HomeMy WebLinkAboutHOLLON PREELEC99(1)Recipient Committee
Campaign Statement
(Government Code Sec'do~s 84200..84216.5)
SEEINSTRUCTIONSONREVERSE
Type o~ print in ink.
1. Type of Recipient Committee: ~Ji Committees- Complete Pints 1, 2, 3, and 7.
~ Officeholder, Candidate
Controlled Committee
(Also Complete Part 4.)
[] Ballot Measure Committee
O Primarily Formed
0 Controlled
O Sponsored
(Also Complete part 5.)
[] Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 6.)
[] General Purpose Committee
O Sponsored
O Broad Based
3. Committee Information
COMMI'I-fEE N~ME
ILO. NUMBER
Date of ejection if applicable:
(Mon63, Day, Year)
Dale Stamp
10C ' 17_ 11:16
.RSFiEL. D Ct~¥ uLE
2. Type of Statement:
~,~,P re-election Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
COVER PAGE
Fo~ Official Use Onty'
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
MAILING ADDRESS
CITY STATE ZIP COOE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER. IF ANY
STREET ADORESS (NO P.O. BOX)
CITY STATE ZIP COOE AREA CODE/PHONE
MAILING ADORESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP COOE AREA COOE/PHONE
OPTIONAl.: FAX / E-MAIL ADDRESS
FPPC Fo;m 460 (8/99)
For Technical Assistance: 91rd3~2-5660
Slate of California
Recipient Committee
Campaign Statement
Cover Page-- Part 2
Type or print in ink.
COVER PAGE * PART 2
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
CITY ~TAT.E ZIP
R®lat~d Committ~$ Hot Included in thi~ Statement: uet~¥coram~
not ~clud~ In ~ls c~fldat~ s~t~t ~.t ~ con~l~ by ~ ~ whl~ ~e ~maaly
D~s O ~
cFrY
STATE ZiP COOE
7. Verification
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
D oPPos~
Identify the conbolling officeholder, candidate, or state measure proponent, if any.
6. Primarily Formed Committee Ust names ofofllceholder(s) or candidate(e)
for which Ibis committee la prfnm~fly formed.
Attach continuation sheets if necessary
OFFICE ~ OR HELD [] su.~
[] oPPosE
[] SUPPORT
I have used all 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 foregoing is tree and correct.
Executed o~
DATE
Executed on
DATE
By ~ /
By,
FPP(:: From 4~0 (w)
For Tec~niMI A~Mt~ce: ~1rd322~660
State el CMIfomll
Campaign Disclosure Statement
Summary Page
Type or print in Ink.
Amounts may be rounded
to whole dollars.
E;UMMARY PAIl F
Contributions Received
1. Monetary Contributions ...................................................... ScheduleA, Line 3
2. Loans Received ................................................................... Schedule 8. Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines t + 2
4. Nonmonetary Contributions ............................................... Schedule C. Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4
Column A
$
Column B*
$
$
Column C
TOTAl. TO OATE
(COLUMNS A * B)
$
$
Expenditures Made
6. Payments Made .................................................................... Schedule E, Line 4
7. Loans Made .......................................................................... Schedule H, Line 7
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
Current Cash Statement
12. Beginning Cash Balance ................................ Previous Summary Page. Line 16
13. Cash Receipts .............................................................. Column A, Line 3 above
14. Miscellaneous Increases to Cash ....................................... Schedule I, Line 4
15. Cash Payments ............................................................ column A. Line 8 above
16. ENDING CASH BALANCE .............. Add Lines 12 + 13 + 14. then subtract Line 15
Il this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule B, Pan 1, Column (U)
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... See instructions on reverse
19. Oulstanding Debts ................................... AddLIne2+LlneginColumnCabove
$
$
20.
* 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 Loans Received (Line 2), Loans Made (Line 7), and Accrued
Expenses (Line g).
