HomeMy WebLinkAboutBASHIRTASH 460 AMEND25Recipient Committee
,,Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 7-1-2024
through 9-21-2024
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
❑� Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
❑ State Candidate Election Committee Committee.
❑ Recall ❑ Controlled
(Also Complete Part5) ❑ Sponsored
(Also Complete Part 6)
❑ General Purpose Committee
❑ Sponsored ❑ Primarily Formed Candidate/
❑ Small Contributor Committee Officeholder Committee
❑ Political Party/Central Committee (Also Complete Part7)
3. Committee Information I.D. NUMBER
1469938
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
ZACK BASHIRTASH FOR CITY COUNCIL - 6 - 2024
CITY . STATE ZIP CODE AREACODE/PHONE
COVER PAGE.
Date Stamp
Date -of election if applicable: Page I of 10
(Month, Day, Year) 2 JAN 3 1 DM 2' 20, For Official Use Only
11/05/2024 BA K_j SF1ELD 101IY CLERK
2. Type of Statement:
❑ Preelection Statement ❑ Quarterly Statement
❑ Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
(Also file a Form 410 Termination)
® Amendment (Explain below)
add a personal payment made by candidate as a loan to campaign
Treasurer(s)
NAME OF TREASURER
LADONNA DODGE
MAILING ADDRESS
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS
zackbash@me.com LADONNADODGEgAOL.COM
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and 21gure
my k le a the infor7ion 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 foreco t
Executed on) �� 2' sZ4 By
Date Signature o rea er or Assistant surer
Executed on s 2,' 2 1C; By
Date Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, Slate 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
COVER PAGE - PART 2
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD (INCLUDELOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER
RESIDENTIAL/BUSINESS ADDRESS (NO.ANDSTREET) 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 COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/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
Page .2 of 10
❑ 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 Listnames 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 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
.Cam al , n Disclosure Statement Amounts may be rounded SUMMARY PAGE
P 9 to whole dollars.
Summary Page Statement covers period • . , ,
from 7-1-2024 • - •
9/21/2024
Page 3 of 10
SEE INSTRUCTIONS ON REVERSE
through
NAME OF FILER
I.D. NUMBER
ZACK BASHIRTASH FOR CITY COUNCIL - 6
- 2024
1469938
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
CALENDAR YEAR
TOTAL TO DATE
Running in. Both the State Primary and
General Elections
1. Monetary Contributions...................................................
Schedule A, Line 3
$ 40600.00
$ 55395.00
9090.52
9090.52
�/� through 6130 7/1 to Date
2. Loans Received................................................................
Schedule e, Line 3
49690.52
49690.52
20. Contributions 15045.00 49690.52
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines 1 + 2
$ ,
$
Received $ $
0
0
4. Nonmonetary Contributions ............................................
Schedule C, Line 3
21. Expenditures
0 0
5. TOTAL CONTRIBUTIONS RECEIVED................................Add
Lines 3+4
$ 49690.52
$ 49690.52
Made $ $
Expenditures Made
6. Payments Made................................................................
Schedule E, Line 4
$
0
$ 0
7. Loans Made.......................................................................
Schedule H, Line 3
0
0
8. SUBTOTAL CASH PAYMENTS .......................................
Add Lines 6+7
$
0
$ 0
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 8+9+10
$
0
$ 0
Current Cash Statement
12. Beginning Cash Balance ............................
Previous Summary Page, Line 16
$
15045.00
To calculate Column B,
13. Cash Receipts...........................................................
Column A, Line 3 above
49690.52
add amounts in Column
0.00
A to the corresponding
14. Miscellaneous Increases to Cash ..................................
Schedule /, Line 4
amounts from Column B
15. Cash Payments.........................................................
Column A, Line 8 above
0.00
of your last report. Some
amounts in Column A may
16. ENDING CASH BALANCE ..................Add
Lines 12 + 13 + 14, then subtract Line 15
$
64735.52
be negative figures that
should be subtracted from
If this is a termination statement Line 16
must be zero.
previous period amounts. If
this is the first report being
17. LOAN GUARANTEES RECEIVED
Schedule e, Part 2
$
0.00
filed for this calendar year, .
