HomeMy WebLinkAboutSHEARER SEMIANN98(2) fficeholder, Candidate,
and Controlled Committee
Campaign Statement -- Long Form
Type or print in ink.
(Government Code Sections 84200-842165)
SEE INSTRUCTIONS ON REVERSE
Check one of the following boxes to indicate the type of statement being filed: [] Pre-election Statement
[] Supplemental Pre-election Statement (Attach a completed FOrm 495 to this statement )
Special Odd-Year Campaign Report
Semi-annual Statement
Termination Statement (ir~Ar.b. E~.a.;..~d Form 415 ~.~aYia~ltlatement.)
RE$1DE~IAL O~U~IN[$S ADDRESS (NO AND $TREET)
CITY $TATI ZIP CODE
COMMITTEE NAME
C~MI~EE ADDRESS IND. AND STREET)
C~Y STATE
NAME ~F TREASURER
fERMANE~ ADDRESS ~ T~A~URER (NO. AND ~TREET)
STALE
Statement covers period Date Stamp
from ~/i/.~ ~
through IZ/C/7/ciE~ C2 27 1]:
Date of election if appllcalq~e~ ,, _
(Month, Day. Year) ;. .Z:: *:~ ~"~ ~; T~'y ol
COVER PAGE - LONG FORM
III Verification
For Official Use Only
;~'~%'r~w~.u'e i(e i,~t~m~ot Included in this Statement: u, ..y ot ,
comml~ees not i~lu~d In this consolidated ~atement thee are controlled by you ~ any
comm~ees of which you have knowledge that are primuily formed to receive contrl~tom
or to make ex~itures on ~haff of your ca~idaq.
COMM~EE NAME [ I.D. NUMBER
NAME ~ T~ASUR~R CONTROLLED C~MI~[~
AREA CODE/DAYTIME PHONE COMMITTEE ADDRESS (NO. AND STREET)
I.D. NUMBER CITY STATE
ZIP CODE AREA CODE/DAYTIME PHONE
ZIP CODE
ZiP COOE AREA CODFJDAYTIME PHONE
COMMITTEE NAME
II D NUMIER
NAME Of TREASURER CONTROLLED COMMITtEE1
] YES [] .O
COMMITTEE ADDRESS (NO, AND STRE~ET)
CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE
Attach additional information on appropriately labeled continuation sheets.
I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my kn wledge the information ontained herein and in the attached schedules is
An officeholder or calldate who controls a commi~ee must also verify the campaign statement I have used all reasonable diligence and to the ~st of my k nowledge the treasurer has used all
reasonable dihgence in preparing this statement. I have rawawed the statement and to the best of my knowledge the information contained h ein and in the a~ached schedules es true and
o
DATE C~V AND STATE SIGNATURE OF CANDIDATE/OFFICEH~DER
Executed on At By
DATE CITY AND STATE SIGNATURE OF (ANDIDAIE/OfFI(EHOIDER
Executed on At By
DATE CITY AND SIAT[ SlGNAIUR[ Of
F OR INFORMATION RETIRED TO 8[ PROVIDED TO YOU PURSUAN1 TO }HE INFORMATION P~IC[S A~ OF 1~77, SEE INFORMATION M~A~ ~N C~AI~ DI~gLU~y~L~f T~ POLIIICAt REFORM A~]
~tate nf I"~llfnrnl.t hl. Pnlhi. ~1 P, ~rllre~ rnrnml,Hl,,
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
Contributions
1. Monetary Contri butions ............................... Schedule A, Ltne 3 $
2. Loans Received ......................................... Schedule e, Line
3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I, 2 $
4. Non-monetary Contributions ......................... Schedule C, Line 3
5. SUBTOTAL CONTRIBUTIONS.(Exdude Enforceable Promises) Add Unes 3
6. Enforceable Promises
(Exclude Loin Guarantees, Line 18 below) ................... Schedule D, Une 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnesS
Expenditures Made
8. Cash Payments (Other than Loans Made) ..........Schedule E, Line 5 S
9. LOans Made .............................................Schedule H, Une 7
10. SUBTOTAL CASH PAYMENTS ............................AddLines8 + 9 $
11. Accrued Expenses (Unpaid Bills) ...................Schedule F, Line S
12. TOTAL EXPENDITURES MADE .........................AddUnes 10 · 11 $
'Current Cash Statement
13. Beginning Cash Balance .................. PreviousSummaryPage, [ine 17 $
14. Cash Receipts ......................................ColumnA, Llne3above
15. Miscellaneous Increases to Cash ........................Schedule I, Line 4
16. Cash Payments .................................... ColumnA, Line lOebDye
17. ENDING CASH BALANCE ..... AddLinesl3 ~ 14 ~ fS, thensubtractUne 16 $
ff this is a termination statement, Line f 7 must be zero.
18. LOAN GUARANTEES RECEIVED .............. Schedule e, Patti, Column(b) $
Cash Equivalents and Outstanding Debts
19. Cash Equivalents ................................See instructions on reverse
20. Outstanding Debts ................. AddLine 2 ~, Line ll inColumnCabove
Type or print In ink.
Amounts may be rounded
to whole dollars.
