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HomeMy WebLinkAboutBFLAG PREELEC02(1)Recipi.tnt Committee Campaign Statement Cover Page (Government Code Sections 84200-842165) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from "~ ,O/ ' O 2- through ~' ~.) 02- 1. Type of Recipient Committee: Alt Committees - Complete Parts 1, 2, 3, and 4. Ballot Measure Committee O Primarily Formed O Controlled (~ Sponsored Primarily Formed Candidate/ Officeholder Committee Officeholder, Candidate Controlled Committee O State Candidate Election Committee ~ Recall Date Stamp COVER PAGE General Purpose Committee Sponsored Small Contributor Committee Political party/Central Committee Date of election if applicable: (Month, Day, Year) 2. Type of Statement: [] Preelection Statement [] Semi-annual Statement ~ Termination Statement [] Amendment (Explain below) Page I of I ~ For Official Use Only Quarterly Statement Special Odd-Year Repod Supplemental Preelection Statement - Attach Form 495 3. Committee Information COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) CITY STATE ZiP CODE AREA CODE/PHONE OPTIONAL FAX / E MAIL ADDRESS Treasurer(s) NAME OF TREASURER~ MAILING ADDRESS CITY NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL FAX / ~ MAiL ADD~ESS 4. Verification I have used all reasonable diligence iR preparing and reviewing this statement and to the best of my knowledge the information contained herein and i~ the attached schedules is true and complete. I certify under penalty of perjury under the laws of ~he State of California that the foregoing is true and correct, on Signature of Treasurer or Assistant Treasurer By SigI~atu e o Con[rolling Of[ceholder Candidate State Measure Pr re of Conlrollin90ff~ceh older Candidate. State Measure Proponent FPPC Form 460 (June/01) Executed on Da~e Signature of ConLcolling Officeholder Candidate S~ate Measure Proponenl FPPC Toll-Free Helpline; 866/ASK-FPPC State of California Recipient Committee Campaign Statement Cover Page-- Part 2 Type or print in ink. COVERPAGE-PART2 Page 2- of I~ 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL/BUSINESS 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 primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMII~EE NAME ID. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? [] YES [] NO COMMITTEEADDRESS STREET ADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONL COMMITTEE NAME ID NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? [] YES [] NO COMMITTEEADDRESS STREET ADDRESS (NO RD. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 6. Ballot Measure Committee NAMEOFBALLOTMEASURE BALLOTNO ORLETTER JURISDICTIONE~ OPPOSE [~ SUPPORT Identify 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 Committee List names of o~ceholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE FFICE SOUGHT OR HELD ~ SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE ~FFICE SOUGHT OR HELD [] SUPPORT ~ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [~SUPPORT E~OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Junel01) FPPC TolNFree Helpline: 866/ASK-FPPC State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ~7' 0 i 0 ~. through ~ 5~) O ~_ SUMMARY PAGE Page ~ of/~c~- NAME OF FILER Contributions Received 1. Monetary Contributions ................................... ScheduleA Line 2. Loans Received ..................................................... Schedule B, Line 3. SUBTOTAL CASH CONTRIBUTIONS ......................... AddLmesl+2 4, Nonmonetary Contributions .................................. Schedule C, Line 5. TOTAL CONTRIBUTIONS RECEIVED ........................ AddLines3+4 Expenditures Made 6. Payments Made .............................................. Schedule E Line 4 7, Loans Made .......................................................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ................................... Add Lines e + 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 + fO Current Cash Statement 12. Beginning Cash Balance ....................... Previous SummaoI Page, Line16 13. Cash Receipts ................................................ column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4 15. Cash Payments ................................................ ColumnA Lineaabove 16, ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 If th/s is a termination statement, Line 16 must be zero. Column A TOT/~ THIS pERiOD {FROM A%TACHED SCHEDULES) Column B CALENDAR YEAR TO fA_ TO DATE s ,r) ¢ 5o s ~ 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Pa~ 2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ...................................... See instructions on reverse 19. Outstanding Debts ........................ AddLme2+LineginCoJumnBab~ve To calculate Column B, add amounts in Column A to the correspondin9 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date FPPC Form460 (Junel01) FPPC Toil-Free Helpline: 866/ASK-FPPC 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made~ (if Subject to Volullta~ Expenditure Limit) Date of Election Total to Date (mm/dd/yy) J__l__ $ ~ / $ / /__ $ / /__ $ /_ /__ $ I J__ $ *Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER DATE RECEIVED FULL NAME, STREET ADDRESS AND ZiP CODE OF CONTRIBUTOR CONTRIBUTORcoDE * ~IND ~COM [] OTH [] PTY E3scc [~IND []COM DOTH ~ PTY [~SCC LL~IND []COM [] OTH ~ PTY [] scc Type or print in ink. Amounts may be rounded to whole dollars, IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPEOYED ENTER NAME OF BUSINESS} Statement covers period from 7 ' ~.2/ . U ~. through SCHEDULE A Page. ~ of ~-~' tD NUMBER PER ELECTION TO DATE (IF REQUIRED) AMOUNT RECEIVED THIS PERIOD I ?-0 CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 - DEC 3t []IND [] COM [] OTH [] PTY ~SCC [~COM ~,OTH [] PTY [] scc SUBTOTALS Schedule A Summary 1. Amount received this period - contributions of $100 or more. (include all Schedule A subtotals.) ........................................................................................................ $ 2. Amount received this period - unitemized 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 $ · *Contributor Codes COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Po[itica~ Party SCC- Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule B- Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER FULL NAME STREET ADDRESS AND ZIP CODE OF LENDER CF COMMI~E~ ALSO ENTER I D NUMBER/ tE~ IND [] COM [] OTH L~ PTY [] SCC t~ iND ~ COM ~. OTH ~ PTY ~ SCC Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period SCHEDULE B PART1 from through _~/' t[] IND ~ COM [] OTH ~ PTY ~ SCC IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (iF SELF.EMPLOYED ENTER NAME OF BUSINESS) (a) ! (b) (c) OUTSTANDING I AMOUNT E~AMOUNTpAIL) PAiD BEGINNING THIS BALANCE RECEIVED THIS OR FORGIVEN - PERIOD PERIOD THIS PERIOD * $ i [] PAID [] PAID $ [] FORGIVEN $ (d) I (e) OUTSTANDING i INTEREST BALANCE AT ~ PAID THIS CLOSE OF THIS I PERIOD I PERIOD DATE DUE DATEDUE $ DATE DUE RAlE Page -~ of _ ID NUMBER (f) } (g) ORIGINAL CUMULATIVE AMOUNT OF CONTRIBUTIONS LOAN TO DATE CALENDAR YEAR DATEINCURRED BATEINCURRED SUBTOTALS $ $ $ $ PER ELECTION** $ CALENDAR YEAR $ PER ELECTION $ CALENDAR YEAR $ -- $ PER ELECTION $ DATE INCURRED Schedule B Summary 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 $ Enter the net here and on the Summary Page, Column A, Line 2. (Enter (e) on Schedu e E Line 3) t Contributor Codes IND Individual COM - Recipient Committee (other than PTY or SCC OTH - Other *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required, PTY- Political Party SCC Small Contributor CommitteeI FPPC Form 460 (Junel01) FPPC Toil-Free Helpline: 866/ASK-FPPC Schedule B - Part 2 Loan Guarantors SEE INSTRUCTIONS ON REVERSE Type or print in ink, Amounts may be rounded to whole dollars. Statement covers period from -? ' C) ~ , ,.3 ~_ through '~ 50 ~ '~'' NAME OF FILER FULLNAME. STREETADDRBSSAND,IFC©MbZIP CODENEE ALS©EN?EROF GUARANTORo NUMBER CONTRIBUTORcoDE BIND [] COM [] OTH [] PTY E3scc E~IND L~ COM [~OTH [] PTY ~scc ~IND [] COM E~OTH ~_~ PTY []scc E~]IND [] COM [] [] PTY E}scc iF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED· ENTER NAME OF BUSINESS) LOAN LENDER DATE LENDER BATE LENDER DATE LENDER DATb SCHEDULE B- PART 2 SUBTOTAL Page ~ of IS ID. NUMBER AMOUNT I BALANCE GUARANTEED I CUMULATIVE OUTSTANDING TO DATE THIS PERIOD i TO DATE CALENDARYEAR PER ELECTION CF REQUIRED} pER ELECTION (IF REQUIRED) CALENDARYEAR $ PER ELECTION (IF REQUIRED) CALENDARYEAR $ PER ELECTION (IF REQUIRED) $ Summary Page, Line 17 only FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC SEE INSTRUCTIONS ON REVERSE Schedule C Type or print in ink. Amounts may be rounded Statement covers period Nonmonetary Contributions Received towhole dollars. i from ID. NUMB~ER SCHEDULE C NAME OF FILER CONTRIBUTOR-~]iN~ -CODE * [~COM ! IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER CUMULATIVEDATE TO CALENDAR YEAR (JAN 1-DEC31) ~ AMOUNT/ PER ELECTION DATE i FULL NAME, STREET ADDRESS AND DESCRIPTION OF FAIR MARKET TO DATE ZIP CODE OF CONTRIBUTOR GOODS OR SERVICES VALUE (IF REQUIRED) RECEIVED I (IF COMMIttEE ALSO ENTER I D NUMBERJ []OTH [] pTY [] scc [~IND ~,COM [] OTH []PTY E~scc []IND ~COM ~OTH ~P~ ~scc ~IND ~COM ~OTH ~scc Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ : Schedule C Summary 1. Amount received this period - nonmonetary contributions of $100 or more. (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 *Contributor Codes IND - Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other PTY Political Party SCC - Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE iNSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars, Statement covers period from O~ 0 J. ''0~._ through SCHEDULE D Page NAME OF FILER DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LE~FER AND JURISDICTION, OR COMMIttEE [~J Suppod [] Oppose [~ Suppod [] Oppose TYPE OF PAYMENT ~t' Monetary Contribution [] Nonmonetary Contribution [] Independent Expenditure J~ Monetary Contribution [] Nonmonetary Contribution [] Independent Expenditure DESCRIPTION [~] Monetary Contribution [] Nonmonetary Contribution [] Independent Expenditure REQUIRED) AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 DEC 31) Support [] Oppose SUBTOTAL I.D NUMBER PER ELECTION TO DATE IF REQUIRED) Schedule D Summary 1. Contributions and independent expenditures made this period of $100 or more. (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 (June/01) FPPC TolPFree Helpline: 866/ASK-FPPC Schedule D (Continuation Sheet) Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from C)7''~j . 0 ~' through ~ ' -~L) C).~ NAME OF FILER SCHEDULED Page c:~ of 1 CD- ID NUMBER DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LEI~ER AND JURISDICTIONi OR COMMITTEE TYPE OF PAYMENT ' [] Support [] Oppose [] Support [] Oppose [] Support [] Oppose [] [] [] [] [] Monetary Contnbution Nonmonetary Contribution Independent Expenditure Monetary Contribution Nonmonetary Contribution Independent Expenditure Monetary Contribution Nonmonetary Contnbution Independent Expenditure Monetary Contribution Nonmonetary Contribution independent Expenditure DESCRIPTION (IF REQUIRED) AMOUNT THIS PERIOD [] Support [] Oppose SUBTOTAL $ (~ ¢,~D O ~~'- : CUMULATIVETO DATE CALENDAR YEAR (JAN l-DEC 31) PER ELECTION TO DATE IF REQUIRED) FPPC Form 460 (June/01) FPPC Toil-Free Helpiine: 866/ASK-FPPC Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 07-~l '~- through Page SCHEDULE E _ of ;~ NAME OF FILER I.D NUMBER CODES: campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events independent expenditure suppoding/opposing others (explain)* LEG legal defense LIT campaign literature and mailings If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. MBR member communications MTG meetings and appearances office expenses PET petition circulating phone banks POL polling and survey research POS postage, delivery and messenger services professional services (legal, accounting) PRT print ads PAD radio airtime and production costs F%~D returned contributions SAL campaign workers' salaries EL t.v. or cable airtime and production costs · RC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) OR DESCRIPTION OF PAYMENT AMOUNT PAID NAME AND ADDRESS OF PAYEE CFCOMMI~EE ALSOENTER]D NUMBER) I CODE I -?-5. 7 / * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS ~' ~-~_. ~ 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 I, 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: 866/ASK-FPPC Schedule E (Continuation Sheet) Payments Made SEEINSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ~7 ' ~i ' ~- through0~ "~(.~ '.~ ~ SCHEDULE E (CONT) Page i~ of 1~ NAME OF FILER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMTM campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events I~ independent expenditure suppoding/opposing others (explain)* LEG legal defense LIT campaign literature and mailings NAME AND ADDRESS OF PAYEE IF COMMF~EE ALSO ENTER I D NUMBERI MBR member communications MTG meetings and appearances O~C office expenses PET petition circulating phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads ID NUMBER PAD radio airtime and production costs ~ returned contributions SAL campaign workers' salaries T~L t.v or cable airtime and production costs ~ candidate travel, lodging, and meals TI~S staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration VVEB information technology costs (internet, e-mail) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule F Accrued Expenses (Unpaid Bills) SEEINSTRUCTIONSONREVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from L)~7 , O i ' {..,) ~_~ through NAME OF FILER CODES: If one of the following codes accurately describes the ~ campaign paraphernalia/misc. MBR CNS campaign consultants MTG CTB contribution (explain nonmonetary)* OFC CVC civic donations FIL candidate filing/ballot fees FND fundraising events POL 1'4D independent