HomeMy WebLinkAboutFRIENDS FOR MR. DICKERSON SEMIANN11(1)Kecipient Committee
tr Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink.
Stateme c 4ers eeriod Data of election If applicable:
from. ZO) 1 (Month, Day, Year)
_11.
through 6IE
Date Stamp
AUG ► o AM to: ►
ERSt ttl0 CI f Y vi c
1. Type f Recipient Committee: An Comm(ttass _ conq&% Partft 1, 2, 3, and 4.
Of' :latd Candidate Con trolled Committee
O date Election Committee
❑ Primady Formed Ballot Measure
O a
committee
O Controlled
W-CompletePaKm
O Sponsored
❑ General Purpose Committee
(AbeC0MA*P8d6)
O Sponsored
❑ Primarily Formed Candidate/
O Small ContdbutorCommittee
Officeholder Committee
O Political Party/Central Committee
(naoCOMA re Pad 7)
3. Committee Information I I.D. NUMBER $~t (2
COMMITTEE NAME (OR CANDIDATES NAME IIF, VO COAMMITTE I
CITY
2. Type of Statement:
❑ eation statement
5em"nnuai Statement
❑ Termination Statement
(Also Me a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s) "W~_ T-'_
COVER PAGE
Page I of . 4
For Oftidal Use Only
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement - Attach Forth 495
.
MAILING ADDocec
r1•rv
6&-1o-n ITT r
STREET ADDRESS (NO P.O.
"
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL: FAX I 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 la ?taate of California that the foregoing is true and correct
Executed on te ~ 0 BY
By
Executed on oaoe 6 ~ l -I,
sno in the attached schedules is true and complete. I certify
K
Executed on
Date By
SrgnsYns orConeoGnp otecandaer. Canes. State Memm PmpmW
Exea+ted on
papa BY
Sfanahue orCmft*V 0MWhWW Cendate. Stoo Meawe Pmpw*M FPPC Forth 4" (Januavy=)
FPPC Toa-Free Heipiine: 866lASK-FPPC (86OW6,1M
State of Calfomia
iJ
• Recipient Committee
Campaign Statement
Cover Page Part 2
Type or print In Ink.
S. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
! ( STATE ZIIPP
Related Committees Not Included in this Statement: List any committees
not included in Ods statement that are conbolled by you or are primarily formed to receive
contrlbutlons or make expenditures on behalf of your candidacy.
COMMTTTEENAME
I.D. NUMBER
NAME OF TREASURER
CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
COMMTTTEENAME
I.D. NUMBER
NAME OF TREASURER
CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE 21P CODE AREA CODEIPHONE
COVER PAGE - PART 2
Page :;g- of 4
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I JURISDICTION I C1 SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, N any.
NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT
OFFICE SOUGHT OR HELD
DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee ust names of
ofteholdWs) 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 N necessary '
FPPC Fomn 480 (JanuwylM
FPPC Top-Free Helpline: 8881ASK-FPPC (888r2?5-M2)
Stab of Caftmia
f"
SCHEDULE B - PART 1
Schedule B-Part 1 rra we Nees,. see He-
Amounts may be rounded
Statement c v# period
'A 460
to whole dollars.
Loans Received
r l
FORM
from
Gj
3tZo (I
P
olo'
SEE INSTRUCTIONS ON REVERSE
_
.
through
age
of
NAME OF FILER
I.D. NUMBER
irelv"Z&
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
OUT ANDING
BALANCE
AM0 jN r
t~l
AMOUNTPAID
DING
9AIANCEAT
INTEREST
In
ORIGINAL
CUMULATIVE
OF LENDER
FCOr
AF
~
BEGINNING THIS
THIS
RECEIVED
ORFORGNEN
CLOSE OF THIS
PAID THIS
AMOUNTOF
CONTRIBUTIONS
p
wiiTEEntsogvrERip,NUaeep
.
NNNEOFeuSMESSy
PERIOD
PERIOD
~
THIS PERIOD
PERIOD
LOAN
TO DATE
❑ PAID
•
CALENDAR YEAR
VVV
~Q~~
C~
S
/
S Ti/
%
.
•
'
r
RATE
~
-
q
`
❑FORCIVEN
PER ELECTION"
a
s
s
to IND COM ❑ OTH ❑ PTY ❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDARYEAR
$
S
%
$
$
❑ FORGIVEN
RATE
PER ELECTION"
s
s
s
s
s
to IND ❑ COM ❑ OTH
❑ PTY ❑SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
S
S
%
S
$
❑ FORGIVEN
RATE
PERELECr10N"
S
$
S
$
S
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑SCC
DATEDUE
DATE INCURRED
SUBTOTALS $ $ $ $ I
)on
Lkw3)
r tContributor Codes
.y
IND-Individual
COM- Recipient Committe`b
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY- Political Party
SCC - Small Contributor Committee
" If required. FPPC Form 46o (January/OS)
FPPC Toll-Flee Helpline: 8661ASK-FPPC (866/2'75-3772)
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. ~•r
'Amounts forgiven or paid by another party also must be reported on Schedule A.
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
-'aj-o~S M►~~
Contributions Received
1. Monetary Contributions schedule A. Line 3
2. Loans Received sdmdme e, Libe 3
3. SUBTOTAL CASH CONTRIBUTIONS Add tines 1 + 2
4. Nonmonetary Contributions sdmdde C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .....................AddLines3+4
Type or print in ink SUMMARYPA
Amounts may be rounded Statement Cover? period CALIFORNIA
to whole dollars. 46-A
from ' •
through (0 5DZ01) Page A_ of 44
I.D. NUMBER
Column A Column B
TOTALTHISPENOD CALEND YEM
fROMATTACHMSCNEDULM TOTALTOtWE
$ $
$ $
Expenditures Made
6. Payments Made schedule E, Line 4
7. Loans Made schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7
9. Accrued Expenses (Unpaid Bills) S&A tde F Line 3
10. Nonmonetary Adjustment sdedde C. Line 3
11. TOTAL EXPENDITURES MADE AddLines8+9+1o
$ $ $
$ $
$ ro- $
Current Cash Statement
12. Beginning Cash Balance Pmv/oussummaryPam Line 16
13. Cash Receipts Colurm A, Line 3 above
14. Miscellaneous Increases to Cash sdm ule 1. Line 4
15. Cash Payments column A, Line a above
16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, wren subb-ad Line 15
If this is a termination statement Line 16 must be zero.
$ 4)-
$
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column 8 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).
17. LOAN GUARANTEES RECEIVED sdradide A Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents see instructions on reverse r~
19. Outstanding Debts Add Line 2 + Line 9 in Cdumn a above $ 51 c q~z
(tom)
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6130 711 to Date
20. Contributions
Received $ -115).- $
21. Expenditures
Made $ - - $
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made'
(If Su*ctto YbkaidryEgmWNure L1mM
Date of Election Total to Date
(mm/dd/yy)
I 'Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toil-Free Helplins: 866/ASK-FPPC (86612753772)