2012-01-31 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)