HomeMy WebLinkAboutKC EMPLOYEES PAC SEMIANN00(2)Recipient Committee
Campaign Statement
(Govemrnent Code Sec~ons 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print In Ink.
Statement covers period
through
Date of election If applicable:
(Monlh, Day, Year)
Date S~amp
OI J~,N 22 Li'q I0:
Eh,~riL[ D CiTY CL
COVERPAGE
Page [ of ~
For Official Use Only
1. Type of Recipient Committee: All Committees-Complete Parts 1, 2, 3, and 7.
[] Officeholder, Candidate
Controlled Committee
(Also Complete Pad 4.)
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(Also Complete Part 5.)
[] Pdmadly Formed Candidate/
Officeholder Committee
(Also Complete Part 6.)
"~ General Purpose Committee
C) Sponsored
(~ Broad Based
3. Committee Information
%%.
(IF DIFFERENT) NO. AND STREET OR RD. BOX
CITY STATE ZlPCOOE AREA CODE/PHONE
2. Type of Statement:
[] Pre-election Statement
"~, Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quarterly Statement
[] Special Odd-Year Repod
[] Supplemental Pre-election
Statement - Attach Form 495
Treasurer(s)
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER. IF ANY
MAlUNG ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX I E-MAIL ADDRESS
FPPC Form 460 {8199)
For Technical Assistance: 9161322-5660
State of California
Recipient Committee
Campaign Statement
Cover Page -- Part 2
Type or print In Ink.
COVER PAGE - PART 2
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANe{DATE
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD (INCLUE)E LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RE SIDENTIAL/B USINESS ADDRESS {NO. AND STREET) CITY STATE ZiP
Related Committees Not Included in this Statement: LJstanyco~mittees
not included in this consolidated statement that are controlled by you or which ere pHmarfly
formed to receive contrfbutlons or to make expenditures on behalf of your candidacy.
COMMITTEE NAME
NAME OF TREASURER
COMMtTFEE ADDRESS
LO. NUMBER
CONTROLLED COMMITTEE?
[] ~ES [] NO
STREET ADDRESS (NO EO. BO)
CITY STATE ZIP CODE
7. Verification
BALLOT NO. OR LETTER JUR{SO~CTION [] SUPPORT
[] OPPOSE
Identlf~ the controlling officeholder, candidate, or state measure proponent, If any.
NAME OF OFFICEHOLDER. CANDIDATE OR, PROPONENT
OFF~CE SOUGHT OR HELD DISTRICT NO. IF ANY
Primarily Formed Committee llstnames ofof~ceholderFs) orcandidate(s)
for which this committee Is primarfly formed.
NAME OF OFFICEHOLDER OR CANOIOATE
NAME OF OFFICEHOLDER OR CANDIDATE
AREA CODEJPHONE NAME OF OFFICEHOLDER OR CANDIDATE
Attach continuab~n sheets if necessary
OFFICE SOUGHT OR HELD [] SUPPORT
[]OPPOSE
OFFICE SOUGHT OR HELD [~SUPPORT
[~OPPOSE
OFFICE SOUGHT OR HELD
~]SUPPORT
~)OPPOSE
have used all reasonable diligence iD preparing and reviewing this statement and tel{he best of my knowledge the information contained herein and in the attached schedules
is true and complete, t certify under penalty of perjury under the lav~s of th~State~mia th'~the foregoing is true add correct.
Executed on,
Executed on
By
FPPC Form 460
For Technical Assistance: 9161322-5660
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in Ink,
Amounts may be rounded
to whole dollars.
Contributions Received
1. Monetary Contributions ...................................................... Schedule A, Line 3
2. Loans Received ................................................................... Schedule B. Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines 1 + 2 $
4. Nonmonetary Contributions ............................................... Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $
SUMMARY PAGE
Page "~ of ~,~
I.D. NUMBER
Column A Column B* Column C
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. Accrued Expenses (Unpaid Bills) ............................................Schedule F, Line 3
10. Nonmonetary Adjustment ....................................................... ScheduleC, Line3
11. TOTAL EXPENDITURES MADE ......................................... Add Lines 8 + 9 + 10
Current Cash Statement
12. Beginning Cash Balance ................................ Previous Summary Page, Line 16
1 3. Cash Receipts .............................................................. Column A, Line 3 above
14. Misceflaneous 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
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule B, Part 1, Column (b)
Cash Equivalents and Outstanding Debts
I
18. Cash Equivalents ..................................................... See instruclions 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 for Loans Received (Line 2), Loans Made (Line 7), and Aocmed
Expenses (Line 9).