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/1 to Date
Contributions
Received ............ $
Expenditures
Made ..................$
FPPC Form 460 (8/9g)
For Technlcsl Aselstsnce: 916/822-5660
Schedule A Typ~ or print in ink. SCHEDULE A
Monetary Contributions Receivedto whole dollara, from
~ IND
~ COM
~ OTH
~IND
~ COM
~ OTH
~IND
~ COM
~ OTH
~IND
~ COM
~ OTH
~IND
~ COM
~ OTH
SUBTOTALS
Schedule A Summary
1. Amount received this pedod - contributions of $100 or more.
(Include all Schedule A subtotals.) .......................................................................................................
2. Amount received this pedod - unitemized 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
['Con~butor Codes
IND - Individual
COM - Recipient Committee
OTH - Other
FPPC Form 460 (8/99)
For Technical Assistance: 916/~22-5660
Schedule B - Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE
RECEIVED
Type or print in ink.
Amounts may be rounded
covers period
SCHEDULE B - PART
to whole dollers.
FUt. L NAME, MAILING ADDRESS AND ZIP CODE
OF LENDER OR GUARANTOR
CONTRIBUTOF
CODE *
IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
LENDER INFORMATION
(~,)
I.D. NUMBER
GUARANTOR INFORMATION
[] Lender [] Guarantor
Lender [] Guarantor
r"]Lende¢ []Guarantor
[-I IND
[] COM
[] OTH
[] IND
[] coM
[] OTH
[]IND
[] COM
[] OTH
DUE DATE
INTEREST RATE
SUBTOTAL $
OF LOAN
TO DATE
CALENDAR YEAR
$
$
ALENDAR YEAR
OTHER
CALENDAR YEAR
$
OTHER
$
GUARANTEED
TO DATE
CALENDAR YEAR
$
OTHER
$
CALENDAR YEAR
Schedule B - Part I Summary
t. Loans of $100 or more received this period. (include all Loans Received - Part t (a) subtotaJs.) ................... $
2. Amount received lhis period - unitemized loans of less than $100 ................................................................... $
3. Total loans received this period. (Add Lines 1 and 2.) ....................................................................... TOTAL $
Schedule B - Part 2 Summary
4. Loans of $100 or more repaid, forgiven, or paid by a third party this period. (include all Part 2 (c)
subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) ............................. $
5. Loans under $100 repaid, forgiven, or paid by a third party. (Do not itemize.) I! forgiven or
paid by a third party, include this amount on Schedule A Summary, Line 2 ...................................................... $
COM - Recip/erff Corem/Ires
6. Total loans repaid, forgiven, or paid by a third party this pedod. (Add Lines 4 + 5.) ........................... TOTAL $
OTH- Other
7. Net change this pedod. (Subtract Line 6 from Line 3.)
Enter the net here and on the Summary Page, Column A, Line 2 .......................................................... NET $
~ ~ a n~live nu~. FPPC Form 460 (8/99)
For Technicel Assistance: 916A~22-5660
Schedule B - Part 2
Repayments Made on Loans Received, Loans
Forgiven, and Loans Repaid by a Third Party
SEEINSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole do#ars.
S~,;=.,~.[ covers period
through '/~*~--//~)~ q~
SCHEDULE B - PART 2
NAME OF FILER
DATE OF
REPAYMENT
OR
FORGIVENESS
DATE OF
ORIGINAL LOAN
FULL NAME OF LENDER
INTEREST
RATE
(c)
AMOUNT REPAID OR
FORGIVEN ON PRINCIPAL*
I.D. NUMRER
OUTSTANOING
PRINCIPAL
(d)
INTEREST
PAID
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ ~ TOTAL INTEREST
PAID THIS PERIOD $ ~.~
* IMPORTANT: If any part of a loan is forgiven or repaid by a third par~, also itemize the transaction on Schedule A, Enterthe amountin column (a~) in the Schedule E I
including the name and address of the person forgiving the loan or the third party making the payment, and the amount Summa~ U'ne 3. Do not ca~rr~ this total to the
forgiven or paid.
