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Home My WebLink AboutSMITH 460 PREELECT12(2)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Date Stamp Statement covers period Date of election if applicable: from U / 1 / zU' z_ (Month, Day, Year) 112 OCT 25 PM 2: 1 through 1. Type of Recipient Committee: All Committees - Complete Pans 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee O Recall Q Controlled (Also Complete Part 5) Q Sponsored (Also com F-1 General Purpose Committee detePart e) Q Sponsored Q Small Contributor Committee Q Political Party /Central Committee 3. Committee Information ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) 90E) SmiTFi Cou�L, w12- STREET ADDRESS (NO P.O. BOX) � CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the under penalty of perjury underthe laws of the State of California that the foregoing is true [i I (, Ito 17 BpKER.�r iti_u Li i Y 2. Type of Statement: ❑ Preelection Statement ❑ Semi - annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) COVER PAGE Page. of u For Official Use Only RK ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 NAME OF TREASURER ✓037i , CAW W MAILING ADDRESS [ NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS herein and in the attached schedules is true and complete. I certify Executed on By zf Dale ignature ofT orASS Treasurer Executed on By Date A%;oSignatuflb alControlling GlIllffahokl6r, C ,S Proponent or Responsible Officer ofSponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Forth 460 (January/06) FPPC Toll -Free Helpline: 866 /ASK -FPPC (86612763772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE 505 SMO OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) WACO 4 , NA 6(sFiritz CITV Cmelc, RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) 6. Primarilv Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page 3 of t I) BALLOT NO. OR LETTER I JURISDICTION E] SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate /Officeholder Committee l.istnames of officeholder(s) or candidate(s) for which this committee is primarily 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 NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE VII T J [Al t 4W LUUt AKtALL)Ut /YP7UNL Attach continuation sheets if necessary FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/276-3772) State of Califomia Campaign Disclosure Statement Summary Page SFF INSTRUCTIONS ON REVERSE NAME OF FILER Contributions Received 1. Monetary Contributions .......................... 2. Loans Received ...... ............................... 3. SUBTOTAL CASH CONTRIBUTIONS .... 4. Nonmonetary Contributions ................... 5. TOTAL CONTRIBUTIONS RECEIVED Expenditures Made 6. Payments Made ............................... 7. Loans Made ...... ............................... 8. SUBTOTAL CASH PAYMENTS ........ 9. Accrued Expenses (Unpaid Bills) ... 10. Nonmonetary Adjustment ............... 11. TOTAL EXPENDITURES MADE ....... CI Schedule A, Line 3 ....... Schedule 8, Line 3 ........... Add Lines 1 + 2 ....... Schedule C, Line 3 .............. Add Lines 3 + 4 ....... Schedule E, Line 4 ....... Schedule H, Line 3 ........... Add Lines 6 + 7 ........... Schedule F, Line 3 .......... Schedule C, Line 3 ........ Add Lines 8 + g + 10 Type or print in ink. Amounts may be rounded to whole dollars. Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) $ [+4 00 0 $ l 1 rioo $ t3lgN!5.3&0 $ X31 NA 0 U SUMMARY PAGE Statement covers period CALIFORNIA i from UVZo1Z ;:ORM 4,11 through li,.017U(29IZ Page 4 of t I.D. NUMBER Column B CALENDARYEAR TOTALTO DATE $ 20150 ,W/0W $ 4q Is�o $ 31 l islg .�5L V $ �1,Slq.SZ U $ 1.3.4,o,:3 is $ 31,511.51 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ nn —�� 1311 13. Cash Receipts .................... ............................... Column A, Line 3 above 1 j �oo 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15. Cash Payments ................... ............................... Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add lines 12 + 13 + 14, then subtract Line 15 $ U 13 14443 1-1,(630.44 If this is a termination statement Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ $ W,000 To calculate Column B, add amounts in Column A to the Corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (R Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd /yy) J_J $ Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) Schedule A Type or print in ink. SCHEDULE A Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period CALIFORNI ' from jULL�OIZ • through AV 120/7017, Page � of 'C) SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER BOB &A i TH C4 2G I DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RADDRESS ZIP EET A CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMIT-TEE, I.D. NUMBER) CODE * (IF SELF -EM PLOY ED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ❑IND � �Ill.