expenditure supporting/opposing others (explain)* POS LEG legal defense PRO LIT campaign literature and mailings payment, you may enter the code. Otherwise, describe the payment. member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, detivery and messenger services professional services (legal, accounting) print ads (a) BALANCE BEGINNING OF THIS PERIOD NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING (iF COkIMiTTEE ALSO ENTER I D NUMBER) DESCRIPTION OF PAYMENT SCHEDULE F Page I~... of IC~ ID NUMBER RAD radio aidime and production costs returned contributions SAL campaign workers' sataries TEL t.v. or cable airtime and production costs candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between commdlees of the same candidate/sponsor VOT voter registration WEB information technology costs (intemet, e-mail) {c) AMOUNT PAID THIS PERIOD (ALSO REPORI ON E} (b) AMOUNT iNCURRED THIS PERIOD (d) OUTSTANDING BALANCE AT CLOSE OF THIS PER~OD * Payments that are contributions or independent expenditures must also be SUBTOTALS $ $ $ $ summarized on Schedule D. Schedule F Summary 1. 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.) ............................................ 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 $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and ~.. on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $ Maybeanegati ...... bet FPPC Form 460 (June/01) FPPC Toll*Free Helpline: 866/ASK-FPPC Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Statement covers period from i thr°ugh 0t:) SCHEDULE G ID NUMBER NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes the payment, you may enter the code, Otherwise, describe the payment. campaign paraphernalia/misc CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/oppos,ng others (explain)* LEG legal defense LIT campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) FRT print ads RAD radio airtime and production costs returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR 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 amounl paid to the agent or FPPC Form 460 (June/01) independent contractor as reported on Schedule E. FPPC Toll-Free Helpline: 8661ASK-FPPC Schedule H Loans Made to Others* SEE iNSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to who}e dollars. Statement covers period from L~ '? · ',~1 - (J ~'- through SCHEDULE H Page ~1~ of ID NUMBER NAME OF FILER FULL NAME, STREET ADDRESS AND ZIP CODE OF RECIPIENT (IF COMMI~EE ALSO ENTER ID NUMBERI (a) (b) ' [] PAl(c)D IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT REPAYMENTOR OUTST~,~ DING INTEREST BALANCE AT RECEIVED OCCUPATION AND EMPLOYER BALANCE LOANED THIS FORGIVENESS CLOSE OF THIS (IF SELF EMPLOYED ENTER BEGINNING THIS PERIOD THIS PERIOD* PER~OD NAME OF BUSINESS/ PERIOD *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. SUBTOTALS [] FORGIVEN $ [] PAID [] FORGWEN DATE DUE OATE DUE ¢) ORIGINAL CUMULATIVE AMOUNT OF LOANS LOAN TO DATE CALENDAR YEAR PER ELECT ON~ DATE NCURRED :ALENDAR YEAR $ PER ELECT lATE NCURRED (Enter (e) on Schedule I, Lme 3) Schedule H Summary 1. Loans made this period ................................................................................................................................................. $ (Total Column (b) plus un itemized loans less than $100.) 2. Payments received on loans ........................................................................................................................................... $ (Total Column (c) plus unitemized payments less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1 .) ........................................................................................ NET $ (Enter the net here and on the Summary Page, Column A, Line 7.) **If Required FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE Type or print in ink, Amounts may be rounded to whole dollars. Statement covers period from ~'~ ' ~ i ' ~ ~ 50 through NAMEOF FILER SCHEDULEI Page [~ of ID. NUMBER DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE ALSO ENTER I D NUMBER} DESCRIPTION OF RECEIPT AMOUNTOF INCREASETOCABH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule I Summary 1. Increases to cash of $100 or more this period ........................................................................................................... $ 2. Unitemized increases to cash 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 Summary Page, Line 14.) ......................................................................................................................... TOTAL $ FPPC Form 460 (Junel01) FPPC Toll-Free Helpline: 866/ASK-FPPC