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Home My WebLink About2012-01-31 Form 460 - PS Fire ManagementCOVERPAGE Recipient Committee Campaign Statement Cover Page Type or print In Ink. CALIFORNIA 460 FORM (Government Code Sections 84200-84216.5) Statement covers period from ( -,, -/r SEE INSTRUCTIONS ON REVERSE through I Z.. -3 r -I I 1, Type of Recipient Committee: All Committees -Complete Perta 1, 2, 3, -4, D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (-C-Patt5/ J2f Gl!J)eral Purpose Committee .,e) Sponsored 0 Small Contributor Committee O Political Party/Central Committee 3. Committee Information D Prlmartly Formed Ballot Measure Committee 0 Controlled 0 Sponsored (AlsoC-Pan•J D Primarily Formed Candidate/ Officeholder Committee (AISoConv,1Qt8Pad7} 1.0. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) . ' [ ';' Data of election if AMIO: 21 (Month, Day, Year) , t: .1_ I' U ... 0 ; • < , : J'f',hc. , 11. "'· CITY Cl.ERK 2. Type of Statement: D Preelection Statement D Semj.annual Statement D Termination Statement (Also file a Form 410 Termlnatton) D Amendment (Explain below) Treasurer(s) NAME OF TREASURER -#' Page ___ of __ _ For Official Use Only D Quarterly Statement D Special Odd-Year Report D Supplemental Preelectlon Statement • Attach Form 495 p::.__l ~ '> /--"7?'" P, ~ /11'7..-,e.,,,~-~-":~- MAILING STREET ADDRESS (NO P.O. BOX) , NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS (IF DIFF RENT) NO. MAILING ADDRESS CIT~ ! STATE ZIP C~°.E~ AREA CODE/PHONE r,::__i ½::J >.,,..,--:3.,~ <:.-4 ,:;::,-z__L...£.> CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX , E·MAIL AcidRESs 4. Verification Executed on -----0,-,..------ Executed on ___________ _ Data Executed on ___________ _ Dal& OPTIONAL: FAX I E-MAIL ADDRESS By ------.•"'llll"'at""1n""o1=convo1="'1,g=ollioaho=::c ... =,,:::c.n::cd:cld"'a1a,::-a:s1a"'1a-:-...==:::.,.ccpQn=.,.=------ By ------.S,-~n-ahn,-eot-=-Corlrol....,..,,lng-=Offioel-dde=-:=-,,:::ea""nd'"~,-.at.,..o,°"s1a:-:,--:Meut,e==:::p,.-:pa,cn""'"'-.------ FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 868/ASK.ff'PC (808/275-3TT2) State of Callfomla Type or print In Ink. Campaign Disclosure Statement Summary Page Amounts may be rounded lo whole dollars. Statement covers period ftom-"-2_-~l~-l~c __ SEE INSTRUCTIONS ON REVERSE through /2.. -)/-t"( Page ___ of __ _ Contributions Received TOTAL THIS PERIOD (FROMATTAQEOSCI-EDULES) 1. Monetary Contributions ... .. . .. .. .•.•..... .. ... .. .. . .. .. .. •...•... Schedule A. uno 3 $ 3ont>~ 2. Loans Received ..••••.•....•....•.•.••••••••....................•••.. Schedule B, Lina 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... AdrJ Lines 1 + 2 $ 4. Nonmonetary Contributions.................................... Schedule c. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .....•.•....•.•••••••...... AdrJ unes 3 + 4 $ ~oc:,o~ Expenditures Made 6. Payments Made........................................................ Schodulo E. Line 4 $ 7. Loans Made . .. .. .. .. ........ •• ... .•• •• •• ••••••• .• .. .. .. . .•. .. .•. •. •••••• Schedule H. Lin• 3 8. SUBTOTALCASHPAYMENTS .................................... AddLines6+7 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schodul<IF. unoa 10. Non monetary Adjustment .......................................... Schoduto c, uno 3 11. TOTALEXPENDITURESMADE ................................ AddLln088•9•10 $ Current Cash Statement 12. Beginning Cash Balance ....................••• PnwiousSummaryPage.Llno16 13. Cash Receipts ................................................... Co/unm A. Lino 3 above 14. Miscellaneous Increases to Cash ...........•............... Schodute 1. Line 4 $ ... ; .3..?6£~.