2004-10-28 Form 460 - PS Fire ManagementRecipient Committee
Campaign Statement
Cover Page
Type or print In Ink. Dale Stamp
(Government Cod e Section s 842 00-84216.5)
Statement covers p e riod
from _.._/P.-;...-__._\ _-....,0.......,</ __ _
SEE INSTRUCTIONS ON REVERSE through I O -'1 l -0 '/
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4.
• Officeholder, Candidate Controlled Committee
O S tate Candidate Election Committee
O Recall ·
(Also Complete Pan S)
% General Purpose Committee
0 S ponsored
;?'Small Contributor Committee
O Political Party/Central Committee
3 . Committee Information
D Ballot Measure Committee
0 Primarily Formed
0 Controlled
0 Sponsored
(Also Complete Pan 6)
O Primarily Formed C andidate/
Officeholder Committee
(Also Complete Pan 7)
1.0 , NUMBER
, -"JbS'Z
CO MM ITTEE NAME (O R CANDIDATE'S NAM E IF NO COMMITTEE)
_
STATE ZIP CODE ARE A CODE/PHONE
_.:..._!:,_!.!.,-,!-,~~~~"'."::'"'""".~=c ='""::-::-::--=-c9=-72k==-====:....!<-f_,..:....,-=-
ENn NO. AND STREET OR P.O . BOX
.,, ,,eo,
C I TY STATE ZIP CODE A REA CODE/PHONE
OPe~:~ ~~~~S 9?,zb:3
4 . Verification
Date of election If applicable:
(Month, Day, Year)
2. Type of Statement:
Ji!f Preelection Statemenl
D Sem i-annual S tatement
D Termination S tatement
D Amendment (Explain be low)
Treasurer(s)
NAME OF TREASURER , 0 mork Vo.,,r~y
MA
. ,,,,
ZIP CODE AREA CODE/PHONE
ZIP CODE AREA CODE/PHONE
I have used all reasonable diligence in preparing and reviewing this s tatement and to the best of my knowledge the Information contained herein and in the attached schedules Is true and complete.
certify under p enalty of perjury under the laws of the State of California that the foregoing
Executed on ------=oa'"'te,-------
Execuled on ------=oa-.,-------
Executed on ------.
08
,..
18
______ _
By ----,----,,,.....--,,,-...=-.,.....,.,.....,.,.... _____ --=-------------Signaium ofConlrolUngOfficeholder, Candidate, Slate Meast..-e Proponent or Responsible ()ffl(erof Sponsor
By -------=-sogna_1ure,_..o...,r""contro1-,-.,,ung---,Offlce=-..,.11o-:lder-,--,Ca,,.....ndod.,..,..a-te,-=s.-1e-te""Me_a_sum_,P,..ro-ponen--,------
By _____________________________ _
SlgnelUte ofConuolilng Offlceholde.-. Candidate. Slate Mea...,. Proponent FP PC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
State of California
Schedule A (Continuation Sheet)
Monetary Contributions Received
Type or print in ink .
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS ANO ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
(IF COMMITTEE, Al.SO ENTER 1.0. NUMBER) CODE *
IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
*Contributor Codes
IND-Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH -Other
PTY -Political Party
sec -Small Contributor Committee
OIND •COM
00TH
O PTY •sec
DINO
OCOM
0 0TH
O PTY •sec
O 1ND
OCOM
00TH
O PTY •sec
O 1ND •CO M
00TH
O PTY •sec
O 1ND
OCOM
0 0TH
O PTY •sec
SUBTOTAL$
SC HEDULE A (CONT.)
Statement covers period
from __,l'-'0,..__-_,\~-__..0.._4_,_ __
CALIFORNIA 460
FORM
t hrough __,_J_.0--.... 1 .. }._•_O=-I.../.__ Page ___ of __ _
AMOUNT
RECEIVED THIS
PERIOD
1.0 NUMBER
I \-3b57 ~85
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
FPPC Form 460 (June/01)
FPPC Toll-Free Helpllne: 866/ASK-FPPC
Ty pe or print In Ink. Schedule B -Part 1
Loans Received
Amount s m ay be rou n ded
to whole dollars.
Statement covers period
from I {) -/ , 0 ~
SEE INSTRUCTIONS ON REVERSE through I o --z., -o':f
FULL NAME , STREET ADDRESS AND ZIP CODE
OF LENDER
(IF COMMITTEE. ALSO ENTER I D. NUMBER)
to IND O COM O 0TH O PTY O sec
to IND o coM o OTH o PTY o sec
to 1ND • coM o OTH o PTY o sec
Schedule B Summary
IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
OF SELF·EMPI.OYEO, ENTER
NMIE OF BUSINESS)
(a) (bl (c) (d)
OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING
BALANCE E T S BALANCEAT
BEGINNING THIS R CEIVED HI OR FORGIVEN CLOSE OF THIS
PERIOD THIS PERIOD '
QPAID
QFORGNEN
$ ___ _
DATE DUE
QPAID
D FORGNEN
DATE DUE
QPAID
s
D FORGN EN
$
DATE DUE
S UBTOTALS $ $ $
1. Loans received this period ........................................................................................................... , ........ $
(Total Colu mn (b) plus unitemized loans 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. (May bo • negaUve number)
t Contributor Codes
$
l•I
INTEREST
PAID THIS
PERIOD
__ '4
RATE
__ %
RATE
__ %
RATE
(Enter (o) on
Schedule E. Line 3)
SCHEDULE B -PART 1
CALIFORNIA 460
FORM
Page ___ of __ _
ID NUMBER
(fl
ORIGINA L
AMOUNT OF
LOAN
DATE INCURRED
DATE INCURRED
DATE INCURRED
(gl
CU MULATIVE
CONTRIBUTIONS
TO DATE
CALENDAR YEAR
PER ELECTION "
CALENDAR YEAR
PER ELECTION ..