Schedule B SummarX.
FPPC: Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule B - Part 3 Type or print in Ink. SCHEDULE E - PART 3
Attach additional information on appropriately labeled continuation sheets. TOTAL
NOTE: This total should be
the same amount as entered
on the Summary Pa~e,
Column C, Line 2, FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule C Typ. or print in ink. SCHEDULE C
Amounts may be rounded
Nonmonetary Contributions Received towhole doller~. ~' '~
from
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE
RECEIVED
FULL NAME, MAILING ADDRESS AND
ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
CODE *
I--lIND
[] COM
[] OTH
[] IND
[] COM
[] OTH
l-liND
[] COM
[] OTH
IFAN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
DESCRIPTION OF
GOODS OR SERVICES
[] IND
[] COM
[] OTH
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
AMOUNT/
FAIR MARKET
VALUE
CUMULATIVE TO
DATE CUMULATIVE TO
DATE OTHER
CALENDAR YEAR
(JAN 1 o DEC 31) (IF APPUCABI. E)
Schedule C Summary
received this period - nonmonetary contributions of $100 or more.
1.
Amount
(Include all Schedule C subtotals.) ................................................................................................................... $
2. Amount received this period - unitemized nonmonetary contributions of less than $100 ................................ $ _,,'(~'"
3. Total nonmonetary contributions received this period.
(Add Lines I and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ................... TOTAL
['Co~tflbuto~ Codes
IND - Individual
COM - Recipient Committee
OTH - Other
FPPC Form 460 (8/99)
For Technical Assistance: g16/322-5660
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUC~ONS ON REVERSE
Type or print in Ink.
Amounts may be rounded
to whola dollars.
through
SCHg:DULE D
.,.,?
DATE CANDIDATE AND O~FICE,
MEASURE AND JURISDICTION, OR COMMITTEE
[] Support [] Oppose
[] Support [] Oppose
TYPE OF PAYMENT
[] rotary
[] ~/
[]
[]
Ex~rd~a
DESCRIPTION OF NONMONETARY
CONTRIBUTION
(IF REQUIRED)
AMOUNT THIS PERIOD
I.D. NUMBER
CUMULATIVE AMOUNT
Calendar Year
$
Other
Calendar Year
$
Other
$
Calendar Year
S
Other
SUBTOTAL $
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 (8/99)
For Technical Assistance: 916/~22-5660
Schedule D
~,UIII. IIIUULIUI! .~!!~'~LI SCHEDULE D iCONT
Summary of Expenditures T~p* or print In Ink.
Amounts may be rounded S~.;.~...;,,~ ~,,,v=,~, ~.~;~; ~ _=.__ _ :.
Supporting/Opposing Other ,o whole dollars, fr°m ~-~/- ~ ~? ~
Candidates, Measures and Committees
th r o ugh / ~) --//~'~ '-- ~/~ [ i.PDa. NgNu~/BE~R of /~
NAMEOF RLER
DESCRIPTION OF NONMONETARY
OATE CANDIDATE AND OFFICE, TYPE OF PAYMENT CONTRIBUTION AMOUNT THIS PERIOD CUMULATIVE AMOUNT
MEASURE AND JURISDICTION. OR COMMITTEE {IF REOUIRED)
[] Monetary Calendar Yea;
ConbibutJon
Contributio~ Other
[] Independent
[] Su~po;t [] Oppose Exper~ture $
[] Moneta~ Calendar Year
Cont~bufion
[] Monetary Calendar Year
Co~bibu~on
Contfibu~on Other
[] suppo~ [] Opp~e Ex~r~e s
[] Monelmy Celendar Year
Contribution
[] No~Monet~y
SUBTOTAL
FPPC Form 460 (8/99)
For Technical Assistance: 916/~22-5660
Schedule E
Payments Made
SEE INSTRUC~ON? ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole doller~.