>. -o?t 15. Cash Payments.................................................. Column A. Lino a above 16. ENDING CASH BALANCE .......... AddLlnos 12• 13 + 14, rhon subrractL/no 15 $ If this is a termination statement, Lim'I 16 must be zero. ColumnB CALENDAR VEAR TOTAL TO DATE $ 5(!;IGD~ $ $ ~~ $ $ 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 ----------------------------------1 the first report being filed 17. LOAN GUARANTEES RECEIVED.,.,....................... Schodul<I s. Part 2 $ for this calender year, only ----------------------------------1 carry over the amounts from Lines 2, 7, and 9 (if any). Cash Equivalents and Outstanding Debts 18. Cash Equivalents .•.•..••...•............................ see tnsrrocrions on reveroe $ 19. Outstanding Debts .•.•..•................•• AddLine2•Line9inColumnB•bove $ 1.0. NUMBER /!- 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. Cumulatlve Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) __J__J __ Total lo Date $ ____ _ __J__j__ $ ____ _ 'Amounts In this section may be different from amounts reported in Column B. FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) ScheduleA Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print In Ink. Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OFBUSINE$S) (IFCOWAITTEE, ALSO ENTER I.•. Nl.loABER) 't,4-.{(AA S'~~ p,.,~ 1,/IA-??~~f-~I i- Schedule A Summary 1. Amount received this period -itemized monetary contributions. CODE• •IND •COM ~ •sec •IND •COM DOTH •PTY •sec •IND •COM DOTH •PTY •sec •IND •COM DOTH •PTY •sec DINO •COM 00TH •PTY •sec SUBTOTAL$ SCHEDULE A Statement covers period CALIFORNIA 460 FORM from ~j_,-/;._,Y'--- through/ 2...-3,/ -tz Page ___ of __ _ AMOUNT RECEIVED THIS PERIOD I.D,NUMBER I-~t.);-;J... 9...8.'. CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 • DEC. 31) PER ELECTION TODATI: (IF REQUIRED) •contributOf Codes (Include all Schedule A subtotals.) ........................................................................................................ $ _____ _ IND-Individual COM-Recipient Committee (other than PTY or SCC) 0TH -Other (e.g., business entity) PTY -Political Party 2. Amount received this period-unitemized monetary contributions of less than $100 ............................. $ _____ _ 3. Total monetary contributions received this period. 2(:;(JC;> ~ SCC-Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ ... ~=------ FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 868/ASK-FPPC (868/275-3772) Schedule B -Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER f v-l {...,c.,\_, FULL NAME. STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, AlSOENTERI.D. NUMBER) to IND O COM O 0TH O PTV O sec t • IND O COM O 0TH O PTY O SCC to IND O COM O 0TH O PTV O sec Type or print In Ink. Amounts may be rounded to whole dollars. a (b) OUTSTANDING AMOUNT IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) BALANCE BEGINNING THIS RECEIVED THIS PERIOD SUBTOTALS$ $ Statement covers period from '7-/ -// through /,t_.-ft-/r: I-f#c (c) I• AMOUNTPAID OUTS, NDING INTEREST BALANCEAT OR FORGIVEN CLOSE OF THIS PAID THIS THIS PERIOD• PERIOD •PAID , ____ __ .. 0 FORGIVEN RA.Tl; DATE DUE •PAID 1----__ .. D FORGIVEN RATE DATE DUE •PAID , ____ __ .. •FORGIVEN RATE DATE DUE $ $ (Entar(e)on SCHEDULEB•PART1 CALIFORNIA 460 FORM Page___ of __ _ I.D. NUMBER g ORIGINAL CUMULATIVE AMOUNTOF CONlRIBUTIONS LOAN TO DATE CALENDAR YEAR $ ___ PER B.ECTION- DATE INCURRED CIILENDAR VEAR $ ___ PEA ELECTION.,_ DATE INCURRED CAU:NOAR YEAR , ___ PER ELECTION- DATE INCURRED Schedule B Summary Schedule E, Line 3) 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.) ............................................................... NET $ ,/£.,~ Enter the net here and on the Summary Page, Column A, Line 2. e,ybeanegatjve,-.,.,1100') tcontributor Codes IND-Individual COM -Recipient Committee (other than PTY or SCC) 0TH -Other (e.g., business entity) PTY -Political Party sec -Small Contributor Committee •Amounts forgiven or paid by ano(her party also must be reported on Schedule A. •• If required. FPPC Form 4410 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) ScheduleE Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER ,/J ,-~ }\A,\. Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period from __:i_:__J_ :... // I J..-'l./-/1 through .c..,__--=-/ ___ _ CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphernalia/misc. fvBR member communications RAO rsdlo airtims and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions C"ra contribution (explain nonmonetary)" OFC office expenses SAL campaign workers' salaries eve civic donations FEr petition circulating TB. Lv. or cable airtime and production costs FIL candidate filing/ballot fees A-tO phone banks lRC candidate travel, lodging, and meals FNO fundraising events POL poling and survey research 1RS staff/spouse travel, lodging, and meals IND indapendent expenditure supporting/opposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense !'Fl) profesaional services (legal, accounting) VOT voter registration UT campaign literature and mailings PRT prlnl ads VI/EB Information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTERI.O. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID 5 /:e "'""°-fc,i_~.,L C'if:J /~D :to ~'-- fc.-1,A--( /4.,t-..:),"v-\.. -er~ /tt>e~ # /33, 9-Y I z_ f'_, ~ e-/4..s~ c.~ l)DOO~ 7Z'-I .>-3 9 .:r ~ 7 • Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ _____ _ 2. Unltemizedpaymentsmadethisperiodofunder$100 .......................................................................................................................................... $ _____ _ 3. Total interest paid this period on loans. (Enter amount from Schedule 8, Part 1, Column (e ).) ............................................................................... $ _____ _ "3000~ 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 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3172) Schedule E (Continuation Sheet) Payments Made Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period from __2_·-L. ·-/ I' through /2.-3 J-/ / CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. OvP campaign peraphernalla/misc. MBR member communications RAD radio airtime and production costs CJIIS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)" OFC office expenses SAL campaign workers' salaries CvC civic donations PET petition circulating TE. t.v. or cable airlime and production costs AL candidate filing/ballot fees 1'1-K) phone banks TRC candidate travel, lodging, and meals FIID fundralslng events POL polling and survey research TRS staff/spouse travel, lodging, and meals NJ Independent expenditure supporting/opposing olhers (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 UT campaign literature and mailings l'RT print ads WEB Information technology costs (internet, e-mail) NAME ANO ADDRESS OF PAYEE CODE (IF COMMITTEE, Al.SO ENTER I.D. NUMBER) )ie_':)µ:_,(_ • Payments that are contributions or independent expenditures must also be summarl.led on Schedule D. OR DESCRIPTION OF PAYMENT AMOUNT PAID SUBTOTAL$ FPPC Form 460 (Januilry/05) FPPC Toll.f'ree Helpline: 886/ASK.f'PPC (886/275-3772) Schedule I Miscellaneous Increases to Cash SEE INSlRUCTIONS ON REVERSE: NAMe OF FILER DATE RECEIVeD FULL NAMe AND ADDRESS OF SOURCE (F COMMITTEE. ALSO ENTER I.D. NUIYSER) ~ ( i<.A... s~~"7<-,,,c/ ;,,,'G-'<..._ ~/???,"'7"!/j;""'-,,d-i.--..,. / ~ I \- Attach additional information on appropriately labeled continuation sheets. Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period from 2-/-// througt,Q -) I -/ ( DESCRIPTION OF RECEIPT SUBTOTAL$ SCHEDULE I CALIFORNIA 460 FORM Page __ of __ 1.0.NUMBER AMOUNT OF INCREASE TO CASH ~~~:~~~= i~:r~::~?:ash this period ........................................................................................................................ $ 5 G'oO e;e 2. Unitemized Increases to cash of under $100 this period ............................................................................................. $ • 6~ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $ _____ _ 4. ~::1n:~~:g:~o~~~nf~~r~~-~-~-~--~-~-~-~--~~'.