HomeMy WebLinkAboutDICKERSON SEMIANN99(2) ecipient Committee
Campaign Statement
(Govem~lent Code Sections 84200-842t 6.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink.
Stateme/nt co~(ere pedod
,rom '7/I f 9'S
Data of election if ap plicable:
(Month, Day, Year)
Dele Stamp
COVERPAGE
Page J of ~
1..Typ~f Recipient Committee: All Committees- Complete Parts 1, 2, 3, and ?.
[~'"Officeholder, Candidate [] Primarily Formed Candidate/
Controlled Committee
(Also Con. ere Part 4.)
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(Also Complete Part 5)
Officeholder Committee
(Also Complete Part 6J
[] General Purpose Committee
0 Sponsored
O Broad Based
2. Type of Statement:
oO~electio n Statement
i-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
I.D. NUMBER
3. Committee Information ~ I 1 7__.1
STREET ADDRESS (NO PlO. BOX)
CITY STATE ZIP COOE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR PlO. BOX
AREA CODE/PHONE
Treasurer(s)
MAILING ADDRESS
CITY
NAME OF ASSISTANT TREA~BL~ER, IF ANY
STATE ZIP CCOE AREA cODE/PHONE
MAILING ADDRESS
CiTY STATE ZIP COOE AREA COOEJPHONE
OPTIONAL: FAX/E-MAIL ADORESS
CITY STATE ZIP COOE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
FPPC From 4~0
For Technical Aesl~tance: 916~2-S660
State of California
Recipient Committee
Campaign Statement
Cover Page-- Part 2
Type or print in ink.
COVER PAGE-PART 2
Page
4. Officeholder or Candidate Controlled Committee
Related Committees Not Included in this Statement: Llstany¢ommlttees
not included In this consol/dated ~tatement that are controlled by you or which ere primarily
formed to receive contributions or to make expenditures on behaff of your candidacy.
CCMMITI-E E NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMIttEE?
[] YES [] NO
COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE
7. Verification
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER J~JRISDICTION I [] SUPPORT
I
[]
OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, ii' any.
NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO, IF ANY
6. Primarily Formed Committee List names of officeholder(s) or candidate(s)
for which this committee Is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE
Attach con~nuation sheets if necessary
OFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
OFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
OFFICE SOUGHT OR HELD
[] SUPPORT
[] OPPOSE
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowle/~'~/t~e J~f~f~nation contained herein and in the attached schedules
is true and complete. I cattily under p~nalty of perjury under the laws of the State of California that the fo~g/~ i~'/r~e/and correct.
Executed on ,.,- [ , , By -
DATE SIeNATURE OF CONTROLIJNG OFFICEHOLDER. CANOIDAIE. STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR
Executed on By
C^~E
Executed on By
FPPC Form 460 (~99)
For Technical Asalatance: 916/322.5;660
State of CMifornie
Campaign Disclosure Statement
Summary Page
Type or print in Ink.
Amounts may be rounded
to whole doller~.
SEE INSTRUCTIONS ON REVERSE
NAME OF F~.ER
SUMMARy PAGr'
,,o,._ 7h/SS
Contributions Received
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, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4
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
1 3. Cash Receipts .............................................................. Column A, Line 3 above
14. Miscellaneous Increases to Cash ....................................... Schedule I, Line 4
1 5. 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 S, Pan t, Column (b)
$
Cash Equivalents and Outstanding Debts
18, Cash Equivalents ..................................................... See inslruclion$ on reverse $
19. Outstanding Debts ................................... Add L/ne 2 + Line 9 Sn Column C above $
Column A
TOT~ T.S PE.~OO
.~:~-~
l--r>-- S
I.D. NUMBER
Column B* Column C
TOTAL PREVIOUS PERIOD TOTAL TO DATE
Z_l,-7 z.3/:-- '._____~s 7z~C-
7 ,
· From previous statement Summary Page, Columa 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 (Une
Summary for Candidates in Both June and
November Elections
20. Contributions
Received ............
21. Expendilures
Made ..................
FPPC Form 460 (8/99)
For Technical Aesletence: 916/322-5660
Schedule ~ - Part 1
Lo.ils Received
Type or print in ink.
Amounts may be rounded
to whole dollara.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
CATE
RECEIVED
E]Lender I-1Guarantor
[]Lender I~Guarantor
CONTRIBUTOR
CODE *
[] IND
[] COU
[] OTH
[] IND
[] COM
r-] OTH
IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
OUE DATE/
INTEREST RATE
DUE DATE
INTEREST RATE
DUE DATE
SCHEDULE B - PART
LENDER INFORMATION
GUARANTOR INFORMATION
Co)
SUBTOTALS
Schedule B - Part I Summary
1. Loans of $100 or more received this period. (Include all Loans Received - Part 1 (a) subtotals.) ................... $
2. Amount received this 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.) I1 forgiven or
paid by a third party, include this amount on Schedule A Summary, Line 2 ...................................................... $
6. Total loans repaid, forgiven, or paid by a third party this period. (Add Lines 4 + 5.) ........................... TOTAL $
7. Net change this period. (Subtract Line 6 from Line 3.)
Enter the net here and on the Summary Page, Column A, Line 2 .......................................................... NET $
["Cor~tributo~ C~odes
IND - h~qvfduaJ
COM- Recipient Committee
OTH - Other
FPPC Form 460 (8/99)
For Technical Aaaiatanc,a: 916/;322-5660
Schedule B - Part 2
Repayments Made on Loans Received, Loans
Forgiven, and Loans Repaid by a Third Party
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE OF
REPAYMENT DATE OF
OR ORIGINAL LOAN
Type or print in ink.
Amounts msy be rounded
to who/e dollars.
St.t=,.e,n~cofers period
FULL NAME OF LENDER
INTEREST (c)
SCHEDULE B - PART 2
RATE
(IF CHANGED)
AMOUNT REPAID OR
FORGIVEN ON PRINCIPAL *
IEXCLUDE PAYMENT OF INTEREST}
OUTSTANDING INTEREST
PRINCIPAL PAID
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ /~::::y~ ~--- TOTAL INTEREST
PAID THIS PERIOD $ ~
* IMPORTANT: If any part of a loan is forgiven or repaid by a third party, also itemize the transaction on Schedule A, Enter the ~tin column (d) in the Schedule E I
forgiveninCludingor paid.the name and address of the person forgiving the loan or the third party making the payment, and the amount Sumn~Schedute e~Summao/.3' Do not carry this total to the
FPPC Form 460 (8/99)
For Technical Asslstsnco: 916/322-5660
Schedule B - Part 3 Type or print in ink. SCHEDULE B- PART 3
Am~'~nts m'ey be rounded
Annual Repo. of Outstanding Loans Received ,o.ho,..o..... ~om 7/I[~ ~
gEE INSTRUCTIONS ON REVERSE Pa~. of ~
NAME OF FILER / ~ LD. NUMBER
FULL NAME OF LENDER ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL UNPAID INTEREST
~ f
/
Attach additional information on appropriately labeled continuation sheets. TO'aL $ '% 77--~ ,'"---
NOTE: This total should be
~he same amount as entered
en fhe Sumn~ry Page,
Colurn~ C, Line 2. FPPC Form 460 (~/99)
For Technical Assistance: 916/322-5660