HomeMy WebLinkAboutPRICE SEMIANN99(1) fficeholder, Candidate,
and Controlled Committee
Campaign Statement -- Long Form
Type or print in ink.
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Check one of the following boxes to indicate the type of statement being filed: [] Pre-election Statement
~ Supplemental Pre-election Statement (Attach a completed Form 49S to this statement)
Special Odd-Year Campaign Report
iSemi-annual Statement
Termination Statement (Attach a completed Form 41S to this statement.)
I ~)fficeholder Candidate. and Controlled Committee
Included in t~is Statement
ZIP CODE
AREA CODE~DAYTIM[ PHONE
LD. NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE M:XIGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER if APPLtCAIILE)
REMDEIfflAL OR BUSINESS ADDRESS (NO AND STREET)
CITY STATE
COMMITTEE NAME '
COMMITTEE AODR~SS
III
COVER PAGE - LONG FORM
from / '
through ~' j~' ~ ~ 9~ ~L 19 P~ Z: 2 3
Dateofe~ionfapplica~A~RSFIELD C)TY CLER~ pa~ /
(MMth, Day, Year) ~ For Official Use Only
NAME OF IEASURER
COMMITTEE ADDRESS
Other Committees ~iot Included in this Statement: cm,nyot~er
committees not included in this consolidated Statement that are controlled by you and any
committees of which you have knowledge that are primarily formed to receive contributEore
or to make expenditures on behalf of your candidacy.
COMMITTEE NAME ] I D. NUMBER
CONTROLLED COIVIMITTEr )
(NO. AND STREET)
crrf STATE ZIP CODE AREA CODEJDAYTIME Iq4ONE
CITY
NAME OF TREASURER
~ERMANEI~I ADDRESS OF TREASURER
CITY
Verification
(NO. AND STREET)
STATE
(NO AND STREET)
ZiP CODE AREA CODE/DAYTIME PHONE
STATE
Ztt CODE AREA CODFJDAYTIME PHONE
C0MMITIEE NAME
II D NUMIER
NAME OF TREASURER CONTROLLED COMMITlEE?
] yes [] ND
COMMITTEE ADDRESS (NO AND STI~ET)
CITY STATE ZIP CODE AREA CODE/DAYTIME tt-K)NE
Attach additional information on appropriately labeled continuation sheets.
I have used atl reasonable diligence in preparing this statement. I have reviewed the 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 7-//--~? At ~,~,~j"_~/~_~ /~-, By ~/~-~ ~'~'"~<~
DATE .~'/ CITY AN~STAIE SIGNATURE Of TREASURER
An officeholder or (l~Mate who controls · comml~ee must also varify the campaign statement, t have used all reasonable diligence and to the ~ of my k nowledge the treasurer has used all
'=;;;';'"" '"" "" ,,,..., ,, ,,....
Executed on A~ ~' By
DATE CITY AND $IATE SIGNA 1 U~E OF CANDIDAT E/O~ ~ ICE HO[ DE ~
E~eculed on A~ By
FOR iNFORMATION RETIRED TO BE PROVIDED TO YOU PURSUANT TO 1HE INFORMATION P~I(ES A~ Of I~77, SEE INFORMATIO~ANUAL ON CAMPAIGN DiSCtOSUR[ P~OVISIONS Of 1HE POLITICAt REFORM AC1
Campaign Disclosure Statement
Summary Page
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from /'/' ?~
SUMMARY PAGE
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
Contributions Received
1. Monetary Contributions ............................... Schedule A, LIne 3 $
2. Loans Received ......................................... Schedule e, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I · 2 $
4. Non-monetary Contri butions ................... schedule c, Line 3
5. SUBTOTAL CONTRiBUTIONS:(Exclude Enforceable Promises) Add Unes 3
6. Enforceable Promises
(Exclude Loan Guarantees, Line 18 below) ................... Schedule D, Une 7
7. TOTAL CONTRIBUTIONS RECEIVED .................... AddUnesS, 6 $
Expenditures Made
8. Cash Payments (Other than Loans Made) ............ Schedule E, Une
9. Loans Made ............................................. Schedule H, Une
10. SUBTOTAL CASH PAYMENTS ............................ AddLines8.
11. Accrued Expenses (Unpaid Bills) ........................ Schedule F, Une
12. TOTAL EXPENDITURES MADE ......................... AddUnes I0 · II
Current Cash Statement
13. Beginning Cash Balance .................. Previous Summary Page, Line 17
14. Cash Receipts ...................................... ColumnA, Line3alx)ve
15. Miscellaneous Increases to Cash ........................ schedule I, Line
16. Cash Payments .................................... CotumnA, Line lOebova
17. ENDING CASH BALANCE ..... Add Lines 13 + 14 ~ 15, then subtract Ltne 16
ff this Lf a termination statement, Line 17 must be zero.