COlumn A
TOIAL THIS I~RIOD
AI'IACHID SCHEDULES)
~;.~ ,
0,OO
C~ ,oo
NDIN6 CAItl IALANCi .$HOUI. D
NOT I1~ A NEGITIVI: AMOUNT
/',
$
$
Statement covers period
from ~/|/~ ~
through 12~-/~'/~ ~
Column B*
TOTAL PREVIOUS PERIOD
O. Go
s c-t, cj, e, c, e,
s ~Sc,c~o
SUMMARY PAGE
Page Z
t.D. NUMBER
Column C
TOTAL TO DATE
(ADD COtUMI~ A · B)
$ ..,,
* From previous Statement Summary Page. Column C. However. if
this is the first reOOrt filed for the calendar year, Column B should be
blank e~cept for Loam Received (Line 2), Enforceable Promises (Line
6). Loans Made (Line 9), end Accrued Expenses (Line 11).
Summary for Candidates in Both June and
November Elections
111 through 6/30 711 to Date
21 ontrib tions
22. Ex nditures
M~er ....... s '
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
FULL NAME AND ADDRESS OF CONTRIBUTOR
DATE (IF COMMITTEE, IN ADDF/R)N TO COMMITTEE'S NAME AND ADDRESS, ENTER I.O NUMBER
RECEIVED o~ tr NO I.O. NUMBER HAS lIEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS)
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers perled
from t /
through
OCCUPATION AND EMPLOYER
(IF SELF-EMPtOYED, ENTER
NAME Or BUSINESS)
AMOUNT
RECEIVED THIS
PERIOD
SCHEDULE A
I.D. NUMBER
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 - DEC. 31)
,ff '77, o o
rn ,0 o
SUeTOVAL $ i~.,llt.(~i~l
Monetary Contributions Summary
1. Amount received this period -- contributions of $100 or more.
(Include all Schedule A subtotals.) .................................................................................................... $
2. Amount received this period -- contributions of less than $100.
(Do not itemize.) ................................................................................................................... $
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ......................................... TOTAL $
CUMULATIVE TO DATE
OTHER
(IF APPLICABLE)
/zS-oo
Schedule E
Payments and Contributions
(Other Than Loans) Made
Type o~ prim in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
CODES FOR CLASSIFYING EXPENDITURES
Statement covers period
through l ~"t ? '
SCHEDULE E
Page. q. of S
I.D. NUMBER
If one of the following codes accurately describes the expenditure, ou may enter the code and leave the "Description of Payment' column blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations otY;ach category.
°C' - MONETARY AND IN-KIND (NON-MONETARY)
CONTRIBUTIONS TO OTHER CANDIDATES
AND COMMITTEES
'1' - INDEPENDENT EXPENDITURES
'L"- LITERATURE
'B'- BROADCASTADVERTISING
'N'- NEWSPAPERANDPERIODICALADVERTISING
'O" - OUTSIDE ADVERTISING
'S' - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS
'F' - FUNDRAISING EVENTS
t
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
(If COMMITlIE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, ENTER I.D. NUMIER
NUMIER HAS IEEN ASSIGNED, ENTER TREASURER'S NAME AND ADORES$)
'G' - GENERAL OPERATIONS AND OVERHEAD
'T' - TRAVEL. ACCOMMODATIONS AND MEALS
(MUST BE DESCRIIED)
"P'- PROFES$1ONAL MANAGEMENT AND CONSULTING
SERVICES
IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW.
CODE OR DESCRIPTION OF PA~'MENT
G
comm,ttees, or ba~ot measures must ;~o be entered on the A~ocation Page, Part L : 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 $
AMOUNT PAID
/
0
0,0o
0
Schedule E
(Continuation Sheet)
Payments and Contributions
(Other Than Loans) Made
SEE INSTRU(TIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
~et~- CLa.,'[ 5h--~rec
Type or prim In ink.
Amounts may be rounded
to whole dollars.
'C' - MONETARY AND IN-KIND (NON-MONETARY)
CONTRIBUTIONS TO OTHER CANDIDATES
AND COMMITTEES
'1' - INDEPENDENT EXPENDITURES
*L'- LITERATURE j
Statement covers period
from 1/(/c~ ~-
CODES FOR CLASSIFYING EXPENDITURES
*B' - BROADCAST ADVERTISING
°N°- NEWSPAPERANDPERK)DICALADVERTISING
"O' - OUTSIDE ADVERTISING
"S*- SURVEYS, SIGNATURE GATHERING, DO OR-TO-DOOR SOLICITATIONS
*F* - FUNDRAISING EVENTS
CODE
OR
NAME AND ADDRESS OF PAYEE. CREDITOR, OR RECIPIENT OF CONTRIBUTION
(tf COMMITlEE, IN &DOlTION 1o COMMITTEE'& NAME AND ADORESc,, EllTEA I.O. NUMIER OR, ii NO I,D,
NUMBER HAS liEN ASS~NED, EN~ER TREASURER'S NAME AND ADDRESS)
SCHEDULE E (cont.)
I.D: NUMBER
'"G' - GENERAL OPERATIONS AND OVERHEAD
"T' - TRAVEL, ACCOMMODATIONS AND MEALS
(MUST BE DESCRIBED)
"P" - PROFESSIONAL MANAGEMENT AND CONSULTING
SERVICES
:
DESCRIPTION OF PAYMENT
AMOUNT PAID