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Home My WebLink AboutBFLAG SEMIANN00(2) ecipient Committee Campaign Statement (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print In ink. Dale Stamp COVER PAGE Statement from JO/~-:~-I Date ol election if applicable: (Mo~, Day, Year) OIJ~t!23 PH 3:5 Page [ of ~' For Official Use ore/ B\KEhoFIELDLh fCLE~K 1. Type of Recipient Committee: AJi committee~ - Complete Part~ 1, 2, 3, ahd 7. [] Officeholder, Candidate Controlled Committee (Also CofftpMM Pad 4.) [] Ballot Measure Committee O Primarily Formed O Controlled O Sponsored (Aisc Complete Part 5.) [] Primarily Formed Candidate/ Officeholder Committee [A/so Complete Part S.) ~ General Purpose Committee O Sponsored ,~ Broad Based 3. Committee Information JI.D. NUMBER ~:,2- t q 55 COMMITTEE NAME CITY STATE ZIP CO~E AREACODE/PHONE MALLING A~ESS (IF DF~RE~} NO, ~D STREET ~ P,O, ~X 2. Type of Statement: [] Pre-election Statement ,~ Semi-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Pre-election Statement ~ Attach Form 495 Treasurer(s) MAILING ADDRESS (;ITt STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILIN(~ ADD~ESS CiTY STATE ZIP CODE AREA CODFJPHONE OPTIONAL: FAX / E-MAIL ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS FPPC Form 460 For Technical Aasl~tance: 916/3;[2-5660 State of California ReCipient Committee Campaign Statement Cover Page -- Part 2 Type or print in ink. COVER PAGE-PART2 Peg. 4. Officeholder or Candidate Controlled Committee NAM E OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD {INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESiDENT!AL~USlNESS ADDRESS (NO. AND STREET) CITY STARE ZIP 5. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER [ JURISDICTION ~ E] SUPPORT It'1 OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees Not Included in this Statement: Llstanycommlttees not Included In this consolidated statement that are controlled by you or which are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. 11.O. NUMBER CCMMITTEE NAME NAME O~: TREASURER CONTROLLED COMMII ItT:? E] ~ES [] .O COMMiTtEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODFJPHONE OFFICE sOUGHT OR HELD I DISTRICT NO. IF ANY 6. Primarily Formed Committee U,t,a,,esofo~coholder(s) ofcandld'lore) for which this ~uii~,~:ttee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE Attach continua~on sheets if necessaq/ OFFICESOUGHT ORHELD OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD [-'~SUPPORT E]OPPOSE [~SUPpOFff E]OPPOSE E]OPPOSE 7. Verification information contained herein and in the attached schedules I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the 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 DATE Executed on. By DATE Executed on By FPPC Form 460 (8/99) For Technical Aeslstance: 916/322-5660 State o! CMIfornle Schedule A Type or print in ink. SCHEDULE A Monetary Contributions Received ~mO~omSwh~aleYdOe~lra°r~.noe= Statement cover~ period I .. i SEE INSTRUCTIONS ON REVERSE through / 7-/~'~ //0(~ I.D. NUMBER IF AN tNDI~AL, ENTER AM~T C~TIVE TO DA~ CUMU~TIVE TO DATE DATE FULL NAME, MAIUNG ADDRESS AND ZIP CODE OF CONTRIB~OR CONTRIB~OR ~CUPA~ON AND EMPLOYER RECEIVEO ~IS CALENOAR YEAR OTHER RECEIVED pF ~I~EE, ALSO ENTER I.D. NU~R) CODE * ~F SE~-EM~OYED, EN~R N~E PERIOD (JAN 1 - DEC. 31 ) (IF AP~IC~LE) ~ IND ~ COM ~ OTH ~ raND ~ CO~ ~ OTH ~ mND ~ COM ~ OTH ~IND D COM ~ OTH SUBTOTALS Schedule A Summary 1. Amount received this period - contributions o! $100 or more. (Include all Schedule A subtotals,) ....................................................................................................... 2. Amount received this period - 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 L'Conl~b~or Codes IND - Individual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 S.chedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER CANDIDATE AND OFFICE. MEASURE AND JURISDICTION, OR COMMITTEE ~ Suppod [] Oppose ~ Support [] Oppose Type or print in Ink. Amounts may be rounded to whole dollars. TYPE OF PAYMENT [] Monetary Contribution ~"l~c~-Monetary Contribution [] Independent Expenditure [] Monetary Contribution [~qon-Monetary Co~tribution [] Independent E~oendilure [] Monetary Conth~oulion [:~-Monetary Contr~oution Expendibare Statement covers period from through '~-/'~ [/C)~:) DESCRIPTION OF NONMONETARY CONTRIBUTION (IF REQUIRED) AMOUNT THIS PERIOD ~'70. ob ~_-7o SCHEDULE r) Page '~ of ~-~ ID. NUMBER CUMULATIVE AMOUNT Calendar Year $ "7 --/o ,cD Other $ Calendar Year Other $ Calendar Year s %'7--70 Other 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 this period of under $100 .................................................................................. $ 3. Total contributions and independent expenditures made this period. (Add Lines I and 2. Do not enter on the Summary Page.) ........ TOTAL $ FPPC Form 460 (8/99) For Technical Assistance: 916/~22-5660 Schedule D (Contihuation Sheet) Fn d'i :SCHEDULE D ICONT.' _umma., of _x~en_.tures Type or print In Init S~,~tcoverspe~lo~ Suppo~in~Opposing Other Candidates, Measures and Commi~ees through NAMEOF FILER DATE CANOIOATE ANO OFFICE, ~PE OF PAYMENT AMOUNT ~IS PERIO0 CUMU~TIVE AMOUNT M~SURE AND JURISOtCTION, OR COMMI~EE CONTRIB~ON (IF REQUtRED) I~0 ~"~ ~~ ~bution ~,~ Calen~rYear ~ntdbuti~ O~er ~ I~ent ~ Sup~d ~ Op~e Ex~i~re $ ~ ~q~ ~n~but~n O~er ~ I~e~n~nt ~ Sup~M ~ Op~e Expe~re $ ~ ~e~ Cale~r Year ~t~buti~ ~bu~ O~er D I~e~nt ~ ~ ~e~r Y~ ~b~ ~ O~er ~ Sup~ ~ ~ E~e $ SUBTOTAL $ I ~ S" 0 , ~ FPPC Form 460 (8/99) For Techrdcal Assistance: 916/i~22-5660 Schedule E Payments Made Type or print In ink. Amounts may be rounded to whole dollars. SEE INSTRUC11ONS ON REVERSE NAME OF RLER SCHEDULE E through / ~~ ~:~ ~-~ Page of LD. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphe malta/misc. CNS campaign consultants CTB contributk~ (explain nonmonetary)' CVC civic dona~ons FND fundraising events IND Independent expeoditum supporting/opposing others (explain)' LIT campaign literature and mailings MTG rneetings and appearances CFC office expanses PET petilion circulating PHC phone banks POL polling and survey research POS postage, delivery and messenger senecas PRO prolessional services (legal, accounting) PRT print ads RAD radio airtime and production Costs RFD returned contributions SAL campaign workers sale,es TEL t.v. or cable airtime and production costs TRC candidate travel, lodging and meals (explain) TRS staff/spouse travel, lodging and meals (explain) TSF transfer between committees of the same candidate/sponsor VOT voter registration 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 PAID * ~~yments that ~re c~~tribut~~n~ ~r Indepe~dent ~xp~nd~ture~ m~st ale~ be ~umm~~zed ~~ schedule D~ SUBTOTALS Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................................................................................... $ 4~::~ -~~ "/Cb// 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 $ ~ I ~-~), 2--) FPPC Form 460 (8/99) For Technical Assistance: 916~322-5660 Schedule E (contihuation Sheet) Payments Made Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period SCHEDULE E (CONT.) SEE INSTRUCTIONS ON REVERSE NAME OF RLER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaignparaphemaita/misc. OFC officeexpenses RFD retumedcontrfbu~fons CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FNO fundraising events IND tr,,depe~dant expenditure supporting/opposing o~ers (explain)* LIT campaign literalure and maitings PET pe~tion circulating PHO phone banks POL polling and survey research POS postage, deliven/and messenger sarvicas PRO professional sawicas (legal, accounting) PRT print ads Page "7 of ~ I.D. NUMBER 9z/ MTG mee~3gsandappearances RAD radloairtimeandpr(;ductioncosts WEB Informati NAME ANO ADDRESS OF PAYEE OR CREOITOR IF COMMITTEE, ALSO ENTER I D NUMeER) CODE OR DE$CRIPTIO~I OF PAYMENT AMOUNT PAID summarized on Schedule D. SUBTOTAL S.~i~/..~ , lC.( FPPC Form 460 (~9J For Technical Assistance: 91~22-5660 SAL campaign workers salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging and meals (explain) TRS sta~f/sPousa travel, lodging and meals (explain) TSF transfer belween committees of the same candidate/sponsor rOT voter registration caml~ai~n Disclosure Statement Summary Page SEE iNSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers ,ro Contributions Received Schedule A. Line 3 1. Monetary Contributions ...................................................... 2. Loans Received ................................................................... Schedule B. Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines t * ~ 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 + 7 9. AccPJed Expenses (Unpaid Bills) ............................................ Schedule F.. Line 3 10. Nonmonetary Adiustment ....................................................... Schedule C. Line 3 11. TOTAL EXPENDITURES MADE ......................................... Add Lines e + s + 10 Column A TOTAL THIS PERIOD $ $ 7;Z tS,c~ $ -"ZZ $ SUMMARY PAGE Page ~ .of (~ I.D. NUMBER Column B* Column C TOTAL PRE~/t OUS PERIOO TOTAL TO DATE $ $ s o s "/7~ 1%. ~ Current Cash Statement 12. Beginning Cash Balance ................................ Previous Summary Page. Line 16 13. Cash Receipts .............................................................. Column A. Line 3 above 14. Miscellaneous Increases to Cash ....................................... Schedule I. Line 4 15. Cash Payments ............................................................ Column A. Line 8 above 16. ENDING CASH BALANCE .............. Add Lines 12 + 13 + 14. then subtract Line 15 I1 this is a termination statement. Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................... Schedule S. Pa, 1. Column (b) Cash Equivalents and Outstanding Debts 18. Cash Equivalents ..................................................... See Instructions on reverse 19. Outstanding Debts ................................... Add Line 2 + Line 9 in Column C above · From previous statement Summary Page. Column C. However. if this is the first report filed for the calendar year. Column B should be blank except lot Loans Received (Line 2). Loans Made (Line 7). and Accrued Expenses (Line 9). Summary for Candidates in Both June and November Elections 1/1 through 6/30 20. Contributions Received ............ $ c:~ ,~'~o .o0 21. Expenditures -7~,~. 70 Made .................. $ 711 to Date FPPC Form 460 (8/99) For Technical Assistance: 916/~22-5660