HomeMy WebLinkAboutDICKERSON SEMIANN20(2)Recipient Committee Date stamp COVER PAGE
Campaign Statement ow
e 1
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement ver period Date of election if applicable: �
Page I - of :
(Month, Day, Y ar) For Official Use Only
from r7 21 FEB 15 Ph 2. 34
Lthrough 2
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 Part 5) 0 Sponsored
(Also Complete Part 6)
❑ General Purpose Committee
0 Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
3. Committee Information
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
I.D. N
; MITTEE NA ( CANATE'S Nf�NA:5 ITTt
STREETADDRESS (NO P.O. BOX)
2. Type of Statement:
❑
Preelection Statement
Semi-annual Statement
❑
Termination Statement
(Also file a Form 410 Termination)
❑
Amendment (Explain below)
l Treasurer(s)
NAME OF TREASURER
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
❑ Quarterly Statement
❑ Special Odd -Year Report
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
4. Verification f
have used all reasonable diligence in pr qj
parin and reviewing this statement and to the -best of my knowledge t for tion contained herein and in the attached schedules is true and complete. I
certify under penalty of perjury under t the tate of California that the foregoing is true and orrect.
Executed on �. By 11
Date ignature o reasurer or easurer
Executed on 2 By 69 411
Date Signature of Cdrjroging 0,976eholder, Can i ate Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
n8-f—k c
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAUBUSINESS ADDRESS (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.
I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
Page J of
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
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 Candidate/Officeholder 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
f�^
`
SUPPORT
V \ -
❑ 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 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Contributions Received
Amounts may be rounded
to whole dollars.
1. Monetary Contributions................................................... Schedule A, line 3
2. Loans Received................................................................ Schedule e, 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+9+10
Statement
from
throuaR
Column A
Column B
TOTAL THIS PERIOD
CALENDAR YEAR
(FROM ATTACHED SCHEDULES)
TOTAL TTODATE
.O cD—
f 6Q
n
4 .
$
$
$ �,2,'� $ 7—
r—
$ o'
$
$ /&.- $ —Z, b
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $
13. Cash Receipts........................................................... Column A, Line 3 above
2 GO
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 e, Part 2 $
Cash Equivalents and Outstanding Debts �d52�g5
18. Cash Equivalents ................................................ See instructions on reverse $
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $
To
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).
SUMMARY PAGE -
Page 7 of
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
Made $ $
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made'
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
'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
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Amounts may be rounded SCHEDULE A
to whole dollars. Statement c6 ers eriod CALIFORNIA 460
/ •
from r -
throu"?—� Page of
I.D. NUMBER
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 $
*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 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
t i0�
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
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
OF BUSINESS)
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL $ --�,
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 $
*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 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULE B - PART 1 "
c e ue — a to whole dollars. l l
Statement cc er period
CALIFORNIA � '
Loans Received
/j%�
•
from
FORM
1
through t �J
SEE INSTRUCTIONS ON REVERSE
Page. of
NAME OF FILER
I.D. NUMBER
4�-
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
(b)
AMOUNT
c
AMOUNT PAID
d
OUTSTANDING
e
INTEREST
ORIGINAL
g
CUMULATIVE
OF LENDER
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF-EMPLOYED, ENTER
BALANCE
BEGINNING THIS
RECEIVED THIS
PERIOD
OR FORGIVEN
THIS F 7D+
BALANCE AT
CLOSE OF THIS
PAID THIS
PERIOD
AMOUNT OF
LOAN
CONTRIBUTIONS
TO DATE
NAME OF BUSINESS)
PERIOD
PERIOD
CALENDAR YEAR
N A _ n 1K
�� G —
^ ��
-
t
IND ❑COM ❑ OTH ❑PTY❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
$
$
%
$
$
❑ FORGIVEN
PER ELECTION -
RATE
t ❑ IND El ❑ OTH El El
$
$
$
$
$
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
$
$
/
$
❑ FORGIVEN
$
PER ELECTION`
RATE
❑ IND El ❑ OTH El El
tEl
$
$
$
$
S.
DATE DUE
DATE INCURRED
SUBTOTALS $ $ 2�b $ 4,9Z3.$ -�-
Schedule B 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 $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) .............................
Enter the net here and on the Summary Page, Column A, Line 2.
'Amounts forgiven or paid by another party also must be reported on Schedule A.
" If required.
........................................$
........................................$
............................... NET $
(May be a negative number)
(Enter (e) on Schedule E, Line 3)
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 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
• � SCHEDULE E
SchedPayments Made from
ule E Amounts may be rounded Statement ver period .
to whole dollars. _'a '
. -
through '"' Pae of
Ja—
SEE INSTRUCTIONS ON REVERSE 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.
CMP
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
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing/ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
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
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR
E5VN�" c1r, '5516)) I CJ.AV�
DESCRIPTION OF PAYMENT
a
AMOUNT PAID
Al
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ �
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.) ........................... TOTAL $ ZIP
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov