HomeMy WebLinkAboutSMITH 460 PREELECT12(2) AMEND 1/2/13Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200- 84218.5)
fro
Type or print In Ink.
Statement covers period
m 10/1/2012
SEE INSTRUCTIONS ON REVERSE I through 10/20/2012
1. Type of Recipient Committee: AN CommMbaa — Complsb Parts 1, 2, 3, and 4.
® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
Q Recall Q Controlled
(Ado cornplara Pat 5) Q Sponsored
(Ado Campdb Part 6)
❑ General Purpose Committee
Q Sponsored
Q Small Contributor Committee
Q Political Party/Central Committee
3. Committee Information
COMMITTEE
Bob Smith for Council 2012
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Compile Part n
I.D. NUMBER
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement
under penalty of perjury under the laws of the State of California that the foregc
Executed on
13JQ
,
Dab
Executed on
( Month, Day, Year)
Dab
Executed on
Dare
Executed on
11/6/2012
Dab
the best
BY
COVER PAGE
Date Stamp
Treasurer(s)
NAME OF TREASURER
Debbie Camp
MAILING ADDRESS
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
the irf6t Cation contained herein agld in the attached schedules is true and complete. I certify
By
SgrraaeotConuollrgoaanadsr, CwddWe, srrsMom" ftWwt
BY swoon otca roong oacw4wer. Cadidab. Stab Manaus PioparM
FPPC Form I60 (Janwry/05)
FPPC ToNfne HdpNne: IWASK+M (INIGI 7EJ77Z)
Sbb of Callbmis
Type or print in Ink. COVER PAGE - PART 2
Recipient Committee CALIFORNIA
'
Campaign Statement FOR
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Bob Smith
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Bakersfield City Council, Ward 4
RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: ust any committees
not Included in this statement that are controlled by you or are pdmadly formed to receive
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME
NAME OF TREASURER
COMMITTEEADDRESS STREET ADDRESS (NO P.O.
I.D. NUMBER
❑ YES ❑ NO
CITY STATE ZIP CODE AREA CODEIPHONE
COMMITTEE NAME
I.D. NUMBER
NAME OF TREASURER I CONTROLLED COMMITTEE?
❑ YES ❑ NO
ADDRESS
(NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Page of
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
DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee List names of
of icaho/der(s) 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 N necessary
FPPC Form 460 (January"
FPPC TojWme Help6ne: 6661ASK -FPPC (8661276 -3772)
Stab of ca0bmie
Campaign Disclosure Statement Type or print In InL
Amounts may be rounded
Summary Page to whole dollars.
statement covers period
from 1011/2012
PAGE
Expenditures Made
6. Payments Made schedule E, Line 4 $ 12,368.45 $ 30,403.59
........................ ...............................
7. Loans Made .............................. ............................... Schedule H, Line 3 0 0
8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 12,368.45 $ 30,403.59
9. Accrued Expenses (Unpaid Bills) ............................... schedule F Line 3 0 0
10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 0 0
11. TOTAL EXPENDITURES MADE . ............................... Add Lines e + 9 + 10 $ 12,368.45 $ 30,403.59
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Pap, Line 16 $ 29,314.86
13. Cash Receipts ....... column A, Line 3 above 1,800
............. ...............................
14. Miscellaneous Increases to Cash ........................... schedule ►, Line 4 0
15. Cash Payments ................... ............................... Column A, Line a above 12,368.45
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract tine 15 $ 18, 746.41
N this is a termination statement Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Schedule S, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ............ ............................ see instructions on reverse $
19. Outstanding Debts ......................... Add tine 2 + Line 9 in column 8 above $
20,000
To ..fate 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`
fir ftWd to Vokwftry Eq -xft- LkW"
Date of Election Total to Date
(mm/dd/yy)
I $
1 _lam $
"Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: SWASK -FPPC (866/275 -3772)
through
10/20/2012
page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Bob Smith for Council 2012
