HomeMy WebLinkAboutBLDG TRDS CNCL PAC PREELECT(2) Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEEINSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
,rD., I0-1-
through
Date of election if applicable:
(Month, Day, Year)
Date Stamp
COVEF~ PAGE
For Official Use Only
1· Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
[] Officeholder, Candidate Controlled Committee O State Candidate Election Committee
O Recall
General Purpose Committee
~ Sponsored
O Small Contributor Committee
O Political Pa~j/Central Committee
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(A/so Ccmp~te Pa. ~)
[] Primarily Formed Candidate/
Officeholder Committee
(Also Comp~te Pa. 7)
2. Type of Statement: ~ Prealection Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] 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 TREASURER
MAILING A D~I~SS
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRES~ (No P.O, BO~
AREA CODE/PRONE
~" ~ ADDRESS (IF DIFFERENT} NO. AND STREET OR P.O. BOX ~AILIN6 ADDRESS
~T~ ~ STATE ZIP CODE AREA CODE/PHONE CiTY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
I have used alt 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. I
certify under penalty of perjury under the laws of the State of California that the foregoll~l is true .~nd correct.
Executed on ~(1~"~b'¢--~¢'~- ~ By *~.¢~ ~~
Recipient Committee
Campaign Statement
COver Page-- Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Type or print in ink.
COVER PAGE - PART 2
6. Ballot Measure Committee
Page ~ of ~
NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET} CITY STA3E ZIP
Related Committees Not Included in this Statement: Llst any committees
not Included in this statement that are controlled by you or are primarily formed to receive
contrfbutlons or make expenditures on behalf of your candidacy.
COMMFITEE NAME
NAME OF TREASURER
COMMITrEEADDRESS
I.D. NUMBER
CONTROLLEDCOMMITTEE?
[] YBS r-'l NO
STREETADDRESS (NORD. BO)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D, NUMBER
NAME OF TREASURER CONTROLLED COMMITrEE?
I [] YBS [] NO
COMMITTEE ADDRESS STREET ADDRESS (NO RD. BOX)
CITY STALE ZIP CODE AREA CODE/PHONE
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 Committee List names of officeholder(s) or candidate(s) for
which this commit~e is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE BOUGHT OR HELD
OFFICE SOUGHT OR HELD
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
I[]SUPPORT
[]OPPOSE
F~SUPPORT
[]OPPOSE
SUPPORT
[]SUPPORT
[]OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (June/01)
FPPC Toll-Free Helpllne: 866/ASK-FPPC
State o! Call!orRis
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers periort
SUMMARY PAGE
Page ,~ of~
NAME OF FILER
LD. NUMBER
Contributions Received
1. Monetary Contributions ........................................... ScheduleA, Line 3
2. Loans Received ...................................................... Schedule B, L/ne 7
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2
4. Nonmonetary Contributions .................................... Schedule C, Line 3
5, TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4
Expenditures Made
6. Payments Made ....................................................... Schedule E, Line
7. Loans Made ........... , ................................................. Schedule H, Line
8. SUBTOTAL CASH PAYMENTS .................................... AddLinese+7
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line
10. Nonmonetary Adjustment .......................................... Schedule C, Line
11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Surnrnaq/Page, L#le 16
13. Cash Receipts ................................................... ColumnA, Line3above
14. Miscellaneous Increases to Cash ........................... Schedule I. Ltne 4
15. Cash Payments .................................................. ColumnA, Line8above
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+LineginColumnBnbove
Column A
TOTAL THIS PERIOD
(FROM ATiACHED SCHEDULES)
OD
0 oo
$ O,
Column B
CALENDAR YEAR
TOTAL TO DATE
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column B ol your last
report. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts. If this is
the tirst repod being filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
lit through 6~30 7/1 to Date
20. Contributions
Received
21.Made Expenditures
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(If Subject to Volunlacy Expendilura Limit}
Date of Election Total to Date
(mm/dd/yy)
__J __L____ $
J.__/__ $
I__/ .... $_
I I .... $
I I__ $
I I__ $
*Since January 1, 2001 Amounts in this section may be
different from amounts reported in Column B.
