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Home My WebLink AboutBFLAG PREELEC00(2) ecipient Committee Ca,mpaign Statement (Government Code Sections 84200-84216.5) Type or print in ink. SEE INSTRUCTIONS ON REVERSE Statement covers period Ithrough 2- 1. Type of Recipient Committee: AII Committees - Complete Parts 1,2,3, andT. Date of election if applicable: (Month, Day, Year) Date Stamp 10FEI~;~h P?~ 1:58 Type of Statement: [] Officeholder, Candidate Controlled Committee (Aisc Complete Part 4.) [] Ballot Measure Committee O Primarily Formed O Controlled O Sponsored (Also Complete Part 5J [] Primarily Formed Candidate/ Officeholder Committee (Aisc Complete Pa~t 6.) [~L General Purpose Committee (~ Sponsored (~) Broad Based (~ Pre-election Statement [] Semi-annual Statement [] Termination Statement [] Amendment (Explain below) COVERPAGE Page For Official Use Only [] Quarterly Statement [] Special Odd*Year Report [] Supplemental Pre-election Statement - Attach Form 495 3. Committee Information COMMIT[EE NAME aT.EET ADDRESS t.o P.O. CITY STATE ZIP COOE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. SOX CITY STATE ZIP CODE AREA CODE~PHONE OPTIONAL: FAX/EoMAIL ADDRESS Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY STATE ZIP COOE AREA CODF-JPHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE Z~P CODE AREA CODE/~HONE OPTIONAL: FAX/E-MAILADDRESS FPPC Form 460 (8/9g) For Technical Asalatance: 916~;~2-5660 Slate of California Recipient Committee Campaign Statement Cover Page -- Part 2 Type or print in ink. COVER PAGE-PART2 Page ~- of d,,' 4. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESlDENTIAL/BUSINES S ADDRESS (NO. AND STREET} CITY STATE ZIP Related Committees Not Included in this Statement: Llstanycommitteea not included In this consolidated statement that are controlled by you or which are primarily formed re receive contributions or to make expenditures on behaff of your candidacy. CO~M,~EE,*ME LD.,UMSER CONTRCi. LED COMMI~rEE? [] YES [] NO 5. Ballot Measure Committee NAME OF BALLOT MEASURE NAME OF TREASURER COMMIT3'EEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 7. Verification Identify the conbolling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER. CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. tF ANY 6. Primarily Formed Committee Llstnamesofofficeholder(s) orcandldate(s) for which this committee Is pr/madly 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 Attach continuation sheets if necessary 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. Executadon DATE ~ S~GNATURE OF TREASUI~ER OR ASSISTANT TREASURER Executed on By DATE SIGNATURE OF CONTROLLIN~i OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLIN(~ OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 (8/99) For Technical Assistance: g16/322-5560 State of California Campaign Disclosure Statement Summary Page Type or print in Ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Contributions Received 1. Monetary Contributions ...................................................... Schedule.~, Line 3 2. Loans Received ................................................................... Schedule B, Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ................................... AddLines 1 + 2 4. Nonmonetary Contributions ............................................... Schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $ Column A TOTALTHISPERIOO ~FROM^TT^C.EUSC.~OU~ES) 0 0 Expenditures Made 6. Payments Made .................................................................... Schedule E, Line 4 $ 7. Loans Made .......................................................................... Schedule H, Line 7 ~) 8. SUBTOTAL CASH PAYMENTS ................................................ Add Lines 6 + 7 $ ~.~. ~ 9. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, Line 3 (~ 10. Nonmonetary Adjustment ....................................................... ScheduleC, Line3 ~ 11. TOTAL EXPENDITURES MADE ......................................... Add Lines 8 + 9 + tO $ '~' -- Current Cash Statement 12. Beginning Cash Balance ................................ Previous Summary Page, Line 16 1 3. Cash Receipts .............................................................. Column A, Line 3 above 14. Miscellaneous increases to Cash ....................................... Schedule I, 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. 