CODES:
If one of the following codes accurately describes the payment, you may enter the code. Othenvise, describe the payment.
C'MP campeign perapherna/la/misc.
CNS csrnp~gn consultants
CTB c(mt~oufion (explain nonmoneta~y)-
CVC civic donations
FND ftmdraising ever~ts
IND Indepe~t expendilurs suppo~ng/opposing others (explain)*
LIT can~aignliterature and mailings
MTG maetingsandappearences
OFC o~se expenses
PET petition circulating
PHO phone benks
POL polling and survey research
POS Postage, detive~j and meSSenger services
PRO profeseiock~l services (legal. accounting)
PRT p~nt ads
RAD radio airfime and prnduction costs
SCHEDULEr
I,D. NUMBER
RFD returned con~s
SAL campaignworkers sala~es
TEL t.v. or cable airlima and production casts
TRC candidate travel, lodging and meals (explain)
TRS slaff/spouse travel, lodging and meals (explain)
TSF transfer behveen carr~nittees of the same candidate/sponsor
VOT voter registration
WEB infommtion techrmlogycasts (intemet, e.majlI
NAME AND ADDRESS OF PAYEE OR CREDITOR
(~ COMMt ~FEE, ALSO ENTER I.D. Nt~M~ERI CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
~ or ~P~;~de,,;.expenditures must also be summarized on Schedule D. SUBTOTAL $
Schedule E Summary
1. Payments made this pedod of $100 or mom. (Include all Schedule E subtotals.) ...............................................................................................
2. Unitemized payments made this period of under $100 ........................................................................................................................................
3. Total interest paid this pedod on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) .......................................................
4. Total payments made this pedod. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ......................... TOTAL
FPPC Form 460 (8/9g)
For Technical Aeeletsn~e: 916~322-5660
Schedule E
(Continuation Sheet)
Payments Made
Type or print in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF RLER
from ~"--//~ ~
through
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaignparaphemaiia/misc. DFC office expenses RFD ;etumedcontdbutions
PET pefilJofl circulating
PHO phofle banks
POL polling and survey research
POS poslage, delivery and messenger sar-~fcas
PRO profesaicxtai services (legal, accounting)
PRT print ads
SCHEDULE E (CONT.}
CNS campaign consultants
CTB cofltributiofl (explain no~mofletary) *
CVC ck4c doflalJofls
FND fundraislng evenls
IND independent exT)enditum ~ng/ef:)posing olhers (explain)*
LIT campaign lJteralure and mailings
MTG men'~ngs end appearances PAD radio airtime and productiofl costs WEB informationtechno~
of/?
I.D. NUMBER
SAL campaign workers salaries
TEL Lv. or cable airtime and production costs
TRC candidate travel, lodging end meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VDT voter registralion
NAME AND ADDRESS OF PAYEE OR CREDITOR
{IF COM~ TTEE. ALSO ENTER ID. NUMBER) CODE OR DESCRIPTIONOF PAYMENT AMOUNT PAID
;;.,~,~,-; ex~C,;~uree must also be summarized on Schedule D. SUBTOTAL ~
FPPC Form 460 (8/99)
For Technical Assistance: 916,~22-5660
Schedule F
Accrued Expenses (Unpaid Bills)
Type or print in ink.
