HomeMy WebLinkAboutSULLIVAN SEMIANN13(1) AMENDRdcipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200- 84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Date Stamp
COVER PAGE
St7.1 t cov rs period Date of election If applicable:
6 l `� 2 (Month, Day, Year) ` - Page of _
from �J
For Official Use Only
through
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
PQ Officeholder, Candidate Controlled Committee ❑
Q State Candidate Election Committee
Q Recall
(Also Complete Part 5)
❑ General Purpose Committee
Q Sponsored
Q Small Contributor Committee
Q Political Party /Central Committee
3. Committee Information
COMMITTEE NAME (OR CANDIDATE'S
Ballot Measure Committee
Q Primarily Formed
Q Controlled
Q Sponsored
(Also Complete Pad 6)
❑ Primarily Formed Candidate/
Officeholder Committee
(Al- Complete Pad 7)
I.D. NUMBEF) S- 0
COMMITTEE)
CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
2. Type of Statement:
❑ Preelection Statement
❑ Semi - annual Statement
❑ Termination Statement
Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
MAILING ADDRESS
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
CITY STATE ZIP CODE AREA CODE/PHONE
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 this statement and to th eSt my knowledge the information ntained herein and in the attached schedules is true and complete. I
certify under penalty of p' under the laws of the State of California that the fo oing i e and rrect.
1
Executed on By
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Executed on By
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Executed on D B �
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Sgnekxe orConhWkg ofrieelwMar, Carddele, Stales Maastne Proponent
Executed on By
Dale Sig vk" arcontroav OMD&OMer, cWadde, Shft Measure RwwleM FPPC Form 460 (June/01)
FPPC Toll-Free Helplins: ti661ASK -FPPC
State of California
01
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidafa Cnnfrnuseri r.......,s+se
NAME OF OFFICEHOLDER OR CANDIDATE
OFF E SOUC�1 OR HELD ELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Type or print in ink.
6. Ballot Measure Committee
NAME OF BALLOT MEASURE
COVER PAGE - PART 2
Page of
BALLOT NO. OR LETTER I JURISDICTION ❑ SUPPORT
❑ OPPOSE
RESIDENTIAL/BUSINESS ADDRES (NO. AND STREET)
Identify the controlling officeholder, candidate, or state measure , if an Y•
onent ro
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT P P
Related Committees Not Included in this Statement: ust any 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
NAME OF TREASURER
CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
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
OFFICE SOUGHT OR HELD
DISTRICT NO. IF ANY
7. Primarily Formed Committee Ust names of otrrceholder(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 if necessary
FPPC Form 460 (June/01)
FPPC Toll -Free Helpifne: 866/ASK-FPPC
State of Califomia
Campaign Disclosure Statement
Summary Page
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
SUMMARY
Current Cash Statement
12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $
13. Cash Receipts .................... ............................... Column A, Line 3above
14. Miscellaneous Increases to Cash ........................... schedule 1, 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 $
1
Cash Equivalents and Outstanding Debts (�
18. Cash Equivalents ......... ............................... see instructions on reverse $ V� 19. Outstanding Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ � (`
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).
I $
1 1 $
'Since January 1, 2001- Amounts in this section may be
different from amounts reported in Column B.
FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 86WASK -FPPC
from
SEE INSTRUCTIONS ON REVERSE
through
Page of
NAME OF FlLER
I.D. NUMBER
Contributions Received
ColumnA
Column B
Calendar Year Summary for Candidates
TOTAL THS PMOD
(FROM ATTACHM SCHEDULES)
CALENDAR YEAR
TOTALTODATE
Running in Both the State Primary and
1. Monetary Contributions
w
6.00
General Elections
............ ...............................
schedule A, Line 3
$
$
2. Loans Received ....................... ...............................
schedule B, Line 3
.
1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 + 2
$
$
20. Contributions
4. Nonmonetary Contributions ..... ...............................
schedule C, Line 3
Received $ $
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ...........................
Add Lines 3 + 4
$
$
6
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made ........................ ...............................
schedule E, Line 4
$
$
O
Candidates
7. Loans Made .............................. ...............................
schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS ..... ...............................
Add Lines 6 + 7
$
O
$
Cumulative umulative Expenditures Made"
(It Subjedto Volwdary Expendlture Umlt)
9. Accrued Expenses (Unpaid Bills) ...............................
schedule F, Line 3
10. Nonmonetary Adjustment ........... ............................... schedule C, Line 3
b •
Date of Election Total to Date
(mm /dd/yy)
11. TOTAL EXPENDITURES MADE . ...............................
Add Lines 8 + 9 + 10
$ 11110
$
s Z :
J_ 1 $
Current Cash Statement
12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $
13. Cash Receipts .................... ............................... Column A, Line 3above
14. Miscellaneous Increases to Cash ........................... schedule 1, 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 $
1
Cash Equivalents and Outstanding Debts (�
18. Cash Equivalents ......... ............................... see instructions on reverse $ V� 19. Outstanding Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ � (`
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).
I $
1 1 $
'Since January 1, 2001- Amounts in this section may be
different from amounts reported in Column B.
FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 86WASK -FPPC
Tv w w& .w 1..1.
SCHFDtIt F R _ PART 1
oulICQU1C a — Part 1 Amounts may be rounded
Statement covers period
Loans Received to whole dollars.
e '
from
• '
SEE INSTRUCTIONS ON REVERSE
through
Page of
NAME OF FILER
I.D. NUMBER
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
OUTSTANDING
BALANCE
(b)
AMOUNT
(�)
AMOUNT PAID
OUTSTANDING
BALANCE AT
'
INTEREST
ORIGINAL
9
CUMULATIVE
OF COMMITTEE, ALSO ENTER I.D. NUMBER)
OF SELF - EMPLOYED, ENTER
BEGINNING THIS
RECEIVED THIS
PERIOD
OR FORGIVEN
CLOSE OF THIS
PAID THIS
AMOUNT OF
CONTRIBUTIONS
NAME OF BUSINESS)
RI D
THIS PERIOD*
p
PERIOD
LOAN
TO DATE
`
❑ PAID
$ /
$
'
$ �v
CALENDARYEAR
S
❑ FORGIVEN
PERELECTION�
❑ OTH ❑ PTY ❑ SCC
DA I RRED
❑ PAID
CALENDARYEAR
❑ FORGIVEN
PER ELECTION'•
RATE
tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
$
s
:
S
:
DATE DUE
DATE INCURRED
❑ PAID
CALENDARYEAR
❑ FORGIVEN
PERELECTION"
RATE
t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
s
s
s
S
S
DATE DUE
DATE INCURRED
SUBTOTALS $ $ $ $
(ERter(e)on
Schedule B Summary Schedule E,Une3)
1. Loans received this period ..................................................................................... ............................... $
(Total Column (b) plus unitemized loans 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 $ 6,61)
Enter the net here and on the Summary Page, Column A, Line 2. (May be a r-jobve number)
t Contributor Codes
IND-individual COM - Recipient Committee (other than PTY or SCC) OTH - Other 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 (June/01)
FPPC Toll -Free Helpline: 8661ASK -FPPC
Schedule E
Payments Made
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from
SEE INSTRUCTIONS ON REVERSE
through
I Page of
NAME OF FILER
I.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CWP
campaign paraphemalia/misc.
WBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MfG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)*
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PEr
petition circulating
TB-
t.v. or cable airtime and production costs
RL
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
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
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internal, e-mail)
NAME AND ADDRESS OF PAYEE
OF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID
MFG
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ b O n /L
Schedule E Summary
1. Payments made this period of $100 or more. (include all Schedule E subtotals.) ................................................................... ............................... $
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 (June/01)
FPPC Toll -Free Helpline: 8661ASK -FPPC
Schedule F
Accrued Expenses (Unpaid Bills)
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from
SCHEDULE F
SEE INSTRUCTIONS ON REVERSE
CODE OR
DESCRIPTION OF PAYMENT
(
OUTSTAA NDING
BALANCE BEGINNING
through
Page of
NAME OF FILER
OF THIS PERIOD
I.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CWP
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
1RC 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
WEB information technology costs (intemet, e-mail)
NAME AND ADDRESS OF CREDITOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR
DESCRIPTION OF PAYMENT
(
OUTSTAA NDING
BALANCE BEGINNING
(
AMOUNTIN CURRED
THIS PERIOD
(e)
AMOUNT PAID
THIS PERIOD
(d)
OUTSTANDING
BALANCE AT CLOSE
OF THIS PERIOD
(ALSO REPORT ON E)
OF THIS PERIOD
%V) ✓Icb�
`
�a
•�'
Q
37 �� 2-,
i
.
Payments that are contributions or Independent expenditures must also be SUBTOTALS $
summarized on Schedule D. s s s
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for � �1accrued expenses of $100 or more, plus total unitemized accrued expenses under $ 100.) ............. ............................... INCURRED TOTALS $ �
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.) .. ............................... PAID TOTALS ; IT
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and qrn .�Ij
onthe Summary Page, Column A, Line 9.) ................................................................................................................. ............................... NET $ bo
May be a number
FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 866/ASK -FPPC
•