HomeMy WebLinkAboutSMITH 460PREELECT12(1)R-Copim, a frll���
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3. CommOm m to i otlon
I.D. NUMBER
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STREET ADORES MD P.O. SOX)
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CITY STATE ZIP CODE AREA COOEIPNONE
OPTIONAL: FAX I GiiML ADDRESS
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❑ $«Hoare iol eteisnMrt ❑ 9badel Odd-llbar Report
❑ Temlkldon 91 elenlerlt
Preelection
(Also tM a Form 410 Tumdnsllm) Atwh Form 495
❑ Amrrdnwd ( q4W bdo"
TruwA.o)
NAME OF TREASURER
MAILING ADDRESS
NAME UF A111151111115TAKY TREASURER, IF ANY
MAIUNG ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL: FAX I E4AA L ADDRESS
into atfalflsd sdleduln ie true and complete. I cww
Elieouled all By Dow F 4n 4AMMMIRM
FPPC ToWcow IIelFile: ierAtK FPPC AMMYO -M 2)
Stets of CdNbrob
Type or print In Ink.
Recipient Committee
Campaign Statement
Cover Page — Part 2
S. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Bob Smith
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
WARD 41 G-Tj CWNn C,
RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: List any committees
not Included in this statement that are controlled by you or are pdm&rW formed to receive
contributions or make expenditures on behalf of your candidacy.
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
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 CODEIPHONE
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
COVER PAGE - PART 2
page Z- of ll U
BALLOT NO. OR LETTER JURISDICTION ro UPPORT
PPO SE
Identity 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
ofllceholdWs) or candidates) 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 H necessary
FPPC Form 160 (Januaryl06)
FPPC Tome He"Ine: 66&ASK -FPPC (866!276 -3772)
Stab of ca8fomla
Campaign Disclosure Statement Type or print In Ink.
Amounts may be rounded
Summary Page to whole dollars.
Statement covers period
from 07/01/1986
Expenditures Made
6. Payments Made ........................ ............................... she E, Line 4
7. Loans Made .............................. ............................... schedule H, Line 3
8. SUBTOTALCASH PAYMENTS ..... ............................... Add tines 6 +7
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3
10. Nonmonetary Adjustment ........... ............................... schedule C, Line 3
11. TOTAL EXPENDITURES MADE . ............................... Add Lines a + a + 10
Current Cash Statement
12. Beginning Cash Balance ....................... Prev►ous summary Page, tine is
13. Cash Receipts .................... ............................... column A, line 3 above
14. Miscellaneous increases to Cash ........................... schedule ►, Line 4
15. Cash Payments ................... ............................... Co►urnn A, Line a above
16. ENDING CASH BALANCE .......... Add lines 12 + 13 + 14, then subtract line 15
If this is a termination statement, Line 16 must be zero.
$ 18,035.14
0
$ 18,035.14
0
I
$ 18,035.14
0
$ 18,035.14
0
0
$ 18,035.14 $ 18,035.14
$ 0
47,350
0
S
17. LOAN GUARANTEES RECEIVED .... ....................... Schedule e, Part 2 $
18,035.14
29,314.86
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ......... ............................... See insbuctions on reverse $
19. Outstanding Debts ......................... Add tine 2 + Line 9 in Column B above $ 20,000
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*
(tr subject to VolurAm Epncib- LknM
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 Toll -Free Helpline: 11MASK -FPPC (866/2753772)
through
09/30/2012
page 3 of to
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Bob Smith for Council 2012
1348552
Column A
Column S
Calendar Year Summary for Candidates
Contributions Received
TOTALTMP M
CALF DM
TOT�LTOOATe
Running in Both the State Prima and
9 Primary
WROM�rr�scrEu.M
General Elections
1. Monetary Contributions ............ ...............................
sonedu/e A, Line 3
350
$ 27 $
27,350
1/1 through W30 7/1 to Date
2. Loans Received ....... . .............. ...............................
Schedule e. Line 3
20,000
20,000
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add tines 1 +2
$ 47,350 $
47,350
20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ...............................
schedule C, Line 3
122.64
122.64
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ...........................