Amount~ may be rount~ed
to whole dollar~
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP carnpaigr~paraphemalia/misc. DFC oft3ceexpensas RFD retumedcontfibuaons
CNS campalg~ consultants
CTB con~bution(exp~nonmonetaryI-
CVC civic donations
FND fundralsing events
IND independent expenditure supporting/opposing others (explain)*
LIT campaign ~teratureand mail/ngs
MTG mee~ngs and appoamnces
PET pel~tion circulating
PHO phone banks
POL polling and survey research
POS postage, delive~ and messanger services
PRO professional se rvfses (legal, accounting )
PRT pdnt ads
SCHEDULEF
I.D. NUMBER
SAL campaign workers saiades
TEL t.¥, or cabJe airtime and pr~Juct~ cos~s
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, Indging and meals (explain)
TSF transfer between commiilees of the same candidate/sponsor
VDT vOterre~stretfon
*Paymentsthatareeontrlbuti(msorindependentexpendituresm RAD radio airtirne and prnduction costs WEB informado~technologycosts(intemet, e.mail
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR ia) lb) lc) id)
OUTSTAND{NG AMOUNT INCURRED AMOUNT PAID OUTSTANDING
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRtPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (^LSD REPOR'r ON E) OF THIS PERtOO
SUBTOTALS $ $ $
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column lb) subtotals for
accrued expenses of $1 O0 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $
2. Total accrued expenses paid this period. (Include all Schedule F, Column lc) subtotals for payments on
accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $I00.) ................................. PAID TOTALS $ ~
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.) ......................................................................... . ........ NET ~
FPPC Form 460
For Technical Assistance: 916/322-5660
Schedule F
(Continuation Sheet)
Accrued Expenses (Unpaid Bills)
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
NAMEOFFILER
SCHEDULE F (CONT.)
I.D. NUMBER
CODES:
If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
DFC office e~oenses
PET pe~on circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO profeselonal services (legal, accounf~ng)
PRT print ads
RAD radio airlime and production costs
CMP campaign paraphernalia/misc.
CNS campaign consultants
CTB ceetributioe (explain noemonetary)*
CVC civic donafioes
FND (tmdreising events
IND indepef~denl expenditure supporlJng/opposing oCqe rs (explain)'
LIT campaign literelure and mailings
MTG meelings and appearances
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
RFD returned co~tfibulJo~s
SAL campaignworkers sela~ies
TEL t.v. or cable aiftime and production costs
TRC caodidate travel, lodging aDd meals {explain)
TRS staff/spouse travel, lodging aDd meals (explain)
TSF transfer between committees of the same candidate/sponsor
VDT voter registratio~
WEB information technology costs (intemet, e-mail)
(a) (b) (c) (d)
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING
(IF COMMITTEE. ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD
SUBTOTALS $ $ $ $
FPPC Form 460 (8/99)
For Technical Aeaistsnce: 916/322-5660
Schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of This CommiE=c)
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Type or print in ink.
Amounts may be rounded
to whofe dolfer~.
covers period
SCHEDULE
I.D. NUMSER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campa~gnpara~misc. DFC officae~penses RFD retun3edconldbuflons
CNS campaign consulfents
CT~ contdbu~on {explein nonmunetary~-
CVC civic donations
FND tondra~ng events
IND independe~ expenditure supporting/opposing others (explain)*
LIT campaign lifera~ure andmailings
PET palJfion circulating
PHC phone banks
POL polling and survey research
POS Poslage, de~veryandmessengersen~ces
PRO profesaionai sewices (legal, accounting)
PRT pdn~ads
MTG meelings and appearances
RAD radio atdime and production costs
SAL campaign wonders salaries
TEL t.v. o~ cable ai~rne and production costs
TRC candidate travel, lodging and meais (explain)
TRS slaff/spousetravel, tod~ngandmeais(expleth)
TSF transfer between committees o! the same candidate/sponsor
VDT vofer r~{ion
WEB information technology costs (intemet, e.mail}
* Payment~ that are contributions or Independent expenditures must afeo be summarized on Sch~,d ,-D.