18. LOAN GUARANTEES RECEIVE D .............. Schedule e, Pan I, Column (b) S
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................ See instructions on reverse
Colurrtn A
TOTAL THIS I~RIOD
ffRO M AllACHED $4:HEDUL[S)
through
Col urfir} Bt
TOTAL PREVIOUS PERIOD
(SEE NOTE IELOVV)
Page ~L of '~'
I.D. NUMBER
~dOd~ /
COlumn C
TOTAL TODATE
(ADD C0tUMN$ A · l)
* From previous Statement Summary Page, Column C. However, if
this is the first report filed for the calendar year, Column B should be
blank except for LOam Received (Line 2), Enforceable Promises (Line
6), Loans Made (Line 9). and Accrued Expenses (Line 11),
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/1 to Date
21 ontrib tions
22. ~ap3e?d!!.Ur.e! S
20. Outstanding Debts ................. AddLine 2 ~, Line I l in Column Cabova S
Schedule E
Payments and Contributions
(Other Than Loans) Made
Type or pdnt tn ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
CODES FOR CLASSIFYING EXPENDITURES
Statement covers period
from / -/- 9 ~,__
through
SCHEDULE E
Page -~ of ~z- :
I,D. NUMBER
If one of the following codes accurately describes the expenditure, u may enter the code and leave the "Description of Payment' co|u mn blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations otY~e;ch category.
'C' - MONETARY AND IN-KIND (NON-MONETARY) 'B' -
CONTRIBUTIONS TO OTHER CANDIDATES ' N' -
AND COMMITTEES ,Oo _
'1' - INDEPENDENT EXPENDITURES- 'S*-
'L'- LITERATURE 'F'-
BROADCAST ADVERTISING 'G" -
NEWSPAPER AND PERIODICAL ADVERTISING 'T' -
OUTSIDE ADVERTISING
SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS *P° '
FUNDRAISING EVENTS
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
(W COIdMIIT~E, IN ADOITION TO CO4dMITTEE'$ NAME ANO ADDliS$, ENTER I.O. NUMI~R OR. I~ NO t.D,
NUMIIR HAS lIEN ASSIGNED, ENTER TREAf~REIr$ NAME AND ADORESS)
GENERAL OPERATIONS AND OVERHEAD
TRAVEL, ACCOMMODATIONS AND MEALS
(MUST BE DESCRIED)
PROFESSIONAL MANAGEMENT AND CONSULTING
SERVICES
IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW.
CODE OR DESCRIPTION OF PAtMENT
SUBTOTAL $
Im ant: Contributions and ex .t~. nditures made out of campai n funds to or on behalf of other
ordered: canal/dates, committees, or ballot measures must ;~; be entered on the Allocation Page, Part L
Payments and Contributions Made Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................
2. Payments made this period of under $100. (Do not itemize.) ....................................................................... $
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) ..............................
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ..................................... $
AMOUNT PAID
,5"_,c:,/', c c
S. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8) ........... TOTAL
Schedule E
(Continuation Sheet)
Payments and Contributions
(Other Than Loans) Made
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITFEE
"C* - MONETARY AND IN-KIND (NON-MONETARY) 'B' -
CONTRIBUTIONS TO OTHER CANDIDATES 'N' -
AND COMMITTEES 'O' -
"t' - INDEPENDENT EXPENDITURES 'S'-
"L'- LITERATURE i
NAME AND ADDRESS OF PAYEE. CREDITOR, OR RECIPIENT OF CONTRIBUTION
(if COMMITtrEE, IN AI)OfTION TO COMMII*r~r$ NAME AND ADDRESS, ENTER I.D. NUMIER OR, I~ NO I.D.
MUMMR HA$ IEEN Ae~gGNED. ElklfER TREAf~4~RER'S NAME AND
Type or prIM In IM.
Amountt may be rounded
to whole dollars.
Statement covers period
from / _/_ c~ ~
through ~ ' "-~ ' ~ ~'
CODES FOR CLASSIFYING EXPENDITURES
BROADCAST ADVERTISING °G' -
NEWSPAPER AND PERIODICAL ADVERTISING *T' -
OUTSIDE ADVERTISING
SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS
FUNDRAISING EVENTS
SCHEDULE E (cont,)
__ ~ PI~, ~ Of "~'
I.D. NUMBER
-
'j.,.,
GENERAL OPERATIONS AND OVERHEAD
TRAVEL, ACCOMMODATIONS AND MEALS
(MUST BE DESCRIBED)
PROFESSIONAL MANAGEMENT AND CONSULTING
SERVICES
..
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
SUBTOTAL
Schedule I
Miscellaneous Increases to Cash
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from /-/- ~;~;
SCHEDULE I
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
DATE FULL NAME AND ADDRESS OF SOURCE
RECEIVE D (~; COMMITTEL IN ADDftlON TO COMMITTEE"~ NAME AND ADDRESS, ENTER I.D. NUhIIER
O~ If NO I,ID, NUMIER NA$ IEEN AS~.IGNEDo ENTER TREASURER'$ NAME AND ADDRESS)
DESCRIPTION OF RECEIPT
Attach additional information on appropriately labeled continuation sheets,
Miscellaneous Increases to Cash Summary
1, Increases to cash of $100 or more this period ............................................................. $
2. Increases to cash under $100 this period. (Do not itemize.) ................................................ $
3. Total ofall interest received this period on loans made to others. (Schedule H, Part ll(b).) ....................$
4, Total miscellaneous increases to cash this period, (Add Lines 1, 2, and 3, Enter here and on the
Summary Page, Line 15,) ....................................................................... TOTAL $
SUBTOTAL
I.D. NUMBER
.~ z~</~ /
AMOUNT OF
INCREASE TO CASH