HomeMy WebLinkAboutHEAP PREELEC00(3) ecipient Committee
Cah~paign Statement
(Govemment Code Sections 84200.84216,5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers pedod
from
through
Data of election if applicable:
(Month, Day, Year)
Dale Stamp
COVERPAG
Page_ of_
For Official Use Only
1. Type of Recipient Committee: A, Committees- Complete Pads I. 2. 3. and 7.
[-'1 Officeholder, Candidate
Controlled Committee
(Also Complele Part 4 J
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(Also Complete Part 5.)
[] Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 6,)
[] General Purpose Committee
O Sponsored
O Broad Based
2. Type of Statement:
[] Pre-election Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quaderly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
3. Committee Information
COMMITTEE NAME
Treasurer(s)
NAME O~ TREASURER
MAILINGADDRESS
CITY STATE ZIP CODE AREA CODE~HONE
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/~HONE
OPTIONAL: FAX/E-MAIL ADDRESS
STREET ADDRESS (NO P.O. SOX)
CiTY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR RD. SOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
FPPC Form 460 (8/99)
For Technical Ae.letanco: 916/3~2-5660
State of California
,Reci'pient Committee
Campaign Statement
Cover Page -- Part 2
Type or print in ink.
COVER PAGE-PART2
Page__ of_
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
O~FFICE SOUGHT OR ~ELD (II;ICL0'~E ~OC~ATIO N AI~D DIS"TRICT NUMBER IF APPLICABLE)
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I JURISDICTION ~] SUPPORT
I
[] OPPOSE
RESIDENT~AL/RUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
~' ~"~ ~-~'~'~-~'~ ~ NAMEOFOFFICEHOLDER,CANDIDATE. OR PROPONENT
Related Committees Not Included in this Statement: Llstanycommltteas
not Included In this consolidated statement that are controlled by you or which are primarily
formed to receive contributions or to make expenditures on behalf of your candidacy,
COMMITTEE NAME
I.D. NUMBER
NAME C~ TREASURER CONTROLLED COMMITrEE?
~ES [] NO
COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY :
6. Primarily Formed Committee £1,t.amo$ ofo,lceholde~(,) orcandldate(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 OFFICE SOUGHT OR HELD
[]§UPPORT
[]OPPOSE
Affach contlhuaflon 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
DATE
E ecutedo.
DATE
Executed on
DATE
Executed on
DATE
SlGNA~JRE OF CONTROLUN~ OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
State of CMifornia
Campaign Disclosure Statement
Summary Page
Type or print in ink,
Amounts may be rounded
to whole doters.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Contributions Received
1. Monetary Contributions ...................................................... ScheduleA, Line 3
2. Loans Received ................................................................... Schedule B. Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Line= I + 2
4. Nonmonetary Contributions ............................................... Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... AddLInes 3 + 4
Expenditures Made
6. Payments Made .................................................................... Schedule E, Line 4
7. Loans Made .......................................................................... Schedule H, Line 7
8. SUBTOTAL CASH PAYMENTS ................................................ AddLines 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 S 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 + ~4, then subtract Line ~5
ff this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule B, Part I. Column (b)
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... see instructions on reverse
19. Outstanding Debts ................................... AddLIne2+Llne9inColumnCebove
Ststemeat covers perlod
from
through
SUMMARYPAGF
Page, of
I.D. NUMBER
Column A Column B* Column C
TOTAL THIS PERIOD TOTAL PREVIOUS PERIOD TOTAL TO DATE
$ $. $
* From previous statement Summary Page, Column C. However. if this
is the first rsporl filed for the calendar year, Column B should be blank
except for Loans Received (Line 2). Loans Made (Line 7). and Accrued
Expenses (Line 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/~22.5660
Schedule A Type or print in ink. SCHEDULE A
Arnoume may oe rounDeD $~;.ei~ent covers period
Monetary Contributions Received towholedollare. · ' P' l
ZEE INSTRUCTIONS ON REVERSE through
'~AME OF FILER MBER
IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE
DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR OTHER
RECEIVED (iF COMMITTEE, ALSO ENTER LO. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 ' DEC. 31 ) (IF APPLICABLE)
OF BUSINESS)
"~C~"~I'~---&~ ~'~ ~'~1
I-lIND
[] COM
i--I OTH
l-liND
[] COM
[] OTH
{-lIND
[] COM
[] OTH
SUBTOTAL $ !,
Schedule A Summary
1. Amount received this period - contributions of $100 or more.
(Include ail 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 Cemmittee
OTH -Other
FPPC Form 460 (8/99)
For Technical Assistance: g*I6A22-5660
Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT.)
