HomeMy WebLinkAboutBTC SEMIANN01(2)Recipient Committee
Campaign Statement
(Government Code Sections 84200-84216.5)
Type or print in ink.
SEE iNSTRUCTIONS ON REVERSE
from
1. Type of Recipient Committee: All Committees- Complete Parts 1.2, 3, and 7.
[] Officeholder, Candidate
Controlled Committee
(Also Complete Pa,'f 4.)
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(Aisc Complete Par1
[] Pdmadly Formed Candidate/
Officeholder Committee
(A/so Complete Par~ 6)
[] Generel Purpose Committee
(~ Sponsored
O Broad Based
Date of election If applicable;-
(Month, Day, Year) L
Date Stamp
':~!:,:, ri C',;'¥ CL
2. Type of Statement:
[~ Pm-election Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
COVERPAGE
For Of Scial Use Onty
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
3. Committee Information
M~LING ~DRESS (IF DIFFERE~ NO. ~D STREE~ OR RO. BOX
Treasurer(s)
NAME OF TREASURER
MAILING ADORESS
CITY STATE ZIP CODE AREA CODE/PHONE
CITY STATE ZiP CODE AREA CODE/PHONE
FPPC Form 460 (8199)
For TechnicM Aeelltance: 916/322-5660
State of California
Recipient Committee
Campaign Statement
Cover Page -- Part 2
Type or print in ink.
COVER PAGE - PART 2
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESiDENTIAL/BUSINESS ADDRESS (NO AND STREET) CITY STATE ZiP
Related Committees Not Included in this Statement: £istanycommitteee
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 J ID. NUMBER
I
CONTROLLED COMMITTEE?
[] YES [] NO
5. Ballot Measure Committee
NAME OFBALLOTMEASURE
BALLOT NO. OR LETTER I JURISDICFION [] SUPPORT
I
[] OPPOSE
Identify the controlling officeholder, candidate, or state mealure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE OR, PROPONENT
NAME OF TREASURER
COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX)
CiTY STATE ZIP CODE AREA CODE/PHONE
OFFICE SOUGHT OR HELD [ DISTRICT NO. IF ANY
I
6. Primarily Formed Committee Uat,,me, ofom¢,hold,,/,~ orc,,dldaler,~
for which thla committee le primarily formed.
NAME OF OFFICEHOLDER OR CAND/OATE OFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE IFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
7. Verification
is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is tree and correct.
Executed on By
DATE
SIGNATURE Cf: CONTROLLING OFFICEHOLDER. CANDIDATE. STATE MEASURE PROPONENT
SIG~L~TU RE OF CONTROLLING OFFICEHOLDER* CANDIDATE. STATE MEASURE PROPONENT
DAlE
FPPC Form 460 (8199)
For Technical Assistance: 916/322.5660
State of California
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
1. Monetary Contributions ...................................................... Schedule A, Line 3
2. Loans Received ................................................................... Schedule B, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ................................... AddLines 1 * 2
4. Nonmonetary Contributions ............................................... Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 * 4
,h.o.g._q?¢2 D/
SUMMARYPAGE
LD. NUMBER
Column A Column B* Column C
,300,00 , flr _ (D
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 (Unpaid Bills) ........................................... Schedule/~ Line 3
10. Nonmonetary Adjustment ....................................................... ScheduleC, Line3
11. TOTAL EXPENDITURES MADE ......................................... Add Lines $ + 9 + tO
, .500 O0
o00
O_CZ)
$~ $ .,
Current Cash Statement
12. Beginning Cash Balance ................................ Previous Summary Page, Line 16 $
13. Cash Receipts .............................................................. Column A. Line 3 above
14. Miscellaneous Increases to Cash ....................................... Schedule l, Line 4
15. Cash Payments ............................................................ Colum. A. Line 8 above
16. ENDING CASH BALANCE .............. Add Lines 12 + 13 + f4. then subtract Line 15 $
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule B, Part l. Column
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... see inslructlons on reverse
19. Outstanding Debts ................................... Add Line 2 + Line 9 in Column C above
O, O0
' Fr~ p~evious 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
$ (~'~,. ~) 20. Contributions
s 0
21.