�l�l�jlvl []OTH V ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC []IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $` Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ............. ............................... 2. Amount received this period — unitemized monetary 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.) .......... ............ $ 1 i %W ............ $ 1 U TOTAL $ ` L 4;w 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) E s -ay CONF(p e u(0NATC A ( VEPOD C00 N% 10 /c /M7, — 1mj2ujZOIZ L0 Date Received I First Last Occupation Address City IND 2501 250 I i otai Tv — mint in inir SCHEDULE B - PART 1 C e U e 13 — Part 1 Amounts may be rounded Statement covers period 1 Loans Received to whole dollars. Ly� 012 O _ • NET $ from (May be a negative number) through l�ll2' Page 7 SEE INSTRUCTIONS ON REVERSE Of NAME OF FILER I.D. NUMBER 31)6 GM[r+i Fv- Co L, (3 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING BALANCE (b) AMOUNT (c) AMOUNTPAID (d) OUTSTANDING BALANCE AT C (e) INTEREST (r) ORIGINAL (g) CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D.NUMBER) (IF SELF - EMPLOYED, ENTER NAME OF BUSINESS) BEGINNING THIS PERIOD RECEIVED THIS PERIOD OR FORGIVEN THIS PERIOD* CLOSE THIS PERIOD PAID THIS PERIOD AMOUNTOF LOAN CONTRIBUTIONS TO DATE nC* 5M1TH �va. EN60NI�WF ,e / ❑PAID CALENDARYEAR � ?.o, Wo a a V L WIZ a y -7 Lt a IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION ** RATE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC a a a E S DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION'* RATE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC a a a a a DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ Schedule B Summary 1. Loans received this period .......................................... ............................... (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ............................... ............................... (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............................. Enter the net here and on the Summary Page, Column A, Line 2. "Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. (Enter (e) on schedule E, Line 3) tContributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK -FPPC (866/275 -3772) $ V NET $ ;� CW (May be a negative number) (Enter (e) on schedule E, Line 3) tContributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK -FPPC (866/275 -3772) Schedule C Type or print in ink. SCHEDULE C Nonmoneta Contributions Received ry Amounts may be rounded to whole dollars. Statement covers riod period CALIFORNIA 60 from 101V2412— FORM through W�`20012— Page tC) SEE INSTRUCTIONS ON REVERSE of NAME OF FILER I.D. NUMBER B 5M 11-H - og- CrN 0,0111MVI IL, ?ZtZ— 134tSS_2- DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR CODE* OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF REQUIRED) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 -)DEC 31) Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.) ...................................................................................... ............................... $ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ..... ............................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ 'Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER &A c J M Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from L9f 11ZVr2_ through Ly(V/X?12- CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment SCHEDULE E Page 1 of t� I.D. NUMBER CW campaign paraphemalia/misc. MBR member communications RAID radio airtime and production costs CNS campaign consultants MfG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PEr petition circulating TEL t.v. or cable airtime and production costs RL candidate filing /ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals IND independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail) " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 131L�f64 3t6 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .................................... ............................... 2. Unitemized payments made this period of under $100 ................................................................ ............................... 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ..... ............................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) $ $ U ............ $ C2 TOTAL $ 13 14"94 • goo FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK -FPPC (866/275 -3772) t�120Iz(A2- Payee Address city Description Reimbursement- Fee Reimbursement - Printin , Stam s, Part Su lies Advertisement - Radio Fundraising Luncheon Postage Invitations Reimbursement -Wine Voter Outreach Labor Voter Outreach Labor Total _ Amount 2,500.00 364.19 6,780.00 1,115.93 1,258.00 201.09 288.67 472.50 504.00 13,484.38 Name of Pa ee Ryan Shultz Ryan Shultz Great Valle Services Stcokdale Count Club USPS Bobbie's Hallmark Debbie Cam tem SERV tem SERV