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Home My WebLink AboutPATIENTS FOR COMPASSIONATE SEMIANN13(2)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 84216.5) Type or print in ink. Date Stamp Statement covers period Date of election if applicable: (Month, Day, Year) from [� ( .. 21 J SEE INSTRUCTIONS ON REVERSE I through ( -'��%C VAX 1. Type of Recipient Committee: All committees - Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (A Completepert5) Sponsored (AlsoCompktePart6) General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee 0 Political Party /Central Committee (Also Comp/ete Part 7) 3. Committee Information I.D. 7 ; :2� COMMITTEE NAME (ppR CANDIDATE'S NA IF NO COMMITTEE) U'5 Treasurer(s) -- C y 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and knowledge the inf m on ontain herein and in the attached schedules is true and com fete. I certify under penalty of perjury under a la of a State of California that the fore g ' g is true and correct. ----Vl /�� Executed on By �. "` Sg ture ofTreasurerorAssaiantT asurer r3� 141"(' 414J5 Execute Dam Executed on Dam Executed on Dam By �'_ p �fl�tClJr S' ignature o4Cordroging „OfficeFwlder, Candidate, State Measure Proponent orResporeible Officer ofSponsor (.� (' n/ B Y (� i By _--� By FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) State of California Attachment to California Form 460 for Patients For Compassionate Use Policies ID# 1332436 For period: July 1, 2013 - December 31, 2013 c-.. RE: 3. Committee Information & 4. Verification Dege Coutee was acting treasurer during the above reporting period and has signed the verification section of the enclosed report. Jennifer Nicoletto became acting treasurer as of January 15, 2013, and appears as the current treasurer as of the filing of this report. I� P Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or nn-,, Amendment List I.D. number: ❑ Termination — See Part 5 List I.D. number: Date qualified as committee Date qualifed as committee Date of Termination (u applicable) Ireasurer a NAME TREASUREI STREET DDRESS CITY NAME ASSISTAN T Date Stamp �%f � &� --Z) For MIA Use Only I have used all reasonable diligence in preparing this statement and t e of my nowledge the information contained herein Is true and complete. I certify under penalty of perjury u der he laws of the Stat is that t� g is tr and correct. Executed on gy TE SIGNA SURER OR ASSISTANT TREASURER Executed on By DATE SIGNATURE OFCONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on BY DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Dec /2012) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov 9 Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFIQ'EHOLDER OR CANDIDATE Type or print in ink. RESIDENTIAL /BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP a;��d Ad,(w46 Pxzk--� Page 6. Primarily Formed Ballot Measure Committee NAME 7/IMEA-SURE BALLOT 40. O IN❑OPPOSE LETTER JURISDICTION Related Committees Not Included in this Statement: Listany committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAMEC7ZR EASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS TADDRESS (NO P.O. BOX) CITY STATE ODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBE NAME OF TREASURER CONTROLLED COMMITT ? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Identify the controlling officeholder; COVER PAGE - PART 2 Of ❑ SUPPORT ❑ OPPOSE 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 officeholder(s) or candidates) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT IN❑OPPOSE T*U4g OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD e ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDA OFFICE SOUGHT OR HELD ❑ SUPPORT ` ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR ❑ SUPPORT P OSE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (86612753772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Summary Page Schedule H, Line 3 Amounts may be rounded to whole dollars. Add Lines 6 + 7 $ Statemen colors period CALIFORNIA 460; 10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ from SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER, I.D. NUMBER Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHISPERICD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTODATE Running in Both the State Primary and 00 aL General Elections 1. Monetary Contributions ............ ............................... schedule A, Line 3 $ $ 2. Loans Received ....................... ............................... schedule a, Line 3 Z 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines l +2 $ * $ 20. Contributions �..,_ $= v�$ 4. onmonetary Contributions ..... ............................... Schedule c, Line 3 /557- Received 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ $ qz ago _ ti Made $ $ 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) ............................... schedule F Line 3 10. Nonmonetary Adjustment ........... ............................... Schedule c, Line 3 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ k xi 13. Cash Receipts .................... ............................