HomeMy WebLinkAboutDICKERSON SEMIANN02(2)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEEINSTRUCTIONS ON REVERSE
Type or print in ink.
Statement~ov/ers period
from '-//J/F
through
Date of election if applicabl,
(Month, Day, Year)
Date Stamp
IFEB-5 /~t11:33
,RSFt,_L~ CIiY C[.ER;
COVER PAGE
Page / of ~
Typ,,c-of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
~,/Officeholder, Candidate Controlled Committee [] Ballot Measure Committee
State Candidate Election Committee C) Primarily Formed
0 Recall
(ALSO Coz np/ele Pa~t 5)
[] General Purpose Commiffee 0 Sponsored
O Small Contributor Committee
O Political Pady/Centrei Committee
0 Controlled
O Sponsored
(Also Ccmplete Pa4 6)
[] Primarily Formed Candidate/
Officeholder Committee
(Also C~plete Part 7)
2. Type of Statement:
[] Son Statement
[~Semi-annual Statement
[] Termination Statement
[] Amendment (Exprain below)
For Official Use Only
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Preelection
Statement - Attach Form 495
3. Committee Information
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Treasurer(s)
NAME OF TREASU~.~R . '
MAILING
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification /
I have used ali reasonable diligence in preparing and reviewing this statement and to the best of my knowledge th~'~,~t~/ion contained herein and in the attached schedules is true and complete. I
certify under penalty of perjury ~nder the laws of the State of California that the foregoing is true and correct, fL/ ///. /'
Executed on ~-~ ((~) ~'~ By //~ ~'~'~' [' ,/]~/.
EX6CUISd on ~J~,;~ ~ By Si.atureolConlro(ling~.ho~r, Ca~le.~t:~s~nlor Re~s~er o,~s~
Executed on By
Date
Executed on By
Recipient Committee
Campaign Statement
Cover Page-- Part 2
Type or print in ink.
COVER PAGE - PART 2
Page '~- of L~
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIALJSUSINESS ADDRESS (NO. AND STREET) CIT~ STAT 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 STREET ADDRESS (NO P.O. BOX
CITY STA~ ZIP CODE AREA CODE/PHONE
COMMI~rEE NAME I.D, NUMBER
NAME OF TREASURER CONTROLLBD COMMri~EE?
[] YES [] NO
COMMI3~'EE ADDRESS STREET ADDRESS (NO P,O. BO)
CITY STALE ZiP CODE AREA CODE/PHONE
6. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION
~j~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 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 (June/01)
FPPC Toll-Free Helpllne: 866/ASK-FPPC
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink,
Amounts may be rounded
to whole dollars,
Stateme.n~ co~vers period
from '7!1
SUMMARY PAGE
Page ~-~ of ~-~
Contributions Received
f)¢ .
1. Monetary Contributions ........................................... Schedule A, Line 3
2. Loans Received ...................................................... Schedule B, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2
4. Nonmonetary Contributions .................................... Schedule C, L/ne 3
5. TOTAL CONTRIBUTIONS RECEIVED ........................... AddLines3+4
Expenditures Made
6. Payments Made ....................................................... Schedule E, Line 4
7. Loans Made ............................................................. ScheduteH, Line 7
8. SUBTOTAL CASH PAYMENTS ....................................AddLinese+7
9. Accrued Expenses (Unpaid Bills) ............................... ScheduleF, Line 3
10. Nonmonetary Adjustment .......................................... Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10
Current Cash Statement
12. Beginning Cash Balance ....................... Prewous Summary Page, Line 16
13. Cash Receipts ................................................... ColumnA, Line3above
14. Miscellaneous Increases to Cash ........................... ScheduleI, Line4
15. Cash Payments .................................................. ColumnA, Lmeaabove
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 ......................... AddLine2+UneginColumnaabove
$ $
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column 8 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).
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, Contribulions
Received $
21. Expenditures
Made $ $
Expenditure Limit Summary for State
Candidates
22, Cumulative Expenditures Made'
(Il SUbject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
/ / $
/ / $
/ / $
/ I $
/ J $
__J / $
*Since January 1, 2001, Amounts in this section may be
different from amounts reported in Column B.
L(~,~-~. L '[~,..4.__ FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule B- Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement c~ve/s period
from 7l~l°'~-
through [ ~/~(/~ ~-
SCHEDULEB-PART1
Page ~/ of ~
/
FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL
OF LENDER OCCUPATION AND EMPLOYER
lip COMMITTEE' ALSO ENTER i D. NUMBER) (rF SEU=-EMPLOYED, ENTER
fEI IND [] COM [] OTH [] PTY [] SCC
t[] IND [] COM [] OTH E] PTY [] SCC
I'[] IND [] COM [] OTH [] PTY [] SCC
NAME OF BUSINESS)
(b) (c)
OUTSTANDING AMOUNT AMOUNT PAID
BALANCE RECEIVED THIS OR FORGIVEN
PERIOD THIS PERIOD *
[] PAID
$
[] FORGIVEN
$
[] PAiD
iNTEREST
BALANCE AT
CLOSE OF THiS PAID THIS
PERIOD
DATE DUE
D~EDUE
$
DATE DUE
RATE
RATE
I,D, NUMBER
ORIGINAL CUMULATIVE
AMOUNT OF CONTRIBUTIONS
LOAN TO DATE
CALENDAR YEAR
$
CALENDAR YEAR
PER ELECT~ON **
DATE INCURRED
CALENDAR YEAR
$ __ $
PER ELECT]ON **
$
DATE INCURRED
SUBTOTALS $ $ $ $
Schedule B Summary
1. Loans received this period ......................................
(Total Column (b) plus unitemized loans 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.) ............................................................... NET $
Enter the net here and on the Summary Page, Column A, Line 2. (May bea negalivenumber)
It Contributor Codes
IND - Individual
COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY- Political Party SCC- Small Contributor Committep ]
(Enter(e) on
Schedule E, Line 3)
'Amounts forgiven or paid by}
'* If required.
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 8G6/ASK-FPPC
'.'ne(lUle B - Part 3
nnual Report of Outstanding Loans
bt
,, ~ add/t/one~ Information on appropriately labeled conUnuatlon sheets.