HomeMy WebLinkAboutCOUCH SEMIANN10(2)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
COVER PAGE
Type or print in ink. Date Stamp
CALIFORNI
Statement covers period Date of election if applicablf I I JAIN 3 1 PH 14: 28 Page of S
from (Month, Day, Year) For Official Use Only
through ~02
Type of Recipient Committee: AN Committees - Complete Parts 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee
❑ Primarily Formed Ballot Measure
Q State Candidate Election Committee
Committee
Q Recall
Q Controlled
(Also compete Part 5)
0 Sponsored
❑ General Purpose Committee
(AlsocompielePar 6)
Q Sponsored
❑ Primarily Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
Q Political Party/Central Committee
(Also Complete Part 7)
3. Committee Information
2. Type of Statement:
❑ Preelection Statement
A,• Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
I.D. NUMBS Treasurer(s)
~ Z 7 V15 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
N~/L i20J0
_'t VID Co ke V hog e ,17-y
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
/ Y l///P'
OPTIONAL: FAX / E-MAIL ADDRESS
NAWou. TREASURER
V
A14-
MAILIN ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4.
Verification
I have used all reasonable diligence in preparing and reviewing this 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. ~7~
Executed on , 6 / l / r BY
Aatir4 Treasurer
0130 6gnak- of Treasurprdflkss
Executed on I _ By
Executed on
Dale
Executed on
rate
By
Signature ofCon"ing Officeholder, Candidate, State Mem" Proponent FPPC Form 460 (Jenuary/06)
FPPC Toll-Free Helpline: 86WASK-FPPC (8661276-3772)
State of California
By
Signature of Controlling Officeholder, Canftate, State Measure Proponent
Recipient Committee
Campaign Statement
Cover Page - Part 2
5. Officeholder or Candidate Controlled Committee
Type or print in ink.
NAME OF OFFICEHOLDER OR CANDIDATE
~OkGA-L-
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUM$E IF yPPLIILLE)
C4 rY 1~'Ol~Ne,L w,~i~ -y. G rA, gx.Ieu>
RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: Llstanycommittees
not included in this statement that are controlled by you or are primarily formed to receive
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME
NAME OF TREASU RER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME
I.D. NUMBER
I.D. NUMBER
NAME OF TREASURER I CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE AREA CODEIPHONE
6. Primarily Formed Ballot Measure Committee
COVER PAGE - PART 2
Page of
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I JURISDICTION I ❑ SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD
DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee List names of
officeholder(s) or candidate(s) for which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (January/06)
FPPC Toll-Free Helpline_ 866/ASK-FPPC (86612763772)
State of Callfomia
Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE
Summary Page Amounts may be rounded Statement covers period
to whole dollars.
from 1411-11,70,10 014. Elm
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
l!/D Go' kcEt
through 1l• .3/ 10d0 Page of
Contributions Received
1. Monetary Contributions schedule A, Line 3
2. Loans Received schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2
4. Nonmonetary Contributions schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED AddLines 3+4
Column A
TOTALTHIS PERIOD
(FROM ATTACHED SCHEDULES)
$
Column B
CALENDAR YEAR
TOTALTO DATE
$ l~ X00
$ •~DO
Expenditures Made
6. Payments Made schedule E, Line 4
7. Loans Made Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS Add Lines 6+ 7
9. Accrued Expenses (Unpaid Bills) schedule F Line 3
10. Nonmonetary Adjustment Schedule C, Line 3
11. TOTAL EXPENDITURES MADE Add Lines s + 9 + 10
$ ~.f . i
$ f G , pZ
6
$ GG.
$ $
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 1, Line 4
15. Cash Payments Column A, Line 8above
16. ENDING CASH BALANCE Add lines 12 + 13 + 14, then subtract Line 15
If this is a termination statement, Line 16 must be zero.
$ sr.
017
v ~
$ 703• r
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column B of your last
report. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts. If this is
the first report being filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents see instructions on reverse $
19. Outstanding Debts Add Line 2 + Line 9 in Column B above $
I.D. NUMBER
/312 -7y1 -
15-Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received $ $ 1
21. Expenditures
Made $ `lam
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made'
IN Subject to Volunmry Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
1 J- 1 $
I $
Amounts in this section may be different from amounts
reported in Column B.
NiJ
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
1-ma yr nLrK
OT VV y > e Daac*-
Statement covers period
from ! /7 _Z0/0
through
Page r of r
i3~ 7Y/J
CODES: If one of the following codes accurately describes the payment
ou ma
t
th
CIuP
c
i
, y
y en
er
e code. Oth
erwise, d
escribe the payment.
CNS
ampa
gn paraphemalia/misc.
campaign consultants
NIBR
member communications
RAD
radio airtime and production costs
CTB
contribution (explain nonmonetary)"
MfG
OFC
meetings and appearances
office expenses
RFD
returned contributions
CVC
civic donations
PET
petition circulating
SAL
campaign workers' salaries
FIL
candidate filing/ballot fees
PHO
phone banks
TEL
t.v. or cable airtime and production costs
FND
fundraising events
POL
polling and survey research
TRC
candidate travel, lodging, and meals
IND
LEG
independent expenditure supporting/opposing others (explain)"
legal defense
POS
postage, delivery and messenger services
TRS
TSF
staff/spouse travel, lodging, and meals
transfer between committees of the same candidate/s
onsor
LIT
campaign literature and mailings
PRO
PRT
professional services (legal, accounting)
i
VOT
p
voter registration
pr
nt ads
WEB
information technology costs (Internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
L~~~o~t~ .dy rt.~ Gve
4C-7-1YE ~of3v G~~r~
Gv~
&AF
" Payments that are contributions or independent expenditures must also be summarized on Schedule D.
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.)
2. Unitemized payments made this period of under $100
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)
SUBTOTAL$
G11Ql-rr jr s per- EoeleiveE loo -
El-r-r-Tia'y /V/,*,&T y *Va
✓A'41,0 r WeZ-71W X
AMOUNT PAID
loge'
$ o",14 $
$
TOTAL $
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule E
(Continuation Sheet)
Payments Made
NAME OF FILER
'Z4lu) I!em'u
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from
through
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CW
CNS
campaign paraphemalia/misc.
campaign consultants
NW
member communications
RAD
radio airtime and production costs
CTB
contribution (explain nonmonetary)•
MiG
OFC
meetings and appearances
office expenses
RFD
returned contributions
'
CVC
FIL
civic donations
candidate filing/ballot fees
PET
petition circulating
SAL
TEL
campaign workers
salaries
t.v. or cable airtime and production costs
FND
fundraising events
PHO
FOL
phone banks
polling and survey research
TRC
TRS
candidate travel, lodging, and meals
IND
LEG
independent expenditure supporting/opposing others (explain)"
legal defense
POS
postage, delivery and messenger services
TSF
staff/spouse travel, lodging, and meals
transfer between committees of the same candidate/sponsor
UT
campaign literature and mailings
PRO
PRT
professional services (legal, accounting)
print ads
VOT
voter registration
WEB
information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
T /1'l 4141T~
CODE OR DESCRIPTION OF PAYMENT
raymems that are contributions or independent expenditures must also be summarized on Schedule D.
SUBTOTAL I
AMOUNT PAID
SCHEDULE E (CONT.)
Page S of
I.D. NUMBER
1.32 -7yls
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772)