Expenditures
Made .................. $ ~, ,
FPPC Form 460 (8199)
For Technical Assistance: 9161322-5660
711 to Dale
Schedule A Type or print in Ink. SCHEDULE A
Monetary Contributions Received towholo do,,rs, from
TO
~IND
~ COM
~ OTH
D COM
~ OTH
~ IND
D COM
DOTH
g COM
~ OTH
SUBTOTAL $ w-~ , ,, · .... ,~'_' ,
Schedule A Summary
1. Amount received this period - contributions of $100 or more.
(include all Schedule A subtotals,) ....................................................................................................... $
O.
2. Amount received this pedod - unitemized contributions of less'than $100 ......................................... $
(Add Lines 1 and 2. Enter here and on the Summary Page. Column A. Line 1.) ................... TOTAL $c:::~'~'~ '
J'Coetributor Codes
INO - Individual
COM - Recipien Commiitee
OTH - Other
FPPC Form 460 (8199)
For Technical Assistance: 9161322-5660
Schedule B - Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
NAME OF FILER
DATE FULL~ILa'ME* MAIUNO ADDRESS AND ZIP CODE CONTRIBUTOR
RECEIVED OF LENDER OR GUARANTOR CODE ~'
[] Lender [] Guarantor
[] Lender [] Guarantor
[] Lender [] Guarantor
[] IND
[] COM
[] OTH
[] IND
C]COM
[] OTH
I~ IND
[] COM
[] OTH
IF AN INDIVID U,ed.. ENTER
OCCUPATtON AND EMPLOYER
DUE DATE
DUE OATE
INTEREST RATE
%
SUBTOTAL $
LENDER INFORMATIO~I
SCHEDULE B - PART
Page ~/':)~ of ~,~-
I.D. NUMBER
GUARANTOR INFORMATION
$
$
15
Schedule B - Part 1 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 I and 2.) ....................................................................... TOTAL
Schedule B - Part 2 Summary
4. Loans of $100 or more repaid, forgiven, or paid by a third pady 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 pedod. (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
'Contributor Codes
IND - Individual
COM - Recipient Committee
OTH - Other
M~y ~. neg~v, re.'~r FPPC Form 460 (8199)
For Technical Alslstance: 9t61322-5660
Schedule B - Part 2
Repayments Made on Loans Received, Loans
Forgiven, and Loans Repaid by a Third Party
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print In ink.
Amounts may be rounded
to whole dollars.
Statsmenil covers period
SCHEDULEB-PART2
Page
(d)
DATE OF INTEREST AMOUNT REPAID OR OUTSTANDING INTEREST
REPAYMENT FULL NAME OF LENDER RATE FORGIVEN ON PRINCIPAL* PRINCIPN. PAID
OR
FORGIVENESS (IF CHANGED) IEXCLUDE PAYMENT OF ~NTERESTI
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 theamount in column (d)~n the Schedule E
including the name and address of the person forgiving the loan or the third pat~y making the payment, and the amount Summaq,, Line 3. Do not cany this total to the
Schedule B Summa~
forgiven or paid.
FPPC Form 460 {8199)
For Technical Assistance: 9161322-5660
SCHEDULEB-PART3
Schedule B - Part 3 A~.'o~.".~:.".~"~;~',,'~o. =:.; ....... ;coversperlod
Annual Report of Outstanding Loans Received to whole dollars, from ~- /--01
FULL ~ ME ~ LENDER ORIGINAL DATE OF LO~ AMOUNT ~ ~IGI~L LOAN UNPAID ~I~IPAL UNPAID I~EREST
Attach additional information on appropriately labeled continuation sheets. TOTAL $ ~i~A,~.~.~:=e. ,. ~
NOTE: Tills total should be
on the Summary Page,
Column C, Line Z FPPC Form 460 (8199)
For Technical Aa~lstance: 916/322-5660
Schedule C
Nonmonetary Contributions Received
Type or print in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
throu9h q--~Y~'~/
SCHEDULEC
NAME OF FILER ID NUMBER
LNAME,MAILINGADDRESSAND CONTRIBUTOR IFANINDIVIDUAL,ENTER OE$CRIPTIONOF AMOUNTI CUMULATIVE TO CUMULATIVE TO
OCCUPATION AND EMPLOYER FAIR MARKET DATE DATE OTHER
DATE ZiP CODE OF CONTRIBUTOR CODE * (~' SEt~.EMPtOYt~D. ENteR GOODS OR SERVICES VALUE CALENOAR YEAR
[] IND
[] eOM
[] OTH
[] IND
[] COM
[] OTH
[] IND
[] COM
[] OTH
[] IND
[] COM
[] OTH
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL, I
Schedule C Summary
1. Amount received this period - nonmonetaP/contributions o! $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 $
['C, omributo~ Codes
G,,,,,m,,,. J
OTH- Other J
FPPC Form 460 (6199)
For Technical AislMance: 9161322-5660
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.
