HomeMy WebLinkAboutBFLAG SEMIANN99(2) ecipient Committee
Campaign Statement
(Government Code Sec~ons 84200~216.5)
Type or print in ink.
SEEINSTRUCTIONSONREVERSE
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 7.
I'-I Officeholder, Candidate
Controlled Committee
(Also Complete Part 4.)
[] Ballot Measure Committee
0 Primarily Formed
O Controlled
O Sponsored
(A/~e comp~ere par~ 5.)
[] Primarily Formed Candidate/
Officeholder Committee
(Al.~o Complete Part 6.)
~. General Purpose Committee
~ Sponsomd
I~. Broad Based
3. Committee Information
COMMIlq'EE NAME
I.D. NUMBER
STREET ADORESS (NO P.O. BOX)
CIT~ STATE ZIP COOE
~,.G*~O"ESS <F D,~.E". HO. ARO ST.~ET O. ,.o. BOx
CRY STATE
OPTIONAL: FAX / E-MAIL ADDRESS
AREA CODFJPHONE
ZiP COOE AREA CODE/PHONE
Date of election if a~plleable:
(Month, Day, Year)
Dale Stamp
COVER PAGE
Jfit~ I~ /[~11:29
.'RSi:;EL.~ Cil¥ CLE;~
2. Type of Statement:
[] Pm-election Statement
~L, Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
Treasurer(s)
,{ o,
NAME OF TREASURER
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
AREA CODE/PHONE
NAME O~ ASSISTANT TREASURER, IF ANY
MA[lNG ~ESS
CITY STATE ZIP COOE AREA COOE~PHONE
OPTIONA~ FAX / E-MAIL ADDRESS
FPPC From 460 (~99)
For Te~hnleal Asslitence: 9f6f3~l!2-5660
State o! 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
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LLI IIcR I JURISDICTION ID SUPPORT[] OPPOSE
Identify the conll'olling offlceholdm', can~dete, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
Related Committees Not Included in this Statement: Llstanycommlttees
not Included In Ibis confolldated statement that are controlled by you or which are primarily
formed to receive contributions or to make expenditures on behaff of your candidacy.
COMMR~EE NAME
NAME OF TREASURER
COMMITTEEADDRESS
I.D. NUMBER
CONTROl_LED COMMITTEE?
[] NO
STREET ADDRESS (NO P.O. BOX
CITY STATE ZIP CODE AREA CODFJPHONE
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
6. Primarily Formed Committee Llstnamesofofficeholde~s)orcandldate(s)
for which thlf 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
Attach con~fnua#on sheets if neeessaty
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 celtify under penalty of perjup/under the laws of the State of California that the foregoing is true and correct.
Executed on By
DATE SIGNAT33RE OF CONTROCUNG OFFICEHOLO~R, CANDIDATE, STATE MEASURE PROFOI~CNT OR RESPONSIBLE OFFICER OF SPONSOR
Executedon By.
