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Home My WebLink AboutBFLAG SEMIANN98(2) ecipient Committee Campaign Statement -- Long Form (Government Code Sections 84200-84216.5) Type Of F|nt tn ink. SEE INSTRUCTIONS ON REVERSE Ch~k erie of the following bexes to imitate the type of stltement being filed: E:] Pre-election Statement ~1~ $emt-lnnual Statement C] Special Odd-year Campaign Report E] SupplementalPre-electionStatement(AttachacompletedFormagStothisStetement.) [3 Termination Statement (Attach a completed Form 415 to this statement.) I Committee Information NAME OF COMMITTEE ADOtilSS O~ COMMITFEE (NO, AND STREET) I I.D, NUMIER COOI,,IMYTIME PHONE NAF~E OF TREASURER F~RNIANINT ADDRESS O~ TIIEASURER (NO. AND STREET) Crrv STATE ZIP COD( Alia CO43~I)AYl'IMI (Check Boxes) See definitions and important information on reverse. Is this a sponsored (ommittee? .................. ~ Yet [] No Is this a broad based politicat committee? ......... ;~] vet [] No III Verification Statement covers period th,oueh (Month, Day, Year) ~COVER PAGE - LONG FORM ,.,., I , For Official Use Only II Primarily Formed Committee (See definition on reverse.) · f · ~ Of CANI)4I)ATE6) 04~ OfFICEHOLDER(S) 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 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. ~_~~~__,~% Zx:7 ~ DATE CITY AND STATE Executed on At By DATE CItY AND STATE 5~GNATURE 0t RESPONSIBtE O~FI(ERO~ fd~, I~ RE HE INFORMATION PRACTICES ACT OF re77, SEE INFORMATION MANUAL ON CAM~A. IGN DISCLOSURE PROVISION~S OF THE POLITICAL~[~O_I~M ACT, Recipient Committee Type ,,, p,~t ~. Amounts may be rounded Statement covers period Allocation Page to M~, do,.,. SEE INSTRUCTIONS ON REVERSE _ through NAME OF COMMITTEE I,D, NUMBER List contfilx#tions ar~l independent expenditur6 t~t total $ ~00 or more m~le to support or oppose officeholders, candidates, t~llot measure, or ¢ommiltee$. ALLOCATION PAGE DATE NAME OF OFFICEHOLDER OR CANDIDATE AND OFFICE, OR NAME OF CHECK ONE IND. AMOUNT THIS MEASURE AND BALLOT NUMBER OR LETTER, OR NAME OF COMMIlq'EE EXP.t PERIOD IF OTHER THAN OFFICEHOLDER, CANDIDATE, OR MEASURE COMMITTEE SUNmeT ti/sl% ,H.~r...***~,,~;o ,~ c,V ('~.,~.t X CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) J ,.f ?sw,oc CUMULATIVE TO DATE OTHER (IF APPLICABLE) *See reverse regarding independent expenditures. Allocation Summary 1. Contributions and independent expenditures of $100 or more made this period. (Include all Allocation Page subtotals,) ...................................................................... $ 2, Contributions and independent expenditure 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 $ ....o,.:' '1, Attach additional information on appropriately labeled continuation sheets. 2.ooo. Oeg 2_C:,3O, Oc Recipient Committee Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF COMMITTEE Contributions Received 1. Monetary Contributions ............................... Scfiedule A, Une 3 S 2. Loans Received ......................................... Schedule a, une 7 3, SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I · 2 S 4. Non-monetary Contributions ......................... Schedule C, Une 3 5. SUBTOTAL CONTRIBUTIONS (Exclude Enforceable Promises) AddUnes 3 · 4 $ 6, Enforceable Promises (E dude Loan Guaranlees, Line 18 below) Schedule D, Une 7 7, TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnes S ~ 6 $ Expenditures Made 8, Cash Payments (Other than Loans Made) ............ Schedde E, Une S 9. Loans Made ............................................. Schedule H, Une 7 10. SUBTOTAL CASH PAYMENTS ............................ AddUnese, 9 11. Accrued Expenses (Unpaid Bills) ........................ Schedule F, Une S 12. TOTAL EXPENDITURES MADE ......................... AddLines 10 · 1~ Current Cash Statement 13, Beginning Cash Balance ..................P~vtous Summary Page, Line 17 14, Cash Receipts ......................................ColurnnA, LineJabove 15, Miscellaneous lncreases to Cash ........................Schedule#,Une4 16, Cash Payments ....................................Column A, ~ne ~0 above 17. ENDING CASH IALANCE ..... Add Unes13 , 14 · IS, then subtracI Ltne I6 ff ~ is · ear··nation st·re·ant, Line 17 must be zero.' 18. LOAN GUARANTEES RECEIVED .............. Sc~edule B, Pert I, Column Cash Equivalents and Outstanding Debts 19. Cash Equivalents ................................ See tnslrucftons on reverse S 20, Outstanding Debts ................. AddLine 2 , Line ll tnColumnCabove $ TypeorpdmMle. Amounts may be ramdad to whole dobrs. Column A TOTAl TIeS II~RIOD (FitOld ATTACHED SO4EOULES) Statement covers period ,,, Iol/ l through / Z/~//c~/ .. Column B* NE NOTE IEL OV4f) s loe, 3 SUMMARY PAGE I,D. NUMBER Column C TOTAL TO DAT! * From previous Statement Summary Page, Column C. However, if this is the first report filed fo~ the calendar year, Column i should be blank except for Loam eeceved (Line 2), Enforceable Promises (Line 6), LOam Made (Line 9), and Accrued Expenses (Line 11 ). Summary for Non-Controlled Committees Primarily Formed to Support or Oppose Candidates in Both June and November Elections 1/1 through 6/30 7/1 to Date 21. ontrib tions ~ ~_ n. , Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF COMMITTEE FULL NAME AND ADDRESS OF CONTRIBUTOR DATE 0; COMMITrIE, IN ADINTION TO COMMITrEE'S NAIRT ANO ADORES5, EN/ER I.O. NUMI~R RECEIVED OF, IIr NO I.O, NUMIER HAS lEER ASgglID, ENTER TI!~ASURER'$ NAME ANI) ADOFEe, S) TylxmpdntininL Amounts may be rounded to whole dollars. OCCUPATION AND EMPLOYER elr !~LF-IMR.OYED, ENTER NAME Of Statement covers p/riod f,om IC~l Ira/9 ~, through IZ, l ~/ / q8 AMOUNT RECEIVED THIS PERIOD SCHEDULE A CUMULATIVE TO DATE CUMULATIVE TO DATE CALENDAR YEAR OTHER (JAN. 1 - DEC. 3 1 ) (IF APPLICABLE) ~/3/,,,:,,- SUBTOTAL 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 $100. (Do not itemize.) ........................................................................................... 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1 .) .............................. TOTAL Schedule E Payments and Contributions (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE NAME OF COMMITTEE typeotpdntininL SCHEDULE E AmOulTtl may be roytided Statement co~ ~r~ ~ to w~ i~. ,,, thr~h /~//~ ~ p~ ~ ~ ~ LD, NUMBER CODES FOR CLASSIFYING EXPENDITURES If one of the following codes accurately describes the expenditure, u may enter the code and leave the "Description of Payment' column blank. Refer to the back of Schedule E-Continuation Sheet for detailed explanations otY~e~ch category. *C' - MONETARY AND IN-KIND (NON-MONETARY) CONTRIBUTIONS TO OTHER CANDIDATES AND COMMITTEES '1" - INDEPENDENT EXPENDITURES °L'- LITERATURE 'B' - BROADCAST ADVERTISING *G' - °N'- NEVVSPAPER AND PERIODICAL ADVERTISING 'T'- °0' - OUTSIDE ADVERTISING ' "S ' - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS "P" ' 'F' - FUNDRAISING EVENTS GENERAL OPERATIONS AND OVERHEAD TRAVEL ACCOMMODATIONS AND MEALS (MUST BE DESCRIIED) PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION (1~ COMMITTEE, Me ADDITION TO COMMfir!'EE'$ NAME ANO ADDNE$S, ENTER I.D. NUMIER OIL W NO I,O, NUMIER HAS IfiEN ASSIGNED, ENTER TREASUI~R~ NAME ANO ADDR~e~S) CODE 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. OR DESCRIPTION OF PAYMENT Important: Contributions and expenditure made out of campoi n funds to or on behalf of off/ceho/den~, ' ' candid_ate, committees, or _te__!l_ot m_easure~__ must also be entertain the Allocation Page, SUBTOTAL $ Payments and Contributions Made Sum maW 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 9~,2,/~ rj tq ,70 #1,-~ #, ~,~ q~o~ Schedule E (Continuation Sheet) Payments and Contributions (Other Than Loans) Made SEE iNSTRUCTIONS ON REVERSE NAME OF COMMITTEE 'C'- MONETARY AND IN-KIND (NON-MONETARY) 'B* - CONTRIBUTIONS TO OTHER CANDIDATES °N' - AND COMMITTEES "O* - INDEPENDENT EXPENDITURES 'S' - LITERATURE 'F* - Typeotpdetlnlnk. Amounts may be rounded Statement evers period 0,, /z CODES FOR CLASSIFYING EXPENDITURES BROADCAST ADVERTISING NEWSPAPER AND PERIODICAL ADVERTISING OUTSIDE ADVERTISING SURVEYS, SIGNATURE GATHERING. 0OOR-TO-DOOR SOLICITATIONS FUNDRAISING EVENTS NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION (IF COMMITTEE, IN AIX)fTION TO CO MMITTEE'S NAME AND AOORESr~, ENTER I.D, NUMIER 04~ W NO I.D. 14UMI~R HAS lIEN ASTd~NED. ~NTIER TREA&URER'~ NAME ANO AOORESS) CODE OR SCHEDULE E (cont.) 'G'- GENERAL OPERATIONS AND OVERHEAD 'T' - TRAVEL, ACCOMMODATIONS AND MEALS (MUST BE DE$I31ED) 'P' - PROFESSIONAL MANAGEMENT AND CONSULTING SERVICES AMOUNT PAID DESCRIPTION OF PAYMENT SUBTOTAL