The URL can be used to link to this page

Home My WebLink AboutROWLES SEMIANN98(2) OH fficeholder, Candidate, and Controlled Committee Campaign Statement - Long Form Type or print in Ink. (Government Code Sections 84200-84216 3) SEE INSTRUCTIONS ON REVERSE (beet one of the following boxes to Indicate the type of statement bolng flied: Pre-election Statement Supplemental Pre-election Statement (Attach a completed Form 495 to this statement,) ' Special Odd-Year Campaign Report ' Semi-lnnuel Statement = Termination Statement (Attach a completed Form 4 15 to this statement.) I :)ffic holder Candidate, and Controlled Committee Inclu:]ed in tt~is Statement ARI, A CODE/OAYTIME PHONE LD, NUMIER AR~A CODE/DAYTIME PHONE ~ 3 ~C) E IIYI COMMI~EE NAME ' STATE ZIP ~A~ ~SS ~ T~R C~ STATE Z~ C~l I A~A C~AYT~E ~E ~cS~CeH, ~ q3,~q L~bS~s* ~ iII Verification Statement covers period Date Stamp ,,ore 'z ltlq~ ,h,oug. xPl,.~a iq~ o.,.o,.,..,o...pp,,c...; S? rE? -. I ~" - ,,, t~:36 II COVER PAGE - LONG FORM ·;, , .~:: ( >. ~': ~:, ';~ s~ ' · ~ ', :) I, ,~ For Official U~e Only uther Committees qot Included in this 5 tatement: cm,.yothe, commil~ees not Included In this consollda ted sla lament that are controlled by you and any coma/frees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on bahaft of your cand/dacy. COMMrFrEE NAME i.O. NUMBER NAME O~ TREASUI~R CONTILED COMMrrrEll ] Y.s [] No COMMIT/E! ADI~IS (NO. AND STREET) CITY STATE Zlt COO[ AREA C00E/DAYTIM[ PfiON! COMMITTEE NAME I I,O, NUMIER NAME O~ TR[ASUPZR CONTROllED COMMITlEE1 ] Y,s [] No . . COMMfirtrEE AOORESS (NO. AND STMtET) CITY STATE ZIP CODE AREA COOl/DAYTIME PItON! Attach additional information on appropriately labeled continua lion sheets, An officehoMer or candidate who controls a committee must also ver~y the campaign statement. I have used all reasonable diligence and to the best Of~knowledge the treasurer has used all reasonable diligence In preparing this statement. I have reviewed the statement and to the best of my k nowledge the in ,,, u, ntair~ ,,; := · d in the attached schedules is true and "':: "" "' """' "':: "' '°",- Executed on At By ~ ~ DATE CITY AND STALE SIGNATURE O~ CANDIDATE/OFFICEHOlDER Executed on At By OAT! CITY AND STATE SIGNATURt 0t CANDIOATE~OtFI(IHOLD| R FOR INFORMATION RIQUm;D TO If PROVll)If) TO YOU PURSUANT TO ttlr INFORMATION PRACTKES ACT or 1971, ~IF INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PRgvI_$tQN$,I~t TH.[ pgtlJK:~t_ ,RIFORM~A~ State of California Fair Political Practices Commission Campaign Disclosure Statement Summary Page Type or print In Ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE Contril~utions Received Hddtr CObJan A TOTAL THIS RERIOO ~ROM AttACHED $(HEDULES) 1. Monetary Contributions ............................... Schedule A, line 2. Loans Received ......................................... Schedule e, line 3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUnes I · 4. Non°monetary Contributions ......................... Schedule C, Line 5. SUBTOTAL CONTRIBUTIONS:(Exdude Enforceable Promises) Add l ines 3 ,, 6. Enforceable Promtse$ (Exdude Lo~n Guarantees, line 18 below) ................... Schedule D, Une 7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddUnesS · Expenditures Made B. Cash Payments (Other than Loans Made) ............ .Schedule E, Une 9. Loans Made ............................................. Schedule H, Une 10. SUBTOTAL CASH PAYMENTS ............................ AddLines8 .~ 11. Accrued Expenses (Unpaid Bills) .................... Schedule F, line 12. TOTAL EXPENDITURES MADE ....................... AddUnes lO · 11 Current Cash Statement 13. Beginning Cash Balance .................. Previous Summary Page, Line I7 14. Cash Receipts ...................................... ColumnA, UneJabove 1S. Miscellaneous Increases to Cash ........................ Schedule CUne 16. Cash Payments ................................... CotumnA, line lOebova 17. ENDING CASH BALANCE ..... AddLines 13 · 14 , 1S. then subtrad LIne 16 ff this Is a termination statement, Une 17 must be zero. 18. LOAN GUARANTEES RECEIVED .............. Sthedule ~, Part~, Column(b) Cash Equivalents and Outstanding Debts 19. Cash Equivalents ................................ See Insfrudlons on reverse 20. Outstanding Debts ................. AddLine 2 · LIne lf lnColumnCabove ']qS.51 s lb. g.qq 5. ENDIN~ CASH IALAN4:[ SHOUt.{) NOT II A NEGATIVE AMOUNT Statement covers period ,,ore lilq through SUMMARY PAGE I D · .N 0503 Column B* Column C TOTAL PREVIOUS PERIOD TOTAL TO DATE (SEE NOTE IELOW) (ADDCIXUMN$ A · I) s ~cY'~,C~ s _~00 · From previous Statement Summary Page, Column C. However, If I this is the first report flied 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 1/1 through 6/30 7/I to Date 21 ontrib tions 22. ~apo~end!!.u.r.e! S Schedule E Payments and Contributions (Other Than Loans) Made Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE .12anaqj ~2nc,\~s ~r Ci ~3 Ebunr', t- O&~E~ Vto~ct~f OrEcourt? CODES FOR CLASSIFYING EXPENDITURES Statement covers period ,,o,. ql~lq~ through t~lSIlq8 SCHEDULE E _ ~ Page 3 of q I.D. NUMBER !f 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 of Y;ach category. "C' - MONETARY AND IN-KIND (NON-MONETARY) "B ' - CONTRIBUTIONS TO OTHER CANDIDATES ' N' - ANDCOMMITTEES 'O' - '1' - INDEPENDENT EXPENDITURES 'S' - °L'- LITERATURE 'F'- NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION [tE COMMITTIE, IN AOD ITION rO COMMITTEE 'S NAME AND ADDRESS, ENTER ID NUMIER O1~ II NO I.D NUMBER HAS lIEN ASSIGNED. ENTER TREASURER'S NAME AND ADDRESS) e~ ~ ADVERTISING NEWSPAPER AND PERIODICAL ADVERTISING OUTSIDE ADVERTISING SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS FUNDRAISING EVENTS 'G' -- GENERAL OPERATIONS AND OVERHEAD 'T" - TRAVEL, ACCOMMODATIONS AND MEALS (MUST BE DE SCRIBED) "P" - PROFESSIONAL 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 iECTION BELOW. CODE OR DESCRIPTION OF PAfMENT AMOUNT PAID Chopr, be-r ~Ccmr~ SUBTOTAL $ E:br',a-h. bn Y.D. ~X ~ o~ant: Contributions ~nd expenditures made out of campaign funds to or on behalf of other o~ehol~en, candidates, committees, or ballot measures must also be entered ?n the Allocation Page, Pa~ I. ,, Payments and Contributions Made Summa~ 1. Payments made this period of $'100 or more. (Inclu : ......................... $ 2. Payments made this peri~ of under $100. (Do not itemize.) ....................................................................... $ 3. Total interest paid this peri~ on outstanding loans. (Enter amount from Schedule B, Pa~ 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 I_inps 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8) ........... TOTAL $ 500 .oo leo.co qO0.cO qqs.s/ Schedule I Miscellaneous Increases to Cash Type Or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE DATE RECEIVED (IF COMMITTEll, IN ADDITION TO COMMITIE['S NAME AND ADDRE ~S, ENTIR I D NUMilER O4~ If NO I.D. NUMIER HAS BEEN ASSIGNED, ENIER IR~ASURER*$ NAME AND ADDRESS) Statement covers period ,h,o. Qh t2-13itq DESCRIPTION OF RECEIPT SCHEDULE I I.D. NUMBER q o5o3 AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. Miscellaneous Increases to Cash Summary 1. Increases to cash of $100 or more this period ............................................................. $ 2. Increases to cash under $100 this period. (Do not itemize.) ................................................. $ 3. Total of all interest received this period on loans made to others. (Schedule H, Part II (b).) .................... $ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 15.) ....................................................................... TOTAL $ SUBTOTAL