HomeMy WebLinkAboutBFLAG PREELEC00(3) ecipic, nt Committee
Campaign Statement
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
State entcoverepedod
from "7
Date of election if applicable:
(Month. Day. Year)
Date Stamp
O0 0CI -3 PH
BA~{ERSFiE[.D el/'
COVER PAGE
oAL,FoR.,A 460
FORM
For Official Use Only
;[ERK
1. Type of Recipient Committee: All Committees - Complete Pads 1, 2, 3, and 7.
[] Officeholder. Candidate
Controlled Committee
(Also Complete Part 4.)
i"i Ballot Measure Committee
0 Primarily Formed
O Controlled
O Sponsored
(Also Complete PaR 5.)
[] Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 6.)
~General Purpose Committee
0 Sponsored
~'9~Broad Based
2. Type of Statement:
~[' Pro-election Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pro-election
Statement - Attach Form 495
3. Committee Information
COMMITTEE NAME
Treasurer(s)
NAME OF TREASURER
MAILING ADDRESS
CITY
MAILIN~ ADDRESS IIF DIFFERENT) NO. AND STREET OR P.O. BOX MAIUNG ADDRESS
CITY STATE ZIPCOOE AREACODE/PHONE CITY
STATE ZIP CODE AREA CODE/PHONE
STATE ZIP CODE AREA CODF_JPHONE
OPTIONAL: FAX / E-MAIL ADDRESS
OPTIONAL: FAX / E-MAIL ADDRESS
FPPC Form 460
For Technical Assistance: 916/3;12-5660
State of California
Recipient Committee
Campaign Statement
Cover Page -- Da'+ '~
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Type or print in ink.
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
COVER PAGE - PART 2
CA',FOR.,A 460
FORM
Page '~- o~' (j~ }
OffIcE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAIJBUSINESSADDRESS (NO. ANDSTREET) CITY STATE
ZIP
SALLOTNO. ORLETTER IJUR,SD,CT H
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT
Related Committees Not Included in this Statement: Llstanycommlttees
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 OF TREASURER
CC~4MITTEEADDRESS
CITY
CONTROLLED COMMITTEE?
[] YES [] NO
STREET ADDRESS (NO P,O, BOX)
STATE ZIP CODE
7. Verification
AREA CODE/PHON E NAME OF OFFICEHOLDER OR CANDIDATE
Attach conb~uatien sheets if necessary
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
6. Primarily Formed Committee Llstnamesofofflceholder(s)orcsndldate(s)
for which this committee Is primarily formed.
NAMEOFOFFICEHOLDERORCANDIDATE OFFICESOUGHTORIIELD q [] SUPPORT
[] OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
OFFICESOUGHTORHELD ~ [] SUPPORT
[] OPPOSE
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained heroin and in the attached schedules
is true and complete. I certify under penalty of perjuW under the laws of the State of California that the foregoing is true and correct.
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on
DAlE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT OR SESPONSIBLE OFFICES OF SPONSOR
Executed on By
DATE
Executed on By
DATE
SIGNATUSE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASUSE PROPONENT ~
SIGNATURE OF CONTROLUN~ OFFICEHCLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5650
State of California
Schedule A
Monetary Contributions Received
Type or print in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF RLER
DATE
RECEIVED
FULLNAME, MAILINGADDRESSANDZIPCODEOFCONTRIBUTOR CONTRIBUTOR
(IFCOMMITrEE, ALSOEN~'ERID,NUMIJER) CODE *
~] IND
[] COM
[] OTH
FAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE
OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR
(IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC, 31 )
OF 6USINSSS)
[] COM
[] OTH
[] IND
[] COM
[] OTH
[] IND
[] COM
[] OTH
SCHEDULE A
,%'z,_q-G, at,,B?,Rc:), oo
CUMULATIVE TO DATE
OTHER
(IF APPLICABLE)
SUBTOTAL S ~57-- '~E} ,o0
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 tess than $100 .........................................
3. Total monetary contributions received this period.
(Add Lines I and 2. Enter here and on the Summary Page, Column A, Line I .) ................... TOTAL
"ContrlbutorCodes
IND-Indivtdual
COM - Recipient Committee
OTH - Other
FPPC Form 460 (8/99)
For Technical Assistance: 9~16~22-5660
-Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
NAMEOFFILER
DATE
CANDIDATE AND OFFIC E,
MEASURE AND JURISDICTION, OR COMMfiq'EE
[] Suppod [] Opp~e
[] Support [] Oppose
Type or print In ink.