1348852
Coiwnn B
Calendar Year Summary for Candidates
Contributions Received
TOColumnA
TALTHa9PERIOD
CALEPDARYEAR
Running in Both the State Prima and
9 Primary
�FROMATTACHEDSCHIawiESt
TOTA�TOOATe
General Elections
1. Monetary Contributions ............ ...............................
Schedule A, Line 3
1,800
$ $
29,150
1/1 through 6130 7/1 to Date
2. Loans Received ....................... ...............................
schedule e, Line 3
0
20,000
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines +2
$ 1,800 $
49,150
20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ...............................
Schedule C, Line 3
500
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED .•.•.. .••• .............••••AddLin"3
+4
$ 2,300 $
Made $ $
Expenditures Made
6. Payments Made schedule E, Line 4 $ 12,368.45 $ 30,403.59
........................ ...............................
7. Loans Made .............................. ............................... Schedule H, Line 3 0 0
8. SUBTOTALCASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 12,368.45 $ 30,403.59
9. Accrued Expenses (Unpaid Bills) ............................... schedule F Line 3 0 0
10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 0 0
11. TOTAL EXPENDITURES MADE . ............................... Add Lines e + 9 + 10 $ 12,368.45 $ 30,403.59
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Pap, Line 16 $ 29,314.86
13. Cash Receipts ....... column A, Line 3 above 1,800
............. ...............................
14. Miscellaneous Increases to Cash ........................... schedule ►, Line 4 0
15. Cash Payments ................... ............................... Column A, Line a above 12,368.45
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract tine 15 $ 18, 746.41
N this is a termination statement Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Schedule S, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ............ ............................ see instructions on reverse $
19. Outstanding Debts ......................... Add tine 2 + Line 9 in column 8 above $
20,000
To ..fate 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`
fir ftWd to Vokwftry Eq -xft- LkW"
Date of Election Total to Date
(mm/dd/yy)
I $
1 _lam $
"Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: SWASK -FPPC (866/275 -3772)
Srhedule A Type or print In Ink. SCHEDULE A
Amounts may be rounded
Monetary Contributions Received to Whole dollars.
Statement covers period
CALIFORNiA
10/1/2012
from
•
through 10/20/2012
Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Bob Smith for Council 2012
1348852
��
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
pFCO rrrEE,usoErrtEa�o.ru +l
CODE "
(FsELF-EMPLOYEO.ENTERNAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF MANJEW
See Attachment
❑COM
1,800
VAR
❑ OTH
❑ PTY
❑SCC
❑IND
❑COM
[10TH
❑ PTY
❑SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
[]SCC
❑IND
❑ COM
❑ OTH
❑ PTY
[]SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTALS 1,800
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 $
1,800
0
1,800
IND — individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC —Small Contributor Committee
FPPC Form 460 (January105)
FPPC TON -Free Helpi ne:11MASK -FPPC (8861275-3772)
ROMO Tv
10/1/'74017 -
���;; nn ,A
C'
lv /gypl2v rZ
Amount
Received
Total
Contribut
this
Receive
Date
Received First
Last
Occu ation
Address
Ci
IND l
1
SCHEDULE B - PART 1
Iype ur profit oil mw.
Schedule B — Part 1 Amounts may be rounded
statement covers period
, CALIFORNIA
,
Loans Received to whole dollars.
