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Home My WebLink AboutKC EMPLOYEES PAC SEMIANN00(2)Recipient Committee Campaign Statement (Govemrnent Code Sec~ons 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Statement covers period through Date of election If applicable: (Monlh, Day, Year) Date S~amp OI J~,N 22 Li'q I0: Eh,~riL[ D CiTY CL COVERPAGE Page [ of ~ For Official Use Only 1. Type of Recipient Committee: All Committees-Complete Parts 1, 2, 3, and 7. [] Officeholder, Candidate Controlled Committee (Also Complete Pad 4.) [] Ballot Measure Committee O Primarily Formed O Controlled O Sponsored (Also Complete Part 5.) [] Pdmadly Formed Candidate/ Officeholder Committee (Also Complete Part 6.) "~ General Purpose Committee C) Sponsored (~ Broad Based 3. Committee Information %%. (IF DIFFERENT) NO. AND STREET OR RD. BOX CITY STATE ZlPCOOE AREA CODE/PHONE 2. Type of Statement: [] Pre-election Statement "~, Semi-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Repod [] Supplemental Pre-election Statement - Attach Form 495 Treasurer(s) MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER. IF ANY MAlUNG ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS FPPC Form 460 {8199) For Technical Assistance: 9161322-5660 State of California Recipient Committee Campaign Statement Cover Page -- Part 2 Type or print In Ink. COVER PAGE - PART 2 4. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANe{DATE 5. Ballot Measure Committee NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUE)E LOCATION AND DISTRICT NUMBER IF APPLICABLE) RE SIDENTIAL/B USINESS ADDRESS {NO. AND STREET) CITY STATE ZiP Related Committees Not Included in this Statement: LJstanyco~mittees not included in this consolidated statement that are controlled by you or which ere pHmarfly formed to receive contrfbutlons or to make expenditures on behalf of your candidacy. COMMITTEE NAME NAME OF TREASURER COMMtTFEE ADDRESS LO. NUMBER CONTROLLED COMMITTEE? [] ~ES [] NO STREET ADDRESS (NO EO. BO) CITY STATE ZIP CODE 7. Verification BALLOT NO. OR LETTER JUR{SO~CTION [] SUPPORT [] OPPOSE Identlf~ the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER. CANDIDATE OR, PROPONENT OFF~CE SOUGHT OR HELD DISTRICT NO. IF ANY Primarily Formed Committee llstnames ofof~ceholderFs) orcandidate(s) for which this committee Is primarfly formed. NAME OF OFFICEHOLDER OR CANOIOATE NAME OF OFFICEHOLDER OR CANDIDATE AREA CODEJPHONE NAME OF OFFICEHOLDER OR CANDIDATE Attach continuab~n sheets if necessary OFFICE SOUGHT OR HELD [] SUPPORT []OPPOSE OFFICE SOUGHT OR HELD [~SUPPORT [~OPPOSE OFFICE SOUGHT OR HELD ~]SUPPORT ~)OPPOSE have used all reasonable diligence iD preparing and reviewing this statement and tel{he best of my knowledge the information contained herein and in the attached schedules is true and complete, t certify under penalty of perjury under the lav~s of th~State~mia th'~the foregoing is true add correct. Executed on, Executed on By FPPC Form 460 For Technical Assistance: 9161322-5660 State of California 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 ...................................................... Schedule A, Line 3 2. Loans Received ................................................................... Schedule B. Line 7 3. SUBTOTAL CASH CONTRIBUTIONS ................................... Add Lines 1 + 2 $ 4. Nonmonetary Contributions ............................................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $ SUMMARY PAGE Page "~ of ~,~ I.D. NUMBER Column A Column B* Column C 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 + 10 Current Cash Statement 12. Beginning Cash Balance ................................ Previous Summary Page, Line 16 1 3. Cash Receipts .............................................................. Column A, Line 3 above 14. Misceflaneous 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 I 18. Cash Equivalents ..................................................... See instruclions on reverse 19. Outstanding Debts ................................... Add Line 2 + Line 9 in Column C above ' From previous statement Summary Page, Column C. However, if this is the first report filed for the calendar year, Column B should be blank except for Loans Received (Line 2), Loans Made (Line 7), and Aocmed Expenses (Line 9). Summary for Candidates in Both June and November Elections 111 through 6130 711 to Dale 20. Contributions Received ............ $ 21. Expenditures Made .................. $ FPPC Form 460 (8/99) For Technical Assistance: 9t61322-5660 Schedule A Typa or print In Ink. SCHEDULE A Amoun{s may oa rounaaa Statement covers period Monetary Contributions Received towhotadollar.. SEEINSTRUCTIONSONREVERSE throughlZ--314 -C)~ I Page 4 of NAME OF FILERJ I.D. NI M FULLNAME MAILINGADDRESSANDZIPCODEOFCONI~RIBUTOR CONTRIBUTOR OCCUPATIONANDEMPLOYER RECEIVEDTHIS CALENDARYEAR OTHER DATE ! , IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE RECEIVED ("= COMMITTEE' AL~O ENTER ID' NUMBER) CODE ~' {IF SELF'F~OYEO, ENTER NAIdE PERIOD (JAN. 1 - DEC. 31 ) (rF APPLICABLE) OF BUSINESS) "~ ~ ~,OTH J O -- "~ ~ [] IND '~OTH J[ -- Z-<~ []IND []cou '11 · 'Z-~(~ ~.DTH I ~_ - I [] IND -~._(2~2~(~ '~,OTH zooo c: ou 1 04 . ~O~H 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 Commiltee OTH-Olhe, FPPC Form 460 {8199) For Technical Assistance: 9161322-5660 Schedule D ~Sum~nary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print In Ink. Amounts may be rounded to whole dollars. from I~ through SCHEDULE D Page _,~ of ~ DATE CANDIDATE AND OFFICE, MEASURE AND JURISDICTION, OR COMMITTEE Support [] Oppose [] Suppod [] Oppose TYPE OF PAYMENT ~..Jvlonetary Contribution [] Non-Monetary Contribution [] Independenl Expenditure [] Monetary Contribution [] Non-Monetary Con[~bution [] Independent Expendilure [] Monelary Contribution Conlribution [] ~ndependent Expendilere DESCRIPTION OF NONMONETARy CONTRIBUTION itF REQUIRED) AMOUNT THIS PERIOD I.D. NUMBER [] Supper [] Oppose I SU.TOT^, $ \ CUMULATIVE AMOUNT Calendar Year Other Calendar Year $; Other 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 Assistance: 9161322-5660 Schedule E Payments Made Type or print In ink. Amounts may be ~ounded to whole dollerB. SEE INSTRUCTIONS ON REVERSE NAME OF FILER covers through SCHEDULE E Page4~-~ of~) I.D. NUMBER 8"10 %q CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, descdbe the-payment. CMP ca mpaign para phemalie~mlsc. CNS campaign consuttanls CTB contribution (explain nonmonetary)* CVC civic donations FND fundraising events Ii,ID independent expenditure suppoding/opposing others (explain)* LIT campaign literature and mailingjs MTG meetings and appearances OFC office expensas PET pefllion circula~ng PHO pbeae banks POL polling and suwey resaarch POS postage, deliver/and messanger sarvlces PRO profesaional sarvisas (legal, accounting) PRT print ads PAD radio airtime and production costs RFD relumed conbibulions SAL campaign workers salaries TEL t.v. o~ cable airUme and production casts TRC candidale travel, lodging and meals (explain) TRS staff/spouse travel, lodging and meals (explain) TSF Iransfer between committees o! the same candidale/sponsor VOT voter registraUon WEB informatio~ lechnology costs (internel, e-mail) NAME AND ADDRESS OF PAYEE OR CREDITOR (iF COMUITTEE. N. SO ENTER I.D. ~R) 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 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 hera and on the Summary Page, Column A, Line 6.) ......................... TOTAL $ FPPC Form 460 (8199) For Technical Assistance: 9161322-5660