CALENDAR YEAR
PER ELECTION ..
• Amounts forgiven or paid by
another party also must be
re ported on Schedule A .
.. II required.
IND -Individual COM -Recipient Committee (o th er than PTY or SCC) 0TH -Other PTY -Political Party SCC-Small Contributor Committee FPPC Form 460 (June/01)
FPP C To ll-Free He lpline: 866 /A SK-FP PC
Ty pe o r pri nt In In k. SUMMARY PAGE Campaign Disclosure Statement
Summary Page
Amounts may be rounde d
to w ho le d o lla rs. Statement covers p eriod
fro m __,_f ~Oc....---1..\ _-....,,0,<...~-4--__
CALIFORNIA 460
FORM
SEE IN STRUCTIONS ON REV ER SE
NAM E OF FILER
?GU"-'
Contributions Received
1. Moneta ry Contrib utions .......... ................ ............ ... .. Schedule A, Une 3 $
2. Loans Recei ved ...................................................... Schedule B. Une 3
3. SUBTOTAL CASH CO NTRI BUTI ONS ......................... Add Unes 1 + 2 $
4. Nonmonetary Contributions .. .... .. .. . ..... ... .. ... ........ .... Schedule c. Une 3
5. TOTALCONTRIBUTI ONS RE CEIVED ........................... AcJdtJnes3 +4 $
Expenditures Made
6. Payme nts Made ........... ...... .. .. ......................... ......... Schedule E. Une 4 $
7. Loan s Made ............................................................. Schedule H, Une 3
8. SUBTOTAL CAS H PAYME NTS .................................... Add U nes 6 + 7 $
9. A ccrued Expenses (Unpaid Bill s) ............................... ScheduleF,Une 3
10 . Nonmon etary Adj ustment .......................................... Schedule c, U ne 3
11. TOTAL EX PENDITURES MADE ................................ Add Unes B + 9 + 10 $
Current Cash Statement
12. Beg in ning Cash Ba lance ....................... Previous Summary Page, Une 16 $
13. Cash Recei pts ................................................... Column A. Une 3 above
14. M iscellaneous Increases to Cas h ........................... Schedule 1, Une 4
1 5. Cash Paym ents ......... ... ................... ..... . ... ...... .... Column A, Une B above
16. ENOINGCASHBALANCE .......... AddUnes 12+ 13+ 14, thensubtract U ne 1s $
If this is a termination statement, U ne 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Schedule a, Part 2 $
Cash Equivalents and Outstanding Debts
18 . Cash Equi valents ........................................ See lnstruclions on revellie $
19. Outs t a nding De b ts ......................... AddUne2+Une9 i nColumnBabove $
Co lumn A
TOTAL THIS PERIOO
(FROM ATTACHED SCI-EOUI.ES)
()/
~oi'
t hro ugh I 0-1,,.\-0 ({ Page ___ of __ _
$
$
$
$
$
$
Col um n s
CALENDAR YEAR
TOTAL TOOATE
To calculate Column B , ad d
amounts in Co lumn A to the
corresponding amounts
from Column B of your la st
report. Some amounts in
Column A may be negative
figures that should be
subtra cte d 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).
I.D . NUMBER
\ ,-3~S--z.qa>S-
Calend ar Year Summary for Ca ndidat es
Runni ng in Both the State Pri mary and
Gene ra l Elect i ons
1/1 through 6/30 7/1 to Date
20 . Contributions
Received $ ____ _ $ _____ _
21 . Expenditures
Made $ ____ _ $ _____ _
Expenditure Limi t Summary for State
Candidates
22. C umulative Expendi tu r es Made•
(If Subject t o Vo luntary Expendltu,. Umlt)
Date of Election Total to Date
(mm/dd/yy)
___)___) __ $
___)___) __ $
___J___J __ $
___J___j __ $
___J___J __ $
___)___) __ $
•since January 1, 2001 . Amounts in this secti on may be
d ifferent from amounts reported in Column 8 .
FPP C Fonn 460 (J u ne/01)
FPP C Toll-Free Helpline: 866/AS K-FPPC
• ,.
.•
Recipient Committee
Campaign Statement
Cover Page -Part 2
Type or print in Ink.
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIALJBUSINESS ADDRESS (NO. AND STREET) Cfl-Y STAlE 21P \
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 ONO
COMMITTEE ADDRESS STREET ADDRESS "(NO P.O. BOX)
CITY STAlE ZIP CODE AREA CODE/PHONE
'
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE? •YES ONO
COM,~ITTEEADDRE,SS STREET ADDRESS (NO P.O. BO~)
-i
' CITY STAlE ZJP CODE · AREA CODE/PHONE
6. Ballot Measure Committee
'.-NAME OF BALLOT MEASURE
CALIFORNIA
FORM
Page___ of __ _
BALLOT No, OR LETTER JURISDICTION 0 SUPPORT
0 OPPOSE
ldt:ntlfy the controlling officeholder, candidate, or state measure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY
7. Primarily Formed Committee List names of officeho/der(s) or candldate(s) for
which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR Hao 0 SUPPORT
0 OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT
0 OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT ..
.· 0 OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFflCE SOUGHT OR HELD 0 SUPPORT
0 OPPOSE
Attach continuation sheets if necessary . '
FPPC Fonn 460 {June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
State of Callfomla