Add Lines3 +4
$ 47,472.64 $
47,472.64
Made $ $
Expenditures Made
6. Payments Made ........................ ............................... she E, Line 4
7. Loans Made .............................. ............................... schedule H, Line 3
8. SUBTOTALCASH PAYMENTS ..... ............................... Add tines 6 +7
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3
10. Nonmonetary Adjustment ........... ............................... schedule C, Line 3
11. TOTAL EXPENDITURES MADE . ............................... Add Lines a + a + 10
Current Cash Statement
12. Beginning Cash Balance ....................... Prev►ous summary Page, tine is
13. Cash Receipts .................... ............................... column A, line 3 above
14. Miscellaneous increases to Cash ........................... schedule ►, Line 4
15. Cash Payments ................... ............................... Co►urnn A, Line a above
16. ENDING CASH BALANCE .......... Add lines 12 + 13 + 14, then subtract line 15
If this is a termination statement, Line 16 must be zero.
$ 18,035.14
0
$ 18,035.14
0
I
$ 18,035.14
0
$ 18,035.14
0
0
$ 18,035.14 $ 18,035.14
$ 0
47,350
0
S
17. LOAN GUARANTEES RECEIVED .... ....................... Schedule e, Part 2 $
18,035.14
29,314.86
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ......... ............................... See insbuctions on reverse $
19. Outstanding Debts ......................... Add tine 2 + Line 9 in Column B above $ 20,000
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*
(tr subject to VolurAm Epncib- LknM
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 Toll -Free Helpline: 11MASK -FPPC (866/2753772)
Schedule A type or print In Ink. SCHEDULE A
Monetary Contributions Received Amoto whole dollars. nded
ollars tided
statement covers period
,
07/01/1986
from
-
09/30/2012
pap 4 jo
through
of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Bob Smith for Council 2012
1348552
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
OF COMMITTEE. ALSO E I.D.
CODE *
(IF SELF-EAPLOYED,eM RNAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
W]IND
See Attachment
❑COM
VAR
❑ OTH
❑ PTY
❑SCC
❑IND
❑ COM
❑ OTH
❑ pre'
[]SCC
❑IND
❑COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
[3Com
❑ OTH
❑ PTY
[]SCC
❑IND
[3Com
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$ 27,350
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.) ......................................................................... ............................... $
2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $
27,350
27,350
*Contributor Codes
IND— Individual
COM— Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Forth 160 (January/05)
FPPC Toll-Free Helplins: 8661ASK -FPPC (8661275-3772)
!' jN���iL`�I i! .UN I l�l BJ fv
� ()p Coy�N6 `71112a Z -- °t /301ZO IZ - - -
Amount
Received Total
Contribut
this Receive
Date
Received First
Donald & Debbie
Last
Camp
Occupation
Business Owner Homemaker
Address
IND
100 100
WINUEO
PACA6TAP4 Cc>Nf F-I6u-PoNS
P�WoD Co\EYztnvCa
iO
9/28/201 Gerald & Sandra
I Mathews
IND
100
100
Tntal
,,,_ w
t 1_ LJ
SCHEDULEB -PART1
�'"U "m "...b rounded Schedule B — Part 1
Amounts may be rounded
Statement covers period
CALIFORNIA
to whole dollars.
Loans Received
07/01/1986
from
• 460
09/30/2012
page of �U
throw h
g
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Bob Smith for Council 2012
1348552
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
OUTSTANDING
BALANCE
AMOUNT
RECEIVED THIS
AMOUcNT PAID
OUTS ANDING
BALANCEAT
INTEREST
PAID THIS
ORIGINAL
AMOUNT OF
a
CUMULATIVE
CONTRIBUTIONS
OF LENDER
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF - EMPLOYED, ENTER
NAM OF BUSINESS)
BEGINNING THIS
PERIOD
PERIOD
OR FORGIVEN
THIS PERIOD
CLOSE OF THIS
PERIOD
LOAN
TO DATE
❑ PAID
CALENDAR YEAR
Bob Smith
Civil Engineer,
0
20,000
0
20,000
s
Business Owner
s
s
%
RATE
s
❑FORGIVEN
PER ELECTION'"
0
20,000
s 0
12/2012
= 0
7/2012
$
t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
s
s
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
$
S
%
$
s
❑ FORGIVEN
RATE
PER ELECTION"
$
S
s
S
$
DATE DUE
DATE INCURRED
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
PAID
CALENDAR YEAR
❑ FORGIVEN
RATE
PERELECTION-
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
f
t
S
DATE DUE
DATE INCURRED
SUBTOTALS $ 20,000$ $ 20,000 $
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.)
