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Home My WebLink AboutBFLAG PREELEC00(3) ecipic, nt Committee Campaign Statement (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. State entcoverepedod from "7 Date of election if applicable: (Month. Day. Year) Date Stamp O0 0CI -3 PH BA~{ERSFiE[.D el/' COVER PAGE oAL,FoR.,A 460 FORM For Official Use Only ;[ERK 1. Type of Recipient Committee: All Committees - Complete Pads 1, 2, 3, and 7. [] Officeholder. Candidate Controlled Committee (Also Complete Part 4.) i"i Ballot Measure Committee 0 Primarily Formed O Controlled O Sponsored (Also Complete PaR 5.) [] Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 6.) ~General Purpose Committee 0 Sponsored ~'9~Broad Based 2. Type of Statement: ~[' Pro-election Statement [] Semi-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Pro-election Statement - Attach Form 495 3. Committee Information COMMITTEE NAME Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY MAILIN~ ADDRESS IIF DIFFERENT) NO. AND STREET OR P.O. BOX MAIUNG ADDRESS CITY STATE ZIPCOOE AREACODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE STATE ZIP CODE AREA CODF_JPHONE OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS FPPC Form 460 For Technical Assistance: 916/3;12-5660 State of California Recipient Committee Campaign Statement Cover Page -- Da'+ '~ 4. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Type or print in ink. 5. Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 CA',FOR.,A 460 FORM Page '~- o~' (j~ } OffIcE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAIJBUSINESSADDRESS (NO. ANDSTREET) CITY STATE ZIP SALLOTNO. ORLETTER IJUR,SD,CT H Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT Related Committees Not Included in this Statement: Llstanycommlttees 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 NAME OF TREASURER CC~4MITTEEADDRESS CITY CONTROLLED COMMITTEE? [] YES [] NO STREET ADDRESS (NO P,O, BOX) STATE ZIP CODE 7. Verification AREA CODE/PHON E NAME OF OFFICEHOLDER OR CANDIDATE Attach conb~uatien sheets if necessary OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 6. Primarily Formed Committee Llstnamesofofflceholder(s)orcsndldate(s) for which this committee Is primarily formed. NAMEOFOFFICEHOLDERORCANDIDATE OFFICESOUGHTORIIELD q [] SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE OFFICESOUGHTORHELD ~ [] SUPPORT [] OPPOSE I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained heroin and in the attached schedules is true and complete. I certify under penalty of perjuW under the laws of the State of California that the foregoing is true and correct. DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on DAlE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT OR SESPONSIBLE OFFICES OF SPONSOR Executed on By DATE Executed on By DATE SIGNATUSE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASUSE PROPONENT ~ SIGNATURE OF CONTROLUN~ OFFICEHCLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 (8/99) For Technical Assistance: 916/322-5650 State of California Schedule A Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF RLER DATE RECEIVED FULLNAME, MAILINGADDRESSANDZIPCODEOFCONTRIBUTOR CONTRIBUTOR (IFCOMMITrEE, ALSOEN~'ERID,NUMIJER) CODE * ~] IND [] COM [] OTH FAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC, 31 ) OF 6USINSSS) [] COM [] OTH [] IND [] COM [] OTH [] IND [] COM [] OTH SCHEDULE A ,%'z,_q-G, at,,B?,Rc:), oo CUMULATIVE TO DATE OTHER (IF APPLICABLE) SUBTOTAL S ~57-- '~E} ,o0 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 tess than $100 ......................................... 3. Total monetary contributions received this period. (Add Lines I and 2. Enter here and on the Summary Page, Column A, Line I .) ................... TOTAL "ContrlbutorCodes IND-Indivtdual COM - Recipient Committee OTH - Other FPPC Form 460 (8/99) For Technical Assistance: 9~16~22-5660 -Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAMEOFFILER DATE CANDIDATE AND OFFIC E, MEASURE AND JURISDICTION, OR COMMfiq'EE [] Suppod [] Opp~e [] Support [] Oppose Type or print In ink. Amounts may be rounded to whole dollare. TYPE OF PAYMENT ~Monetary Contdbution [] Non-Monetary Contribution [] Independent Expenditure ,[~ Monetary Contribution [] Non-Mo,letary Contribution [] h',dependent Expenditure [] Monetary Contdbution [] Non-Monetary Contribution [] Independent Expenditure from