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Home My WebLink AboutKC EMPLOYEES PAC PREELEC00(2) AMENDRecipient Committee Campaign Statement (Government Code Sen~ons 84200-64216,5) SEE INSmUCTK)NS ON REVERSE 'l~pe or print In Ink. StMement ~over, period 1. Type of Recipient Committee: [] Officeholder, Candidate Controlled Committee (Al~o Complete Part 4.) [] Ballot Measure Cor~rittee O Pflmadly Formed O Controlled O Sponsored V~o c,3m~a Pen [] Primarily Formed Candidate/ Officeholder Committee (,41~ Complete P~t e.) ~ General Pu~ose committee O Sponsored ~L Broad Based e STREET ADORESS (NO P.O. BOX) (~-~--'~ STATE ZIP COOE MAILING ADORESS (1~ DIFFERENT) NO. AND STREET OR P.O. BOX Date of d~tlon If applloatfle: (Moath, Day, Yem) ~ 3. h9 2. Type of Statement: [] Pm-election Statement [] Semi-annual Statement [] Termination Statement COVE, [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Pre-election ~ Ame~mant (Explain ~elow) ~\ Statemem- Attach Form 495 Treasurer(s) NAME OF ASSt~ANT TREASURER, IF ANY MAILING AD(~RESS C~Y STATE ZIP C(X)E AREA COOF. JPHONE STATE ZIP C~E AREA ~ OPTIONN.: FAX / E4AAIL ADORESS OPTIONAL: FAX IE-Iv~[ADORESS FPPC Form ~0 For Technical Aa$1atance: State of California Type or print in Ink. COVER PAGE - PART 2 Recipient Committee ~ , Campaign Statement ~[~lJ Cover Page -- Part 2 ~ 4. Officeholder or Candidate Controlled Committee 5. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BAllOT MEASURE OFFICE SOUGHT OR HELD (INCLUOE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIMJBUSINESS ADOflESS (NO. AND STREET) C~'Y STATE ZIP Related Committees Not Included In this Statement: Ucteaycommmvec not Included In Ibis consolidated sMtement Ihs t are controlled by you or which arc primarily formed to receive conbfbutloca or to make expenditures on behsff of your candidacy. COMMITTEE NAME ; I.D. NUMBER NAME OF TREASURER COMMffTEE ADDRESS CONTROl ~ (=n COMMITrEE? O~s O No STREET ADDRESS (NO P.O. BO) BALLOT NO. OR LEI I ~R I JURISDICTION D SUPPORT I [] OPPOSE IdenUfy the ¢onbolling officeholder, candidate, or state measure proponent, if any. OFFICE SOUO~T OR HELD I DISTRICT NO. IF ANY I 6. Primarily Formed Committee u.t...., of o~c.ho~d.~./or c..,lU.f.r./ ~E ~~R ~ C~DI~TE ~ ~ HE~ D SUP~ D oPPOSE D OPPOSE CITY STATE ZiP COOE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE Attach con#nuation sheets ff necassa~y 7. Verification I have used all reasonable diligence in preparing and reviewing this statement and ,tp the best of my knowledge the information contained herein and in the attached schedules iS tme and complete. I certify under penalty of perjury under the la. of the Sta~orni~Jhat the foregoing is true and correct. Executedon By ~'rE Executedon By DATE FPPC Form 460 (8/99) For T®chnlcal Assistance: 916/322-5660 State ot California 2. 3. 4. 5. Campaign Disclosure Statement Summary Page SEE IN~'rRUCTIONS ON REVERSE NAME OF FILER ~q)4 or print In Ink. Amounts may be rounded to whole dollam. OFFICE Moneta~ Contributions ................. Loans Received ................................................................... 8~ule B, Line SUBTOTAL CASH CONTRIBUTIONS ................................... AddLInes ! +2 Nonmonetary Contributions ........................ · ........... ; ........... Schedule C, Line TOTAL CONTRIBUTIONS RECEIVED .................................... Add LInee 3 ~ SUMMARYPAGF I.D. NUMBER Column C Expenditures Made ,~ 6. Payments Made ........................................................... ; ........ : Schedule E. Line 7. Loans Made .................................................... Schedule H, Line 8. SUBTOTAL CASH PAYMENTS ................................................ AddLInese*? 9. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, Line 10. Nonmonetary Adjustment ....................................................... Schedule C, Line 11. TOTAL EXPENDITURES MADE ......................................... AddLInesS+9*10 Current Cash Statement ' ' ~* ':~ L ~ P ~ 13. Cash Receipts .................................................. : ........... ColumnA. LIneSebove 14. Miscellaneous Increases to Cash..... .................................. $chedulel, Line4 15. Cash Payments ............................. ; .............................. ColumnA, LlneS.bov. ,6. E,..,o c^s..^L*.CE .............. A,dL,... ,,. ,,. ,,. ,h....h..,,,n. ,, If this !s a termination statement. Line 16 must be zero. :' ' From Ixevlous 81atement Summap/Page, Column C. However, it ihls / Is the flint report flied ~r fha cale~:tsr year, Column B .hould be b snk except f~r Loans Received (Une 2), Loan~ Made (Une 7) and A=c~ued Expermes (Uae 9). 17. LOAN GUARANTEES RECEIVED ................... Schedule S, Pa~t t, Column (b) $ Cash Equivalents and Outstanding Debts '~'~' ', 18. Cash Equivalents .................................................... ~ See instruceona On reverse 19. Outstanding Debts ................................... AddLIne2+LlneglnColumnCebove S ', Summary for Candidates In Both June and November Elections 20. Contributions Received ............ $ 21. Expenditures Made .................. FPPC Form 460 (8/99) For Technical Assistance: 916/322-5660 Schedule A ~n~ or print in ink. SCHEDULE ~ COM ~ OTH ~ OTH ~ IND ~ ~OM ~ OTH ~ IND ~ OOM SUBTOTAl. Schedule A Summary '~ 1. Amount received this pedod - contributions of $100 or more. '' r ' + ~; : ' ' ' (include ell Schedule A subtotals.) ....................................................................................................... 2. Amount received this pedod - unltemlzed contributions of less th~ $100 ......................................... 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summery Page, Column A, Line 1.) ................... TOTAL tOM - R~pI~I Comml#~ FPPC Form 460 (8/99) For TechnlcM A,slstance: 9t6/322-5660