through
SCHEDULE D
Page q of/~--
NAME OF FILER
ID. NUMBER
DATE
CANDIDATE AND OFFICE,
MEASURE AND JURISDICTION, OR COMMITTEE
[] Support [] Oppq~e
[] s~opo~ []
[] Su~ [] Oiqx~e
TYPE OFPAYMENT
Conlribu~'l
Expenditure
DESCRIPTION OF NONMONETARY
CONTRIBUTION
(IF REQUIRED)
AMOUNT THIS PERIOD
00.00
SUBTOTAL
CUMULATIVE AMOUNT
Calefldar Year
$
Calendar Year
$
Other
$
Calendar Year
$
Olher
$
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 $100 ..................................................................................
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2, Do not enter on the Summary Page.) ........ TOTAL
FPPC Form 460 (8199)
For Technical Assistance: 9161322.5660
Schedule E
Payments Made
Type or print in Ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON RE'VERSE
NAME OF FILER
,o. q-Fol
CODES: If one o~0the following codes accurately describes the payment, you may enter the code. Otherwise, descdbe the payment.
CMP campaign par aphemalia/misc.
CNS campaign coflsultants
CTB contdtxdiofl (explatn no~monetarJ) '
CVC civic donations
FND Cundraising events
IND independen{ expenditure supfx~ing/opposing others (explain)'
LIT campaign literature and mailings
MTG mee§ngs and appearances
OFC office exp~3ses
PET peUUon circulating
PHO phone banks
POL polling and survey reseanYn
POS postage, delivery afld messeflgor se~4cas
PRO professional sennces (legal, accounting)
PRT prinl ads
RAD radio aidime and production cosls
SCHEDULE E
I.D. NUMBER
I cq gJ I
RFD relumed con~bulions
SAL campaign workers salariee
TEL t.v. or cable aitfime and production costs
TRC candidate travel, lodging and meals (ex~ain)
TRS staff/spouse travel, lodging and meel$ (explain)
TSF trar~fer between committees of the same candidale/spoflsor
VDT voler regi$1raUon
WEB infeenation lechnology cosls (intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(iF COMMiT[EE ALSO ~:NTE~ i O NUMBER) CODE OR DESCRiPTiON OF PAYMENT AMOUNT PAiD
* Payments that are contributions or Independent expeedltures must also be summarized on Scbedule 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 ........................................................................................................................................ $
4. I
FPPC Form 460 (8199)
For Technical Aeelstanca: 9161322-5660
Schedule F
Accrued Expenses (Unpaid Bills)
SEE iNSTRUCTIONS ON REVERSE
Type or print In ink.
Amounts may be rounded
to whole dollars.
SCHEDULE F
Statement cover8 period
CODES: If one of ~Je following codes accurately describes the payment, you may enter the code. Otherwise. describe'the payment.
CMP campaign paraphemalie/misc.
CNS campaign consultants
CTB contribulion (explain nonmonetary)'
CVC civic donations
FND fundraising events
IND indepeadent expenditure suppoding/opposing othem (explaln)'
LIT campaign titerature and rnaiiings
MTG meetings and appearances
OFC o~ce expenses
PET petition circulating
PHO phone banks
POL polling and survey resemch
POS postage, delivery a~d nmssenger services
PRO professioflal sewices (legal. accounting}
PRT print ads
RAD radio airlime and productlon costs
I,D* NUMBER
RFD returned contributions
S^L campaign wooers salaries
TEL tlV. o~ cable airtime aad production costs
TRC candidate bavel, ladging and meals (explath)
TRS stafflspouse travel, lodging and meals (explath)
TSF transfer belween committees of the same candidate/sponsor
VOT vote; registration
WEB infon~ation technology costs (internel, e-mail)
(8) (b) (c) (d)
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING
{iF CO~IMiTIEE Al. SO ENTER ~ [J NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERICO THiS PERIOD BALANCE AT CLOSE
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 period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $
FPPC Form 460
For T®chnlcal Assistance: 916/322-5660
Schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink.
