HomeMy WebLinkAboutSULLIVAN SEMIANN99(1) OH fficeholder, Candidate,
and Controlled Committee
Campaign Statement - Long Form
Type or print In ink,
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Check one of the following boxes to Indicate the type of statement being filed:
r'l Pro-election Statement
[::] Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.)
' Special Odd-Year Campaign Report
"Semi-annual Statement
e, Termination Statement (Attach a completed Form 415 to this statement.)
I .~fficeholder Candidate. and Controlled Committee
Included in tAis Statement
ARLA CODE~)AYTME NK)NE
I,D, NUMIER
STATE ZIP CODE A~ C~AYTNE ~!
STATE Z~ C~ ~A C~AYT~( ~E
Statement covers period
,,o,
Date of election if applicable:
Date Stamp
COVER PAGE - LONG FORM
Page, of
(Month, Day, Year)
II
Other Committees ~]ot Included in this Statement: List any other
cornre/frees not Included in this consolidated statement that are controlled by you and any
coma/frees of which you have knowledge that are primarily formed to receive contributions
ot to make exDergfitures on behalf of yOur candidacy.
COMMITTEE NAME J I.D. NUMBER
CC)MMITrIE NAME I t,O, NUMIER
(~/~e Of'T, hEA,,_..~ ' Co,,,OLLED
COMMITTEE ADDRESS IND. AND $TRE~ET)
CITY STATE ZIP COC~ AREA COl)E/DAYTIME PHONE
Attach additional in formation on appropria rely labeled continua tlon shee
!11
Verification
I have used all reasonable, diligence in preparing ,this statement. I have reviewed the st.atement and to the best of ·/ge the lnfor tion contea ed~/erei nd in the attached schedules is
,,,,..nd.omp,.,..,..,,,und.,pan..,lu ..d.,,.,.,,,, ,h. Sta,'
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An officehoMer or cendldete who controls I committee must also ver~r the campaign stiromens. I have used all reasonable diligence o the best of my knowledge the treasurer has used all
Executed on DATE At CITY ANO STATE By ~ ~W SIGNATURE Of CANDIDATE/OIIICEHO{DIR
DATE CITY AND STATE $1GNATUR[ Of CANDIOATE/OfFIC[HOtDER
Executed on At By
DATE CFrY AND STATE SIGNAIUR[ Of CANDtDAr[/0FflCEHOLDER
FOR INFONaATION REQUIRED TO II PROVIDED TO YOU IPdRSUANT TO THE INFORMATION PRACTICES ACt CNc 1~77o SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS Of THE POUTICAL REFORM ACT
State of California Fair Polltl¢al Practices Commission
Campaign Disclosure Statement
Summary Page
Type or print in ink,
Amounts may be rounded
to whole dollars,
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTRO LED COMMI E ,
on r mons Received
Column A
TOTAL THI~ I~RJOD
~ROM ATTACHED S~HEDULE$)
I. Monetary Conzributions ............................... Sche~..le A, Une 3 S
2. Loans Received ......................................... Schedule a, Une 7
~ SUBTOTAL CASH CONTRIBUTIONS AddUnes t + 2 S
4. Non-moneta~ Contributions ......................... Sc~dute C U. 3
5- SUBTOTAL CONTRIBUTIONS:(Exctu~ En~ea~e ~omise$) A~U~s3 + ~ 5
6. Enforceable Promi~
(Exd~ L~n Gumrmntees, U~ t g ~1~) ................... $~edu~ D, U~ 7
7. TOTAL CONTRIBUTIONS RECSIVED ..................... A~U~sS + 6 S
~cheduie E, -tjne 5
5chedute H, Une 7
AOdLines8 + 9
Expenditures Made
g. Cash PaymenTs (Other than L. oans Made)
9. Loans Made ............................................
10. SUBTOTAL CASH PAYMENTS
! !. Accrued Expenses (Un~aid Bills) ............ Sc~edu~F, uneS
12. TOTAL EXPENDITURES MADE .........................AddUne$10 +
Current Cash Statement
', 3. Beginning Cash Balance .................. Previou~Summan/PaBe, fine 77
;4. Cash Receipts ......................................CotumnA, Line3above
': 5. Miscellaneous Increases to Cash ........................Schedule l, Line 4
16. Cash Payments ....................................Cotumn A, Line 10 above
17. ENDING CASH BALANCE ..... AddLlnesl3 +
ff this Lf a termination &'tatemenC, Line T 7 muSt be zero.