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule A Type or print in ink. SCHEDULE A
Amounts may be rounded Statement covers period
Monetary Contributions Received to whole dollars.
SEEI.STRUO,IO,SONREVERBE ,h,o..h t0-1q-O;)- .e,e q o,
NAME OF FILER I.D. NUMBER
I IF A~ [~IVIDUAL, E~TER AMOUNT CUMULATIVETO OATE PER ELECTION
DATE FULL NAME, STREET ADDRESS A~D ZIP CO~E OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AN~ EMPLOYER RECEWED THIS CALENDAR YEAR TO ~ATE
RECEIVED {IFCO~I~EE'ALSOENTERID'NUM~R) COO~ ~ {IFSELF.EMPLOY~D, ENTERNAM~ PERIOD (JAN1 I -DEC. 31) (IF REQUIRED)
OF BUSINESSI
~- Dscc
~IND
~COM
~OTH
~ .TY
~SCC
~IND
UCOM
~ OTH
~ PTY
Qscc
~lND
~ COM
~ OTH
~ PTY
~scc
~ND
~ COM
~ OTH
~ PTY
Q scc
SUBTOTALS
Schedule A Summary
1. Amount received this period - contributions of $100 or more.
(Include all Schedule A subtotals.) ........................................................................................................ $ I.~{~c~''-.
2, Amount received this period - unitemized contributions of Jess than $100 ............................................. $
3. Total monetary contributions received this period, j~ ,
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1 .) ....................... TOTAL $
*Conlributor Codes
IND + Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other
PTY - Political Parly
SCC - Small Contributor Commitlee
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 8661ASK-FPPC
Schedule B- Part 1
Loans Received
SEE~NSTRUCTIONS ON REVERSE
NAME OF FILER
FULL NAME, STREET ADORESS AND ZIP CODE
OF LENDER
(IF COMMITTEE, ALSO ENTER ID, NUMBER)
f[] IND [] COM [] OTH [] PTY [] SCC
tel IND [] COM [] OTH [] PTY [] SCC
Type or print in ink.
Amounts may be rounded
to whole dollars.
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(iF SELF-EMPLOYED, ENTER
NAME OF BUS~NESS}
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
AMOUNT
RECEIVED THIS
PERIOD
(c)
AMOUNT PAID
OR FORGIVEN
THIS PERIOD *
[] FORGIVEN
$
Statement covers period
from t 0 - (~ I-d) ;L
(d)
OUTSTANDING INTEREST
BALANCE AT PAID THIS
CLOSE OF THIS
PERIOD PERIOD
__%
$
DATE DUE
%
DATE DUE
__%
$
DATE DUE
SCHEDULEB-PART1
Page ~-~ of ~
I.D. NUMBER
(~) (gl
ORIGINAL CUMULATIVE
AMOUNT OF CONTRIBUTIONS
LOAN TO DATE
CALENDAR Y~-AR
$
PER ELECTION**
$
DATE INCURRED
CALENDAR YEAR
$
PER ELECTION **
$
DATE INCURRED
CALENDAR YEAR
$
PER ELECTION **
$
DAlE INCURRED
$
t[] IND [] COM [] OTH [] PTY [] SCC
SUBTOTALS $ $ $ $
{Enter (e} on
Schedule B Summary Schedul. E,Line3)
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.)
'Amounts forgiven or paid by1
another party also must be
reported on Schedule A
/
"If required. /
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.
t Contributor Codes ~
IND-Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contribulor Committee
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 86G/ASK-FPPC
SCHEOULEB-PART2
:~cneaule ts - t, an z ~ype or print ~n tnK.
