HomeMy WebLinkAboutCOUCH 410 TERM 12/28/11Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Date Stamp
COVER PAGE
Statement covers period Date of election if applicable: Page of
! v D (Month, Day, Year) ' I DEC 28 PM 28 For Official Use only
from 1/~ h a 2 (J f f~ p']
/Y v 1' I~Of,D 81"Ki hi Ji it_~. ~r ti 1. Ll~
through
Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
0 State Candidate Election Committee Committee
0 Recall Q Controlled
(Also Complete Part 5) O Sponsored
(Also Complete Part 6)
❑ General Purpose Committee
Q Sponsored
Q Small Contributor Committee
Q Political Party/Central Committee
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
3. Committee Information I I.D. NUMBER
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
VIf
STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
2. Type of Statement:
❑ Preelection Statement ❑ Quarterly Statement
Semi-annual Statement ❑ Special Odd-Year Report
Termination Statement ❑ Supplemental Preelection
(Also file a Form 410 Termination) Statement -Attach Form 495
❑ Amendment (Explain below)
Treasurer(s)
~Ia~Ly.~.. ~otac~
MAILING
ADDRESS
CITY
FAX / E-MAIL ADDRESS
STATE ZIP CODE AREA CODE/PHONE
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.
Executed on I.-A7, kh/ ey
Dat
Executed on By
Yft?*Air~ling OfficehoMeroCandidate, State Measure Proponent or Responsible Officer at Sponsor
Executed on
Date
Executed on
Date
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (January/OS)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
State of California
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
}
Type or print in ink. COVERPAGE-PART2
Recipient Committee CALIFORNIA
Campaign Statement FORM 460
Cover Page -Part 2
Page egn of
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AN DI TRICT NUMBER IF APPLICABLE)
cou~vcic. - w ,
e-17,
Ad'i T sF/oG. D
RESIDENTI USINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
/
Related Committees Not Included in this Statement: Lisranycommittees
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 I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
BALLOT NO. OR LETTER I JURISDICTION I El 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
CITY STATE ZIP CODE AREA CODE/PHONE
Attach continuation sheets if necessary
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772)
State of California
Campaign Disclosure Statement Type or print in ink.
Amounts may be rounded
Summary Page to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
z,> cokcw
Contributions Received
1. Monetary Contributions Schedule A, Line 3 $
2. Loans Received Schedule a, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 $
4. Nonmonetary Contributions Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 + 4 $
Column A
TOTALTHS PERIOD
(FROMATTACHED SCHEDULES)
Expenditures Made
6. Payments Made schedule E, Line 4 $ 09049
7. Loans Made Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ O B
9. Accrued Expenses (Unpaid Bills) schedule F Line 3
10. Nonmonetary Adjustment schedule C, Line 3
11. TOTAL EXPENDITURES MADE ................................Add lines 6 + g + 10 $ Q
Current Cash Statement ~j
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-Q~
15. Cash Payments Column A, Line 6 above I
16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $
if this is a termination statement Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED Schedule a, Part 2 $
Cash Equivalents and Outstanding Debts -0•
18. Cash Equivalents See instructions on reverse $
19. Outstanding Debts Add Line 2 + Line s in Column s above $
SUMMARY PAGE
Statement covers period CALIFORNIA
FORM 46
from 7 I e I
through Page of
I.D. NUMBER
98Ar9o
Column B Calendar Year Summary for Candidates
CALENDAR YEAR
TOTALTODATE Running in Both the State Primary and
„b General Elections
1/1 through 6/30 7/1 to Date
$ 20. Contributions -10-
Received $ $
$ 21.
Made Expenditures $ - J 6/ $ Q S
Expenditure Limit Summary for State
$
Candidates
22. Cumulative Expenditures Made`
$
(it Subjed to voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
To calculate Column B, add
amounts in Column A to the
corresponding amounts
'Amounts in this section may be different from amounts
from Column B of your last
reported in Column B.
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).
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772)
Schedule E
Payments Made
Type or print In ink.
Amounts may be rounded
to whole dollars.
from SCHEDULEE
Statement covers period
SEE INSTRUCTIONS ON REVERSE through Page -Y- of -iL
NAME OF FILER I.D. NUMBER
'P,4vi D G ouc,q 940% / 90
CODES: If one of the following codes accurately describes the payment you may enter the code Otherwise describe the payment
CMP
campaign paraphemalia/misc.
NW
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)'
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing/ballot fees
PFID
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
independent expenditure supporting/opposing others (explain)'
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (intemet, e-mail)
Schedule E Summary
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 $
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS
•
B
A
K
E
R
S
F
I
E
L
D
C A L I F O R N I A
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December 28, 2011
CITY COUNCIL
Roberta Gafford
Harve> L. Hall City Clerk, City of Bakersfield
1fgw,r 1600 Truxtun Avenue
David Couch Bakersfield, CA 93301
lice-R1nPur
liiird4 Re: Transmittal of Form 410 Termination - Friends of
David Couch
Rudy Salas, Jr.
Hiurl 1
To Whom It May Concern:
Susan M. Benham
Mm12 I recently discovered that I had not filed a closing Form 410 and
a closing Form 460 for the committee named "Friends of David
Ken Weir Couch".
II'rn•d 3 Harold NV. Hanson These two forms (the closing 410 and the closing 460) should
If4rd, have been filed on January 30, 2011. Only the Form 410 needs
to be forwarded to the Secretary of State.
Jacquie Sullivan
11iird0 1 apologize for any inconvenience this may have caused.
Russell Johnson
Iliad , Thank you for your assistance.
Best Re r s,
ouch,
Councilmember, Ward 4
S TounciMETTERS\COUCH\Late 410 and 460.doc
1600 "I RMLIn Avenue • Bakersfield, Califtxnia 93301 • (661) 326-3767 • Fax (661) 323-3780