18. LOAN GUARANTEES RECEIVED .............. Schedule B, Part l, Col..ran (b)
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................ see in_s/J'uctlons on reverse
20. Outstanding Debts ................. AddLine 2 + Line ll inColumnCabove
/ H0.
ENDING CAIH BALAI,,K~ ~HOULD
NOT BE A NEGATIVE AMOUNT
Statement covers period
,,o.
Column B*
TOTAL I~VIOU$ PERIOD
(SEE NOTE BELOW)
SUMMARY PAGE
I.D. NUMBER
cot. n c
TOTAL TO DATE
CAD0 COLUMNS A +
$ S
' From previous Statement Summary, Page, Column C. However.
this ~s the first report. filed for the calendar year, Column a snouic~ De
3ian~ exceot for Loam Received (Line ~1 Enforceable ~romises (Li~e
6). LOans Made (Line 9), and Accrued Expenses (Line; 1 ).
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/1 to Date
2t. Contributions
Received .... S
22. Ex nditures
M~)o~; ....... $
Schedule E
Payments and Contributions
(Other Than Loans) Made
Type or print in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE through
Statement covers period
,,ore l'1
SCHEDULE E
Page ~ of
I D NUMBER
If one of the following codes accurately describes the expenditure, ou may enter the code and leave the "Description of Payment' column blank. Refer to the
back of Schedule E-Conti nuation Sheet for detailed explanations of Y;ach category.
"C' - MONETARY AND IN-KIND (NON-MONETARY) * B° _
CONTRIBUTIONS TO OTHER CANDIDATES oNo _
AND COMMITTEES 'O" -
· I' - INDEPENDENT EXPENDITURES
'L'- LITERATURE 'F'-
BROADCAST ADVERTISING
NEWSPAPER AND PERIODICAL ADVERTISING
OUTSIDE ADVERTISING
SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS
FUNDRAISING EVENTS
°G° - GENERAL OPERATIONS AND OVERHEAD,
*T" - TRAVEL. ACCOMMODATIONS AND MEALS
(MUST BE DESCRIBED)
*P'- PROFESSIONAL MANAGEMENT AND CONSULTING
SERVICES
NAME AND ADDRESS OF PAYEE. CREDITOR, OR RECIPIENT OF CONTRIBUTION
ef COMMITTEE, IN ADOnlON TO COMMIll'EE~ NAME AND ADORE$$, ENTER LD. NUMIER OR, IF NO I,O.
~JMIER HAS I~EN ASSIGNED, ENTER TREASURER'5 NAME ANO AIX)Rtt~4
IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW,
CODE OR
DESCRIPTION OF PAYMENT
Im ortant: Contributions and expenditures made out of campaign funds to or on behalf of other SUBTOTAL $
o~iic~eholders, candidates, commtttees, or ballot measures must also be entered on the Allocation Page, Part L
Payments and Contributions Made Summary
1. Payments made this period of $100 or more. (include all Schedule E subtotals.) ............................ : ......................... $
2. Payments made this period of under $100. (Do not itemize.) ....................................................................... $
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part il, Column (d).) .............................. $
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ..................................... $
5. Total payments madethis period. (Add Lines l, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line S.) ........... TOTAL $
AMOUNT PAID
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~ Bakersfield City Clerks O~ce
~ ~ 1501 Truxtun Ave
~ ~ ............... Bakersfield, CA 93301
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