Loan GuarantorsAmounts may be rounded Statement covers period
to whole dollars, from
NAME OF FILER I.D. NUMBER
FULL NAME, STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT BALANCE
ZiP CODE OF GUARANTOR CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED CUMU~TIVE OUTSTANDING
{IF C~I~EE, ALSO ENTERID NUMBER} CODE (iF SE~-~MPLOYED, ENTER THIS PERIOD TO DATE TO DATE
N~E OF BUSINESS)
~IND LENDER C~ENOAR YEAR
,
~scc
CALENDAR YEAR
~ IND LENDER
~ COM
PER ELECTION
~ OTH DATE (IF REQUIRED)
~ PTY
~SCC
CALENDAR YEAR
~IND LENDER
~ COM
PER ELECTION
~ OTH (IF R~QUIRED)
DATE
~ PTY
~SCC
CALE~BAR YEAR
~ IND LENDER
OCOM
PER ~LEC~ON
~ OTH DATE (IF REQUIRED)
Q PTY
~ SCC
SUBTOTAL $ Summa~ Page, ,: .
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK~FPPC
Schedule C
Nonmonetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
,ro.
SCHEDULE C
NAME OF FILER
DATE
RECEIVED
FULL NAME, STREET Al)DRESS AND
ZIP CODE OF CONTRIBUTOR
(IF COMMiTrE~, ALSO ENTER ID NUMSERI
CONTRIBUTOR
CODE *
OIND
E~COM
~IOTH
[~PTY
~]scc
~JlND
I-ICOM
I~OTH
[~PTY
r~scc
OIND
[~COM
I~OTH
OPTY
E]scc
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS}
DESCRIPTION OF
GOODS OR SERVICES
AMOUNT/
FAIR MARKET
VALUE
I.D NUMBER
[~IND
I~COM
[~]OTH
[~PTY
E]scc
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL
Schedule C Summary
1. Amount received this period - nonmonetary contributions of $100 or more.
(Include all Schedule C subtotals.) ..................................................................................................................... $
2. Amount received this period - unitemized nonmonetary contributions ol less than $100 .................................... $
3. Total nonmonetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $
*Contributor Codes
IND - Individual
COM - Recipient Committee
{other than PTY or SCC)
OTH - Other
PTY - Political Pady
SCC- Small Contributor Committee
FPPC Form 460 (June/01)
FPPC Toll-Free Hetpline: 866/ASK-FPPC
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE rNSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from ~
through [0--lq-O~.~
SCHEDULE D
NAME OF FILER
DATE
NAME OF CANDIDATE, OFFICE. AND DISTRICT, OR
MEASURE NUMBER OR LEttER AND JURISDICTION,
OR COMMITrEE
[] Supped [] Oppose
[] Supped [] Oppose
[] Supped [] Oppose
TYPE OF PAYMENT
~ Monetary
Contribution
[] Nonmonetary
Contribution
[] Independent
Expenditure
[] Monetary
Contribution
[] Nonmonetary
Contribution
[] Independent
Expenditure
[] Monetary
Contribution
[] Nonmonetary
Contribulion
[] Independent
Expenditure
DESCRIPTION
(IF REQUIRED)
AMOUNT THIS
PERIOD
I O(D,
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN 1-DEC 31)
PER ELECTION
TO DATE
IIF REQUIREDI
G-
Schedule D Summary
1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) .............................................. $
2. Unitemized contributions and independent expenditures made this period of under $100 ...................................................................................... $
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .............. TOTAL $
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
through JO-~q~d}~-
Page
SCHEDULEF
I.D. NUMBER
CODES:
QVP campaign paraphernalia/misc.
CNS campaign consultants
c'rB contribution (explain nonmonetary)*
CVC civic donations
RL candidate filing/ballot fees
FND fundraising events
I',,O independent expenditure supporting/opposing others (explain)*
LEG legal defense
LIT campaign literature and mailings
If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition circulating
R-lO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I D NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
* Payments that are contributions or independent expenditures must also be summarized on Schedule e. SUBTOTALS
Schedule E Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ......................................................... $ I -,~, ~-~
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
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from 1(~-~' ~ t-~c:~
through lO-\ ~- 0,-~
NAME OF FILER
SCHEDULEF
ID. NUMBER
CODES: If one of the following codes accurately describes the
~ campaign paraphernalia/misc. MBR
CNS campaign consultants
CTB contribution (explain nonmonetary)'
CVC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IXID independent expenditure supporling/opposing others (explain)*
LEG legal defense
payment, you may enter the code. Otherwise, describe the payment.