(Enter (e) -
Sdwdtk E. Une 3)
20,000
tContributor Codes
0
3. Net change this period. Subtract Line 2 from Line 1. ............................................................... MET $ 20,000
Enter the net here and on the Summary Page, Column A, Line 2. (Mrj be e fw nmbo
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 Wpllne: 866/ASK -FPPC (866!276 -0772)
Schedule C
Nonmonetary Contributions Received
Bob Smith for Council 2012
FULL NAME, STREET ADDRESS AND
DATE ZIP CODE OF CONTRIBUTOR
RECEIVED (W COMMITTEE, ALSO ENTER I.D. NUMBER)
8/25/2012 Bob Smith
f3��-
Type or print in Ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/1986
through
CONTRIBUTOR I IF AN INDIVIDUAL, ENTER I DESCRIPTION OF
CODE * OCCUPATION AND EMPLOYER GOODS OR SERVICES
(IF SELF - EMPLOYED. ENTER
NAME OF BUSINESS)
OIND Food for
❑� Civil Engineer,
❑0TH Business Owner Volunteers
❑PTY
❑SCC
❑IND
[3Com
❑0TH
❑PTY
❑scc
❑IND
❑COM
❑OTH
❑ PTY
❑SCC
MIND
❑COM
❑0TH
❑PTy
❑SCC
Attach additional information on appropriately labeled continuation sheets.
09/30/2012 Page :� of
AMOUNT/
FAIR MARKET
VALUE
I.D. NUMBER
1348552
CUMULATIVE TO PER ELECTION
DATE TO DATE
CALENDAR YEAR (IF REQUIRED)
(JAN 1 - DEC 31)
122.64 1 122.64
SUBTOTAL $ 122.64
Schedule C Summary
1. Amount received this period — itemized nonmonetary contributions.
(Include all Schedule C subtotals.) ...................................................................................... ............................... $
2. Amount received this period — unitemized nonmonetary contributions of less than $100 ..... ............................... $
3. Total nonmonetary contributions received this period. TOTAL $
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ......................
122.64
0
122.64
FPPC Form 460 (Januery106)
FPPC To"ree Helpline: SGWASK -FPPC (066f276 -3772)
.Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC - Small Contributor Committee
Schedule E Type or print In Ink. Statement covers period CALIFORNIA
Amounts may be rounded J S ,
Payments Made to whole dollars. from 07/01/1986 FORM
" Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Tts'uJ0.14
Schedule E Summary
.................. $ 18,035.14
1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................. ...............................
n
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.) ............................. TOTAL $
0
18,035.14
FPPC Form 160 (January/05)
FPPC Tog -Free Helplkw: 8WASK -FPPC (8661V&3772)
09/30/2012
9 L�
through
Page of
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
NAME OF FILER
1348552
Bob Smith for Council 2012
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CNP campaign parephemalia/misc.
NOR
member communications
RAD
RFD
radio airtime and production costs
returned contributions
CNS campaign consultants
CTB contribution (explain nonmonetary)'
WM
OFC
meetings and appearances
office expenses
SAL
campaign workers' salaries
CVC civic donations
PET
petition circulating
Tfl.
TRC
t.v. or cable airtime and production costs
candidate travel, lodging, and meals
FIL candidate Ming/ballot fees
PHD
POL
phone banks
polling and survey research
TRS
staff/spouse travel, lodging, and meals
FND fundraising events
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
VYEB
voter registration
information technology costs (internal, e-mail)
LIT campaign literature and mailings
PRr
print ads
" Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Tts'uJ0.14
Schedule E Summary
.................. $ 18,035.14
1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................. ...............................
n
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.) ............................. TOTAL $
0
18,035.14
FPPC Form 160 (January/05)
FPPC Tog -Free Helplkw: 8WASK -FPPC (8661V&3772)
PAYMWr5 ATTACHM6VT .5cHEouc� "E'
pe(uoD CDVER -w!a 71I/702- °Y3ol201Z
(U c-F to
Name of Payee
Payee Address
Walking Flyers
Total