' salaries t.v. or cable airtime and production costs 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 (internal, e-mail) 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. SUBTOTALS 3~' ~'~ 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: 866/ASK-FPPC Sara L. Takii August 8, 2002 City Clerk, I was unable to file my forms 410 and 460 on 7/31. I was out of town and did not open the mail in a timely manner. When I finally realized that this filing was due, I had to locate my treasurer to sign the appropriate paperwork. I would like to request that the late fees be waived. I thank you for your consideration into this matter. Please do not hesitate to contact me if you have any questions.