10/1/2012
from
a • •
REVERSE
through 10/20/2012
Page of
SEE INSTRUCTIONS ON
I.D. NUMBER
NAME OF FILER
1348852
Bob Smith for Council 2012
ZI
FULL NAME, STREET ADDRESS AND P CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
le)
OUTSTANDING AMOUNT AMOUNTPA {D
BALANCE RECEIVED THIS
OUTSTANDING
BALANCEAT
lei
INTEREST
PAID THIS
Iff 191
ORIGINAL CUMULATIVE
AMOUNT OF CONTRIBUTIONS
OF LENDER
(IF SELF -R P Y®. ENTER
BEGINNING THIS PERIOD OR FORGIVEN*
THIS PERIOD
CLOSE OF THIS
PERIOD
LOAN TO DATE
(IF coMMiTTEE- Also ENTER I.D. NUMBER)
NAIVEof OUST EW
PERIOD
❑ PAID
CALENDAR YEAR
Bob Smith
Civil Engineer,
: 0
= 20,000
0
20,000
$ 20,000
Business Owner
%
RATE
$
PER ELECTION"
❑FORGIVEN
20,000
O
$ 0
12/2012
0
0712012
= 20,000
s
$
s
DATE INCURRED
DATE DUE
t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
❑ PAID
CALENDAR YEAR
It
$
❑ FORGIVEN
RATE
PER ELECTION"
S
S
S
S
S
DATE DUE
DATE INCURRED
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
RATE
PER ELECTION"
S
S
2
DATE DUE
$
$
DATE INCURRED
to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
SUBTOTALS $ $ $ $ 20,000
(Enter (9)-
ScheddN E, Une 3)
l4tr_hedule R 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.) ,�T
E. (May be a negative numW
3. Net change this period. (Subtract Line 2 from Line 1.) .............................. ...............................
Enter the net here and on the Summary Page, Column A, Line 2.
I
lil
tContributor Codes
IND — Individual
COM — Recipient Committee
(other then 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. 1 FPPC Form 460 (January/06)
** If regw�• FPPC Toll -Free Helpllne. 666/ASK -FPPC (8661276 -3772)
Q0.tighA1lift r Type or print in ink. SCHEDULE C
Amounts may oe rounaea
Nonmonetary Contributions Received to whole dollars.
Statement covers period
• - ,
from 10/1/2012
• -
10/20/2012
through
Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Bob Smith for Council 2012
1348852
DATE
FULL NAME, STREET ADDRESS AND
CONTRIBUTOR
FAN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
DESCRIPTION OF
AMOUNT/
FAIR MARKET
CUMULATIVE TO
DATE
PER ELECTION
TO DATE
RECEIVED
ZIP CODE OF CONTRIBUTOR
(F COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE *
(IF SELF-EMPLOYED, ENTER
GOODS OR SERVICES
VALUE
CALENDAR YEAR
(JAN 1 - DEC 31)
(IF REQUIRED)
NAME OF BUSINESS)
Managed Care Systems
Office Space
500
500
10/19/12
❑PTM
❑SCC
❑IND
❑COM
❑0TH
❑PTY
❑SCC
❑IND
❑COM
❑OTH
❑PTY
❑SCC
❑IND
❑COM
❑0TH
El PTY
[]SCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 500
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.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $
500
0
r�
*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 Form 460 iJonuory/06)
FPPC Toll-Free Helpline: 86WASK -FPPC (8661275~4772)
SCA60uLs e:-;--
PMMyX-
o q"KOZL6"O ('�1 iA AW
�a �, 1 I
L1 2012 I PMV, dF
^IAmE et. FILAL
C306 WITH F0i- L'o(ANCl L Zo tZ 3gg8sZ
FL candidate fifing/ballot fees PHD phone banks TRC candidate travel, lodging, and meals
FPD fundraising events POL polling and survey research TRS staf ispouse travel, lodging, and meals
W independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor
LEG legal defense PRD professional services (legal, accounting) VOT voter registration
LJr campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail)
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 12,165.63
Schedule E Summary
1. Itemized payments made this period. (include all Schedule E subtotals.) ......... $ 12,165.63
........................................................ ...............................
2. Unitemized payments made this period of under $100 0
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ................................................ ............................... $ 0
4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 12,165.63
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 666/ASK -FPPC (86612753772)
Name of Payee
I ► V !.c/
Pa ee Address
!.� v
Ci
State
zip
Description
Amount
420.00
tempSery
Mailer
1,156.02
Total