Amounts may be rounded
to whole dollars.
through
NAME OF AGENT OR INDEPE~I~NT CONTRACTOR . -- - ' ~ -- --
SCHEDULE G
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 (exptain nonmonelary)'
CVC civic donatior~s
FND fundraisir~ events
IND independent expenditure suppo~ling/opposing others (explain)*
LiT campaign lileralure and mailings
MTG meetiogs and appearances
OFC o0ice expenses
PET pedt~n circula~g
PHO phone banks
POL polling and sun~ey research
POS postage, delivery and messenger services
PRO prolessioeal services (legal, accou nfi~g)
PRT prin[ ads
RAD radio airtime and produclion costs
Payments that are contributions or independent expenditures must also be summarized on Schedule D.
RFD returned co~lribulions
SAL campaign w~:xkers salaries
TEL t.v. or cable airtime and production costs
TRC candidate [ravel, lodging and meals (explain)
TRS stafflspouse travel, lodging and meats (explain)
TSF transfer between comrniltees of Ihe same candidate/sponsor
VeT voter registration
WEB inlon-nat~on technology costs (inlemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Attach additional information on appropriately labeled continuation sheets. TOTAL'
· Do not transfer to any other schedule or lo the Summaq/Page. This total may not equal the amountpaid lo the agent or indepe~deot contractor FP PC Form 460 (8199)
asrepo~edonScheduleE. For Technical Assistance: 9161322-5660
Schedule H - Part 1
Loans Made to Others*
Type or print in ink.
Amounts may be rounded
to whole dollars.
SEEINSTRUCTIONSONREVERSE
,,om q-l-O't
SCHEDULE H - PART 1
NAME OF FILER I.D. NUMBER
DATE OF LOAN
NAME AND ADDRESS OF RECIPIENT
(IF CCMMIT~EE, ALSO ENTER I O N~4~ER)
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 I subtotals.) ............................................... $
2. Unitemized loans under $100 made this pedod ............................................................................................................. $
3. Total loans made this period. (Add Lines I 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 $ Uaybeen®g,bv, numb~
FPPC Form 460 (8199)
For Technical Assistance: 9161322-5660
Schedule H - Part 2
Repayments on Loans Made to Others
and Loans Forgiven
SEEINSTRUCTIONSONREVERSE
Type or print in ink.
Amounta may be rounded
to whole dollars.
NAME OF FILER
REPAYMENT OR
INTEREST
FULL NAME OF RECIPIENT OF LOAN RATE
(iF CHANGED)
FORGIVEN ON PRINCIPAL*'
?XCLUDE RECEIPT OF INTEREST
SCHEDULEH-PART2
I.D. NUMBER
OUTSTANDING INTEREST
P~INCIPAL RECEIVED
TOTAL INTEREeT
SUBTOTAl.
RECEIVED
Attach additional information on appropriately labeled continuation sheets.
PERIOD
* IMPORTANT' If any part of a loan is forgiven, also itemize the forgiveness on Schedule E. If a repayment is received Enterthearnountincolumn(b)inthe
Schedule I Surnrnary, Line 3. Do not carry
from a third party, enter the name and address of third par~y in the 'FULL NAME OF RECIPIENT OF LOAN" column above, along with the this total to the Schedule H Sumrnaq4
name of the recipient of the loan.
FPPC Form 460 (8199)
For Technical Assistance: 9161322-5660
SCHEDULE H - PART 3
Schedule H - Part 3AmountsType Ormayprintbelnroundedink. S[.;e,,,~,,; covers ~e,;,~d ~~
~,nnual Report of Outstanding Loans Made to,,ho,edo...r.. ~0. ~--[~/ '' ~i
SEE iNSTRUCTIONS ON REVERSE
FUL~ME OF RECIPIENT OF LOAN ORIGINAL DATE O~ LO~ AMOUNT OF ORIGINAL LOAN ~NPAID PRINCIPAL UNPAID INTEREST
Attach additional information on appropriately labeled continuation sheets. TOTAL $ .~'.11~,~ ~ :.. . . ~
NOTE: This fotalshouldbe
the same amount as entered
on the Summary Page,
Column C, Line 7.
FPPC Form 460 (6199)
For Technical Assistance: 9161322-5660
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounta may b~ rounded
to whole dollars.
Page
SCHEDULE I
NAME OF FILER
ID. NUMBER
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF C(3~IM ITTEE. ALSO ENTER I D NU~ER)
DESCRIPTION OF RECEIPT
AMOUNT OF
INCREASE TO CASH
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 (8199)
For Technical Assistance: 9161322-5660