HomeMy WebLinkAboutPRICE SEMIANN00(1) ecipie~t Committee
Cai~paign Statement
(Government Code Sec§Des 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covera pedod
from -/'
through
Dale Stamp
Date of elecUon if applicable:
(Month, Day, Year) 0[!JUL21 AHII:35
ERSFIELD CITY
COVER PAGE
Page. / of 6
For Ol~icia; Use Only
1. Type of Recipient Committee: All Committee~ - Complete Parts f, 2, 3, and 7,
~ Officeholder, Candidate
Controlled Committee
(Also Complete part
[] Ballot Measure Committee
O Primarily Formed
0 Confroiled
O Sponsored
(A/so Complete Part 5.)
[] Primarily Formed Candidate/
Officeholder Committee
[~ General Purpose Committee O Sponsored
O Broad Based
3. Committee Information
NUMBER
COMMI3-rEE NAME
-
CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
2. Type of Statement:
[~ Pm-election Statement
,[~ Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
Treasurer(s)
NAME Oq TREASURER
MAILING ADDRESS
CITY
NAME OF ASSISTANT TREASURER, IF ANY
STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS
CIT~ STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ABDRESS
CiTY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX I E-MAIL ADDRESS
FPPC Form .i60
For Technical Aeel~tan~e: 916/3;~2-5550
State of California
· Recipient Committee
Campaign Statement
Cover Page m Part 2
Type or print in ink.
COVERPAGE-PART2
· ~ of /~
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD {INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAL/BUSINES S ADDRESS (NO. AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: Llstanycommlttees
not included in this conso#da ted statement that are con trolled by you or which are primarily
formed to receive contributions or to make expenditures on behalf of your candidacy.
COMMIYrEENAME D. NUMBER
NAME OF TREASURER CONTROLLED COMMIT'~EE?
I-i YES [] HO
STREETADDRESS (NO~O. BO)
COMMITTEE ADDRESS
CITY STATE ZIP CODE
7. Verification
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETrER JURISDICTION
[]SUPPORT
(--]OPPOSE
Identify the controlling officeholder, candidate, or slate measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD D~STRIOT NO. IF ANY
6. Primarily Formed Committee L/stn=,~,s ofo~ceholder(,) orcandldatefs)
for which this committee I~ primarily formed. -
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE
Affach continuation sheets if necessary
OFF~CE 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 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,
Executedon '/'_ ,-~./- ~o,~ By
DATE
DATE
Executedon By
DATE
-- /~ ~ SIOAfATURE OF TR~EASURER OR ASSISTANT TREASURER
SIG~..~ OF G~:~T R(~O OFFICEHOLDEr, CANOIDATE, STATE MEASURE PROPONENT OR RESPONSISLE OFFICER OF SPONSOR
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
Executedon By
DATE
SIGNATURE OF CONTROLDNd OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 460 (8/99)
For Technical Aeaistanoe: 916/322-5660
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAM E OF FILER
Type or print In Ink.
Amounts may be rounded
to whole dollars.
SUMMARYP
Statement covers period
through ~ - ~'.'~d .:~-~?~ Page~ ~' of. ~
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 .......................................................................... Schedu/e 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
Column A
TOTAL THIS PERIOD
Column B*
TOTAl. PREVIOUS PERIOD
(SEE NOTE BELOW)
I.D. NUMBER
Column C
S
Current Cash Statement
12. Beginning Cash Balance ................................ Previous Summary Page, Line t6
13. Cash Receipts .............................................................. Column A, Line 3 above
14. Miscellaneous increases to Cash ....................................... Sched;#e I. £/n~ 4
15. Cash Payments ............................................................ column A, Line 8 above
16. ENDING CASH BALANCE .............. Add Lines 12 + 13 + 14. then sublract Line 15
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule S, Pa. l, Column
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... See instructions on reverse
19. Outatandi~9 Debts ................................... Add Li.e 2 + Lin~ 9 ir~ Column C above
· From previous statement Summary Page, Column 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 (Line 9).
Summary for Candidates in Both June and
November Elections
111 thrOugh 6/30 7/1 in Date
20. Contributions
Received ............
21. Expenditures
Made .................. $
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from /- /- d ~ ~'~ ~
SCHEDULE
through ~- ~B. ~o Page '~ of ' ~
NAME OF FILER
I.D. NUMBER
~P~z~d~ 1
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
OTB contribut[on (explain nonmonetary)*
CVC civic donations
FND fundraising events
IND independent expenditure supporting/opposing others (explain)*
LIT campaign literature and mailings
MTG meetings and appoarances
CFC office expenses
PET petition cimulating
PHC phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT pdnt ads
RAD radio air~ime and production costs
RFD returned contributions
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 came candidate/sponsor
VDT voter registration
WEB information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE. ALSO ENTER I D. NUMSER) 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 sulS~totals.) ...............................................................................................
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).) .................................................. ~i..
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
(~ontinuation Sheet)
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in Ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from../~- /-
through ~
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaignparaphemalia~nisc. OFC officeexpsnses RFD returnedconldbu~ons
CNS campaign consultants
cTe contribution (explain nonmonetary}*
CVC civic donations
FNO farm'raising evenls
IND independent expenditure supporting/opposing others (explain)'
campaign literature and mailings
PET paiJtion circulating
PHO phone banks
POL polling and survey research
POS postage, deliver/and messenger sendcas
PRO professional services (legal, accounting)
PRT print ads
SCHEDULE E (CONT.)
MTG meefingsandappearances RAD radioairtimeandproductioncosts
Page ~ of ....'.~
I.D. NUMBER
SAL campaign workers salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, Indging and meals (explain)
TRS staff/spouse lravai, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
'VOT voter registra~on
rr ' VV~"~u[mauon [ecnnology costs (interest, e.mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
IIF COMMITTEE. ALSO ENTER ID. NUMBER) CODE OR DEBCRIPTIO,N OF PAYMENT AMOUNT PAID
e D, SUB¥O~AL ~o~ ?:. o o
· FPPC Form 460 (8/99)
For Technical Asslstsnce: 9~6/~22-5660
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from r/-
through
SCHEDULEI
I~age ~ of ~
NAME OF FILER
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(iF COMMITTEE, ALSO ENTER I.D. NUMBER)
DESCRIPTION OF RECEIPT
LD. NUMSER
AMOUNT OF
INCREASETOCASH
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
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
Summary. Page, Line 14.) ........................................................................................................................... TOTAL $
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660