Summary for Candidates in Both June and
November Elections
111 through 6130 711 to Dale
20. Contributions
Received ............ $
21. Expenditures
Made .................. $
FPPC Form 460 (8/99)
For Technical Assistance: 9t61322-5660
Schedule A Typa or print In Ink. SCHEDULE A
Amoun{s may oa rounaaa Statement covers period
Monetary Contributions Received towhotadollar..
SEEINSTRUCTIONSONREVERSE throughlZ--314 -C)~ I Page 4 of
NAME OF FILERJ I.D. NI M
FULLNAME MAILINGADDRESSANDZIPCODEOFCONI~RIBUTOR CONTRIBUTOR OCCUPATIONANDEMPLOYER RECEIVEDTHIS CALENDARYEAR OTHER
DATE ! , IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE
RECEIVED ("= COMMITTEE' AL~O ENTER ID' NUMBER) CODE ~' {IF SELF'F~OYEO, ENTER NAIdE PERIOD (JAN. 1 - DEC. 31 ) (rF APPLICABLE)
OF BUSINESS)
"~ ~ ~,OTH
J O -- "~ ~ [] IND
'~OTH
J[ -- Z-<~ []IND
[]cou '11 ·
'Z-~(~ ~.DTH
I ~_ - I [] IND
-~._(2~2~(~ '~,OTH
zooo c: ou 1 04 .
~O~H
Schedule A Summary
1. Amount received this period - contributions of $100 or more.
(Include all Schedule A subtotals.) ....................................................................................................... $
2. Amount received this period - 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 $
'Contributor Codes
IND - Individual
COM - Recipient Commiltee
OTH-Olhe,
FPPC Form 460 {8199)
For Technical Assistance: 9161322-5660
Schedule D
~Sum~nary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print In Ink.
Amounts may be rounded
to whole dollars.
from I~
through
SCHEDULE D
Page _,~ of ~
DATE
CANDIDATE AND OFFICE,
MEASURE AND JURISDICTION, OR COMMITTEE
Support [] Oppose
[] Suppod [] Oppose
TYPE OF PAYMENT
~..Jvlonetary
Contribution
[] Non-Monetary
Contribution
[] Independenl
Expenditure
[] Monetary
Contribution
[] Non-Monetary
Con[~bution
[] Independent
Expendilure
[] Monelary
Contribution
Conlribution
[] ~ndependent
Expendilere
DESCRIPTION OF NONMONETARy
CONTRIBUTION
itF REQUIRED)
AMOUNT THIS PERIOD
I.D. NUMBER
[] Supper [] Oppose I
SU.TOT^, $ \
CUMULATIVE AMOUNT
Calendar Year
Other
Calendar Year
$;
Other
Calendar Year
$
Other
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 1 and 2. Do not enter on the Summary Page.) ........ TOTAL $
FPPC Form 460 (8/99)
For Technical Assistance: 9161322-5660
Schedule E
Payments Made
Type or print In ink.
Amounts may be ~ounded
to whole dollerB.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
covers
through
SCHEDULE E
Page4~-~ of~)
I.D. NUMBER
8"10 %q
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, descdbe the-payment.
CMP ca mpaign para phemalie~mlsc.
CNS campaign consuttanls
CTB contribution (explain nonmonetary)*
CVC civic donations
FND fundraising events
Ii,ID independent expenditure suppoding/opposing others (explain)*
LIT campaign literature and mailingjs
MTG meetings and appearances
OFC office expensas
PET pefllion circula~ng
PHO pbeae banks
POL polling and suwey resaarch
POS postage, deliver/and messanger sarvlces
PRO profesaional sarvisas (legal, accounting)
PRT print ads
PAD radio airtime and production costs
RFD relumed conbibulions
SAL campaign workers salaries
TEL t.v. o~ cable airUme and production casts
TRC candidale travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF Iransfer between committees o! the same candidale/sponsor
VOT voter registraUon
WEB informatio~ lechnology costs (internel, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(iF COMUITTEE. N. SO ENTER I.D. ~R) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL
Schedule E Summary
1. Payments made this period of $100 or more. (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 hera and on the Summary Page, Column A, Line 6.) ......................... TOTAL $
FPPC Form 460 (8199)
For Technical Assistance: 9161322-5660