HomeMy WebLinkAboutBFLAG PREELECT10(2)COVER PAGE
Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 134200-84216.5)
from
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period I Date of election if applicable:
jc , i iL (Month, Day, Year)
through i 0 1(13 10
1. Type of Recipient Committee: AN Conimittaas - Complete Paris 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Committee
Q State Candidate Election Committee
Q Recall
(Also Complete Part 5)
(General Purpose Committee
mall Contributor Committee
Q Political Party/Central Committee
3. Committee Information
❑ Primarily Formed Ballot Measure
Committee
O Controlled
Q Sponsored
(A~ pads1
❑ Primarily Formed Candidate/
Officeholder Committee
(Also CompktePW 7?
I.D. NUMBER
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
z-4 -nv~54cll-e~N)
STREET ADDRESS (NO P.O. BOX)
;'
AREA CODE/PHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL: FAX / E-MAIL ADDRESS
Kc'N' L; 7, u7c-'
Date Stamp
10 OCT 20 Fri 3:3
2. Type of Statement:
6?-'Preelection Statement
❑ Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Page of
For Official Use Only
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
/
MAILING 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 f my knowledge m 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 a_ IM~"~ e9ct:
Executed on BY
Dale i urer Assistant Treasurer
Executed on
Data of Cantd"Officeftoldt. Canddaie, State Measure Proponent or Responsible Officerof Sponsor
Executed on Dale By SgialireofConinia gOfteholder.Candidate.StaleMeasureProponent
Executed on Dais By Sgr»re of Cowoarg pNAhoNer, Carodate. State Measure Proponent
FPPC Form 460 (January105)
FPPC Toll-Free Helpifne: 8661ASK-FPPC (86612T6-3772)
State of Califomia
Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE
Amounts may be rounded Statement covers period
Summary Page to whole dollars.
.1
- from 1C}-'i
SEE INSTRUCTIONS ON REVERSE
through ° -I ) C Page 'ZI of
NAME OF FILER I.D. NUMBER
Contributions Received
1. Monetary Contributions schedule A, Line 3
2. Loans Received Schedule e, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2
4. Nonmonetary Contributions schedule C, Lure 3
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 + 4
Column A
TOTALTHIS PERIOD
(FROM ATTACHED SCHEDULES)
0
$
$
$
Column B
CALENDAR YEAR
TOTALTO DATE
$ ~ql . u
C)
` f
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received $ $
21. Expenditures
Made $ $
Expenditures Made
6. Payments Made schedule E. Line 4 $ T7
7. Loans Made Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ ; CA03 . P 7 7
9. Accrued Expenses (Unpaid Bills) Schedule F Line 3
10. Nonmonetary Adjustment `
Schedule C, Line 3
11. TOTAL EXPENDITURES MADE Add tines e + s + 10 $ , f3
$ 61.7, r7~
G
s 97 1-7 1
$ C0 1-7 &ct
Current Cash Statement
12. Beginning Cash Balance Previous Summary Page. Line 16 $ T+ T~1!f fC)
13. Cash Receipts Column A, Line 3 above IJ
14. Miscellaneous Increases to Cash schedule 1. Line 4 0
15. Cash Payments Column A, Line 6 above 0. 04,3 71
16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 91, z":L
H this is a termination statement Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED Schedule B. Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents see instructions on reverse
19. Outstanding Debts Add Line 2 + Line 9 in column a above
$ r)
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 calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made'
(s subject to Volunhry Expenditure Limit)
Date of Election
(mm/dd/yy)
Total to Date
I JI $
'Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
- Schedule D
SCHEDULED
Summary of Expenditures Type or print in ink. Statement covers period
Amounts may be rounded
SuppordnWOpposing Other to whole dollars.
Candidates, Measures and Committees from i i -1 C
SEE INSTRUCTIONS ON REVERSE through Page 3 of J
NAME OF FILER - I.D. NUMBER
tK3 FLA r- iF~ Z' I 5
DATE
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION,
OR COMMITTEE
TYPE OF PAYMENT
DESCRIPTION
(IF REQUIRED)
AMOUNTTHIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
ic)/,
MAP-I A A
~Aonetary
Contribution
Z cc)
C'
Z QC-` if'c'
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
SUBTOTAL $ 2
Schedule D Summary
1. Itemized contributions and independent expenditures made this period. (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.)
rY ) TOTAL $
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 86WASK-FPPC (8661275-3772)
Schedule E Type or print In ink. Statement covers period
P~~ Amounts may be rounded
to whole dollars.
from ~C."t -IC
SEE INSTRUCTIONS ON REVERSE through `C' I IC Page of
NAME OF FILER I.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CbP
campaign paraphernada/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)'
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filinglbalot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising everts
POL
poling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
independent expenditure supporting/opposing others (explain)'
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
UT
campaign literature and mailings
PRT
print ads
VVEB
information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(W COMWrrEE, ALSO EWER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
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' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $
• ( f
Schedule E Summary
$
1. Itemized payments made this period. (Include all Schedule E subtotals.)
2. Unitemized payments made this period of under $100
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)
$ Z~17- E,
$
17
TOTAL $
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 86WASK-FPPC (8661275-3772)
Schedule E
SCHEDULE E (CONT.)
(Continuation Sheet)
Type or print in ink
Amounts may be rounded
Statement covers period , . '
Payments Made
to whole dollars'
from
h I _(6
thro
SEE INSTRUCTIONS ON REVERSE
u
g
Page ✓ of
NAME OF FILER
I.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP Campaign poaphenwha/misc.
NW
member communications
RAD
radio airtime and production costs
CNS campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB conirlIxAm (explain nonmonetary)*
OFC
office expenses
SAL
campaign workers' salaries
CVC civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FL. candidate filingiballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
tltD independent expenditure supporting/opposing others (explain)"
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
Iii legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
UT campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
ALSO
ENTER I.D.
NU
OF COM UrrTTEE.
MBERR)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
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* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772)