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4 15. Cash Payments ................... ............................... column A, Line 8 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. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ _ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in column 8 above $ E '24_ 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 f r State Candidates 22. Cumulative Expend Liras Made* (If Subject to Voluntary Expenditure Limit) at.e of Election Total to Date (m 1— , $ 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 (86612753772) Schedule A Type or print in ink. SCHEDULE A Amounts may be rounded S Statement co ers eriod • - ff from - . 1 SEE INSTRUCTIONS ON REVERSE t through P Page Of OF FI ER I I.D. NUMBER DATE F FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR C CONTRIBUTOR I IF AN INDIVIDUAL, ENTER A AMOUNT C CUMULATIVE TO DATE P PER ELECTION OF BUSINESS) One Yoh �0 �1 `QIV ' ❑ ❑COM TH ❑ PTY f f/ i3 [ []SCC /3 C C'ci!C (ns , r o o�oM [ ❑PTY � �%260 [:]SCC 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.) ...... ....................... $ E ....................... $ J TOTAL $ "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 (January/06) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/276 -3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period J from through Jl Page of NAM ILER ' �4 �� ( 0'0 r� Q. t a Ct I.D. NUMBER �3 ` -S(P DATE RECEDED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ( IFCOMMITTEE ,ALSOENTERI.D.NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IFSELF- EMPLOYED, ENTER NAME AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) OF BUSINESS) �n La+ El SCC V1 O1 1W ^ ✓" �( ❑ COM ❑ PTY Qw'li E] SCC ❑COM ❑ PTY j C� ❑ SCC r ❑COM PTY Cf ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276.3772) SCNFnI1LP R _ PORT I acneauie t3 — roan i Amouuntnt may may be rounded Statement covers period Loans Received to whole dollars. � ' 0 from "-4— SEE �,/"1 22 INSTRUCTIONS ON REVERSE through of OF OF FILER �� X 1 04. � �� r>ti a� ��SQ r c �S I.D. NUMBER 3Co FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING BALANCE AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENiERI.D.NUMBER) (IF SELF- EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAMEOFBUSINESS) PERIOD THIS PERIOD" PERIOD LOAN TO DATE ❑ PAID $ % $ CALENDAR YEAR $ f. ❑FORGIVEN "� RATE PER ELECTION"°" to IND ❑ COM ❑ OTH ❑PTY ❑ SCC DATE INCURRED "' - -... DATE DUE ^� CALENDAR YEAR $ �$'— % $ ❑ FORGIVEN PER EL N RATE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑.SCC TE INCURRED _ DATE DUE r^� ❑ PAID CALENDARYEAR ❑ FORGIV RATE «« PER ELEC t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ $ $ $ DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ 7 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.) ................ Enter the net here and on the Summary Page, Column A, Line 2. "Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. ............... $ .............. I...... NET $ 2 (May WiMgative number) (tmer (e) on Schedule 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 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275-3772) Schedule C Type or print in ink. SCHEnuI F c nnmuunas may oe rounaeo onmonetary Contributions Received to whole dollars. Statement covers pew -- - -- - , . . 1 from /?, SEE INSTRUCTIONS ON REVERSE through Fpage / of DAME OF FILER/ T'� 00 ' I.D. NUMBER 8 2 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONCODE *OR CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER DESCRIPTION OF GOODS OR SERVICES AMOUNT/ FAIR MARKET VALUE CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF REQUIRED} NAME OF BUSINESS) (JAN 1 -DEC 31) -, �;�� 0,1 t l_ ` ❑IND ❑COM �1 �r� " ( ❑SCC l � EJIND ❑COM1ti �TM PTY r (� [:1 ❑SCC / ❑-]COM JC20TH / ❑SCC /3 lY , ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 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. 2 J (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ 2✓ / '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276 -3772) ichedule C Type or print in ink. SCH-EDA&ELC Amounts may be rounded Statement covers period 14onmonetary Contributions Received to Whole dollars. CALIFORNIA , from •- • EE INSTRUCTIONS ON REVERSE through Page of 21 NAME OF FILEJR I.D. NUMBER IF AN INDIVIDUAL, ENTER AMOUNT! CUMULATIVE TO PER ELECTION FULL NAME, STREET ADDRESS AND CONTRIBUTOR DESCRIPTION OF DATE DATE OCCUPATION AND EMPLOYER FAIR MARKET TO DATE RECEIVED ZIP CODE AL CONTRIBUTOR CODE * (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR (IF COMMITTEE, ALSO ENTER I. D. NUMBER) NAME OF BUSINESS) (IF REQUIRED) (JAN 1 -DEC 31) o O � � �� oscc ❑Scc � ❑IND (� ❑SCC U ❑IND ❑ COOT M �c ❑SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ ci 0 ,14-0,Ut "Contributor Codes 1 IND — Individual COM — Redplent Committee (other then PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) Helpline: 8661ASK•FPPC (8661276 -3772) Schedule C Type or print in ink. SCHEDULE C mmounis may De rounaea Nonmonetary Contributions Received towholedollars. Statement covers period CALIFORNIA , •- • from through Page _J�__. of 3EE INSTRUCTIONS ON REVERSE LAME OF FILER I.D. NUMBER DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE AL CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, S) NAME OF BUSINESS) DESCRIPTION OF GOODS OR SERVICES AMOUNT! FAIR MARKET VALUE CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 -DEC 31) PER ELECTION TO DATE (IF REQUIRED) �� Ac lWit C., ❑IND OCOM1 [3 PTY (�t (l C^✓� /C iIN y � [3 SCC z 00 [3oTH OPTY �►` �ltQ�( -� []SCC /l MO?411 Y4 V / l Ci��ll/Kr �� [3Com [30TH [3PTY ❑ PTY � ❑scc Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ *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 (January)06) Helpline: 8661ASK -FPPC (8661275 -3772) ichedule C Type or print in ink. SCHEDULE C 4onmonetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period , • 1 l . from _ through Pager of� EE INSTRUCTIONS ON REVERSE i_AME OF FILEJR ��c`� /%/�., �� O i �'� �i`°�tJ � l.t' /�Cit�VC lJ`-' .✓t l �1..— �� I.D. NUMBER ( �� C �� DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT! FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF•EMPLOYED,ENTER NAME OF BUSINESS) GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) (IF REQUIRED) OM Aut ^ . ❑OTH ❑PTY ��,�� (/ /C , ]I ND / [:]Com ❑SCC ❑IND QP/1� [3Com .26M LV scu [3scc OPTY �^� ❑ IND C d' r [3Com�� s [:]PTY � $cc 0 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ r *Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Poiitical Party SCC — Small Contributor Committee FPPC Form 460 (January/05) Helpline: 8661ASK -FPPC (866/276 -3772) Schedule C Type or print in ink. SCHEDULE C Amounrs may ne rounaea Nonmonetary Contributions Received to whole dollars. Statement covers Period III l CA LIFORNIA • - from through page of .y 'EE INSTRUCTIONS ON REVERSE LAME OF FILER I.D. NUMBER DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP COgE, AL CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) DESCRIPTION OF GOODS OR SERVICES AMOUNT/ FAIR MARKET VALUE CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 - DEC 31) PER ELECTION TO DATE IF REQUIRED) c4"faaX0 ❑ ❑CO M ❑ PTY % EISCC C EICOM ❑0TH ❑PTY scc z Q�l - oG ❑ P ` ❑$CC U OIND TH r-JPTY 3, ❑scc Y Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ R Z� *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 (Januaryl06) Helpline: 8661ASK -FPPC (8661278 -3772) Schedule C Nonmonetary Contributions Received Type or print in Ink. Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA . from 1 through ZE Page of tAME OF FILER I.D. NUMBER c� t` '41k ` C Coo r � � ��e .2- DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF DESCRIPTION OF AN INDIVIDUAL, ENTER AMOUNT/ CUMULATIVE TO PER ELECTION OCCUPATION AND EMPLOYER FAIR MARKET DATE TO DATE RECEIVED ZIP CODE CONTRIBUTOR CODE * GOODS OR SERVICES CALENDAR YEAR (IF COMMITTEE, ALSO ENTER 1. D. NUMBER) pFSELF - EMPLOYED, ENTER VALUE (IF REQUIRED) / NAME OF BUSINESS) (JAN 1 - DEC 31) ❑INDl�iQ QCOM QsCC n % QIND c�c ( QCOM 2errH QPTY QSCC �S Q IND QCOM ❑ OTH []SCC QIND ❑COM _ _ ❑oTH Q PTY Q SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ "ConMbutor Codes IND — individual COM — Recipient Committee (other then PTY or SCC) OTH — Other (e.g., business entity) PTY — Politloal Party SCC — Small Contributor Committee FPPC Form 460 (January/05) Helpline: 888 1ASK -FPPC (886/275 -3772) Schedule D n _ _ -- -- _ -- v — SCHEDULED Sufi ma OT Expenditures Type or print in ink. Supporting/Opposing Other Amounts may be rounded to whole dollars. Candidates, Measures and Committees Statement covers period from - -- •' J • , • SEE INSTRUCTIONS ON REVERSE through 3 /�, Page 1 . N F FILE F_^ I I.D. NUMBER DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN.1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) ❑ Monetary ' Contribution ❑ Nonmonetary Contribution [] Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) . 2. Unitemized contributions and independent expenditures made this period of under $100 ...................................................... ............................... $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ............ TOTAL $ FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/2764772) Schedule E Type or print in ink. Amounts may be rounded Statement covers period • - , Payments Made to whole dollars. • - • ' from SEE INSTRUCTIONS ON REVERSE through z N F FILE ® I.D. NUMBER C) rX 0&93b 1101;""04e CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment CMP campaign paraphernalia /misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PE? petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals 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 voter registration Lrr campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ ZV `/Y Schedule E Summary I 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................... ........................ .I...... $ 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 $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/2753772) SCHEDULEF Schedule F Type or print in ink. Stateme t c vers period CALIFORNIA Amounts may be rounded 460 Accrued Expenses (Unpaid Bills) to whole dollars. fro m •' through Page of SEE INSTRUCTIONS ON REVERSE NAMt-QF,FILERj I.D.NU� IE4 (?0 I/kPW&�5(Vka �VYn ' CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CUP campaign paraphemalia /misc. MBR member communications RAID radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)` OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals 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 voter registration LIT campaign literature and mailings PRT print ads VVEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT ( OUTSTANDING BALANCE BEGINNING OF THIS PERIOD ( AMOUNT INCURRED THIS PERIOD ( AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) ( OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD . Payments that are contributions or independent expenditures must also be SUBTOTALS $ $ $ $ summarized on Schedule D. Schedule F Summary Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.)....... 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) ................................................................. ............................... ............ INCURRED TOTALS $ i i ....................... PAID TOTALS $ .... NET $ May be a negative number FPPC Form 460 (January /05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) Schedule G Type or print in ink. SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded State t c vers period • - Contractor (on Behalf of This Committee) to whole dollars. from • - ' v through L11V Page o SEE INSTRUCTIONS ON REVERSE NA LER / ( I.D. UMBER C)�* 0 NAME OF AGENT OR INDEPENDENT CONTRACTOR /nom, , r / h �_-- CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia /misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals 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 voter registration Lrr 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. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Attach additional information on appropriately labeled continuation sheets. TOTAL* $ * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) SCHEDULE H Schedule H Type or print in ink. Statem t c vers period , • , Amounts may be rounded • , Loans Made to Others* to whole dollars. from • SEE INSTRUCTIONS ON REVERSE through Page of N F FILE _ J g 0 I.D. NUMBER c1a FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING BALANCE (b) AMOUNT (c) REPAYMENT OR (d) OUTSTA DING BALANCE AT (e) INTEREST M ORIGINAL (9) CUMULATIVE OF RECIPIENT (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF- EMPLOYED, ENTER BEGINNING THIS LOANED THIS PERIOD FORGIVENESS CLOSE OF THIS RECEIVED AMOUNT OF LOAN LOANS TO DATE NAME OF BUSINESS) PERIOD THIS PERIOD" PERIOD El PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION " DATE DUE DATE INCURRED PAID CALENDAR YEAR $ % $ $ FORGIVEN RArE PER ELECTION " $ $ $ $ $ DATE DUE DATE D "Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must SUBTOTALS $ $ $ $ also be reported on Schedule E. Schedule H Summary _ 1. Loans made this period ................................... ............................... (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans ............................ ............................... (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) ................... (Enter the net here and on the Summary Page, Column A, Line 7.) (Enter (e) on Schedule I, Line 3) ..... ............................... $ ........................... NE ( m ber " "If Required FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (886/2764772) SCHEDULFI Miscellaneous Increases to Cash Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from through CALIFORNIA • FORM Page,� of cam. Ilse I.D. NUMBER 133-04Y4 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. Schedule I Summary Itemized increases to cash this period ..... ............................... 2. Unitemized increases to cash of under $100 this period ....................................... ............................... 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) .......... 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.) ..................................................................................... ............................... TOTAL SUBTOTAL $ FPPC Form 460 (January /05) FPPC Toll -Free Helpline: 666 /ASK -FPPC (866/275 -3772)