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Home My WebLink AboutBFLAG SEMIANN97(2) ecipient Committee Campaign Statement -- Long Form (GOVernment Code Sections 842~-842 !iS,5) Type M print In ink. SEE INSTRUCTIONS ON REVERSE Chect ofle of the following boxes to Indicate the type of statement being filed: J--I Pre-election Statement ~ Semi-annuaIStatement [] SPecml Odd-year Cam paign Report [] Supplemental Pre'election Statement (Attach a completed Form 495 to this Statemeflt.) [] TerminationStatementCAttachacomplntedForm41Stothisstatement.} Statement covers period f,~ 7///~ 7 through Date of (Month, Day, Yeir) FILE Date Stamp 'ER ~NG FORM NAME OF COMMI1TEE / /.~Z ? ,8z-rz~ (Check Boxes) See definitions and important information on reverie. Is this a sponsored committee? .................. ~ Yes [] NO II [ir~.m_a_rily__Fo_r?_e~d. Co.m.m. itt. e.e (See de..fi, nition on reverse.) at .dme~ OT oTTmcenolaer~s) or canamate(s) for which thi r formed. Is this a broad based political committee? ......... ~ Ye 1"'1 NO Attach additional information on appropriately labeled continuation sheets. Ill Veri , I have used all reasonable diligence in preparing this statement. I have reviewed the 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. A, , C .___~ S~NA,U.~,~^S~,~,,~ Executed On At. DATE Recipient Committee Allocation Page Type M ixim in ink. Amounts may be rounded to whe# doNars. Statement covers period ALLOCATION PAGE SEE INSTRUCTIONS ON REVERSE NAME OF COMMfTTEE LD NUMBER List contributions and independet~t expenditures that total $ t O0 or more made to support or oppose officeholders, candidates, ballot measures, or committees. DATE NAME OF OFFICEHOLDER OR CANDIDATE AND OFFICE, OR NAME OF CHECK ONE IND. AMOUNT THIS CUMULATIVE TO DATE CUMULATIVE TO DATE MEASURE AND BALLOT NUMBER OR LETTER. OR NAME OF COMMITTEE EXP.* PERIOD CALENDAR YEAR OTHER (JAN. 1 - DEC. 31 ) (IF APPLICABLE) IE OTHER THAN OFFICEHOLDER, CANDIDATE, OR MEASURE COMMITTEE Sueeo~ "See reverse regarding independent expenditures SUBTOTAL Allocation Summary Attach additional information on appropriately labeled continuation sheets. 1. Contributions and independent expenditures of $100 or more made this period. ~ (Include all Allocation Page subtotals.) ...................................................................... $ 2. Contributions and independent expenditures under $100 made this period. (Do not itemize.) ......................................................................................... 3. Total contributions and independent expenditures made this period. ~/ (Do not carry this to the Summary Page.) ............................................................ TOTAL $ Recipient Committee Summary Page SEE INSTRUCTIONS ON REVERSE Type ec g~M~ I~ ~nk. Amounts mir be roumled to vA~Qle dollars. SUMMARY PAGE thr~ Pa~ '~ of NAME OF COMMI~rEE Contributions Received 1. Monetary Contributions ............................... S<bed~/e A Une $ 2. Loans Received ......................................... s~bed~ a, Une 7 3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnec ! , 2 4. Non-monetary Contributions ......................... Scbed~le CUne 3 5. SUBTOTAL CONTRIBUTIONS (Exckafe Enforceable Promises) AddUnec ~ + 4 6. Enforceable Promises (Exclude Loan Guarantees, Line Il below) ................... ~cbedu/e O, Une 7 7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddLinesS * 6 Expenditu res Made 8. Cash Payments (Other than Loans Made) ............ Schedu/e E, Une S 9. Loans Made .......................................... schedu/e H, Une 7 10. SUBTOTAL CASH PAYMENTS ........................... AddUnese, g 11. Accrued Expenses (Unpaid Bills) ........................ Scbedu/e RUne S 12, TOTAL EXPENDITURES MADE ............ AddL/nec !0 + l! Current Cash Statement 13. Beginning Cash Balance .................. PreviousSummatyPa~e, Line 17 14. Cash Receipts ...................................... ColumnA, LlneSabove 15. MiKellaneous Increases to Cash ........................ S~hedu/e I, une 4 16. Cash Payments .................................... ColumnA, Line fOabove 17. ENDING CASH BALANCE ..... AddLInesl$ , 14 ·IS, thensubtrectLtne l6 If this is a termination ~tetement, Une ! 