SCHi~DULE D DESCRIPTION OF NONMONETARy CONTRIBUTION (IF REQUIRED) SUBTOTAL $ AMOUNT THIS PERIOD '~:>000 , Oc::' CUMULATIVE AMOUNT Calendar Year Other $ Calendar Year $ '-~ c,,o,,,c:>, o c,~ Other I $ Calendar Year $ Other $ Schedule D Summary 1. Contributions and independent expenditures made this period of $100 or more. (Include all 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 FPPC Form 460 (8/99) For Technical Aeslstence: 916~22-5660 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF RLER Type or print in Ink. Amounts may be rounded to whole dollars. Statement oversperiod from '~ Z7 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.' CMP campaignparaphemalia/misc. CNS campaign consulfanls CTB contdbuilon(explainnonmonelary). CVC civicdonations FND fundraising events IND indePendent expendi~ure suppoding/opposing o{hers (expMin). LIT campaign literature and mailings MTG mee~ngsandappeamnces OFC office expenses PET petition circulating RFD refurnedcontdbutions SAL campaign workers saMdes SCHEDULEE OA',FOR.,A 460 FORM -. I.R o,. t PHO phonebanka POL poffingandsurveyresearch POS Postage, delive~and messengerservices PRO pmtessionalsen/ices(legal, accoun~ng) PRT printads RAD radioalllimeandproduclioncosts TEL t.v. or cable airtime and production costs TRC candidatetravel, lodgingandmeals(explain) TRS staff/sPousetravel, lodgingandmeals(explain) TSF transferbetweencommiffeesofthesamecandidate/sponsor VOT voterregistration WEe informaliontechnologycosts(intemet, e.mait} NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMM TREE, ALSO ENTER I D+ CODE Cy F~'-J D ~Paymentethatarecontributionsor|nde endentex P penditures must also be summarized on Schedule Schedule E Summary OR DESCRIPTION OF PAYMENT AMOUNT PAID SUBTOTAL i. Payments made this period of $100 or more. (include all Schedule E suS~tota s ) .. . ........................................... 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-S660 Campaign Disclosure Statement Summary Page Type or print In ink. Amounts may be rounded to Whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF RLER Contributions Received L Monetary Contributions ...................................................... Schedule A, Line 3 2. Loans Received ...................................................................Sshedule t~, Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add LInes I + 2 4. Nonmonetary Contributions ............................................... Schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... AOd Lines 3 + 4 Expenditures Made S. Payments Made ....................................................................Schedule E, Line 4 7. Leans Made ..........................................................................Schedule B. SUBTOTAL CASH PAYMENTS ................................................ Add Lines S g. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, Line 3 10, Nonmonetary Adjustment .......................................................Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ......................................... AddLinesS+9+ tO Current Cash Statement ~. ~e~in,..~Casb~a~a.ce ................................ 13. Cash Receipts ..............................................................column A, Line 3 above ~ 4. Miscellaneous Increases to Cash .......................................Schedule I, LIne 4 15. Cash Payments ............................................................ColumnA, Lineaabeve 16. ENDING CASH BALANCE .............. Add LInes 12 + If ~hls Is a term/nation s~atement, L(ne f6 must be zero. 17. LOAN GUARANTEES RECEIVED ................... Schedule a. Pirt i. Column (b) Cash Equivalents and Outstanding Debts 18. Cash Equivalents .....................................................See inslmcllons on reverse 19. Outstanding Debts ................................... AddLtne2+Line9inColumnCebove S.~JMMARy PAGE FORM $__! %itz} "2. ~ Z ( ' From previous statement Summary Page Column C, Howeve~ if this is the firs! repor~ filed tot the calendar year, Column ~ should be except for Leans Received (Line 2), Loans Made (Line 7), and Accrued Expenses (Line Summary for Candidates 'in Botl~ Jt~ne a~" November Elections 111 through 6/30 20. Contributions Received ............ 2L Expenditures Made .................. $ 7/1 to Date FPPC Form 460 (8/99) ForTechnlcelAs~letence: 916/322-S660