~--~~~'.~~: .. ~~~~--~~-~-~-~ .. ~: .. ~:.~~~-~ .. --~~~~~-~~~~-~-~~--~~--~~~---···· TOTAL $ ~l:)~ FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (666/275-3772) .... COVERPAGE Recipient Committee Campaign Statement Cover Page Type or print In Ink, Dato Starnp CALIFORNIA 460 (Government Cock> Sections 84200-84216.5) Statement covers period from / ~ / -// SEE INSTRUCTIONS ON REVERSE through t-36-f / 1. Type of Recipient Committee: All Committees-Complete Pa11S 1, 2, 3, and 4. D Officeholder, Candidate Controlled Committee D & Jallot Measure O State Candidate Election Committee Committee O Recall O Primefil~ Fe!'ffled (Alsocom,,,etePMSJ O Controlled }! General Purpose Committee fl! Sponsored O Small Contributor Committee O PoUlical Party/Central Committee 3, Committee Information 0 Sponsored (Also Coolp{ell!t Patt6) • Primarily Formed Candidate/ Officeholder Committee (AlsoCompletePart7J l.i?~B 3 "2~ f:/- COMMITTEE NAME (OR CANDIDATE'S NAME If NO COMMITTEE) / f9o-li-. -Sy,._,-~ ,r=:-,~ h'-1'~ "-~ p;4-c._ ~re./4 STATE ZIP CODE ~ 9-z..24'2.. 74'0- en¥' ,e.._ l ~ 5 A STA< ,,;_P c? LL dEA cooEIPHONE OPTIONAL: FAX I E-MAIL ADohESS ~ 4. Verification Date of election If applicable: (Month. Day, Year) 2. Type of Statement: D Preelectioo Statement D Semi-annual Statement D Termination Statement D Amendment (Explain below) Treasurer(s) RECEIV CITY OF PALH : 2001102 F-'.::Rr,11 D Quarterly tement D Special Odd-Year Report D Supplemental Preelection Statement -Attach Form 495 CIT'z? ;(.. ~ ( ~ STATE Awcooe .(:'.:~~ ~~ 0-4 9z s, NAME OF ASSISTANT TREASURER, IF AN a:; AREA CODE/PHONE 76,-77?-I<. Y/ MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. certify under penalty of perjury under the laws of the State of California that the foregoing Is true correct. Executed on --2~-___.Z.O"!'!,-,,::----/.:.../ __ -Executedon _____ ~.,.------- Executed on -------,o.=te _____ _ Executed on -----,Date=------ By Bv--s"';,--,r,a""tu-,,.,.,o""tC-O'"'n..,...,-,,,-,ng""oo=ce""hOld-,,-.,-,,c,,--nd'"'ioa""i.-,,s"'...,=M,-••-ou-.. --,Pro,-po_oe_nt"'"'o-.,R=-cuporu,=--,.,.,.,.--,Olllcer=-o-,fS"""poo-so-,,-- By -------,S~i,-rlll""tu-,....,o,~Co-ntro1-,n-g~Offi~ceho-~lde-,.~C-,nd-,ldat-•~.S.,.lele-Me-,-,u-.,~~ro-po-ne...,nt _____ _ BY--------=--=----~-----------Signature ofControlNng Officeholder, Candidate. $I.al$ Measure Proponent FPPC Fonn 480 (Drall-Augu&tlll4) FPPC Toll-Free Helpline, 8Ge/ASK-FPPC (866/275137721 State of Callfomla Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print in Ink. Amounts may be rounded to whole dollars. DATE FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IFCOMMITTEE,ALSOENTERI.D.NJMBeR) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OFBUSINE&<:;) Schedule A Summary •IND •COM DOTH •PTY •sec •IND •COM DOTH •PTY •sec •IND •COM DOTH •PTY •sec 011-.0 •COM 00TH OPTY •sec •IND •COM 00TH •PTY •sec SUBTOTAL$ SCHEDULE A Statement covers period from /~/-// CALIFORNIA 46 0 FORM through ~ -Jti -/ f Paga AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 • DEC. 31) "Contributor Codes I ND -Individual of __ _ PER ELECTION TO DATE (IF REQUIRED) 1. Amount received this period-1•••••1 contributions ef $108 er mere. (Include all Schedule A subtotals.) ........................................................................................................ $ _____ _ COM -Recipient Committee (other than PTY or SCC) 0TH Other 2. Amount received this period-unitemized contributions of less than$ 100 .......... : ... : .............. $ ______ _ PTY -Polnical Party 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ SCC -Small Contributor Committee FPPC Form 460 (Oraft-Auguat/04) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/27513rr2) Schedule B-Part 1 Loans Received SEE INSTRUCTIONS ON ReVERSE NAME OF ALER p ~ L \.A,,i\.. FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER