HomeMy WebLinkAboutDICKERSON SEMIANN10(2)Kecipient Committm
Campaign Statement
Cover Page
(Government Code Sections 8420D-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in InL Date stamp
3tatemen co era period Date of election if applicable; page Of
Zola (Month, Day, Year) For Ofncial Use
from
- 201 FEB IQ: 43
through
1 • Type Af Recipient Committee: All cornmiea.t -comgaa Parts 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee
Q State Candidate Election Committee
❑ Primarily Formed Ballot Measure
O Recall
Committee
O Controlled
W- Par)
Q Sponsored
❑ General Purpose Committee
oftCMOs&Perte/
O Sponsored
Q Small Contributor Committee
❑ Primarily Formed Candidate/
Officeholder Committee
Q Political Party/Central Committee
0VWConipiovPart n
3. Committee Information
I.D. NUMBER [ , l z_
cc n.+mc turf GANDtoATE'S NAME IF O COMMITTEIG#
STREET
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
2. Type of Statement: -
❑ Perri-anion Statement
/Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement - Attach Forth 495
Treasurer(s)
MAILING
r•iTv
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 Btis statement and to the best of
under penalty of my knowledge the information con
perjury under the la of the of Catlfomta that the firegoing is true and correct.
ZZtl rzc By
Executed on
Si¢rahaaorT
Executed on &'I 1 By
and in the attached schedules is true and complete. 1 certify
K
Executed on
Dow By
Sf ak-ofCanM&V0ftdWNff.CandWab.S41fMantraPropanerrt
Executed on
naf By
SgrwdraafCarmoFrgolAcahalder. Carte, Stale MaauaPmpmfnt
GWASK-FPPC 460 (January
FPPC Toll-Free Helpane: 8FPPC FPPC Form 4 0 (Ja uary 2)
State of California
Recipient Committee
Campaign Statement
Cover Page - Part 2
Type or print in ink
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
'-49511z I
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Related Committees Not included in this Statement: Listanycommmees
not Included In this statement that are convolved by you or are primarily formed to receive
contributions or make expendhrres on behalf of your candidacy.
I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
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 CODE/PHONE
COVER PAGE - PART 2
Page 9- of A
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I JURISDICTION I ❑ 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 List names of
ofrfcehoider(s) or candk%Ws) for which this committee Is primad7y 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 ff necessary
FPPC Form 160 (January/"
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275.3772)
State of Cawomia
SCHEDULE B - PART 1
Schedule B - Part 1 *b'e-rou"'-Amounts may be nded
statement e v rs period
CALIFORNIA
Loans Received to whole dollars.
]
_ •
from
Z
~
1-0
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SEE INSTRUCTIONS ON REVERSE
'
through
-
- o
age -
NAME OF FILER
I.D. NUMBER
~tf~ -
X31 2 )
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
OUTSMU
ALANC
T
lb)
O
AMOUNT
RECEIVED THIS
(O)
AMOUNT PAID
OR FORGIVEN
~
NTEREST
PAID THIS
IF)
ORIGINAL
AMOUNT OF
UMULATIVE
CONTRIBUTIONS
(FcommITTMALWENTERLD.NWOM
(F$RF4WPL0YED,ENTER
I OFOUSINE s)
BEGI
HIS
PERIOD
THIS PERIOD'
OF THIS
PERIOD
LOAN
TODATE
VVV
❑ PAID
CALENDAR YEAR
c
~
s.
-4t~,- %
.
,
_ M ~ . A N _ l
~vic
❑ FORGIVEN
RATE
PER ELECTION
i{ ~ ~
S rL!~~?
$
S
i
S
t❑ IND COM
❑ OTH ❑ PTY ❑SCC
~
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
S
S
%
S
S
❑ FORGIVEN
RATE
PER ELECTION"
S
i
S
$
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
S
t
%
S
$
❑ FORGIVEN
RATE
PER ELECTION
s
i
S
s
s
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
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
(Mey ee a epetlw )
Enter the net here and on the Summary Page, Column A, Line 2.
(Enter (e) on
Sdmdde E. Une
tContributor Codes
IND-Individual
COM-Recipient Committel
(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. I
If required. J FPPC Form 460 (January/05)
FPPC Toll-Free Heipline: 866/ASK-FPPC (8661275-3772)
Campaign Disclosure Statement
Type or print In Ink.
SUMMARY PAGE
Summary Page
Amounts may be rounded
to whole dollars.
statement c e period
. -
'
o
from
•
Page 14 of
SEE INSTRUCTIONS ON REVERSE
through
NAME OF FILER
i
I.D. NUMBER
Column A
Column a
Calendar Year Summary for Candidates
Contributions Received
TOVY.TMPEF oD
ca.ENWY
T
Running In Both the State and
9 Primary
FROUN-AcrtEDscre~
TOTPL
OOKE
General Elections
1. Monetary Contributions Sdredule a Lie 3
$ $
111 through 6/30 7i1 to Date
2. Loans Received Sdodule B, Line 3
$
.
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS addunes 1 +2
$
Received $ $
Lme 3
Sdredae C
4
Nonmonetary Contributions
enditures
Ex
21
,
.
_
p
.
$ $
5. TOTAL CONTRIBUTIONS RECEIVED .................AddLines3+4
$ $
Made
Expenditures Made
6. Payments Made Sdredde E, Line 4
7. Loans Made Sdredub H, Line 3
8. SUBTOTAL CASH PAYMENTS add Lines 6 + 7
9. Accrued Expenses (Unpaid Bills) Sdmdu+e F Line 3
10. Nonmonetary Adjustment Schedule C, Line 3
11. TOTAL EXPENDITURES MADE Addunese+9+io
$ 19' $
$ $
$ ro-- $
Current Cash Statement
12. Beginning Cash Balance Prevkxo S-wnwyF%W Une 16
13. Cash Receipts Comm A. Line 3 above
14. Miscellaneous Increases to Cash Sdheatle i, Line 4
15. Cash Payments Column,, Una a above
16. ENDING CASH BALANCE Add uses 12 + 13 + 14. then subtract Une 15
If this is a termination statement, Line 16 must be zero.
$ ...G_
4~0-
$ 'It7-
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 mounts. 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).
17. LOAN GUARANTEES RECEIVED S h duce B, Pert 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents see instructions on reverse $
19. Outstanding Debts Add Une 2 +tkre 9 in Column a above $ f p
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made'
M $uWdto voMee.ry Eq-W%mre t.imdt)
Date of Election Total to Date
(mm/ddlyy)
'Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toil-Free H@Ipline: 888/ASK-FPPC (886!275-3772)