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HomeMy WebLinkAboutKC EMPLOYEES PAC SEMIANN00(1)Recipient Committee Campaign Statement (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print In ink, Statement covers period COVERPAGE Data Stamp JUL 17 AH 9:57 Dateofelecttonlfappllc~[~ [RSFIE[.D CITY CLER Page I of '7 (Month. Day, Year) For Official Use Only 1. Type of Recipient Committee: Aim Committees- Complete Parts 1, 2, 3, and 7. [] Officeholder, Candidate Controlled Committee (Also Completa Part 4.) [] Ballot Measure Committee O Primarily Formed O Controlled O Sponsored (Also Complete Part 5.) [] Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 6.) ~ General Purpose Committee O Sponsored ~[. Broad Based 3. Committee Information ~u~c:~ ~__ COMMiTtEE NAME STP'EET ADDRESS (NO P.O. BOX) MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P-O. BOX CiTY STATE 7JPCODE AREA CODE/PHONE · ~r O ~AL. FAX I E-MAIL ADDRESS 2. Type of Statement: [] Pre-election Statement ~Semi-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Pre-election Statement - Attach Form 495 Treasurer(s) MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZlPCODE AREA CODE/PHONE OPTIONAL: FAX i E-MAiL ADDRESS FPPC Form 460 (8/39} For Technical Assistance: 916/322-5660 Recipient Committee Campaign Statement Cover Page -- Part 2 Type or print in Ink. COVER PAGE - pART 2 Page ~ of 7 4. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DiSTRiCT NUMBER IF APPLICABLE) RESIDENTiAL/BUSINESS ADDRESS (NO. AND STREET) CiTY STATE ZIp Related Committees Not Included In this Statement: LIstany¢ommittees not included in this consolidated statement that are controlled by you or which are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER CONTROLLED COMMIT[EE? [] YES [] "0 STREETADDRESS (NO P.O. BOX) 5. Ballot Measure Committee NAME OF BALLOT MEASURE NAME OF TREASURER COMMITTEE ADDRESS CITY STATE ZIP CODE 7. Verification BALLOT NO. OR LETTER I JURISDICTION [] SUPPORT I r-I OPPOSE Identify the conb'olllng officeholder, candldata, or state rneasum proponent, if any, NAME OF OFFICEHOLDER, CANDIDATE OR, PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 6. Primarily Formed Committee Llstnamseofofflceholder(s)orcandldate($) For whlch this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE Attach continuation sheets if necessary OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE I have used all reasonable dirigence in preparing and reviewing this statement and to the b~st of my knowledge the information contained herein and in the attached schedu es is true and complete. I certify under penaity of perjury under the lav~s of the Stateo~that th~foregoing is true and correct. Executed on By DATE Executed on By DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. STA~'E MEASURE PROPONENT FPPC Form 460 {8199) For Technical Assistance: 916/322-5660 State of Ca;ifo~nia Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print In Ink, Amounts may be rounded to whole dollars. Contributions Received 1. Monetary Contributions ...................................................... ScheduleA, Line 3 2. Loans Received ................................................................... ScheduleB, Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines I + 2 4. Nonmonetary Contributions ............................................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 · 4 Column A -0- ~;eii~ent covqrs period SUMMARY PAGE Page -~ of -7 I.D. NUMBER Column B* Column C Expenditures Made 6. Payments Made .................................................................... Schedule E, Line 4 $ 7. Loans Made .......................................................................... Schedule H, Line 7 8. SUBTOTAL CASH PAYMENTS ................................................ AddLines6+7 9. Accrued Expenses (Unpaid Biffs) ............................................ Schedule F, Line3 10. Nonmonetary Adjustment ....................................................... Scbedu/e C, Line 3 11. TOTAL EXPENDITURES MADE ......................................... Add Lines $ * From previous etatement Summary Page. Column C. However. if this Is the first report filed for the calecdar year. Column B should be blank except for Loans Received (Line 2), Loans Made (Line 7). and Accrued Expenses (Line 9). Current Cash Statement 12. Beginning Cash Balance ................................ Previous Summary Page, Line 16 13. Cash Receipts .............................................................. ColumnA, Line3above 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. 17. LOAN GUARANTEES RECEIVED ................... Schedule B, Part 1, Column (b) $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ..................................................... See instructions on reverse $ t9. Outstanding Debts ................................... Add Line 2 + Line 9 in Column C above $ LO,C 0 Summary for Candidates in Both June and November Elections lit through 6130 7/1 to Date 20. Contributions Received ............ $ 21. Expenditures Made .................. FPPC Form 460 (8199) For Tech nlcal Assistance: 9161322-5660 Schedule A Type or print in Ink. SCHEDULE A Amoume may De roun(~ed Statement cove,, ,~ period . . · ·. Monetary Contributions Received towholndollars, from ,( NAuESEE 'NETRUCTiONE ON REVEREEoF FILER DATE FULL NAME, MAILING ADDRESS ~D ZIP CODE OF CONTRIBUTOR ~ CO~RIBUTOR ~CUPATION ~O EMPLOYER RECEIVED THIS C~END~ Y~R OTHER RECEIVED 0F COMMI~E, ~SO EN~R IO NUMBER) CODE ~ (IF SELF*EM~OYED. E~R ~E PERIOD (JAN. 1 - DEC. 31 ) (IF APPLICABLE) B~r~ ~f~ 93301 ~OTH  ~soc~ ~bl~ E~ ~ IND ~ lO01SeventeenthS~., DCOM ~[0~ 10~ C*n~ C~f~m ~soc~t~n of Publ~ Emp~ 0 IND , ~] ~ A~ *~:t~Oc Employe~,:, Street DDIND COM ~ ~ Bef6~sJ i~t,~, Oo~b~ nia 93301 ~OTH SUBTOTAL Schedule A Summary I. 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: 9161322-5660 Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT.) =onetary tsontrmut,ons .eceive(I from~~ IF AN INDIVIDUAL, ENTER ~OUNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE DATE FULL NAME. MAILING ~DRESS AND ZIP CODE OF CONTRIBUTOR; CO~RIBUTOR OCCUPATION ~D EMPLOYER RECEIVED TH~S C~END~ YEAR OTHER RECEIVED (IF COMMITTE~' ALSO ENTER I D' NUMBER) CODE ~ (IF SELF'EMPLOYED' ENTER N~E PERIOD (JAN 1 - DEC 31) (iF APPOCABLE) 'G O OTH ~/~5 ~sociation of ~bl~ Emp~ O IND j ~ OTH ~ j ~soci~ion of Publk Emp~e~ ~ / ~ OTH ~ OTH ~/, ~soc~tionofPubb'cEmp~ye~ OIND ~ ~ OTH ~ND D cOM ~ OTH SUeTO~^, $_B 5 q5 ~ *Contributor Codes IND - Individual COM- Redpient Committee OTH- Other FPPC Form 460 (8199) For Technical Assistance: 9161522-5660 Schedule D SCHEDULED Summa~ ' et' I=xpenaltures Type or print In Ink. S:.-;.,~,,,,~,~[cOvers period tg/Opposing Other Amounts may be rounded from [ / ~~/1~1 ~'~ to whole dollam. ~ /~-~ ~-.C'~ es, Measures and Committees I ,.s o. R,,,RSE "'"°""" DESCRIPTION OF NONMONETARY CANDIDATE AND OFFICE. TYPE OF PAYMENT CONTRIBUTION AMOUNT THIS PERIOD CUMULATIVE ANIOUNT MEASURE AND JURISDICTION, OR COMMITTEE (IF REQUIRED) Calendar Year --~--~t~' 0,-%o · [] Non-Mo.etary $ Contribution O~her [] Independent ~ Supped [] Oppose Expenditure $ '- Contribu'don Conthbul~on Other [] Independent ~ Support [] Oppose Expenditure $ & [] Non-Monetary 1 ~'*)~'~ $ I ~ © Con~bulJon O~er O~['~l CO~L V\O ~' ~ ~-] Independent ~ Support [] OplX~e Expenditure $ SM! Candidates NAME OF FILER DATE Schedule D Summary i. Contributions and independent expenditures made this period of $100 or more. (include ail Schedule D subtotals.) ........................................ $ ~ ~"~ ~--~ 2. Unitemized contributions and independent expenditures made this period of under $100 .................................................................................. $ ~ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ........ TOTAL $ ~'~ ~'~Ld' ' FPPC Form 4i60 (8199) For Technical Assistance: 916/322-5660 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print In ink, Amounts may be rounded to whole dollars. SCHEDULE E Page '"'"( of '7 I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/misc. CNS campaign consultants CTB contribulion (explain nonmonetary)* CVC civic donations FND fundraising events IND independent expenditure supporlJng/opposing others (explain)* LiT campaign literalum and mailings MTG meetings and appearances OFC office expenses PET petition cimulating PHO phone banks POL polling and survey research POS postage, delivery and messenger servicos PRO professional servicos (Isgal, accoungng) PRT print ads RAD radio airtime and producllon costs RFD mlumod contribu[[ons SA[. campalgn workers salaries TEL t.v. or cable aidime and production costs TRC candidate lravel, lodging and meals (explain) TRS staff/spouse travel, lodging and meals (explain) TSF transfer between commiltees of the same condidate/sponsor VOT voter registration WEB Informatfon technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE OR CREDITOR IIF COMMITTEE. ALSO ENTER LD. NUMBHR) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAiD * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL Schedule E Summary t. Payments made this period of $100 or more. (include all Schedule E subtotals.) ............................................................................................... $ ~' f~> O ~ 2. Unitemized payments made this period of under $100 ........................................................................................................................................ $ ~ 3. Total interest paid this pedod 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 $ ~ f:~O~ ' FPPC Form 460 (8199) For Technical Assistance: 9161322-5660