HomeMy WebLinkAboutTATUM PREELECTION20(2) AMENDCOVER PAGE
Recipient Committee Date Stamp $I, I
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from q_2 2 () a .
through / — / -7
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
] Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
0 State Candidate Election Committee Committee
0 Recall 0 Controlled
(Also Complete Pad 5) 0 Sponsored
(Al- Complete Part 6)
❑ General Purpose Committee
0 Sponsored ❑ Primarily Formed Candidate/
0 Small Contributor Committee Officeholder Committee
0 Political Party/Central Committee (Also Complete Pad 7)
3. Committee Information I I.D. NUMBER
4.
MITTEE NAME (OR CANDIDATE'S NAME IF NO
67 d-eoj,:w�, _Fcam 74-W ro
STREET ADDRESS (NO P.O. BOX)
MAILI
Solne Rs 9,6oilf
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
Date of election if applicable: Page of —
(Month, Day, Year) 20 DEC 22 0-11:
' 11: 5 I For official Use Only
6 A iii;-
_i,{S
2. Type of Statement:' r:'".
Preelection Statement ❑ Quarterly Statement
❑ Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
(Also file a Form 410 Termination)
Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
MAILING ADDRESS
CITY STATE ZIP CODE AREA couNPHONE
NAME OF ASSISTANT TREASURER, IF ANY
N /Fi
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
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.
certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
J a2 G
Executed on /o �/ ^ Dale By Signature o Treasur orAssist reasurer
Executed on Date By Signature of Controlling 0 eh ol at. Candidate. State Measure Proponent or Responsible Officer of Sponsor
Executed on
Date
Executed on
Date
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
Signature of Controlling Oticeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
Amounts may be rounded
to whole dollars.
Statement covers period
from
SUMMARY PAGE
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ �/ 0
13. Cash Receipts........................................................... Column A, Line 3 above
14. Miscellaneous Increases to Cash .................................. schedule 1, 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.
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
Ato 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).
$
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Page of
SEE INSTRUCTIONS ON REVERSE
through
NAME OF FILER
I.D. NUMBER
67rec)6v, /
%
/ J/ 3o 9
Column A
Column B
Calendar Year Summary for Candid ates
Contributions Received
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
CALENDAR YEAR
TOTAL TO DATE
Running in Both the State Primary and
/
Aleb U
General Elections
1. Monetary Contributions...................................................
schedule A, Line 3
$
$
1/1 through 6/30 7/1 to Date
2. Loans Received................................................................ schedule B, Line 3
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines 1 +2
$
$
Received $ $
4. Nonmonetary Contributions ............................................
Schedule C, Line 3
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED
Lines 3+4
$
�� Fi
$
Made $ $
................................Add
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made................................................................
Schedule E, Line 4
$
$
Candidates
7. Loans Made.......................................................................
Schedule H, Line 3
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS .......................................
Add Lines 6 + 7
$
$
(If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ..........................................
schedule F Line 3
Date of Election Total to Date
10. Non monetary Adjustment.........................................................
Schedule C, Line 3
(mm/dd/yy)
11. TOTAL EXPENDITURES MADE....................................Add
Lines 8+9+10
$
$
$
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ �/ 0
13. Cash Receipts........................................................... Column A, Line 3 above
14. Miscellaneous Increases to Cash .................................. schedule 1, 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.
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
Ato 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).
$
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov