HomeMy WebLinkAboutPANICK PREELEC00(3) eCipient Committee
Campaign Statement
(Govemm ant Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from / ~ (~2 ('"~,~2
through
1. Type of Recipient Committee: All Committee~- Complete Parts 1, 2, 3, and 7.
Date of election if applicable:
(Month, Day, Year)
Date Stamp
O0 FEB 25 P~-! 3:
2. Type of Statement:
COVER PAGE
i:P~ge ~ of
For Official Use Only
[] Officeholder, Candidate
Controlled Committee
(Aisc Complete Part 4.)
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(Aisc Complete Part 5.)
[] Primarily Formed Candidate/
Officeholder Committee
(Aisc Complete Part 6~)
[] General Purpose Committee
O Sponsored
O Broad Based
[~P'~'e-electio n 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
COMMITTEE NAME
NUMBER
Treasurer(s)
NAME OF TREASURER
MAILING ADDRESS
CITY STATE ZiP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
STREET ADDRESS (NO RD. BOX)
CITY
STATE ZIP CODE AREA CODFJPHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR RD. BOX
CITY STATE ZIP CODE
AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
FPPC Form 460 (8/gg)
For Technlcel Assistance: g16/3~2-5660
State of California
Recipient 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
OFFICE SOUGHT OR HELD (iNCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIALJ~USINESS ADDRESS (NO/7(ND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: Llstanycommtttees
not Included In this consolidated s tatemeat that are controlled by you or which are primarily
formed to receive con trlbuttons or to make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER COHTROi_LED COMM~FrEE?
[] Rs [] NO
STREET ADDRESS (NO P,O.
COMMITTEE ADDRESS
CiTY STATE ZIP COOE
7. Verification
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT .O. OR LETI'ER I JURISDICTION I[] SUPPORT[] OPPOSE
Identify the controlling officeholder, eandidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
6. Primarily Formed Committee Llstnamesofofficeholder(s)orcandldate(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 conb'nuation sheets if necessary
OFFICE SOUGHT on HELD SUPPORT
~ OPPOSE
OFFICE SOUGHT OR HELD [] SUPPORT
r~; OPPOSE
OFFICE SOUGRT OR HELD
[~SUPPORT
[]OPPOSE
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
OAT~
Executed oG
DATE
Executed on
DATE
Executed on
DATE
SIGNATURE URER OR ASSISTA TRE URER
By
SIGNATURE OF CONTROLLING OFPICEH ,(~e~'~ T~TE MEASURE PRORONEN~ OR RESPONSIBLE OFFICER OF SPONSOR
SIGNATURE OF CO OLDER, CANDIDATE, STARE MEASURE PROPONENT
By
FPPC Form 460 (8/99)
For Technical Assistance: 9t6/322-5660
State of California
Campaign Disclosure Statement
Summary Page
Type or print In ink.
Amouots may be rounded
to whole dollars.
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 Lines I + 2
4. Nonmonetary Contributions ............................................... Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... AddLines3+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 (Uopaid Bi~ls) ............................................ $chedul~ F, L/ne 3
10. Nonmonetary Adjustment ...................................... Schedule C, Line 3
11. TOTAL EXPENDITURES MACE ......................................... AddLines8 + 9+ 10
Current Cash Statement
12. Beginning Cash Balance ................................ Previous Summary Page, Line
13. Cash Receipts .............................................................. Column A, Line 3 above
'14. Miscellaneous Increases to Cash ....................................... Schedule [, Line 4
15. Cash Payments ............................................................ ColumnA, LineSabove
16; ENDING CASH BALANCE .............. Add Lines t2 + t3 + t4, then subtract Line 15
If this is a termination statement, Line 16 must be zero.
Column A
?OTAL THr$ PER[O0
(FROM ATTACHED SCHEDULES)
from.
through
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 ................................... Add Lille 2 + Line 9 in Column C above
$
$
$
Column B*
TOTAL PREV[OUS PERIOD
Page
SUMMARY PAG
I.D. NUMBER
Column C
* From previous statement Summary Page, Column C. However, if this
is the first report Iliad for the calendar year, Column El shou/d be b~ank
except for Loans Received (Line 2), Loans Made (Line 7), and Accrued
Expenses (L{ne 9).
ummary 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: 956)322-5660
Schedule A *ryp. or print In ink. SCHEDULE A
NAMESEE INSTRUCTIONS ON REVERSEoF FILER~ ~A~ L/,._ ~/. [~% ~ ~/~ 'hr°ugh '~'"~'~ ~ ,:r:: ;O,~MB
IF AN INDIVIDUAL, ENTER AMOUNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE
DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIB~OR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED ~lS CALENDAR YEAR OTHER
RECEIVED (~F CO~I~EE, A~O ENTER I.O. NUMBER) CODE * (IF SE~-EM~OYED, ENTER N~E PERIOD (JAN. 1 ' DEC. 31 ) (IF APPLICABLE)
~IND
~ COM
~ OTH
~IND
~ COM
~ OTH
~IND ~
D COU
~ OTH ~
~[ND
~ COM
~ OTH
~IND
~ COM
~ OTH
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 -Individua]
COM - Recipient Committee
OTH - Other
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule A (Continuation Sheet) Typs or print in ink. SCHEDULE A (CONT.)
Monetary Contributions ReceivedAmounts may 13e rouncle~l S[a;e,~ent covers period
through ~'~ I Pag,~ of '4
~AME OF FILER I I.D. NUMBER
IF AN INDIVIDUAL, ENTER AMOUNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE
DATE FULL NAME. MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ~CUPATION AND EMPLOYER RECEIVED ~[S CALENDAR YEAR OTHER
RECEIVED (IF COMM~EE. A~O ENTER I.D. NUMBER) CODE * (IF SELF-EM~OYEO, ENTER N~E PERIOD (JAN 1 - DEC 31 ) (IF APPLICABLE)
~ IND
D COM
~ OTH
~IND
D cou
~ OTH
~ IND
D COM
~ OTH
~ IND
D cou
DOTH
~ lED
D COM
~ OTH
~IND
D COM
~ OTH ~}
*Contributor Codes
IND - IndMduaJ
COM - Recipient Committee
OTH - Other
SUBTOTALS
FPPC Form 460(W99)
ForTechnlcalAsslstance: 916~22-5660
schedule B - Part I
Loans Received
Type or print in ink.
Amounts may be rounded
towhole dollars.
S;a;.eiii=ii;.covers period
from /~0 1 ~
SEE INSTRUCTIONS ON REVERSE
through
NAME OF FILER
DATE
RECEIVED
FULL NAME, MAILING ADDRESS AND ZIP CODE
OF LENDER OR GUARANTOR
(IF COMMITTEE. ALSO ENTER LO. NUMBER)
I--JLender r-lGuarantor
I-ILender r~Guarantor
Lender [] Guarantor
CONTRIBUTOR
CODE *
[]IND
[]COM
[] OTH
[] IND
[] COU
[] OTH
I'~ IND
[] eOM
[] OTH
IFAN iNDIvIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF EELF-EMPLOYEO, ENTER
NAME OF BUS~NESS)
DUE DATE/
INTEREST RATE
DUE DATE
INTEREST RATE
DUE DATE
INTERESTRATE
DUE DATE
INTEREST RATE
SUBTOTAL $
LENDER INFORMATION
AMOUNT CUMULATIVE
OF LOAN TO DATE
CALENDAR YEAR
$
OTHER
CALENDAR YEAR
$
OTHER
CALENDAR YEAR
OTHER
$
SCHEDULE B - PART 1
GUARANTORINFORMATION
AMOUNT CUMULA~VE
$
$
$
$
$
Enler (b) on
Summar/Page,
$ Une 17 c~¥.
Schedule B - Part I Summary
1. Loans of $100 or mom 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 period. (Subtract Line 6 from Line 3.)
Enter the net here and on the Summary Page, Column A, Line 2 .......................................................... NET $
May be a negetiv~'~umbsr. FPPC Form 460
For Technical Assistance: 916/1322-5660
*Contributor Codes
IND - IndMdual
COM - Recipient Committee
OTH - Other
Schedule B - Part I (Continuation Sheet) Type or print in ink. SCHEDULE B- PART 1 (CONT.)
Loans Received towholedollars, from / ~1~2 1 ~ ~ ~1~ i~
through ~--~2~ Page ~'~ of'~"/
~IND
~ COM INTEREST RATE
~ OTH OmER OTHER
~IND
~ COM INTEREST RATE
~ OTH O~E. O~HE~
Lender ~ Guarantor % [ $ $.
~ IND
~ COD INTEREST RATE
~ OTH OmE~ OTHER
~ IND
~ OTH OmE~ OmE~
~ IND
~ COD INTEREST ~TE
~ OTH OmE~ OTHER
Le~er ~ Guarantor
SUBTOTAL $
I*Contributor Codes
IND - Individual
COM - Recipient Committee
OTH - Other
FPPC Form 460 (8/99)
For Technical Assistance: 9t6/322-5660
Schedule B - Part 2
Repayments Made on Loans Received, Loans
Forgiven, and Loans Repaid by a Third Party
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULE B - PART 2
Statement covers pei
through ~2 ' ~'~/~'J Page
NAME OF FILER
DATE OF
REPAYMENT
OR
FORGIVENESS
DATE OF
ORIGINAL LOAN
FULL NAME OF LENDER
LO. NUMBER
INTEREST AMOUNT REPAID OR OUTSTANDING INTEREST
RATE FORGIVEN ON PRINCIPAL* PRINCIPAL PAID
(IF CHANGEO) (EXCLUDE PAYMENT OF iNTEREST)
Attach additional information on appropdately labeled continuation sheets. SUBTOTAL $ ~ PAIDTOTALTHIsINTERESTpERIOD $ ~
* IMPORTANT: If any part of a loan is forgiven or repaid by a third party, also itemize the transaction on Schedule A, Enter the amountin column (d) in the Schedule E
Surnmaq4, Une 3, Do not cany this total to the
includingforgiven or paid.the name and address of the person forgiving the loan or the third party making the payment, and the amount Schedule e Summa~
FPPC Form 460 (8/99)
For Technical Assistance: 916t322-5660
Schedule B Part 3 Type or print ln ink. SCHEDULEB-PART3
· .~., ~o~u~G ~.B -- r c~; · ~ Amo'~nts m'ay be rounded S[.[=.i=nt covers period
Annual Report of Outstanding Loans Receivedtowhole dollars.
SEEINSTRUC~ONSONREVERSE through ~-~'~
NAME OF FILER
FULL NAME OF LENDER ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL
Attach additional information on appropriately labeled continuation sheets.
TOTAL $
NOTE: This total sho~M be
the same amount as entered
on the Summary Page,
Column C, Line 2. 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[&;.,,,,,ei,t covers period
from '~ -~ 1 "~
through
SCHEDULEC
NAME OF FILER
FULL NAME, MAILING ADDRESS AND
ZIP CODE OF CONTRIBUTOR
(IF COMMI~i'EE, ALSO ENTER LD, NUMBER)
DATE
RECEIVED
[] IND
[] COM
[] OTH
I-liND
[] COM
[] OTH
I-lIND
[] COU
[] OTH
i--i IND
[] COM
[] OTH
CONTRIBUTOR
CODE *
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(~F SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
DESCRIPTION OF
GOODS OR SERVICES
AMOUN~
FAIRMARKET
VALUE
CUMULATIVE TO
DATE
CALENDAR YEAR
(JAN 1 - 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
Typo or print in ink.
Amounts may be rounded
to whole dollars.
S;.&[=~,ent covers period
through
SCHEDULE D
· of ~
NAME OF FILER
I.D. NUMBER
DATE
CANDIDATE AND OFFICE,
MEASURE AND JURISDICTION, OR COMMITTEE
[] Support [] Oppose
[] Support [] Oppose
[] Support [] Oppose
Tt'PE OF PAYMENT
[] Monetary
Contribution
[] Non-Monetary
Contribution
[] Independent
Expenditure
[] Monetary
Contribution
[] Non-Monetary
Contribution
[] Independent
Expend~re
[] Monetary
Contribution
[] Non-Monetary
con~bution
[] Independent
Expenditure
DESCRIPTION OF NONMONETARY
CONTRIBUTION
(iF REQUIRED)
AMOUNT THIS PERIOD
CUMULATIVE AMOUNT
Calendar Year
$
Other
Calendar Year
$
Other
$
Calendar Year
$
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 SummaP/Page.) ........ TOTAL $
FPPC Form 460 (8/99)
For Technical Assistance: 916/~22-5660
Schedule D
Continuation Sheet
~,~.s~sl ~L~ ~MClL~',.S~ ~ ,,~ I~.~ SCHEDULE D (CONT.
Summa~ of Expenditures ~p' or print In ink. Sla;~[~nt covers ~e[;~G/
Suppoding/Opposing Other to.hol~do,=r,, from ~
Candidates, Measures and Committees
NAMEOF FILER M
DESCRIPTION OF NONMON~ARY
DATE CANDIDATE AND OFFICE, ~PE OF PAYME~ AMOUNT ~IS PERIOD CUMU~TIVE AMOUNT
M~SURE AND JURISDICTION, OR COMMI~EE CONTRIB~ION
(IF REQUrRED)
~ Mone~ Calendar Year
~ntdbution
~ Non'M~e~ $
~ntdbuaon 0~er
~ I~e~ndent
~ Suppo~ ~ Op~e Expe~re $
~ ~e~ Cale~ar Year
~nt~bution
~ Non'M~e~ $
~nt~buaon O~er
~ I~e~ndent
~ Suppo~ ~ Opp~e E~e~i~re $
~ ~e~ Calen~r Year
~ntdbu~on
~ Non-M~e~ $
~n~bution O~e~
~ I~e~ndent
~ Sup~ ~ Op~e ExplOre $
~ ~ ~e~r Year
~nMb~on
~ Non'M~ $
~ntdbuaon O~e~
~ I~e~ent
~ Sup~ ~ Op~e ExplOre
SUBTOTAL
FPPC Form 460 (8/99)
For Technical Assistance: 916/1~22-5660
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts mey be rounded
to whole dollers.
from / ~(~/'~
SCHEOULEF
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
DFC office expenses
PET petition cimulating
PHC phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional se~ces (legal, accouniing)
PRT print ads
RAD radio airtime and production costs
CMP campaign paraphernalia/misc.
CNS campaign consultants
CTB contribut;on (explain nonmonetary)*
CVC cMc donations
FND fundraising events
iNO independent expenditure supporiing/opposing o~hem (explain)*
LIT campaign literature and mailings
MTG meelings and appearances
I.D. NUMBER
RFD returned contdbulions
SAL campaign workers salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, Indging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF ;ransfer beiween committees of the same candidate/sponsor
VDT voter registration
WEB information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITS'ES. ALSO EN'iER I.D. NUMBER) 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 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
Schedule E
(Continuation Sheet)
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAMEOF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
S~&;.em=nt covers period
through ~- ~-'~,~
CODES: If one of the following codes accurately deScribes the payment, you may enter the code, Othenvise, describe the payment,
CMP campa~jnparaphemaita/n'~sc. DFC office expenses RFD retureedcontd~u~ons
SCHEDULEE(CONT.)
CNS campaign consultants
CTB contribution (explaio nonmonetary)*
CVC cMc donations
FND fuodraising events
(ND independent expeoditure support~g/opposing o~hers (exptain)*
UT campaignliterature and mailings
PET petition cimulating
PHO phone banks
POL polling ar'~l survey reseamh
POS postage, delivery and messenger se~ces
PRO professh3natse~ces(legai, accounting)
PRT pdnt ads
MTG meefingsandappearances RAD radloairtimeandproductioncosts WEB informationtechr~lo
I.D. NUMBER
SAL campaignwo~kerssalar~es
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging and rneals (explain}
TRS staff/spouse treavel, lodging and reeals (explain)
TSF transferbelweencomreiffeesofthesamecandidate/sponsor
VDT voter registration
NAME AND ADDRESS OF PAYEE OR CREDITOR
tlFCOMMITTEE, 3LSOENTERI.D, NUMgES) CODE OR DESCRIPTIO~I OF PAYMENT AMOUNTPAID
must also be suremaHzed on Schedule D,
SUBTOTAL ~,
FPPC Form 460~8/99)
For Technical Assistance: 916/~22-5660
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 '~";~'/~/"~
SCHEDULEF
Page / ~ of ~ ~
NAME OF FILER
CODES: If one of the following Codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia/misc.
CNS campaign consultants
CTB contribution (explain nonmonetary)*
CVC civic donalJons
FND fundraising events
IND independent expenditure supporting/opposing others (explain)*
LIT campaign literature and mailings
MTG meetings and appearances
dFC office expenses
PET petition circulating
PHO phone banks
POL polling and suwey reseamh
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio airtime and production costs
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
LD. NUMBER
RFD ratumed contributions
SAL campaign workers saiaries
TEL t.v. or cable airame and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spousa travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
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 OUTSTAN DING
(iF COMMITTEE, ALSO ENTER La. 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 all 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 pedod. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $' '~
May be · nega~b~,e number
FPPC Form 460 (8/99)
For Technical Assistance: 916f322-5660
Schedule F
(Continuation Sheet)
Accrued Expenses (Unpaid Bills)
Type or print In ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from ~ ~(~ 1~C:~
through
NAME OF FILER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia/misc.
CNS campaign consultants
CTB contribution (explain nonmonetary)*
CVC civic donaticns
FND fundraising events
IND Independent expenditure supporting/opposing others (explain)*
LIT campaign litemtura andmailings
MTG meetings and appearances
CFC office expenses
PET petition cimulating
PHC phone banks
POL polling and survey mseamh
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio airtime and production costs
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
SCHEDULE F (CONT.)
I.D. NUMBER
RFD returned cont~bu~ons
SAL campaign workem sale,es
TEL t.v. or cable ai~rne and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF transfer between committees of the came candidate/sponsor
VDT voter registration
WEB information tschnology costs (intemet, e-mail)
(.) (b) (c) (d)
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTAN DING
(IF COMMI'CFEE. ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (^~so REPORT ON E) OF THIS PERIOD
FPPC Form 460 (8/99)
For Technical Assistance: 9t6/322-5660
· 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.
from ! ~(~ ~'~-~
through '~-- ~'/J'F"c~
SCHEDULE G
SEE INSTRUCTIONS ON REVERSE Page ! ~ of ~', (~
,AMEOPr,L. ,.D. NUMSE,
NAME OF AGENT OR INDEPENDENT CONTRACTOR
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphe malia/misc.
CNS campaign consultants
CTB contribution (explain r~nmonetary)*
CVC c'n4c dofiations
FND fundraising events
IND independent expenditure supporting/opposing others (explain)*
LIT campaign literature and mailings
MTG meetings and appearances
DFC office expenses
PET petition circulating
PHO phone banks
POL poi!lng and survey rasearch
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio aidime and production costs
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
RFD returned contributions
SAL campaign workers saiades
TEL t.v. or cable airtlme and production costs
TRC candidate t ravel, Indging and rneals (explain)
TRS staff/spouse t ravel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VDT voter registration
WEB information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
{IF COMMITTEE* AESO ENTER I.D, NUMBER)
Attach additional information on appropriately labeled continuation sheets. TOTAL*
· DO not transfer to any other schedule or to the Summary Page. This totalmay not equal the amount paid to the agent or independent contractor FPPC Form 460 ('~/99)
asraportedonScheduleE. For Technical Assistance: 916/322-5660
Schedule H - Part 1
Loans Made to Others*
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE OF LOAN
NAME AND ADDRESS OF RECIPIENT
(IF COMMIITEE, ALSO ENTER ~.D. NUMBI;R)
Type or print in ink.
Amounts may be rounded
to whole dollars.
*Loans that are contributions to another candidate or committee must also be summarized on Schedule D.
from
through
INTEREST RATE DUE DATE
SUBTOTAL $
Page . ..
SCHEDULEH-PART1
AMOUNT
I.D. NUMDER
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 $
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 c,~ver~ period
from / '~) / ~
through ~-~ ~/~'~
SCHEOULE I~ - PART 2
Page /~ of_~/
NAMEOF FILER
DATE OF
REPAYMENT OR
FORGIVENESS
DATE OF
ORIGINAL
LOAN
INTEREST
RATE
(IF CHANGED)
FULL NAME OF RECIPIENT OF LOAN
Attach additional information on appropriately labeled continuation sheets.
SUBTOTALS
AMOU.T~P^,~OR
FORGIVEN ON PRINCIPAL*
EXCLUDE RECEIPT OF INTERES1
* IMPORTANT: If any part of a loan is forgiven, also itemize the forgiveness on Schedule E. If a repayment is recei~ve
from a third party, enter the name and address of third party in the ~:ULL NAME OF RECIPIENT OF LOAN' column above, along with the
name of the recipient of the loan.
I.D. NUMBER
OUTSTANDING INTEREST
PRINCIPAL RECEIVED
TOTAL INTEREST
RECEIVED THIS
PERIOD
Enter the amount in column (b) in the
Schedule I Summa~, Line 3. Do not carry
this total to the Schedule H Summaq4.
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule H - Part 3
Annual Report of Outstanding Loans Made
SEEINSTRUC~ONSONREVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
S;.=~e,,~e,,;.covers period
through
NAME OF FILER
FULL NAME OF RECIPIENT OF LOAN
ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN
UNPAID PRINCIPAL
SCHEDULEH-PART3
Page ~ of~/
I.D. NUMBER
UNPAID iNTEREST
Attach additional information on appropriately labeled continuation sheets.
TOTAL
NOTE: This totalshoutdbe
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 Type or print in ink. SCHEDULE
Miscellaneous Increases to Cash Amountsmayberounded S~.[,;ii~i~;.coversperiod
'O wh°le d°llar" from
~EE INSTRUCTIONS ON REVERSE through
NAME OF FILER I.D. NUMBER
DATE FULL NAME AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT AMOUNT OF
RECEIVED (~F COMMI~EE, A~O ENTER I.O. NUMBER} INCREASE TO CASH
Attach additional information on approp#ately labeled continuation sheets.
SUBTOTALS
Schedule I 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 ~L.
Summary Page, Line 14.) ........................................................................................................................... TOTAL $ ~ FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660