7 mu~t be zero. 18. LOAN GUARANTEES RECEIVED ............. Scheo~ulea, partl, Column(b) Cash Equivalents and Outstanding Debts 19. Cash Equivalents ............................ Seelnsfrucflonson~eva~se 20. Outstanding Debts ................ AddLine 2 ,, Line ll inColumnCabove Column A s i~ s I iuilO.~ $ $ LO. NUMBER ,~'z/95'~ Column B* Column C S ~-~-7 ,o~ S ~ , s ~v. 0o s ~ 9 ~'7. oo s s s 73_ 3 s Lp' -7, / s -~.3-~-3 .Fe~ s /'Z ~77, 7/ s -/~3 ,~ s /z~'~ 7 · 71 · From ptev~US Stltement Summery Page, Column C. However, if this is the first report filed fo~ the calendar year. Column B should be blank except for Loans Received (Line 2), Enforceable Prome~es (Line 6), Loans Ml~e (Line 9), and Accrued Expenses (Line 1 ? ). , Summary for Non-Controlled Committees Primarily Formed to Support or Oppose Candidates in Both June and November Elections 1/1 through 6J30 711 to Date 21. ~;ontribqtions Kece~vea s Schedule A TVa, o~ ~lnt In I~. SCHEDULE A NAME OF COMMI~EE I.D. NUMBER FULL NAME AND ADDRESS OF CONTRIBUTOR ~CUPAT~N AND EMPLOYER A~UNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE RECEIVE D ~ · ~ to N~g ~S e~E, AS~D. Emir ~ASU~R'S NAME AND A~RESS) ~ME ~ ~SS) PERIOD (JAN 1 - DEC. 31 ) (IF APPLI~BLE) SUITOTAL $ iIL/I~).~ Monetary Contributions Summary 1. Amount received this period -- contributions of $100 or more. (Include all Schedule A subtotals.) ............................................................................ $ ///-//43. ~o 2. Amount received this period --contributions of less than $100. (Do not itemize.) ........................................................................................... $ ~ 3. Total monetary contributions received this period. (Add Lines l and 2. Enter here and on the Summary Page, ColumnA, Linel.) .............................. TOTAL $ I/~/l~J.oO Schedule E Payments and Contributions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE Type m i~lnt In Ink. Amount~ may be rounded to wheae dollarL NAME OF COMMITTEE CODES FOR CLASSIFYING EXPENDITURES Statement cover~ period from ~ SCHEDULE Pig* ~ of ~" I.D. NUMBER Ifoneof the following codes accurately def, cribes the expenditure you may enter the codeandleavethe 'Description of Payment' column blank. Refer tothe back of Schedu · E-Continuation Sheet for detailed explanations of each category. 'C'- MONETARYANDIN-KIND(NON-MONETARY) 'B'- BROAOCASTADVERTISING 'G'- GENERALOPERATIONSANDOVERHEAD CONTRIBUTIONSTOOTHERCANDIDATES 'N'- NEWSPAPERANDPERIODICALADVERTISING 'T'- TRAVEL. ACCOMMODATIONSANDMEALS AND COMMITTEES 'O'- OUTSIDE ADVERTISING (MUST BE DESCRIBED) 't' - INDEPENDENT EXPENDITURES 'S' - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOORSOLICITATIONS 'P' - PROFESSIONAL MANAGEMENTANDCONSULTING 'L' - LITERATURE 'F' - FUNDRAISING EVENTS SERVICES NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E. ~w coeaMrrrEi, I~ ADO~f~O~ tO COMMn'rEI[~ IM.M! AMD &DO. SS. ENTER ID. NUMIER ~ e ~ I.D. RE~RT O~Y THE LUMP SUM OF SUCH PAYME N~ ON LINE 4 OF THE SUM~RY SE~N BE LOW. CODE OR DESCRIPT~N OF PAYMENT A~UNT P~O Important: Contributions and expenditures made out of campaign funds to or on behalf of officeholder, candidates, committee$, or ballot measures must also be entered on the AIIocetion Pa~e. SUBTOTAL 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 $100. (Do not itemize.) ....................................................................... 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. 4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ..................................... 5. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) ........... TOTAL Schedule E (Continuation Sheet) Payments and Contributions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE Typ~ or lyint M IM. Amounts may be rounded to who~ dobrL HAME OE COMMITTEE 'C'- MONETARY AND IN-KIND (NON-MONETARY) CONTRIBUTIONS TO OTHER CANDIDATES AND COMMI"rI'E ES '1° - INDEPENDENTEXPENDITURE$ °L° - LITERATURE Statement ~ov~/rs period through CODES FOR CLASSIFYING EXPENDITURES "r- BROADCAST ADVERTISING "N'- NEWSPAPER AND PERIODICAL ADVERTISING "O' - OUTSIDE ADVERTISING 'S'- SURVEYS, SIGNATURE GATH E RING, DOOR-TO-DOOR SOLICITATIONS 'F' - FUNDRAISING EVENTS SCHEDULE E (cont.) LD. NUMBER 'G'- GENERAL OPERATIONS AND OVERHEAD TRAVE L, ACCOMMODATIONS AND MEALS (MUST BE DE$CRMED) PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID SUBTOTAL