HomeMy WebLinkAboutBFLAG SEMIANN98(2) ecipient Committee
Campaign Statement -- Long Form
(Government Code Sections 84200-84216.5)
Type Of F|nt tn ink.
SEE INSTRUCTIONS ON REVERSE
Ch~k erie of the following bexes to imitate the type of stltement being filed:
E:] Pre-election Statement ~1~ $emt-lnnual Statement
C] Special Odd-year Campaign Report
E] SupplementalPre-electionStatement(AttachacompletedFormagStothisStetement.)
[3 Termination Statement (Attach a completed Form 415 to this statement.)
I Committee Information
NAME OF COMMITTEE
ADOtilSS O~ COMMITFEE (NO, AND STREET) I I.D, NUMIER
COOI,,IMYTIME PHONE
NAF~E OF TREASURER
F~RNIANINT ADDRESS O~ TIIEASURER (NO. AND STREET)
Crrv STATE ZIP COD( Alia CO43~I)AYl'IMI
(Check Boxes) See definitions and important information on reverse.
Is this a sponsored (ommittee? .................. ~ Yet [] No
Is this a broad based politicat committee? ......... ;~] vet [] No
III Verification
Statement covers period
th,oueh
(Month, Day, Year)
~COVER PAGE - LONG FORM
,.,., I ,
For Official Use Only
II
Primarily Formed Committee (See definition on reverse.)
· f ·
~ Of CANI)4I)ATE6) 04~ OfFICEHOLDER(S)
Attach additional information on appropriately labeled continuation sheets.
I have used all reasonable diligence in preparing this statement. I have reviewed the 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. ~_~~~__,~% Zx:7 ~
DATE CITY AND STATE
Executed on At By
DATE CItY AND STATE
5~GNATURE 0t RESPONSIBtE O~FI(ERO~ fd~, I~ RE
HE INFORMATION PRACTICES ACT OF re77, SEE INFORMATION MANUAL ON CAM~A. IGN DISCLOSURE PROVISION~S OF THE POLITICAL~[~O_I~M ACT,
Recipient Committee Type ,,, p,~t ~.
Amounts may be rounded Statement covers period
Allocation Page to M~, do,.,.
SEE INSTRUCTIONS ON REVERSE _ through
NAME OF COMMITTEE I,D, NUMBER
List contfilx#tions ar~l independent expenditur6 t~t total $ ~00 or more m~le to support or oppose officeholders, candidates, t~llot measure, or ¢ommiltee$.
ALLOCATION PAGE
DATE NAME OF OFFICEHOLDER OR CANDIDATE AND OFFICE, OR NAME OF CHECK ONE IND. AMOUNT THIS
MEASURE AND BALLOT NUMBER OR LETTER, OR NAME OF COMMIlq'EE EXP.t PERIOD
IF OTHER THAN OFFICEHOLDER, CANDIDATE, OR MEASURE COMMITTEE SUNmeT
ti/sl% ,H.~r...***~,,~;o ,~ c,V ('~.,~.t X
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 - DEC. 31)
J
,.f ?sw,oc
CUMULATIVE TO DATE
OTHER
(IF APPLICABLE)
*See reverse regarding independent expenditures.
Allocation Summary
1. Contributions and independent expenditures of $100 or more made this period.
(Include all Allocation Page subtotals,) ...................................................................... $
2, Contributions and independent expenditure under $100 made this period.
(Do not itemize.) ......................................................................................... $
3. Total contributions and independent expenditures made this period.
(Do not carry this to the Summary Page.) ............................................................ TOTAL $
....o,.:' '1,
Attach additional information on appropriately labeled continuation sheets.
2.ooo. Oeg
2_C:,3O, Oc
Recipient Committee
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE
Contributions Received
1. Monetary Contributions ............................... Scfiedule A, Une 3 S
2. Loans Received ......................................... Schedule a, une 7
3, SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I · 2 S
4. Non-monetary Contributions ......................... Schedule C, Une 3
5. SUBTOTAL CONTRIBUTIONS (Exclude Enforceable Promises) AddUnes 3 · 4 $
6, Enforceable Promises
(E dude Loan Guaranlees, Line 18 below) Schedule D, Une 7
7, TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnes S ~ 6 $
Expenditures Made
8, Cash Payments (Other than Loans Made) ............ Schedde E, Une S
9. Loans Made ............................................. Schedule H, Une 7
10. SUBTOTAL CASH PAYMENTS ............................ AddUnese, 9
11. Accrued Expenses (Unpaid Bills) ........................ Schedule F, Une S
12. TOTAL EXPENDITURES MADE ......................... AddLines 10 · 1~
Current Cash Statement
13, Beginning Cash Balance ..................P~vtous Summary Page, Line 17
14, Cash Receipts ......................................ColurnnA, LineJabove
15, Miscellaneous lncreases to Cash ........................Schedule#,Une4
16, Cash Payments ....................................Column A, ~ne ~0 above
17. ENDING CASH IALANCE ..... Add Unes13 , 14 · IS, then subtracI Ltne I6
ff ~ is · ear··nation st·re·ant, Line 17 must be zero.'
18. LOAN GUARANTEES RECEIVED .............. Sc~edule B, Pert I, Column
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................ See tnslrucftons on reverse S
20, Outstanding Debts ................. AddLine 2 , Line ll tnColumnCabove $
TypeorpdmMle.
Amounts may be ramdad
to whole dobrs.
Column A
TOTAl TIeS II~RIOD
(FitOld ATTACHED SO4EOULES)
Statement covers period
,,, Iol/ l
through / Z/~//c~/ ..