OFCOIIIOITl'EE.ALSOENIERI.D.MJMlll!RJ to IND O COM O 0TH O PTY O sec to IND O COM • 0TH O PTY O sec to IND O COM O 0TH O PTY O sec Schedule B Summary (IF SELF,.EMPLOYED,ENTER NAME OF 11US1>EBS1 "fype or print In" Ink. Amounts may be rounded to whole doll•ra. /- SUBTOTALS$ Statement covers period trom L-/-t( through 6-;JO--£'/ f)v4<._ l•I ~NG AMOUNTPAID BALANCEAT OR FORGIVEN ClOSE OF THIS THIS PERIOD* INTEl!EST PAIDTHIS PERIOD •PAID •-----" OFOROIV"fN RATE Dl'J'EOUE •PAID $ ___ --" •FORGIVEN RATE •---DATE DUE •PAID $ ___ __ .. OF0RGIYEN RAT£ DATE DUE $ $ $ <•> .. Schedule E, Una3} · SCHEDULE B • PART 1 CALIFORNIA 460 FORM Page Of I.D. NUMBER • ORIGINAL CUMULATIVE AMOUNTOf CONTRIBUTIONS LOAN lODATE CALENDAR VEAR •---$ PER B.ECTION .. DATE INCURRED CALENDAR YEAR $ ___ I PERELECTIOti .. DATE INCURRED CAI.Et,IJARYEAR •---s PERB.ECTION .. DATE INCURRED 1. Loans received this period .................................................................................................................... $ _____ _ (Total Column (b) plus unitemized loans•less than $100.) tcontrtbutor Codes IND-Individual 2. Loans paid or forgiven this period ......................................................................................................... $ _____ _ COM -Recipient Committee (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.) ............................................................... NET $ 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. (other than PTY or SCC) OTH-Other 1 PTY -Po!Hlcal Party SCC-SmaH Conbibl.torCommlllee FPPC Fomi 4e0 (Dnlft.AalguaW4J FPPC Toti-Free Hetpllne: 8118/ASK.fPPC (888/2751:S772J .. SCI-EDULEE ScheduleE Payments Made 'fype or print In Ink. Amounta may be rounded to whole dollar•, Statement cover• period from ;.,.. / -/ / CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE through b-;Jo-1( Page ___ of __ _ NAME OF FILER I-1.0. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. O,P campaign paraphernalia/misc. lol3R member communleallons RAO radio airtime and produelion .coets allS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expanses SAL campaign workers' salaries eve civic donations l'ET petition circulating 1B. t.v. or cable airtime and prodUGtlon costs FIL candidate llllnglballot fees PH) phOne banks 1RC candidate l.favel, lodging, and meals F1IO fundralslng events POL polllng and survey research iRS staff/spouse lravel, IOdglng, and meal& N> independent expenditure supporting/opposing others (explain)" F'OS postage, delivery and messenger services TSF transfer between committees of the ssme candidate/sponsor LEG legal defense PR> professional services Oegal, accounting) VOT voter ~stration UT campeign literature and mallilgs PRl' print ads 11\EB lnfonnation lachnology costs {internet, a-mall) NAMEANDAOORESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT (FCOMMITTEE,ALSOENTER ID. NUMEER) AMOUNT PAID JI[~ * Payment• that are contribution• or Independent expendhun111 must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 1. -payments made this period of $188 or rnor<e. (lncludeaH 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.) ............................. TOTAL $ ~ FPPC Fonn480(Augustl04) FPPC TOIi-Free Helpline: 888/ASK-FPPC Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period from ---'-I--'------1--=-/___,__r_ through b-.7o-l/' CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE E (CONT.) CALIFORNIA 460 FORM Page ___ of __ _ 1.D.NUMBER I t -:J6r.??JJ ;- CNP campaign paraphernalia/misc. MEIR member communications RAO radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries eve civic donations FEf petition circulating TI3.. t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks 1RC candidate travel, lodging, and meals RID fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals NJ lndependen1 expendtture supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidale/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PITT print ads WEB information technology cosls (internet. e-mail) NAME AND ADDRESS OF PAYEE CODE (IF COMMITTEE, Ai.SO ENTER I.D. NUMBER) v(ax.JL • Payments that are contributions orlndependentexpendlturesmustalso be summarized on Schedule D. OR DESCRIPTION OF PAYMENT AMOUNT PAID SUBTOTAL$ ~ FPPC Fonn480jAugusl/04) FPPC Toll-Free Helpline: 866/ASK.fPPC Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (II" COIIINITTEE, ALSO ENTl;R 1.0. NUIIB&:R) Attach additional Information on appropriately fabaled continuation sheets. 