HomeMy WebLinkAboutBFLAG PREELEC99(1) ecipient Committee
Campaign Statement
(Government Code Seclk~s 84200-84216,5)
COVER PAGE
Type or print in ink.
St~eme~t eover~ period
SEE INSTRUCTIONS ON REVERSE
1. Type of Recipient Committee: m~ Committees- Complete Parts 1, 2, 3, and 7.
Date of election if applicable:
(Month, Day, Year)
2. Type of Statement:
Date S~mp
99 OCT 25 PN 12:
~AKERSFiE[.O CITY
of .__
Fo~ onlciM Use Only
[] Officeholder. Candidate
Controlled Committee
(Aisc Complete Part 4.)
[] Ballot Measure Committee
0 Primadly Formed
O Controlled
O Sponsored
(Also Complete Part 5.)
[] Primarily Formed Candidate/
Officeholder Committee
(A~o Comp~e Part 6.)
J~ General Purpose Committee
~ Sponsored
{~ Broad Based
/~" Pre-election Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
3. Committee Information
I.D. NUMBER
COMMITTEE NAME
STREET ADDRESS (NO P.O. BOX)
Pc,, ~x q2g,~
CITY STATE
ZIP COOE AREA CODE/PHONE
MA~_ING ADORESS (IF DIFFERENT) NO. AND STREET OR RO. BOX
/
CITY STATE ZIP COOE
ilE27 ~
OPTIONAL: FAX / E-MAIL ADDRESS
Treasurer(s)
NAME OF TREASURER
MAIUNG ADDRESS
CITY STATE ZIP COOE
AREA CODF_/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP COOE AREA CODE~HONE
OPTIONAL: FAX/E-MAll. ADDRESS
FPPC Form 460
For Technical Aealstenee:. 916/'322-5660
State of California
Recipient Committee
Campaign Statement
Cover Page-- Part 2
Typo or print in ink.
COVER PAGE - PART 2
Page__ of.__
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DIS]RICT NUMBER IF APPt. ICABLE)
RESID~NTIAL~USINESS ADORE SS (NO. AND STREET) CITY STATE ZIP
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
Related Committees Not Included in this Statement: Llstanycommlttee=
not Included In thl~ consolidated etatoment the t ere conb~lled by you or which are p#marlly
formed to receive contributions or to make expenditures on behaff of your candidacy.
COMMn~'EE NAME
NAME OF TREASURER
COMMI~FEE ADDRESS
LO. NUMBER
CONTROl_LED COMMITTEE?
rq ~s [] NO
STREET ADDRESS (NO P.O. BOX
CiTY STATE ZIP COOE AREA CODEJPHONE
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
6. Primarily Formed Committee Ustnamesofofficaholder[s)orcandldata(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 OFF ICE SOUGHT OR HELD
[] OPPOSE
A~ach cont~nua#on sheets if necessary
7. Verification
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 true and correct.
Executed on By
SIGNATURE OF CONTROLUNG OFFICEHOLRER. C N*4~l DATE, STALE MEASURE PROPONENT OR RESPONSIBLE CFFICIER OF SPONSOR
Executed on By,
Executed on By,
DATE
FPPC Form460(8/99)
For TechnlcalAeelstence: 916/322-5660
Stete ofCMifornia
Schedule A Typ* or print in ink. SCHEDULE A
Monetary Contributions Received to,,hoindoll.r,, from
SEE INSTRUC~ONS ON REVERSE through
~IND
~ eOM
~ OTH
~IND
~ COM
~ OTH
~IND
D COM
~ OTH
~ IND
D cou
~ OTH
SUBTOTAL
Schedule A Summary
1. Amount received this period - 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 I and 2. Enter here and on the Summary Page, Column A, Line 1.) ................... TOTAL
['Con~butor Codes
IND - Individual
COM - Recipient Commiffee
OTH - Other
FPPC Form 460 (8~99)
For Technical Assistance: g16~22-5660
Campaign Disclosure Statement
Summary Page
Type or print in ink.
Amotmt~ may be rounded
to whole dollars.
SEEINSTRUCT/ONSONREVERSE
NAME OF FILER
Contributions Received
1, Monetary Contributions ...................................................... Schedule A, Line 3 $
2. Loans Received ................................................................... Schedule B, 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*
TOTAL PREVIOUS
(SEE NOTE SELOW)
s //$~o, -
SUMMARY P~m
Page. of __
I.D. NUMBER
Column C
$
$
$
Expenditures Made
6. Payments Made .................................................................... Schedule E. Line 4 $
7. Loans Made .......................................................................... Schedule H. Line 7
8. SUBTOTAL CASH PAYMENTS ................................................ Add Lines s + 7 $
9. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, Line 3
10. Nonmonelary Adjustment ....................................................... Schedule C. Line 3
11. TOTAL EXPENDITURES MADE ......................................... AddLinesS+9+ tO $
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 subtrac! Line 15 $
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule B, Part 1, Column (b)
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... See instructions on reverse
19. Outstanding Debts ................................... AddLIne2+LlneginColumnCabove
· From previous statement Summary Page, Column C. However, if this
is the first report filed for the calendar year, Column B sh~JId be blank
except for Loans Received (Line 2), Loans Made (Line 7), and Accrued
Expenses (Uoa 9).
Summary for Candidates in Both June and
November Elections
$ ~ 20.
21.
$ C'
Contr~ufions
Received ............ $
Expenditures
Made ..................$
1/1 through 6~J0 7/1 tO Date
FPPC Form 460 (8/99)
For Technloal Aeststanoa: 916~22-5660
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print In ink.
Amounts may be rounded
to whole dollars.
from
through
Page of
SCHEDULEE
NAMEOFRLER
I.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphe malie/misc.
CNS cem~gn consultants
CTB contfibulk~ (explai~ ~ta~)'
CVC civic dortafions
FND fundraising events
IND indent expenditure supporfing/oplx~ing others (explain}*
LIT campaign literature and mailings
MTG meel]ngs and appearances
DFC office expenses
PET pe#Uo~ circulating
PHO I:~xxte banks
POL polling and survey research
POS postage, dalivery and messenger se ri, ices
PRO profes~:)nal sewices (legal, accounting )
PRT print ads
RAD radio aiftime and production costs
RFD returned contfibug~ns
SAL campaign workers salaries
TEL t.v. or cable ai~me and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF ~ansfer between committees of the same candidate/sponsor
VDT voter registration
WEB infonnatio~ technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COk~IITTEE. AkSO ENTER ID. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ '~ j ~)C~. pc,
Schedule E Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................................................................................... $
2. Unitemized payments made this period of under $100 ........................................................................................................................................ $
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) ....................................................... $
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 (8/99)
For Technical Assistance: 916~322-5660