0 17. LOAN GUARANTEES RECEIVED ................... Schedule S. Part I, Coluron (b) $ 0 Cash Equivalents and Outstanding Debts t8. Cash Equivalents ..................................................... See instructions on reverse 19. Outstanding Debts ................................... AddLIne2+Llne91nColuronCabove Statement covers period from / - ~:S~ ~ O through 2 ~ ]~'- O0 SUMMARY PAGE Page 3 of, '~ I.O. NUMBER Column B* Column C TOTAL PREVIOUS PERIOD TOTAL TO DATE _~' 3-7a , - $ ~ ~ 7~. $ $ $ $ $ $ · From previous statement Summary Page, Column C. However. if this is the first report tiled for the calendar year. Column B should be blank except for Loans Received (Line 2). Loans Made (Line 7), and Accrued Expenses {Une 9). Summary for Candidates in Both June and November Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received ............ $ 21. Expenditures Made ..................$ FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule A Type or print in ink. SCHEDULE A ~moums may oe rounaea St~r,t covers period I Monetary Contributions Received to who,e dollars, from /-~ ~oo j /~mW SEEINSTRUCTIONSONREVERSE through ~/~-oO I Page ~ of '~ NAME OF FILER LD. NUMBER IF AN INDI~DUAL, ENTER AMOUNT CUMU~TIVE TO DATE CUMU~TIVE TO OATE DATE FULL NAME. MAILING AODRESS AND ZIP CODE OF CONTRIB~OR CONTRIBUTOR ~CUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR OTHER RECEIVED (~F CO~I~EE, A~O ENTER LD+ NUMBER) CODE * {IF SE~-EM~OYED, ENTER N~E PERIOD (JAN. 1 - DEC. 31 ) (IF APPLICABLE) OF BUSINESS) ~ eOM ~ OTH ~IND ~ COM ~ OTH ~IND ~ COM ~ OTH ~ IND eOM ~ OTH ~IND D cou ~ OTH SUBTOTALS Schedule A Summary 1. Amount received this period - contributions of $100 or more. (Include all Schedule A subtotals.) ....................................................................................................... $ 2. Amount received this period - unitemized 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 $ 'Contributor Codes IND - Individual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: 916~322-5660 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print In ink. Amounts may be rounded to whole dollars. Statement covers period from /- Z.~- ~O through Page SCHEDULEE NAME OF FILER I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaig n paraphe malia/misc. CNS campaign consultants CTB contr~b~on (explain nonmoneta~/)* CVC civic donations FND fundraising events IND independent expenditura suppodingJopposing othem (explain)* LIT dampaign literature and mailings MTG meetings and appoarancas DFC office expenses PET pe§tion circulating PHC phone banks POL polling and survey research POS postage, delivery and messenger sa~icas PRO professional services (legal, accounUng) PRT p~int ads RAD radfo airtime and production costs RFC returned contribuaons SAL campaign workers salades TEL t.v. or cable airtime and production costs TRC candidate travel, lodging and meals (explain) TRS staff/spouse travel, lodging and meals (explain) TSF transfer between committees of the same candidate/sponsor VDT voter regialrat~on WEB information technolo§y costs (intemet, e-mall) NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMrT~EE. A~SO EN'rER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * Payments that are contributions or Independent expenditures must also be summarized an Schedule D. SUBTOTAL $ -~c.%0, ~ Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................................................................................... 2. Unitemized payments made this period of under $100 ........................................................................................................................................ 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) ....................................................... 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 (8/99) For Technical Assistance: 916/322-5660 S(~hedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from through NAME OF FILER CODES: if one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign para phemalia/mtsc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC cMc donations FND fundraising events IND independent expenditure suppoding/opposing othem (explain)* LiT campaign literature and mailings MTG mee§ngs and appearances DFC offica expenses PET petition circulating PHO phone banks POL polling and survey mseamh POS postage, datively and messenger services PRO professional se~vicas (legal, accounting) PRT print ads RAD radio airUme and production costs SCHEDULE E (CONT.) NAME AND ADDRESS OF PAYEE OR CREDITOR I{F COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTIO ,N OF PAYMENT AMOUNT PAID ~ C~ ~. P~7 ~ 3~,~° C~ * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL FPPC Form 460 (8/99) For Technical Assistance: 916~22-5660 RFD returned contributions SAL campaign workere salaries TEL t.v. or cable airUme and production cosls TRC candidate travel, lodging and meals (explain) TRS staff/spouse travel, lodging and meals (explain) TSF transfer between committees of the same candidate/sponsor VDT voter registration WEB informattun technology costs (intemet, e-mail) Page I.D. NUMBER ~2 / ~.s-~"-