'l)pe or print In Ink. Amounts may be rounded to whole dollars. ~ant covers period from ,wff /-/-// through 6 -.>Q -/ / DESCRIPTION OF RECEIPT SUBTOTAL$ Schedule I Summary 1. -increases to cash of $188 or more this period .............................................................................................. $ --~"'"/""'.), __ _ 2. Unitemized increases to cash •under $100 this period ............................................................................................. $ _____ _ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $ _____ _ 4 · ~~:!~~~;:~~!n~~~t~~-~-~~--~-~-~-~--~~'.~--~~~'.~~: .. ~~~~-~~~~-~--~ .... ~:-~~~-~: .. ~~~~~-~~~-~-~-~--~~-~~~---···· TOTAL $ __ , _/_~--- SCHEDULE! CALIFORNIA 460 FORM Paga __ of __ I.D.NUMBER AUOUIIITOF INCREASE TO CASH FPPC Form 480 (Auguat/04) FPPC Toll-F-HalpNne: 86&/ASK-FPPC Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Contributions Received 1. Monetary Contributions ........................................ .. Schedule A, LJne 3 2. Loans Received ...................................................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ................ ......... Add Lines 1 + 2 4. Nonmonetary Contributions.................................... Schedule c, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 Expenditures Made 6. Payments Made .. .... ..... .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ...... Schedule E, Line 4 7. Loans Made .. ............................ ................ ...... ......... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 9. Accl'\Jed Expenses (Unpaid Bills) ............................... Schedule F. Line3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTALEXPENDITURESMADE ................................ AddLlnes8+9+ 10 Current Cash Statement 12. Beginning Cash Balance ....................... PreviousSumma,yPage, Line 16 13. Cash Receipts .. .... ............................. ................ COiumn A. Line 3 above 14. Miscellaneous Increases to Cash........................... Sclledule I, Line 4 15. Cash Payments .. .. .. ...................... ..................... Column A, Uno 8 above 16. ENDING CASH BALANCE .......... Ade/Lines 12 + 13 + 14, lhensu11Iractune 15 If this is a tennination statement, Une 16 must be zero. 17. LOAN GUARANTEES RECEIVED........................... Schedule B, Part 2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents........................................ see instructions on"'"""'" 19. Outstanding Debts .... ..................... Add Un• 2 + Line 9 in Column B above Type or print In Ink. Amounts may be rounded to whole dollars, Statement covers period $ $ $ $ $ $ $ $ $ $ $ TOTAL THISPERIOO (FROM A.TT ACHED SCHEDULES) §6£.19 ,,/3, 566 r.~2-,. from~/_-~/:_-~/~/ __ _ $ $ $ $ $ $ through ColumnB CALENDAR YEAR TOTAi. TOOAiE 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). b-20-/I"' Page ___ of __ _ 1.0. NUMBER //-~b.> 2.9 .Y. 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. Expend~ures Made $ ____ _ $ ____ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (lf$ubJact1:o Voluntary EXl)endltuN!I l.lmlt) Date of Election (mm/dd/yy) ___J___J __ ___J---,-.--1 __ Total ta Date $ _____ _ •siaee Janual) 1, 2001. Amounts in this section may be different from amounls reported in Column B. FPPC Form 460 (Draft-August/04) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275/3772) Statement of Organization Recipient Committee Statement Type D Initial Not yet qualified O o.