HomeMy WebLinkAboutKC EMPLOYEES PAC PREELEC00(1)PRIMARYRecipient Committee
Campaign Statement
~ or I~tnt In Ink.
(Govemmont Code Sections 84200-84216.5)
1. Type of Recipient Committee: ~ committees - complete Parts 1,2, 3, and 7.
D~ta of election If appllcaU~J
(Month, Day, Year)
~AKE
Date St~mp
2. Type of Statement:
[] Officeholder, Candidate
Controlled Committee
(A/so complete Pa~t 4.)
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(A/so Com~ete PertS. )
[] Pdmafily Formed Candidate/
Officeholder Commiltee
(Also Comptete Pert 6.)
"~. General Purpose Committee
O Sponsored
~, Broad Based
'~ Pm-election Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
COVERPAGE
Page t of ~
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
3. Committee Information
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR ~O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX ! E-MAll. ADDRESS
Treasurer(s)
MAILING ADDRESS
CITY STATE ZIP CODE AREA COOE/PHON E
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
FPPC Form 460 (8/99)
For Technic, al Assistance: 916/322-5660
Stab of Calffomla
Recipient Committee
Campaign Statement
Cover Page -- Part 2
Type or print in ink.
COVER PAGE - PART 2
F,.. Z-- of
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD (INCLU DE LOCATION AND D~STRICT NUMBER IF APPLICABLE)
RESIDE NTIAL~ USI N ESS ADD RESS (NO. AND S"reEET) CITY STATE ZIP
BALLOT NO. OR LETTER JURISDICTION
[] SUPPORT
[] OPPOSE
Ider41fy ~te ~ontrolllng officeholder, can,edate, or state measure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE OR, PROPONENT
Related Committees Not Included In this Statement: Ll~tanycommlttees
not Included In this consolidated ~tatement that are conb~tled by you or which am primarily
NAME OF 1REASURER I C~TROLLEOYES COMMITTEE?[] NO
CITY STATE ZIP COOE
7. Verification
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
6. Primarily Formed Committee L~t,..,~ofo~,~o~=..~d~*)
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 ~ue and complete. I certify under penally of perjur~ under the lavl~s of the State of~.C.C.C:~/~mia thal',l~le foregoing is true and correct.
Executed on By
DATE
Executed on By
DATE
Executed on By
DATE
FPPC Form 460 (8/99)
For Technical Assistance: 916/322.5660
State of California
Campaign Disclosure Statement
Summary Page
SEEINSTRUCTIONSONREVERSE
Contributions Received
1. Monetary Contributions ...................................................... Schedule A, Line 3 $
2. Loans Received ................................................................... Schedule B, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add LInes I + 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 ................................................ AddLines6*7 $
9. Accrued Expenses (Unpaid Bills) ............................................ Schedule ~ Line $
10. Nonmonetary Adjustment ....................................................... Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ......................................... Add Lines 8 + 9 + tO $.
Current Cash Statement
12. Beginning Cash Balance ................................ Previous Summary Page, Line t6 $
1 3. Cash Receipts .............................................................. Colu/nn 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 + 14, then subtract Line 15 $
ff this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule S, l~er~ l, Column (b) $.
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... See inatructions on reverse $
19. Outstanding Debts ................................... Add Line 2 + Line § in Column C above $
Type or pdnt In Ink.
Amount~ may be rounded
to whole dollam.
SUMMARY PAGE
I.D. NUMBER
Column A Column B* Column C
'0
* From previous statement Summary Page, Column C. However, if this
is Ihe first report flh~d for the calendar year, Column B should be blank
except for Loans Received (Une 2), Loans Made (Line 7), and Accrued
Expenses (Line 9).
Summary for Candidates in Both June and
November Elections
111 ~rough 6/30 7/1 to Date
20. Contributions
Received ............ $
21. Expenditures
Made .................. $
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
Schedule A Typ, or print I. Ink. SCHEDULE A
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. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ................... TOTAL
*Cont~buto~ Codes J
IND- Individual
COM - Recipient Committee
OTH- Other
FPPC Form 460 (8/99)
For T~chnlcal A~slstan~e: 916/322-5660
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
~p~ or print In Ink,
Amount~ may be rounded
to whole dollam,
SCHEDULE D
NAME OF FILER
DATE
CANDIDATE AND OFFICE,
ME~SURE AND JURISDtCTIOfl, OR COMMfTTEE
Support
n O~x~e
Support I~ Opfx~=e
TYPE Of= PAYMENT
[]
Expe~re
Cortt~t~tio~
Contnt~tio~
Expencll~ure
I.D. NUMBER
CUMULA~VEAMOUNT
Calendar Year
Calendar Year
Cale~:lar Year
SUBTOTAL
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 Ihis period of under $100 .................................................................................. $
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on Ihe Summary Page.) ........ TOTAL $
FPPC Form 460 (8/99)
Fo~ TeehnlcM AsMstance: 91~322-5660
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
SCHEDULE E
I.D. NUMBER
CODES: tf one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
IND independent expanditum supporting/opposing o~hers (explain)*
LIT campaign literature and mailings
DFC ofice exbenses
PET pavilion circulating
PHO phone banks
POL Ix~ing and survey research
POS postage, delivery end messerlger serv~es
PRO pmf'--.msio~al servicas (lagal, accounting )
PRT print ads
RAD radio airtlme and production costs
RFD returned oontflbuflons
SAL campa~n we~emsalaries
TEL tv. or cable airflme and prnduction costs
TRC candidate t ravel, lodging and meals (explain)
TRS stafflspat~e travel, lodging and rneala (explain)
TSF transfer between committees of the same candidate/sponsor
VDT votur registm~Jon
WEB infom3atio~ tech~31ogy costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMrCrEE, AL~O ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
%,11
* Payments that are ¢onfltbutlon$ or Independent expenditures mum also be summarized on Schedule D.
SUBTOTAL
Schedule E Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................................................................................... $ ~7'._'.'.~,
2. Unitemized payments made this pedod 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 $ '~-~:~"~,
FPPC Form 460 (8/99)