................................
only carry over the amounts
from Lines 2, 7, and 9 (if
Cash Equivalents and Outstanding Debts
so9o.52
any).
18. Cash Equivalents ................................................
See instructions on reverse
$
19. Outstanding Debts ..............................
Add Line 2 + Line 9 in Column B above
$
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)
� 1 $
'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 Amounts may be rounded SCHEDULE A
to whole dollars. Statement covers period
Monetary Contributions Received CALIFNIA
1-2o2a OR40
�`
from •
9-21-2024
Page 4 oi`�
SEE INSTRUCTIONS ON REVERSE
through
g
I.D. NUMBER
NAME OF FILER
1469938
ZACK BASHIRTASH FOR CITY COUNCIL - 6 - 2024
..........
FULL NAME, STREET ADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
CONTRIBUTOR'
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVEDIF
CODE
(IF SELF-EMPLOYED, ENTER NAME
OF
PERIOD
(JAN 1 -DEC- DEC 31)
REQUIRED)
(IF COMMITTEE. ALSO ENTER 10 NUMBER)
8/12/2024
Tom Edmonds
ZIND
RFTIRED
150.00
150.00
150.00
❑ COM
10003
p scc
08/13/2024
_
Sam Jouda
® IND
owner SamCo
1500.00
1500.00
1500,00
p COM
4300
❑ SCC
8/14/2024
John Paul Lake
®,IND
Owner and Director at Rain
1500.00
1500.00
1500.00
Cl COM
for Rent
6424
8/14/2024
Lavonne Mccumber
® IND
owner
250.00
250.00
250.00
p COM
5500
p scc
8/14/2024
Kris Pelster
m IND
financial advisor
500.00
500.00
500.00
❑ COM
2808
SUBTOTAL $ 3900.00
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include all Schedule Asubtotais.).......... ..................... ........... .... .......... ....................... .... ....... $
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 $
'Contrlbutor 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/2026))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Monetary Contributions Received
kME:O,F
ZACK BASHIRTASH FOR CITY COUNCIL - 6 - 2024
FULL NAME, STREET ADDRESS AND ZIP CODE OF
DATE
CONTRIBUTOR
RECEIVED
(IF COMMITTEE, ALSO ENTER 10, NUMBER)
8/14/2024
Tom Willis
8/15/2024
Bruce Freeman for City Council
8/15/2024
Purpose Driven Home Health
8/15/2024
California Air Systems, Inc
9/21/2024
Craig Tobin
`Contributor 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 may be rounded
to whole dollars.
from 7-1-2024
through 9-21-2024
IF AN INDIVIDUAL, ENTER
AMOUNT
CONTRIBUTOR
OCCUPATION AND EMPLOYER
RECEIVED THIS
CODE
IIF SELF EMPLOYED, ENTER NAME)
OF BUSINESS)
PERIOD
pIND
Veterinarian
200.00
❑ OTH
San Joaquin
❑PTY
Veterinary Hospital
❑scc .
❑ IND
1394672
1000.00
0 COM
❑ OTH
❑ PTY
❑'SCc
❑ IND
5000.00
❑ COM
❑✓,OTH
❑ PTY
❑ SCC
❑ IND
2000.00
❑ COM
QI OTH
❑ PTY
❑ scc
W] IND
President
SoOo.00
❑ COM
❑ OTH
JB Cotton Trading,
P PTv
Inc
SUBTOTAL $ 13200.00
SCHEDULEA (CONT.)
Page 5 o�� f
I NU M8 ER
1469938
CUMULATIVE TO DATE PER ELECTION
CALENDAR YEAR TO DATE
(JAN. I - DEC.31) (IF REQUIRED)
200.00 200.00
I OOD.00
5000.00
1000.00
5000.00
2000.00 12000.00
5000.00 5000.00
FPPC Form 460 (Jan/ZO16))
FPPC Advice: advice@fppc.ca.gov (BBB/275-377Z)
www.fppc.ca.gov
gchoehilp A Mnntinuation Sheet) Amounts may be rounded SCHEDULE (PONT.)