MonetaryContributions Received p. moumsmayoerounnen Sta~,,~e,,~coversperlod
to whole dollars.
from~ i iI~ /dl
through of __
NAME OF FILER I I.D. N~BER
IF AN INDIVIDUAL, ENTER AMOUNT CUMULATtVE TO DATE CUMULATIVE TO DATE
DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AN D EMPLOYER RECEIVEO THIS CALENDAR YEAR OTHER
RECEIVEO (IFCOMMITrEE. ALSOENTERI.D. NUMBER) CODE * (IFSELF*EMPLOYED. ENTERNAME PERIOD (JAN1-DEC31) (IFAPPLICABLE)
OF BUSINESS)
i-liND
[] COM
[] OTH
[]
[-1 COM
[-I OTH
I-lIND
ID COM
[] OTH
[] IND
i-'i COM
i-'l OTH
F-lIND
[] COM
[] OTH
[] IND
[] COM
[] OTH
SUBTOTALS
"Contributo~ Codes
IND - Individual
CONi - Recipient Committ ee
OTH - Other
FPPC Form 460 (8/99)
For Technlca! Assistance: 916~22-5660
SchedUle B - Part 1
L, oans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE
RECEIVED
FULL NAME, MAILING ADDRESS AND ZIP CODE
OF LENDER OR GUARANTOR
(IF COMMITTEE, ALSO ENTER LO. NUMEER)
[] Lender [] Guarantor
[] Lender [] Guarantor
[] Lender [] Guarantor
CONTRIBUTOR
CODE *
[] IND
[] COM
[] OTH
[] IND
[] COM
[] OTH
DIND
[] COM
[] OTH
Type or print in Ink.
Amounts may be rounded
to whole dollars.
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
from
through
LENDERINFORMATION
DUE DATE/
INTEREST RATE
DUE DATE
INTEREST RATE
DUE DATE
INTEREST RATE
DUE DATE
INTEREST RATE
SUBTOTAL $
AMOUNT CUMULA~VE
OF LOAN TODATE
CALENDAR YEAR
$
OTHER
$
CALENDAR YEAR
OTHER
ICALENDARYEAR
OTHER
SCHEDULE B ' PART 1
GUARANTOR INFORMATION
$
$
Enter (b) o~
Summe~y Pegs,
$ L~ ~7
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.) If 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 pedod. (Subtract Line 6 from Line 3.)
Enter the net here and on the Summary Page, Column A, Line 2 .......................................................... NET $
*Contributor Codes
IND - ImlividuaJ
COM - Recipient Committee
OTH - Other
May be a negative numbe~. FPPC Form 460 (8/99)
For Technical Assistance: g16/~22-$660
Schedule B - Part I (Continuation Sheet) Typn or print in ink. SCHEDULE B* PART 1 (CONT.)
.. .... ,,.. ......... ~ ..................... / Amo-~nts may be rounded Statement covers period
Loans Received to whole dollars.
through Page of__
~AMEOF FILER I.D. NUMBER
IF AN INDIVIDUAL, ENTER LENDER INFORMATION GUARANTOR INFORMATION
DATE FULL NAME, MAILING ADDRESS AND ZIP CODE CONTRIBUTOR OCCUPATION AND EMPLOYER (a)
RECEIVED OF LENDER OR GUARANTOR CODE * (IF SELF-EMPLOYED, ENTER DUE DATE/ AMOUNT CUMULATIVE AMOUNT CUMULATiVE
(IF COMMII~rEE, ALSO ENTER LD. NUMBER) NAME OF BUSINESS) INTEREST RATE OF LOAN TO DATE GUARANTEED TO DATE
DUE DATE CALENDAR YEAR CALENDAR YEAR
[]IND
$ $
[] ODE iNTEREST RATE
[] OTH OTHER OTHER
[] Lender [] Guarantor -- % $ $
DUE DATE CALENDAR YEAR CALENDAR YEAR
~IIND
[] COM INTEREST RATE $ $
[] OTH OTHER OTHER
[] Lender [] Guarantor __ % $ $
DUE DATE CALENDAR YEAR CALENDAR YEAR
r-liND
[] COM INTEREST RATE $ $
[] OTH OTHER OTHER
[] Lender [] Guarantor __ % $ $
DUE DATE CALENDAR YEAR CALENDAR YEAR
r-liND
[] COM iNTEREST RATE $' $
[] OTH OTHER OTHER
[] Lender [] Guarantor __ % h S
DUE DATE CALENDAR YEAR CALENDAR YEAR
[] IND
COM INTEREST RATE $ I
r-1
[] OTH OTHERI OTHER
[] Lender [] Guarantor __ % $ $
~1 Enter (b) on
SUBTOTAL $ $ Summa~/Page.