Column B*
NE NOTE IEL OV4f)
s loe, 3
SUMMARY PAGE
I,D. NUMBER
Column C
TOTAL TO DAT!
* From previous Statement Summary Page, Column C. However, if
this is the first report filed fo~ the calendar year, Column i should be
blank except for Loam eeceved (Line 2), Enforceable Promises (Line
6), LOam Made (Line 9), and Accrued Expenses (Line 11 ).
Summary for Non-Controlled Committees
Primarily Formed to Support or Oppose
Candidates in Both June and November
Elections
1/1 through 6/30 7/1 to Date
21. ontrib tions ~ ~_
n. ,
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE
FULL NAME AND ADDRESS OF CONTRIBUTOR
DATE 0; COMMITrIE, IN ADINTION TO COMMITrEE'S NAIRT ANO ADORES5, EN/ER I.O. NUMI~R
RECEIVED OF, IIr NO I.O, NUMIER HAS lEER ASgglID, ENTER TI!~ASURER'$ NAME ANI) ADOFEe, S)
TylxmpdntininL
Amounts may be rounded
to whole dollars.
OCCUPATION AND EMPLOYER
elr !~LF-IMR.OYED, ENTER
NAME Of
Statement covers p/riod
f,om IC~l Ira/9 ~,
through IZ, l ~/ / q8
AMOUNT
RECEIVED THIS
PERIOD
SCHEDULE A
CUMULATIVE TO DATE CUMULATIVE TO DATE
CALENDAR YEAR OTHER
(JAN. 1 - DEC. 3 1 ) (IF APPLICABLE)
~/3/,,,:,,-
SUBTOTAL
Monetary Contributions Summary
1. Amount received this period -- contributions of $100 or more.
(Include all Schedule A subtotals.) ............................................................................
2. Amount received this period --contributions of less than $100.
(Do not itemize.) ...........................................................................................
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1 .) .............................. TOTAL
Schedule E
Payments and Contributions
(Other Than Loans) Made
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE
typeotpdntininL SCHEDULE E
AmOulTtl may be roytided Statement co~ ~r~ ~
to w~ i~.
,,,
thr~h /~//~ ~ p~ ~ ~ ~
LD, NUMBER
CODES FOR CLASSIFYING EXPENDITURES
If one of the following codes accurately describes the expenditure, u may enter the code and leave the "Description of Payment' column blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations otY~e~ch category.
*C' - MONETARY AND IN-KIND (NON-MONETARY)
CONTRIBUTIONS TO OTHER CANDIDATES
AND COMMITTEES
'1" - INDEPENDENT EXPENDITURES
°L'- LITERATURE
'B' - BROADCAST ADVERTISING *G' -
°N'- NEVVSPAPER AND PERIODICAL ADVERTISING 'T'-
°0' - OUTSIDE ADVERTISING '
"S ' - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS "P" '
'F' - FUNDRAISING EVENTS
GENERAL OPERATIONS AND OVERHEAD
TRAVEL ACCOMMODATIONS AND MEALS
(MUST BE DESCRIIED)
PROFESSIONAL MANAGEMENT AND CONSULTING
SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
(1~ COMMITTEE, Me ADDITION TO COMMfir!'EE'$ NAME ANO ADDNE$S, ENTER I.D. NUMIER OIL W NO I,O,
NUMIER HAS IfiEN ASSIGNED, ENTER TREASUI~R~ NAME ANO ADDR~e~S)
CODE
IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW.
OR
DESCRIPTION OF PAYMENT
Important: Contributions and expenditure made out of campoi n funds to or on behalf of off/ceho/den~, ' '
candid_ate, committees, or _te__!l_ot m_easure~__ must also be entertain the Allocation Page, SUBTOTAL $
Payments and Contributions Made Sum maW
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.)
...................................................... $
2. Payments made this period of under $100, (Do not itemize.)
....................................................................... $
3. Total interest paid this period on outstanding loans, (Enter amount from Schedule B, Part II, Column (d),) .............................. $
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4,)
..................................... $
5. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) ........... TOTAL $
AMOUNT PAID
9~,2,/~
rj tq ,70
#1,-~ #,
~,~
q~o~
Schedule E
(Continuation Sheet)
Payments and Contributions
(Other Than Loans) Made
SEE iNSTRUCTIONS ON REVERSE
NAME OF COMMITTEE
'C'-
MONETARY AND IN-KIND (NON-MONETARY) 'B* -
CONTRIBUTIONS TO OTHER CANDIDATES °N' -
AND COMMITTEES "O* -
INDEPENDENT EXPENDITURES 'S' -
LITERATURE 'F* -
Typeotpdetlnlnk.
Amounts may be rounded
Statement evers period
0,,
/z
CODES FOR CLASSIFYING EXPENDITURES
BROADCAST ADVERTISING
NEWSPAPER AND PERIODICAL ADVERTISING
OUTSIDE ADVERTISING
SURVEYS, SIGNATURE GATHERING. 0OOR-TO-DOOR SOLICITATIONS
FUNDRAISING EVENTS
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
(IF COMMITTEE, IN AIX)fTION TO CO MMITTEE'S NAME AND AOORESr~, ENTER I.D, NUMIER 04~ W NO I.D.
14UMI~R HAS lIEN ASTd~NED. ~NTIER TREA&URER'~ NAME ANO AOORESS)
CODE OR
SCHEDULE E (cont.)
'G'- GENERAL OPERATIONS AND OVERHEAD
'T' - TRAVEL, ACCOMMODATIONS AND MEALS
(MUST BE DE$I31ED)
'P' - PROFESSIONAL MANAGEMENT AND CONSULTING
SERVICES
AMOUNT PAID
DESCRIPTION OF PAYMENT
SUBTOTAL