- ____j____j __ Date quaified as committee Type or print In Ink ~ Amendment List I.D. numbe<: Date qualified as committee (tt aPjllicable) D Termination -See Part 5 List I.D. number: #-------- ----1--~-- Date of Termination Date Stamp STATEMENT OF ORGANIZATION Ci\'JrnRNIA 41 0 f'ORM For Official Use Only 2011 FEB 2 PH 12: 08 1 JAil,ff; mt.:''1 1. Committee Information NAA"E OF COMMITTEE 2. Treasurer and Other Principal Officers r~Jw,_ 5/i-1~1 A~ /JA-c- STREET ADDRESS (NO P.O. BOX) Jt;I# # et Cie/11 STATE ZIP CODE AREA CODEIPHONE l,A &( 'll.12-71,-l.J,f'li'I COUNTY OF DOMICILE n /J...~.1er5 t &-L COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE Attach additional information on appropriately labeled continuation sheets. 3. Verification NAME OF TREASURER 6et, ("9<!-f,.. ; fk STREET ADDRESS (NO P.O. BOX) t·'J Ibo /)tAn.itf o ~}IA( ~f NAME OF ASSISTANTTREASURER"F M-JY STATE u... ZIP CODE AREA CODE/PHONE f"?2) Y ~()~i()f-tJl6f STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE STATE AREA CODE!PHONE ~ 60-']Z-Z--c/0; I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and co Executed on __ Z.c:=:...-..c/Z._..,.,__--"/;.....,.'/ ____ _ DA~ Executed on _ __.J,."'---.... ~_..{,.__-_.2-..,o!'±e/~I ____ _ OATE Executed on -------=oA'"'r""e _____ _ Executed 011 -------=o,.-:-:TE:=------- By By_-+--------------~~~-~~---------------StGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE P-ROPONENT By ______ "'s1""GN"'A"'ru"'R"'E""O""Fc"'o""N"'TR""O"'LL"'fN""G,..,O"'F"'FIC"'E"'HO"'L"'"D"'ER ... _"'cA"'N""b1""bA'"f'""E.""O"R'"ST ... AT"'E""M""E"'As"'u""RE""P""R""O"'PO""N""EN""t~----- FPPC Form 410 (June/09I FPPC Toll-Free Helpline: 866/ASK.f PPC (8661275-3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME 4. Type of Committee Complete the applicable sections. Controlled Committee STATEMENT OF ORGANIZATION CALIFORNIA 41 0 FORM 1.0. NUMBER • List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election. • List the political party with which each offioeholder or candidate is affiliated or check "non-partisan.• • lf this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD ONCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION • List the financial institu1ion where the campaign bank account is located (controlled ·candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE($) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(Sl OFFICE SOUGHT OR HELD OR MEASURE($) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) PARTY D Non-Partisan D Non-Partisan CHECK ONE FPPC Fann 410 (June/09) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772) ,._, Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE STATEMENT OF ORGANIZATION CALIFORNIA 410 FORM COMMITTEE NAME LD. NUMBER 4. Type of Committee (Continued) General Purpose Committee Not fanned to support or oppose specific candidates or measures in a single election. Check only one box: 0 CITY Committee O COUNTY Committee O STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Comnuttee list additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION Of SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIPCOOE Small Contributor Committee • __ .,_ _ _,_ __ Date qualified 5. Termination Req Ui rements By signing the werification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the folowing conditions ha11e been met: • This committee has ceased to receive contributions and make expenditures; This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; This committee has no surplus funds; and This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. --There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. -Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511 - 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (Junelll9) FPPC Toll-Free HelpHne: 866/ASK-FPPC 18661275-3772)