Line 17
I'Contributor Codes
IND - Individual 1
COM - Recipient CommitteeOTH - Other J
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
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 dollars.
S[a[,=ii~ent covers period
from
SCHEDULEB-PART2
through Page of
NAME OF FILER
I.D. NUMBER
DATE OF
REPAYMENT
OR
FORGIVENESS
DATE OF
ORIGINAL LOAN
FULL NAME OF LENDER
INTEREST
RATE
(IF CHANGED)
AMOUNT REPAID OR
FORGIVEN ON PRINCIPAL*
IEXCLUOE PAYMENT OF INTEREST~
(d)
OUTSTANDING INTEREST
PRINCIPAL PAID
TOTAL INTEREST
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 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 Ihe amountin column (d)in the Schedule E
including the name and address of the person forgiving the loan or the third party making the payment, and the amount Summa~ Line 3. Do not cam/this total to the
forgiven or paid. Schedule BSummary.
FPPC Form 460 (8/99)
For Technical Asslstsnce: 916/322-5660
Type or print in Ink. SCHEDULE B ~ PART 3
Annual Report of Outstanding Loans Received towholedollare, ~a: /~i
~IAME~EE INSTRUCTIONSoF FILER ON REVERSE through ,.D. NuPageMBER of
Attach additional information on appropriately labeled continuation sheets. TOTAL $
NOTE: This total should be
the same amount as entered
on the Summary Page,
Column C, Line2. FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule C
Nonmonetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
S;.,~;.=i~=i~;. covers period
from
through
Page of__
SCHEDULE C
NAME OF FILER
LD. NUMBER
DATE
RECEIVED
FULL NAME, MAILING ADDRESS AND
ZIP CODE OF CONTRIBUTOR
(IF COMMITrEE, ALSO ENTER I.D. NUMEER)
CONTRIBUTOR
CODE *
[] IND
[] COM
[] OTH
i--liND
[] COM
[] OTH
I-lIND
[] COU
[] OTH
[] IND
[] cou
[] OTH
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYEO, ENTER
NAME OF BUSINESS)
DESCRIPTION OF
GOODS OR SERVICES
AMOUNW
FAIRMARKET
VALUE
CUMULATIVE TO
DATE
CALENDAR YEAR
(JANI~DEC 31)
CUMULATIVE TO
DATE OTHER
(IF APPLICABLE)
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 of 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
OTH - Other
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
St&~ei~zei~;. covers period
from
through Page__ of__
SCHg:DULE D
NAME OF FILER
I.O. NUMBER
DATE
CANDIDATE AND OFFICE,
MEASURE AND JURISDICTION, OR COMMITTEE
[] Support [] Oppose
[] Support [] Oppose
TYPE OF PAYMENT
[] Monetary
Contribution
[] Non-Monetary
Contribution
[] Independent
Expenditure
[] Monetary
Contribution
[] Non-Monetary
Contribution
[] Independent
Expenditure
[] Monetary
Contribution
[] Non-Monetary
Contribution
[] Independent
Expenditure
DESCRIPTION OF NONMONETARY
CONTRIBUTION
(IF REQUIRED)
AMOUNT THIS PERIOD
CUMULATIVE AMOUNT
Calendar Year
Other
$
Calendar Year
$
Other
$
Calendar Year
$
Other
$
[] Support [] Oppose
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/e22-5660
Schedule D
(Continuation Sheet)
· ..................... · SCHEDULE D ICONT.
Summary of Expenditures Typoor print In Ink. Statement covers
SuppoSing/Opposing Other ~o~ho~o.~.