1Aonetary Contributions Received to wholedotlars. statomentcaversprirtad
CALIFORNIA
from 7-1-2024
FORM
9-21-2024
6
Page of
through
-
- LD NUMBER
4AE�f~'63E: q;ER
1459938
ZACK 13AS14IRTASH FOR CITY COUNCIL - 6 - 2024
FULL NAME, STREET ADDRESS AND ZIP CODE OF
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME)
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
(IF COMMITTEE: ALSO WIER IO NUM05R)
OFeuSINESS)
PERIOD
(JAN. I -DEC 31)
(IF REOUIRED)
8/29/2024
PTM Properties
Cl IND
10000.00
20000.00
20000.00
P
❑ COM
I'I PTY
C,.J SGC
9/4i2024
Svv�S
0 IND
7000.00
7000.00
7000.00
p COM
❑ so
scc
_
9/5/2024
Southern Tire Mart, LLC
Eli"o
I000.oa
l000,00
l000.00 -
❑ COM
❑ PTY
_ ❑ scc
9/10/2024
Wayne Long
Z IND
CPA
500.00
500.00
500.00
Cl COM
❑ PTY
p scc
9/17/2024
James Leyendecker
Z IND
General Manager
500.00
500.00
500.0D
❑ COM
❑ Prr
scc
SUBTOTAL $ 19000.00
'Contributor Codes
IND—lndlvldual
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/2816))
FPPC Advice: advice@fppc.ca.gov (866/Z75-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet)
Amounts may be rounded
SCHEDULE (CONT)
Monetary Contributions Received to whole dollars.
Statemontcovers period
CALIFORNIA
from 7-1-2024
FORM
9-21-2024
7
Page of
through
IO.NUMBER
NAME O,F.P11:Eq
1469938
ZACK BASHIRTASH FOR CITY COUNCIL - 6 - 2024
FULL NAME, STREET ADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
CONTRIBUTOR
�
OGCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
(IF COMMITTEE. ALSO EN(ER 10 NUMBER)
CODE
(IF SELF.EMPLOYED, ENTER NAME)
OF BUSINESS)
PERIOD
(JAN 1 -DEG 31)
(IF REQUIRED)
9/17/2024
Central Valley Business Fereration PAC
❑IND
1450194
1000,00
1000.00
1000.00
Z corm
455
Qscc
-
-
9/17/2024
Process Instruments Inc
❑ IND
2500.00
2500.00
2500.00
❑ COM
8802
❑ sce
9/19/2024
Jessica Huculak
Z IND
250.00
250.00
250.00
1509
SCC
9/21/2024
Cherie Child
ZIND
retired
250.00
250.00
250.00
14313
OTH
❑ PTY
❑ SCC
9/21/2024
James Ward
Z IND
retired
250.00
250.00
250.00
10209
❑ PTY
SCC
-
SUBTOTAL $ 4250.00
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 (tan/2026))
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULER (CONT.)
Monetary Contributions Received to whole dollars.
Statement covers period
CALIFORNIA
6'
from 7/1J2024
FORM
through 9/21/2024
Page 8 of 9
NAME OFFICER
I.D. NUMBER
ZACK BASHIRTASH FOR CITY COUNCIL - 6 - 2024
1469938
FULL NAME, STREET ADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE"
PER ELECTION
DATE
CONTRIBUTOR
CONTRIBUTOR
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
(IF COMMITTEE,ALSO ENTER.LD. NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME)
OF BUSINESS)
PERIOD
(JAN.1-DEC, 31)
(IF REQUIRED)
07/23/20240
JoshuaSherley'
®IND
❑ COM
250.00
250.00
250.00
El PTY
❑SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
SCC
IND
0 COM
OTH
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
jj SCG
SUBTOTAL $ 250.00
'`Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committe
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULE B - PART 1.
El
%IIIVUII M FFUSY LOU IUU11UCu
Schedule B — Part 1 to whole dollars.
