HomeMy WebLinkAboutTAVORN SEMIANN99(2) ecipient Committee
Campaign Statement
(Government Code Sections 84200-84216.5)
Type or print in ink.
SEE INSTRUCTIONS ON REVERSE
Statement covers pedod
through /--/~ - O~
1. Type of Recipient Committee: All Committee~- Complete Pa~ts t, 2, 3, and 7.
{~ Officeholder, Candidate
Controlled Committee
(Also Complete Part 4 J
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(Also Complete Part 5.)
[] Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 6J
[] General Purpose Committee
O Sponsored
O Broad Based
Date of elecUon if applicable:
(Month, Day, Year)
Dale SI;~mp
I0 J~.~! 21 F?, 3:0'7
K~;~or~L.b Cii'Y CL£i
2. Type of Statement:
[] Pre-election Statement
.
Semi-annual Statement
Termination Statement
[] Amendment (Explain below)
COVERPAGE
Page /; of ~"
Fm Official Use Only
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pm-election
Statement - Attach Form 495
3. Committee Information
COMMITTEE NAME
I.D. ~:MBER
7'? o/75"
Treasurer(s)
NAME OF TREASURER
MAILING ADDRESS
CITY STATE ZIP CCOE AREA COOF-/PHONE
NAME OF ASSISTANt' TREASURER, IF ANY
STREET ADDRESS (NO RO. BOX)
CID/
STATE Zl~ C~E ~EACO~HONE
MAILING ADORESS (IF DIFFERENT) NO. AND STREET DR RS. BOX
CITY STATE ZIP COOE
OPTIONAL: FAX / E-MAIL ADDRESS
AREA CODE/PHONE
FPPC From 4~0 (~g)
For Technical Assistance:
Stale of C~llt~rnl~
Recipient Committee
Campaign Statement
Cover Page -- Part 2
Ty~e or print in ink.
COVER PAGE-PART2
Page ~ of ~
4. Officeholder or Candidate Controlled Committee
NAME OF OFF ICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DIS]RICT NUMBER IF APPLICABLE)
RESIDENTIA/UBUSINE S S ADDRESS (NO. AND STREET) CITY STATE ZiP
Related Committees Not Included in this Statement: Llstanycommlttees
not Included In this consolidated statement the t are controlled by you or which are primarily
formed to receive contributions or to make expenditures on behalf of your candidacy,
ILO. NUMBER
COMMITI~E ADDRESS
STREETADDRESS ("O P.O.
CITY STATE ZIP CODE
7. Verification
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION[][] OPPosESUPPORT
Identi~ the conb'olling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
6. Primarily Formed Committee LIst names of officeholder(s) orcandldat,(,)
for which this committee la primarily formed.
NAMEOFOFFICEHOLDERORCANDIOATE OFFICE SOUG~HT OR HELD [] SUPPORT
[] OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
AREA CODFJPHONE
Attach con#nua~on sheets if necessary
[]SUPPORT
[]OPPOSE
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules
is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on /~/? - ~ o By
DATE
Executed on By
DATE
Executed on By
Executed on By
DATE
FPPC Form 4~0 (~/99)
For Technical Aealetanee: g!6/~22-5660
State of California
Schedule A Typ. or print in ink. SCHEDULE A
Monetary Contributions Received ~moumsmayoerou~eeo
SEE INSTRUC~ONS ON RE~RSE ~rough
/
DATE FULL NAME. MAILING ADDRESS AND ZIP CODE OF CONTRIB~OR CONTRIBUTOR ~CUPATION AND ~PLOYER RECEIVED ~IS CALENDAR Y~R OTHER
D COM
DOTH
O ~NO
D COM
~ OTH
~ COM
~ OTH
SUBTOTAL
Schedule A Summary
1. Amount received this period - contributions of $100 or more.
(Include all Schedule A subtotals.) ....................................................................................................... $
2. Amount received this pedod - unitemized contributions of less than $100 ......................................... $
3. Tolal monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ................... TOTAL $
FP~C ;on. 4~0 (~)
For Technical Aeslstence: 916~22-5660
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink.
Amounts may be rounded
to whole dollars,
through
Page
SCHEDULE E
NAME OF FILER
I.D. NUMBER
CODES: I1 one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP careDaign paraphe mails/misc.
CNS campaign consultants
CTB cont ributio~ (explain n~nnmnetmy)'
CVC civic dona~ons
FND fundraising events
IND independent expenditure supporling/opposing others (explain)*
LIT campaign literature and mailings
MTG n~e§ngs and appearances
DFC office expenses
PET pe§fion circulating
PHO phone banks
POL pelling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT p~int ads
RAD radio airtime and production costs
RFD returned contribulJo~s
SAL campaign workers salaries
TEL t.v. o~ cable aidime and production costs
TRC candidate travai, Iodgthg and meals (explain)
TRS staff/spouse travai, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VDT voter reg~strafio~q
WEB information technology costs (intemet, e-mail}
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE. ALSO ENTER ID. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PArD
* Payments that ~re contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ / ~_. ~.~, O0
Schedule E Summary
1. Payments made this period o! $100 or mom. (Include all Schedule E subtotals.) ............................................................................................... $
2. Unitemized payments made this period of under $100 ........................................................................................................................................ $
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) ....................................................... $
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ......................... TOTAL $
/Z ?5, oo
FPPC Fm'm 460 (8/99)
For Technical Aaalstance: 916~22-5660
Campaign Disclosure Statement
Summary Page
Type or pdnt in ink.
Amount~ may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Sta~,~r,~ covers period
from
through
SUMMARY PAGE
P,g* ~' of -~
I.D. NUMBER
Column B* Column C
TOTAL PREVIOUS PERIOD TOTAL TO DATE
$
$ $
$ $
$ $
$ $
$ $
Contributions Received
1. Monetary Contributions ...................................................... ScheduleA, Line 3
2. Loans Received ................................................................... Schedule B. Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ................................... AddLines 1 + 2
4. Nonmonetary Contributions ............................................... Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4
Expenditures Made
6. Payments Made .................................................................... Schedule E, Line 4
7. Loans Made .......................................................................... Schedule H, Line 7
8. SUBTOTAL CASH PAYMENTS ................................................ Add Lines 6 + z
9. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, Line 3
10. Nonmonetary Adjustment .......................................................ScheduleC, Line3
11. TOTAL EXPENDITURES MADE ......................................... Add Lines 8 + 9 + 10
Column A
TOTAL THIS PERIOD
/,~5~, ~ o
~5, o ~
Current Cash Statement
12. Beginning Cash Balance ................................ Previous Summary Page, Line 16
1 3. Cash Receipts .............................................................. column A, Line 3 above
14. Miscellaneous Increases to Cash ....................................... Schedule I, Line 4
1 5. Cash Payments ............................................................ Column A, Line 8 above
16. ENDING CASH BALANCE .............. Add Lines 12 + 13 + t4, then subtract Line 15
If this is a termination statement. Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule S, Pert l, Column (b)
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... See instructions on reverse
19. Outstanding Debts ................................... AddLIne2+LlneginColumnCabove
· From previous statement Summery Page. Column C. However. if ~is
is the first report filed for the calendar year, Column B should be biank
except for Loans Received (Line 2}, Loans Made (Line 7), and Accrued
Expenses (Line 9).
Summary for Candidates in Both June and
November Elections
1/1 thr~Jgh 6/30 711 I00ate
20. Contributions
Received ............ $
21. Expenditures
Made ..................
FPPC Fort. 4~0 (MJ9)
For Technical Assistance: 916~22.5660