Candidates, Measures and Committees
through ~ ~ge of
NAMEOFFILER ] ~NUMBER
DESCRIPTION OF NON MON~ARY
DATE CANDtDATE AND OFFICE, ~PE OF PAYMENT AMOUNT ~IS PERIOD CUMU~TIVE AMOUNT
M~SURE AND JURISDICTION, OR COMMI~EE CONTRIB~ON
(IF REQUIRED)
~ ~e~ Calen~r Year
~nt~bution
~ Non'M~eta~ $
~nt~bufion O~er
D I~e~ent
~ suppo~ ~ op~e Expe~i~re $
~ ~e~ Calen~r Year
~ntdbution
~ ~n'M~e~ $
~n~buUon O~er
~ I~e~ndent
~ Suppod ~ Op~se Expe~i~re $
~ ~e~ Calen~r Year
Cont~but~n
~ Non*M~e~ $
~ntHbuti~ O~er
~ I~ependent
D sup~ D op~e E~e~i~m $
~ ~e~ C~e~r Year
~t~b~on
~ N~'M~
~tdbu~ O~er
~ I~pe~ent
D sup~ ~ op~ E~i~re $
SUBTOTAL $
FPPC Form 460 (8/99)
For Technical Assistance: 916/~22-5660
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink,
Amounts may be rounded
to whole dollars.
S~a[e,,,ent covers period
from
through
Page
SCHEDULE E
of.--
NAME OF FILER
I.D. NUMBER
CODES: I! one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalia/misc.
CNS campaign consultants
CTB contributE)n (explain nonmonetary)*
CVC cMc dona§ohS
FND fundraising events
IND independent expenditure supponlng/opposing obhers {explain)'
LIT campaign literature and mailings
MTG meetings and appearances
OFC office expenses
PET petition cimulaling
PHO phone banks
POL polling and survey reseamh
POS postage, delivery and messenger services
PRO professional sewices (legal, accounting)
PRT print ads
RAD radio airllme and production costs
RFD returned contribu§ons
SAL campaign workem salaries
TEL l.v. or cable airtime and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB infon~nation technology costs (intemet, e.mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(iF COMMITTEE. ALSO ENTER I.D. NUMS£R) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL
Schedule E Summary
1. Payments made this pedod 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 pedod. (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
Sch ,edule E
,(Continuation Sheet)
Payments Made
Type or print in th~.
Amounts may be rounded
to whole dollars.
SEE iNSTRUCTIONS ON REVERSE
NAME OF FILER
from
through
Statement covers period
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaignparaphemalia/misc. OFC office expanses RFD retumedcontdbutions
CNS campaign consultants
CTB contribution (exptain nonmonetary)'
CVC civic donations
FND fufidraistng events
IND independent expenditure supporting/opposing others (explain)'
LIT campaign lite rature and mailings
PET pel~lion circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professlonal services (legal, accounting)
PRT print ads
Page,
I.D. NUMBER
MTG meet~ngsandappearances RAD radioa'~rtimeandproductioncosts WES informationtech,
SCHEDULE E (CONT.)
of~
SAL campaignworkers salaries
TEL t.v. or cable airtirne and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
rOT voter registration
NAME AND ADDRESS OF PAYEE OR CREDITOR
(~F CO~M~Ti'EE. ALSO ENTER ~.D. NUM~Ee) CODE OR DESCRiPTIO~N OF PAYMENT AMOUNT PAID
su.~,,~a[;~ed on Schedule D. SUBTOTAl.
FPPC Form 460 (8/99)
For Technical Aaalstance: 916/322-S660
,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
through
Page__ of'
$CHEDULEF
NAME OF FILER
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 paraphemalia/misc,
CNS campaign consultants
CTB contribution (explain nonmonetary)'
CVC civic donations
FND fundraising events
iND independent expenditure supporting/opposing others (explain)*
LIT campaign literature and mailings
MTG meetings and appearancas
OFC office expenses
PET petition cimutating
PHO phone banks
POL polling and survey reseamh
POS postage, delivery and messanger services
PRO professional services (legal, accounting)
PRT print ads
RAD redio airtime and production costs
* Payments that are contributions or independent expenditures must also be summarized on Schedule E
RFD returned contributions
SAL campaign workers saladss
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spousa travel, Indging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VOT voter registral~on
WEB information technology costs (interest, e-mail)
(s) ' (b) (c) (d)
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR OUTSTAN DING AMOUNT INCURRED AMOUNT PAID OUTSTANDING
(IF COMMJTr EE, 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 $ $ $ $
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 ali 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 here and
on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $ M.y~*..~,~,o..m~
FPPC Form 460 (8/99)
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
from
through
SCHEDULE F (CONT.)