Statement covers period
CALIFORNIA
Loans Received
from 7/1/2024
FORM
through 9-21-2024 _
Page 9 of 9
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
ZACK BASHIRTASH FOR CITY COUNCIL - 6 - 2024
_
1469938
FULL NAME, STREETADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
BALANCE
b)
AMOUNT
RECEIVED THIS
a
AMOUNT PAID
OR FORGIVEN
OUTSTANDING
BALANCEAT
e
INTEREST
PAID THIS
ORIGINAL
AMOUNT'OF
g
CUMULATIVE
CONTRIBUTIONS
OF LENDER
{IF COMMITTEOFLSO ENTER I,D, NUMBER)
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
BEGINNING THIS
PERIOD
PERIOD
THIS PERIOD*
CLOSE OF THIS
....PERIOD
PERIOD
_._..._
LOAN
-.....
TO DATE
;..:...
0 F�No'
CALENDAR YEAR,
ZACK BASHIRTASH
CANDIDATE
0
$ 2000.00.
0
$ 2000.00
200000'
❑ FoRGSVEN
psri;E` GTit)ii"
0.00
$_
2000.00
$
s. p
11/10/202,
$ '0
7/1/2024
$ 2000'AQ
t Z IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATE INCURRED
DATE DUE
`
..........
PAID
CALM AR EAR
ZACK BASHIRTASH
CANDIDATE
$ 0
$ 4000.00
0
$ 4000.00
$ 600b:00
❑ FORGIVEN
PER.ELECTIOW'
0.00
4000.00
$ 0
11/10/202,
$ 0
7/8/2024
.16000:00.
t ® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
$
DATE INCURRED
$
DATE DUE
❑ PAID
CALENDAR YEAR
ZACK BASHIRTASH
CANDIDATE
$ 0
,20o0;i1(i
0
200fl.00
$ $00.0 UO
RATE
0.00
2000.00
0.
11/10/202,
$ 0
7/17/2024
$ 8000.00,
DATE DUE
DATE INCURRED
t ® IND [I COM ❑ OTH ❑ PTY ❑ SCC
SUBTOTALS $ 8000.00 $ 0 $ 8000.00 $ 0.00
Schedule B Summary
8000.00
1. Loans received this period.......................................................... ... , $
(Total Column (b) plus unitemlzed loans of less than $100.)
.......$ 0.00
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) 8000.00
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.
(Maybe a negative number)
*Amounts forgiven or paid by another party also must be reported on Schedule A.
— If required.
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.cl.gov (866/275-3772)
www.fppc:ca.gov
SCHEDULE B- PART 1
17111V 411W Illar V
Sched%le B — Part 1 to whole dollars.
Statement covers period
- ,
A
Loa"ns Received
from 7-1-2024
•1SEE
F
through 9-21-2024
of 10
INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
ZACK BASHIRTASH FOR CITY COUNCIL - 6 - 2024
1469938
FULL NAME, STREET ADDRESSAND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
AMOUNT
c
AMOUNT PAID
OUTSTANDING
e
INTEREST
ORIGINAL
g
CUMULATIVE
OF LENDER
BALANCE
RECEIVED THIS
OR FORGIVEN
BALANCEAT
PAID THIS
AMOUNT OF
CONTRIBUTIONS
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF-EMPLOYED, ENTER
•NAME OFBUSINESS)
BEGINNING THIS
PERIOD
PERIOD
THIS PERIOD*
CLOSE OF THIS
PERIOD
PERIOD
LOAN
TO DATE
❑ PAID
CALENDAR YEAR
ZACK BASHIRTASH
CANDIDATE
$ 0.00
$ 9090.52
0 %
$ 1090.52
$ 9090.52
7320 ALAMOSA IN
BAKERSFIELD CA 93309
❑ FORGIVEN
RATE
PER ELECTION'*
0.00
$
1090.52
$
$ 0.00
12/12/202
$ 0.00
08/06/202
$ 9090.52
DATE DUE
DATE INCURRED
t Z IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION**
RATE
t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION**
RATE
$
$
$
$
$
DATE DUE
DATE INCURRED
t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
SUBTOTALS $ $ $ $
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 (a) 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)
buww.fppc.ca.gov