HomeMy WebLinkAboutDICKERSON SEMIANN10(1)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink
Stateme co ra period
from n TZIA>t
through & F-z-o to
1. Typ"f Recipient Committee: AN Cormnatees _ ce n i a Parts 1, 2, 3, and 4.
[Oficeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
Q Recall Q Controlled
(A1so CorrPWt Parts) O Sponsored
M1W Connote Pere 6m
❑ General Purpose Committee
Q Sponsored
Q Small Contributor Committee
Q Political Party/Central Committee
3. Committee Information
COMMITTEE NAME (OR CANDIDATE'S NAMI
- -1,rT,.rr ¢ce h-1
❑ Primarily Formed Candidate/
Officeholder Committee
~ C-#bbe Pot n
I.D. NUMBER $31 I z
Date of election If applicable;
(Month, Day, Year) ,
Date Stamp
I1fEB-4 AX10:4
2. Type of Statement:
Sem
❑ ,Oelectlon Statement
Semi-annual Statement
❑ Termination Statement
(Also fie a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s) IM
COVER PAGE
CALIFORN
FORM 'A 4.1
Page --I- of
For Official Use Only
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
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 best of my knowledge the
under penalty of perjury under the of the State of California that the foregoing is true and correct.
Executed on By
Executed on i By
.e ~r w sk new
Da*
and in the attached schedules is true and complete. I certify
Executed on By Gals Sookm ofCwbx4N 5K-e et,Cendda Stara Meamm Proponent
Exerted on D.re By Signaaaa of Conhoinq g6odndder. Carditlare, Shls I/naaa PrapanerN
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: a661ASK-FPPC (6661275~1772)
Stab of California
Type or print in ink COVER PAGE - PART 2
Recipient Committee
Campaign Statement • i CALIFOPMA FORM
Cover Page - Part 2
Page of _
S. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Kant '1c)►~Q~~-1 g?jl 12 I
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Related Committees Not Included in this Statement Lw any committees
not Included in this statement that are controlled by you or are prfmafly formed to receive
conMbudons or make expenditures on behalf of yaw candidacy.
COMMITTEE NAME
I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
I ❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
COMMITTEE NAME
I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA COOE/PHONE
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER i JURISDICTION
❑ 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. IF ANY
7. Primarily Formed Candidate/Officeholder Committee ust names of
officeholder(s) or candidate(s) for which this committee is primarily formed
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
FPPC Form 160 (JanuaryMS)
FPPC Toll-Free Hipline: WWASK-FPPC (66=75JT72)
Stab of CaMmia
Campaign Disclosure Statement
Summary Page
Type or print In Ink.
Amounts may be rounded
to whole dollars. Statement a ve tperiod
from , I to
SEE INSTRUCTIONS ON REVERSE through Page of
NAME OF FILER I.D. NUMBER
t1-{.mss-
Cohan A Column a Calendar Year Summary for Candidates
Contributions Received TOTALT111SPOCOW CALerx YEM
(FTM ATTACHM SCFEDULM TOWTOUAM Running in Both the State Primary and
General Elections
1. Monetary Contributions Sdiedure A. Line 3 $ $ 111 through 6130 711 to Date
2. Loans Received Sdredde B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines r + 2 $ $ 20. Contributions Received $ $
4. Nonmonetary Contributions Sdiedure C, Line 3 21 Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ..................AddLima3+4 $ $ Made $ -
Expenditures Made
6. Payments Made
Schedule E, Line 4 $
7. Loans Made
Sdredre H, Line 3
8. SUBTOTAL CASH PAYMENTS
Add Lines 6 + 7 $
9. Accrued Expenses (Unpaid Bills) Sch dae F Line 3 -1&--
10. Nonmonetary Adjustment Sdodule C. Line 3
11. TOTAL EXPENDITURES MADE
Add Lines 6 + 9 + 10 $ ' a
a
$
$
Current Cash Statement
12. Beginning Cash Balance PreviowSurtrmeryPage, Line 16 $
13. Cash Receipts Column A, Line 3 above
14. Miscellaneous Increases to Cash Scnedu►e Lime 4
15. Cash Payments Cdumn A, Line 6 above
16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, Own subWad Line 15 $ ' if this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED SCh dlde 8, Part 2 $ -1cl'_
Cash Equivalents and Outstanding Debts
18. Cash Equivalents See kat ucoons on reverse s
19. Outstanding Debts Add Line 2 +Lkw 9 in column e above $ f f
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 fled
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*
IM subiedto lrokeAwry Em-Will- UrrAl
Date of Election Total to Date
(mm/dd/yy)
I _ I $
I -lam $
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 (8661273-3772)
SCHEDULEB-PART1
ryps or pnrtt in mR.
Schedule B -Part 1 Amounts may be rounded statement v rs period
i
-ALIFORNIA
, ,
`2o10
Loans Received to whole dollars. from
-1 ri
FORM
pap
of
through
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
NAME OF FILER
n
C'Y -1`c
2-
FULL NAME. STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
BALANCE
b
AMOUNT
RECEIVED THIS
(al
AMOUNTPAID
ANCMG
BALANCEAT
•
INTEREST
PAID THIS
ORIGINAL
AMOUNT OF
9
CUMULATIVE
CONTRIBUTIONS
OF LENDER
IF - couwRTEE ALSO ENTERLD.M1M8Bi)
(IF ggFEMPLOYED, ENTER
wwEoFSUSINESS)
BEGINNING THIS
PER OD
PERIOD
OR FORGIVEN
THIS PERIOD'
CLOSE OF THIS
PERIOD
AN
LO
TO DATE
\
~~T
C] PAID
CALENDAR YEAR
%
R
C~
RATE
-
❑ FORGIVEN
PERELECTION
~
s
S
t❑ IND COM ❑ OTH ❑ PTY ❑ SCC
S /
S
s
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
%
S
S
$
i
'
E] FORGIVEN
RATE
PER ELECTION"
s
s
s
s
s
DATE DUE
DATE INCURRED
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
❑ PAID
CALENDAR YEAR
S
i
%
S
S
❑ FORGIVEN
RATE
PER ELECTION-
$
$
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
S
S
3
DATE DUE
DATE INCURRED
SUBTOTALS ~ $ $
Schedule B Summary
1. Loans received this period $
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period $
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) NET $
Enter the net here and on the Summary Page, Column A, Line 2.
--e--
(May boa MOO- Moo"
(Enter (e) on
Sdbdk/e E. Line 3)
tContributor Codes
IND-Individual
COM- Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC - Small Contributor Committee
'Amounts forgiven or paid by another party also must be reported on Schedule A.
" If required. FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772)