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE. ALSO ENTER LD* NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAiD
Attach additional information nn Rnrlrnrtri;f=lt/ I~h,~lanf ,w~n~i,~, ,~h~,~ ~;.~+~
eats. To'rAI.* $ ~
° Do not IJ~= =fa to any other schedu(e or to the Summary Page. This to~almaynot equal the amount paid to the agent orindependent contractor
as reported on Schedule E. FPPC Form 460 (8f99}
For Technical Assistance: 916/322-5660
Schedule H - Part 1
Loans Made to Others*
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULEH-PART1
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
NAME AND ADDRESS OF RECIPIENT INTEREST RATE DUE DATE AMOUNT
DATE OF LOAN (~F COMM/T~EE, ALSO ENTER 1.0. NUIV;~ER)
*Loans that are contributions to another candidate or committee must also be summarized on Schedule D. SUBTOTAL $
Schedule H - Part I Summary
1. Loans of $100 or more made this period. (Include all Loans Made - Part I subtotals.) ...............................................
2. Unitemized loans under $100 made this period .............................................................................................................
3. Total loans made this period. (Add Lines 1 and 2.) .......................................................................................... TOTAL
Schedule H - Part 2 Summary
4. Payments received on loans of $i00 or more. (include ail loan payments received and ail
loans of $100 or more forgiven by this committee - Part 2 (a) subtotals.
If forgiven, also itemize on Schedule E.) ................................................................................................................... $
5. Unitemized payments received on loans under $100.
(Including a forgiveness.) ............................................................................................................................................ $
6. Total loan payments received this period.
(Add Lines 4 and 5.) ........................................................................................................................................ TOTALS
7. Net change this period. (Subtract Line 6 from Line 3.
Enter the net here and on the Summary Page, Column A, Line 7.) ................................................................ NET $
May ;~e a negative number
FPPC Form 460 (8/99)
For Technical Aaslstsnce: 916/322-5660
Schedule H - Part 2
Repayments on Loans Made to Others
and Loans Forgiven
Type or print in ink.
Amounts may be rounded
to whole doltare.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE OF
ORIGINAL
LOAN
DATE OF INTEREST
REPAYMENT OR FULL NAME OF RECIPIENT OF LOAN RATE
FORGIVENESS {iF CHANGED)
^~ouNT ;~.Ai~ OR
FORGIVEN ON PRINCIPAL*
EXCLUDE RECEIPT OF INTERES*I
Atfach additional information on appropriately labeled continuation sheets. SUBTOTAL $ ~
* IMPORTANT: If any part of a loan is forgiven, also itemize the forgiveness on Schedule E. If a repayment is received
from a third part~, enter the name and address of third parry in the 'FULL NAME OF RECIPIENT OF LOAN" column above, along with the
name of the recipient of the loan.
OUTSTANDING INTEREST
PRINCIPAL RECEIVED
Enter the amount in column (b) in the
Schedule I Summary, Line 3. Do not cany
this total to the Schedule H Summaq4
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
SCHEDULE H-PART3
Schedule H - Part 3Amou..Ty'a o, pti., i. inl~may b~ rounded s"-""~'" c°wr' ~'"'~ ~i i~
Annual Report of Outstanding Loans Made towho~do.ere, from ~'~'/--/~ g
t,,ro,,,!,h
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
FULL NAME OF RECIPIENT OF LOAN ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL
Attach additional information on appropriately labeled continuation sheets. TOTAL
NOTE: This totalshouldbe
the same amount as entered
on the Summary Page,
Column C, Line 7.
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule I
Miscellaneous Increases to Cash
Type or print in ink.
Amounts may be rounded
to whole dollars.
period
SCHEDULEI
SEE INSTRUCTIONS ON REVERSE Page / (~ ' °f /(~
NAME OF FILER I.D. NUMBER
DATE FULL NAME AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT AMOUNT OF
RECEIVEO (IF CO~t~&fl~r EE. ALSO ENTER I.D. NUMBER} INCREA,¢~E TO CASH
Attach addJtionai information on appropriately iabeied contt)3uab'on sheets. SUBTOTAL
Schedule ! 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, Part 2 (b).) .................................
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 (8/99)
For Technical Assistance: 916/322-5660