member communications
lvlTG meetings and appearances
OFC office expenses
PET petition circulating
phone banks
POL polling and survey research
POS postage, delive~ and messenger services
PRO prolessional services (legal, accounting)
RAD radio aidime and production costs
RFD relurned conlributions
SAL campaign workers' salaries
TEL t.v. or cable airtirne and production costs
candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOl voter registration
LIT campaignliterature and mailings PRI' print ads WEB information technology costs (internet, e-mail)
(a) (b) (c) (d)
NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING
(iF COMMn-i'EE, ALSO ENTER hD, NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD
* Payments that are contributions or Independent expenditures must also be SUBTOTALS $ $ $ $
summarized on Schedule D.
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $
2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on
accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................. PAID TOTALS $
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference heme and
on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $
May be a negal~ve numbel
FPPC Form 460 (Junel01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
SEEINSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULEb
NUMBER
NAME OF FILER
NAME OF AGENT OR INDEPENDENT CONTRACTOR
CODES: If one of the following codes accurately describes the
QVP campaign paraphernalia/misc. MBR
CNS campaign consultants
contribution (explain nonmonetary)*
CVC civic donations
FIL candidate filing~allot fees
FND fundraising events
IND independent expenditure supporting/opposing others (explain)*
LEG legal defense
LIT campaign literature and mailings
payment, you may enter the code. Otherwise, describe the payment.
member communications
MTG meetings and appearances
OFC office expenses
PET petition circulating
PIE) phone banks
FOL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salades
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB information lechnology costs (internet, e-mail)
*p ·
ayments that are contr butions or independent expenditures must also be summarized on Schedule D.
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE, Al. SO ENTER ID. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Attach additional information on appropriately labeled continuation sheets. TOTAL* $
· Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or
independent contractor as reported on Schedule E. FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule H
Loans Made to Others*
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
through
I.D. NUMBER
SCHEDULE H
of
FULL NAME, STREET ADDRESS AND ZIP CODE
OF RECIPIENT
{~F COMMITTEE. ALSO ENTER I.D. NUMBER)
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
~)
AMOUNT
LOANED THiS
PERIOD
(c)
REPAYMENT OR
FORGIVENESS
THIS PERIOD*
[] PAID
[] FORGIVEN
[] PAID
$
[] FORGIVEN
OUTsT~d~DING
BALANCE AT
CLOSE OF THIS
PERIOD
CATE DUE
INTEREST
RECEIVED
ORIGINAL
AMOUNT OF
LOAN
CATE INCURREC
$ $
CATE CUE CATE INCURRED
*Loans that are contributions to another candidate or committee · ~ ~;
must also be summarized on Schedule D. Loans forgiven must
also be reported on Schedule E. SUBTOTALS iS $ $ iS , :
(Enler (e) on
Schedule I. L~e 3)
CUMULATIVE
LOANS
TO DATE
CALENGAR YEAR
PER ELECTION**
CALENDAR YEAR
$
PER ELECTION**
Schedule H Summary
1. Loans made this period .................................................................................................................................................. $
(Total Column (b) plus unitemized loans less than $100.)
2. Payments received on loans ........................................................................................................................................... $
(Total Column (c) plus unitemized payments less than $100.)
3. Net change this period. (Subtract Line 2 from Line 1.) ........................................................................................NET $
(Enter the net here and on the Summary Page, Column A, Line 7.)
*'If Required
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule !
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print In ink.
Amounts may be rounded
to whole dollars.
Statement covers period
,rom l(b-Ot-O
through t ~.~ ~ ~ '~'~}-
I.D. NUMBER
SCHEDULEI
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE, ALSO ENTER I.O. NUMBER)
DESCRIPTION OF RECEIPT
AMOUNTOF
INCREASETOCASH
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Schedule I Summary
1. Increases to cash of $100 or more this period ........................................................................................................... $
2. Unitemized increases to cash under $100 this period ............................................................................................... $
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ........................................................................................................................... TOTAL $
FPPC Form 460 (June/01)
FPPC Toll-Free Helpllne: 866/ASK-FPPC