HomeMy WebLinkAboutDICKERSON SEMIANN04(2)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEEINSTRUCTIONS ON REVERSE
Type or print in ink.
through
1. Type~ Recipient Committee: A, Comm=~*$ - Comp~*t~ Pa~ts 1, 2, 3, ;*nd 4.
L~bV Officeholder. Candidate Controlled Committee [] Ballot Measure Committee
0 Primarily Formed
0 Controlled
O Sponsored
[] Primarily Formed Candidate/
Officeholder Committee
O State Candidate Election Committee
O Recall
Dale Stamp
[] General Purpose Committee O Sponsored
O Small Contributor Committee
O Political Party/Central Committee
Date of election if applicable:
(Month. Day, Year)
05FE -? L;;tl
2. Type of Statement:
aStatement
I Statement
[] Termination Statement
[] Amendment (Explain below)
COVER PAGE
For Official Use Only
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Preelection
Statement * Attach Form 495
3. Committee Information lID NUMS~ i,Z /
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE}
Treasumr(s)
NAME OF TREAS RER
MAILING
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowtedge the info~
ceMify under penalty of perju~j ~nder ~e laws~ of the State of California that the foregoing is true and correct. / J
/
Executed on [ By / !
fntained herein and in the attached schedules
is true and complete. I
Campaign Disclosure Statement
Summary Page
Type or print in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Contributions Received
Statement c er period
,.o.
$ ~ $
Column A Column B
1. Monetary Contributions ........................................... Schedule A, Line 3 $ $
2. Loans Received ...................................................... Schedule B, Ur~ 3 ~
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Unes 1 + 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 3
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $
9. Accrued Expenses (Unpaid Bills) ............................... Schedule ~ Line 3
10. Nonmonetary Adjustment .......................................... Schedute C. Line 3
11. TOTAL EXPENDITURES MADE ................................ AddLinesS+9+ 10
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Sumrnaq/ Page, L~ne 16
13. Cash Receipts ................................................... ColumnA, Llee3above
14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4
15. Cash Payments .................................................. Column A, Line $ above
16. ~NGCASH BALANCE .......... Add L/nes 12+ 13+ 14, then subtrect Line 15
If this is a termination statement, Line 16 must be zero.
$
/
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column B of your last
report. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts. If this is
the first report being filed
for this ca~endar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Par~ 2
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ........................................ s~ins~uc~o~son~ve~se
19. Outstanding Debts ......................... AddLine2+LineginColumnBebove
SUMMARY PAGE
Page ~ of ~
'y for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contdbufions ~_~ (~
Received $ $
21 Expenditures ~ ~
Made $ $
Expenditure Limit Summary for State
Candidates
22, Cumulative Expenditures Made*
Date of Election Total to Date
(mmJdd/yy)
/ / $
/ / $
I / $
__/ / $
__1 / $
__/ / $
*Since Janua~ 1, 2001. Amounts in this section may be
different from amounts repealed in Column B.
FPPC Form 460 (June/01)
FPPC Toll-Free Hell)line: 866/ASK-FPPC
, , ,4ule B- Part 1
I.tlens Received
Ammmll nm,/be ~ound~d
lo whol~ 6oll~m,
SCHEDULE B * PART I
2. Loans imid or forgiven this pedod ......................................................................................................... $
(Total C~urnn (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on $cheduleA.)
3. Net change lhis period. (Subtract Line 2 from Line 1.) ............................................................... NET $
Enter the net hem and cm the Summary Page, Col~q~n A, Une 2.
anolher pe~/also must be I
relX~ed o~ Schedule A.
I
~ *' If required. J
"4dual COM- RectpiefltCommitlee (otherlhan PTYetSCC) OTH-Olher PTY-PoilicaiParty SCC-SmaaConlfll~tm-Commi~e FPPC Form 460 (June/01)
Recipient Committee
Campaign Statement
Cover Page -- Part 2
Type or print in ink.
COVER PAGE - PART 2
Page~'~ of ~--~
5. Officeholder or Candidate Controlled Committee
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAL/BUSINESS ADDRESS (NO AND STREET) CITY STAT ZiP
Related Commiffees Not Included in this S~tement: us~ any commi~s
not included in ~is sM~m~t ~at are con~oll~ by you or a~ p~marily fo~ ~ r~eive
con~ibu~ons or make exp~ditures on behalf of your candidacy.
COMMITTEENAME I D NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
[] YES [] NO
COMMITTEE ADDRESS STREET ADDRESS (NO RO. BOX)
CiTY STAT ZIP CODE AREA CODE/PHONE
[] YES [] NO
COMMITTEE ADDRESS STREET ADDRESS (NO PO BOX)
CITY STALE ZIP CODE AREA CODEJPHONE
6. Ballot Measure Committee
NAME OFBALLOT MEASURE
BALLOT NO OR LETTER JURISDICTION
D SUPPORT
[~OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME Of OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD
DISTRICT NO IFANY
7. Primarily Formed Committee List names of officeholder(s) or candidate(s) for
which ~is committee is p~marily formed.
NAME OF OFFICEHOLDER OR CANDIOATE OFFICE SOUGHT OR HELD
E]SUPPORT
[~OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
[]SUPPORT
[]OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD E~]SUPPORT
~]OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
•SUPPORT
[]OPPOSE
A~ach continuation sheets if necessary