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Home My WebLink AboutSCRIVNER SEMIANN10(4)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Date Stamp 201111 Statement covers period Date of election if applicable: ZOI FP-9- 7/1/10 (Month, Day, Year) from through 12/31/10 1. Type of Recipient Committee: All 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 Complete Pan 5) O Sponsored (Also Compete Part 6) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee Q Political Party/Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Pan 7) 2. Type of Statement: ❑ Preelection Statement ® Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE of 5 For Official Use Only ❑ Quarterly Statement ❑ Special Odd-Year Report ❑ Supplemental Preelection Statement -Attach Form 495 3. Committee Information ;OMMITTEE NAME (OR CANDIDAIt'S n Scrivner for Supervisor 2014 STREET ADDRESS (NO P.O. BOX) OPTIONAL: FAX / E-MAIL ADDRESS 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 ntained 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 s~ J r~ i k BY S~gnatureafT arAs ' reasurer ' Executed on oat. Executed on BY Date SignatrseofCoNro9irrgOl6oetwlder,Carrdidate,State Me or Responsible Ot6cerofSponsor Executed on Date BY Signalise of CormobV 016ceholder. CardKkte, State Measure Proponent Sign6iaueorConootlingOr6«0older. Candidate. StateMeauaeProponent FPPC Form 460 (January/05) Executed on Oat. BY FPPC Toll-Free Helptine: 8661ASK-FPPC (8661275-3772) State of California I.D. NUMBER 1334335 Type or print in ink. Recipient Committee Campaign Statement Cover Page - Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Zack Scrivner OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLIUMSL.) Kern County Supervisor, 2nd District RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any committees 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. NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO.OR LETTER 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 R HELD ❑ SUPPORT 7 ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE R HELD OFFICESOUGHT ❑ 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/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772) State of California Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. c - oMlcocr- SUMMARY PAGE • 1 Statement covers period CALIFORNIA 7/1/10 • from through 12/31/10 Page 3 of 5 NAME OF FILER Scrivner for Suaervisor 2010 Column A Contributions Received TOTALTHISPERrOO ES ) (FRO M ATTACHM SCHEDUL 600.00 1. Monetary Contributions Schedule A, Line 3 $ 0.00 2. Loans Received Schedule B, Line 3 600.00 3 SUBTOTAL CASH CONTRIBUTIONS Add lines 1 +2 $ . 0.00 4. Nonmonetary Contributions Schedule C, Line 3 s 3 + 4 Add Li $ 600.00 5. TOTAL CONTRIBUTIONS RECEIVED ne Column B CAU NDARYEAR TOTALTO DATE 600.00 0.00 600.00 0.00 $ $ 600.00 Expenditures Made 6. Payments Made Schedule E, Line 4 $ 7. Loans Made Schedule H. Line 3 8. SUBTOTALCASH PAYMENTS Add Lines 6+7 $ 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 10. Nonmonetary Adjustment Schedule C, Linea 11. TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10 $ Current Cash Statement 12. Beginning Cash Balance Previous SummaryPage, Line 16 $ 13. Cash Receipts Column A, Line 3above 14. Miscellaneous Increases to Cash Schedule 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. 596.32 $ 0.00 596.32 $ 0.00 . 0.00 596.32 $ 0.00 600.00 0.00 596.32 3.68 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2 +Line 9 in Column B above $ 0.00 0.00 596.32 0.00 596.32 0.00 0.00 596.32 I.D. NUMBER 1334335 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 711 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made` IN Subject to Voluntary Expenditure Limh) Date of Election Total to Date (mm/dd/yy) -J--/ $ _l ---J $ 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). `Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Type or print in ink. SCHEDULE A Schedule A Amounts may be rounded Statement covers period ' • 460 Monetary Contributions Received to whole dollars. 7/1/10 . from through 12/31/10 Page 4 of 5 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER 1334335 Scrivner for Supervisor 2014 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER CONTRIBUTOR OC ON AND EMPLOYER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE (IF REQUIRED) DATE RECEIVED (IFCOMMRlEE.ALSO ENTER I.D.NUMBER) CODE it OF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) OF BUSINESS) Mary Jane Wilson ® IND ❑COM Executive 500.00 500.00 500.00 12/20/10 FJPTY ❑SCC ❑ IND Scrivner for Supervisor 2010 ZCOM Transfer 100.00 100.00 11/24/10 ❑ PTY , ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS 600.00 Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.) $ 2. Amount received this period - unitemized monetary 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 $ 600.00 0.00 600 00 'Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY -Political Party SCC- Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E Type or print in ink. Amounts may be rounded Payments Made to whole dollars. ccc 1 -ol 1!` InAlc np l RFX/FRCP Statement covers period from 7/1/10 through 12/31/10 NAME OF FILER Scrivner for Supervisor 2014 Page 5 of 5 I.D. NUMBER 1334335 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. t i MBR member communications RAD on cos s radio airtime and product CLIP CNS campaign paraphemalia/misc. campaign consultants MTG meetings and appearances RFD SAL returned contributions campaign workers' salaries CTB contribution (explain nonmonetary)' OFC office expenses TB t.v. or cable airtime and production costs CVC civic donations PET POD petition circulating phone banks . TRC candidate travel, lodging, and meals l FL IL candidate file llot fees POL polling and survey research TRS s staff/spouse travel, lodging, and mea mmittees of the same candidate/sponsor FND tZ fundraising events endent expenditure supporting/opposing others (explain)' inde POS postage, delivery and messenger services OTSF T tra voter regist n co LEG p legal defense PRO professional services (legal, accounting) WEB information technology costs (intemet, e-mail) LIT campaign literature and mailings PRT print ads NAME AND ADDRESS OF PAYEE OF COMMI I I Also ENTER I.O. NUMBER) Minuteman Press Subvendor: U.S. Postal Service $532.54 CODE OR POS ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS 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.) TOTAL $ DESCRIPTION OF PAYMENT AMOUNT PAID 532.54 532.54 532.54 63.78 0.00 596.32 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772)