DATE
Executed Off By,
FPPC Form 460 (8/99)
For Technical Aeeistance: 916/322-5660
State of Cdllfornla
Schedule A Typ* or print in ink. SCHEDULE A
Contributions Received Amoun~ may ne rotmeea I
~IND
~ cou
~ OTH
~ IND
~ COM
~ OTH
~ IND
~ COM
~ OTH
DiND
~ COM
~ OTH
Monetar~
SEE INSTRUCTIONS
NAME OF RLER
DATE
RECEIVED
SUBTOTALS
Schedule A Summary
1, Amount received this period - contributions of $100 or more,
(Include all Schedule A subtotals.) ....................................................................................................... $ (~'
2. Amount received this period - 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 $
'Contributor Codes
IND - Individual
COM - Recipient Committee
OTH - Other
FPPC From 460 (8/99)
For Technical Assistance: 916~22-5660
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
S~.;.~-...=.i;. covers
from '~ /' ~
NAME OF FILER
Contributions Received
Column A
TOTAL THIS FERIOO
1. Monetary Contributions ...................................................... Schedule A, Line 3 $ ~
2. Loans Received ................................................................... Schedule B, Line 7 ~')
3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines I + 2 $, 0
4. Nonmonetary Contributions ............................................... Schedule C, Line 3 0
5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $ O
Expenditures Made
6. PaymentsMade.................................................................... Schedule E' Line ~ ~ ~' ~fl
7. Loans Made .......................................................................... Schedule H, Line 7 C'
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 ......................................... AddLInes8+9+lO $
SUMMARYPAGE
I.D. NUMBER
Column B* Column C
$ $
$ $
$ $
$ $
Current Cash Statement
12. Beginning Cash Balance ................................ P~evlous S.mmary Page, Line ~S
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
If this is a termination statement. Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule B, Pail 1, Column (bi
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... See instructions on reverse
19. Outstanding Debts ................................... Add Line 2 + Line 9 in Column C above
* From previous statement Summary Page, Column C. However, if this
is the flint repo~t filed for the calendar year, Column B should be blank
except for Loans Received (Line 2), Loans Made (Line 7), and Accrued
Expenses (Une 9).
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received ............ $
21. Expenditures
Made .................. $
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule E
Payments Made
SEEINSTRUC~ONSONREVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
NAME OF FILER
from
through
SCHEDULE E
NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernaliaknisc.
CNS campaign consullents
CTB contfibetion (exCein nonrnm~tary)*
CVC civic donations
FND fundraising events
IND independent expen~ura supporting/opposing others (explain)*
LIT campaign literature end mailings
MTG rn~elJngs and appearances
OFC office expenses
PET pelition circulating
PHO phone banks
POL p(flling and survey research
POS postage, delivery and messenger sewices
PRO professi(~el services (tsgal, accounf~ng )
PRT p~nt ads
RAD radio a~rlime and production costs
RFD retumed co~bu~ons
SAL campaign workers salaries
TEL t.v. o~ cable airtime end produc{Jo~ costs
TRC candidate travel, lodging and meals (explain)
TRS slaff/s~3use travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VDT voter rngistrafion
WEB i~formation technology costs (tntemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(iF COMMITTEE. ALSO ENTER I D NUM6ER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
* Payments that ere contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL
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
Sche~Jule E
,.(Continuation Sheet)
:Eayments Made
SEE INS11~NS ON REVERSE
Type or print In Ink
Amounts may be rounded
to whole
CODES: If one of the following c. odes .accurately d. escribes the payment you may enter the code..Otherwise, describe the payment.
CNS can~n cemu~mts
OTB con~t~ (exp~n noanmemy)'
GVC cMc ~l~ns
FND t~ ~,~Jng eve~s
INO ~ Indepmd~te~m~oppos~ngo~ers(expl~n)'
LIT campaign litsratt=e and m~llngs
OFC- oBce expenses
PET petil~ cln:ulalJn~
PHO phone banks
POI. poll, rig and suwey research
POS postage, de#vmy and messenger se~ces
PRO professkmal senates (legal, accounting)
PRT prb~t ads
SCHEDULE E (CON[
P.g.
I.D. NUMBER
RFD* returned cerdflbu~:~.s
SAL campaign woekers satsHes
TEL Lv. or cable alrlirne m~d production costs
TRC candidate travel, lodging and meals (explaio) '
TRS stalFspouse travel, lodging and rneals (explain)
TSF bansfor between committees of Ihe same candidate/sponsor
VOT voterreglstm~n ~
MTG meet~g~andappeamnces RAD radlo~tlmeandproductloncosts WEB InfoTTnatk~technologycosts(intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE. ALSO ENTER LO. t~M~ER) CODE OR DESCRIPT~O,N OF PAYMENT AMOUNT PAID
? .)' .).
* Paymeetl that are ¢ontrlbutlonl or Independent expendlturel mull itso be summarized on Schedule D. SUBTOTALS
FPI)C Fon~ 46O (8~9)
For Technical Alslltince: 916~22-~0