Amounts may be rounded
to whole dollare.
TYPE OF PAYMENT
~Monetary
Contdbution
[] Non-Monetary
Contribution
[] Independent
Expenditure
,[~ Monetary
Contribution
[] Non-Mo,letary
Contribution
[] h',dependent
Expenditure
[] Monetary
Contdbution
[] Non-Monetary
Contribution
[] Independent
Expenditure
from
SCHi~DULE D
DESCRIPTION OF NONMONETARy
CONTRIBUTION
(IF REQUIRED)
SUBTOTAL $
AMOUNT THIS PERIOD
'~:>000 , Oc::'
CUMULATIVE AMOUNT
Calendar Year
Other
$
Calendar Year
$ '-~ c,,o,,,c:>, o c,~
Other
I $
Calendar Year
$
Other
$
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 Aeslstence: 916~22-5660
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF RLER
Type or print in Ink.
Amounts may be rounded
to whole dollars.
Statement oversperiod
from '~ Z7
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.'
CMP campaignparaphemalia/misc.
CNS campaign consulfanls
CTB contdbuilon(explainnonmonelary).
CVC civicdonations
FND fundraising events
IND indePendent expendi~ure suppoding/opposing o{hers (expMin).
LIT campaign literature and mailings
MTG mee~ngsandappeamnces
OFC office expenses
PET petition circulating
RFD refurnedcontdbutions
SAL campaign workers saMdes
SCHEDULEE
OA',FOR.,A 460
FORM
-. I.R o,. t
PHO phonebanka
POL poffingandsurveyresearch
POS Postage, delive~and messengerservices
PRO pmtessionalsen/ices(legal, accoun~ng)
PRT printads
RAD radioalllimeandproduclioncosts
TEL t.v. or cable airtime and production costs
TRC candidatetravel, lodgingandmeals(explain)
TRS staff/sPousetravel, lodgingandmeals(explain)
TSF transferbetweencommiffeesofthesamecandidate/sponsor
VOT voterregistration
WEe informaliontechnologycosts(intemet, e.mait}
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMM TREE, ALSO ENTER I D+
CODE
Cy
F~'-J D
~Paymentethatarecontributionsor|nde endentex
P penditures must also be summarized on Schedule
Schedule E Summary
OR
DESCRIPTION OF PAYMENT
AMOUNT PAID
SUBTOTAL
i. Payments made this period of $100 or more. (include all Schedule E suS~tota s ) ..
. ...........................................
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-S660
Campaign Disclosure Statement
Summary Page
Type or print In ink.
Amounts may be rounded
to Whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF RLER
Contributions Received
L Monetary Contributions ...................................................... Schedule A, Line 3
2. Loans Received ...................................................................Sshedule t~, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add LInes I + 2
4. Nonmonetary Contributions ............................................... Schedule C. Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... AOd Lines 3 + 4
Expenditures Made
S. Payments Made ....................................................................Schedule E, Line 4
7. Leans Made ..........................................................................Schedule
B. SUBTOTAL CASH PAYMENTS ................................................ Add Lines S
g. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, Line 3
10, Nonmonetary Adjustment .......................................................Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ......................................... AddLinesS+9+ tO
Current Cash Statement
~. ~e~in,..~Casb~a~a.ce ................................
13. Cash Receipts ..............................................................column A, Line 3 above
~ 4. Miscellaneous Increases to Cash .......................................Schedule I, LIne 4
15. Cash Payments ............................................................ColumnA, Lineaabeve
16. ENDING CASH BALANCE .............. Add LInes 12 +
If ~hls Is a term/nation s~atement, L(ne f6 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule a. Pirt i. Column (b)
Cash Equivalents and Outstanding Debts
18. Cash Equivalents .....................................................See inslmcllons on reverse
19. Outstanding Debts ................................... AddLtne2+Line9inColumnCebove
S.~JMMARy PAGE
FORM
$__! %itz} "2. ~ Z (
' From previous statement Summary Page Column C, Howeve~ if this
is the firs! repor~ filed tot the calendar year, Column ~ should be
except for Leans Received (Line 2), Loans Made (Line 7), and Accrued
Expenses (Line
Summary for Candidates 'in Botl~ Jt~ne a~"
November Elections
111 through 6/30
20. Contributions
Received ............
2L Expenditures
Made .................. $
7/1 to Date
FPPC Form 460 (8/99)
ForTechnlcelAs~letence: 916/322-S660