Page of__
NAME OF FILER
I.O. NUMBER
CODES:
If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
OFC office expenses
PET petition cimulating
PHO phone banks
POL potling and survey reseamh
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio airt[me and prnduction costs
CMP campaign paraphernalia/misc.
CNS campaign consultants
CTB contribution (explain nonmoneta~/)*
CVC civic donaticns
FND lundraising events
IND independent expenditure supporting/opposlngothers (explain)*
LIT campaign litsmture and mailings
MTG meetings and appoarances
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
RFD returned contribufions
SAL campaign workers salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB information technotogy costs (intemet, e-mail)
(.) (b) (c)
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTAN DING
(IF COMMITTEE, AESO ENTER I.O. NUMBER) DESCRIPTION OF PAYMENT BALANCE REGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD
SUBTOTALS $ $ $ $
FPPC Form 460 (8~39)
ForTechnlcal Assistance: 916/322-5660
Schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
Type or print In ink.
Amounts may be rounded
to whole dollars.
Statement covers peried
from..
SEE INSTRUCTIONS ON REVERSE through_
NAME OF FILER --
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Page of ~
I.D, NUMBER
SCHEDULE G
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaignparaphemalia/misc. DFC office expenses RFD returnedcontdbutions
CNS campaignconsultants
CTB contribution (exp!ain nonmonetary)*
CVC cMc donatfons
FND fundraising events
iND independent expenditure supporting/opposing others (explain)*
LIT camp~gnliteratureandmaJ~ings
PET po~§oncimulaling
PHO phone banks
POL POlling and survey research
POS postage, delivery and msasenger se~cas
PRO Professional se~icas (legal, accounting)
PRT printads
MTG meetings add appearances
RAD radio airtime and production costs
SAL campaign wodrerssala~ies
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VDT voterregistration
WEB Information technology costs (intemet, e-mail)
* Payments that are contributions or independent expenditures must also be summarized on Sch,
NAME AND ADDRESS OF PAYEE OR CREDITOR
'Donottransfertoanyo~herschedufeortofheSummaryPage. Th/s~otafmaynotequaftheamountpaidrothea entor[nde n
as reported on Schedule E. g pe denlconlractor
TOTAL* $
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-$660
Schedule H - Part 1
Loans Made to Others*
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink.
Amounts may be rounded
to whole dollars.
from
through
SCHEDULEHoPART1
Page of.__
NAME OF FILER
I.D. NUMBER
NAME AND ADDRESS OF RECIPIENT
DATE OF LOAN iNTEREST RATE DUE DATE AMOUNT
*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 1 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 $100 or more. (Include all loan payments received and all
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 be a negative number
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
~schedule H - Part 2
Repayments on Loans Made to Others
and Loans Forgiven
SEE iNSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from
through
SCHEDULE I-~ - PART 2
Page__ of__
NAME OF FILER I.D. NUMRER
DATE OF
REPAYMENT OR
FORGIVENESS
DATE OF
ORIGINAL
LOAN
FULL NAME OF RECIPIENT OF LOAN
INTEREST
RATE
(IF CHANGEDI
^MOU.T ~PAIO OR
FORGIVEN ON PRINCIPAL*
(EXCLUDE RECEIPT OF INTERESt)
TOTAl. INTEREST
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ RECEIVED THIS
PERIOD
* IMPORTANT: If any part of a loan is forgiven, also itemize the forgiveness on Schedule E. If a repayment is received
from a third par~, enter the name and address of third pady in the "FULL NAME OF RECIPIENT OF LOAN" column above, along with the
name of the recipient of the loan.
(b)
OUTSTANDING INTEREST
PRINCIPAL RECEIVED
Enter the amount in column (b) in the
Schedule I Summa~ Line 3. Do not carry
this total to the Schedule H Summary.
FPPC Form 460 (8~J9)
For Technical Assistance: 916~J22-5660
SCHEDULE H - PART 3
Amounts may be rounded I
~,nnual Report of Outstanding Loans Madetowholedollars, from m
through I Page of__
SEE INSTRUCTIONS ON REVERSE
~AME OF FILER 1,0, NUMBER
FULL NAME OF RECIPIENT OF LOAN ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL UNPAID ~NTEREST
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