1995-10-26 Form 420 - PS POA•i " , ·-
Recipient Committee .
Campaign Statement -Long Form
(Government Code Sections B4200-B4216.5)
Type or print In Ink,
SEE INSTRUCTIONS ON REVERSE
Check one of the following boxes to Indicate the type of statement being flied:
DD Pre-election Statement p('seml-•nnuol Statement
Special Odd-year Campaign Report
D Supplemental Pre-election Statement (Attach• completed Form 495 to this Statement.)
D Termination Statement (Attach• completed Form 415 to this statement.)
Statement crvers period
from "'1/ ( _ 'if'
through I,{ ')I ( Cj 5""
Date of election If applicable:
(Month, Day, Year)
Date sta·mp
RECEIVED·
OCT 2 6 1995
CITY CLERK
Pig•
For Official Use Only
/...,_,~ommittee Information II
!., )NAME OF COMMITTEE Primarily Formed Committee (See definition on reverse.)
List names of officeholder(s) or candidate(s) for which
. PoL\TICln..,. Acr,0rv o~ o'f= 1>t"G {)l'r\.M <;pt., .... G-~~/¼ S,:i (...
h" . . fc d t 1s committee is Drrmarilv orme .
NAME Of CANDIDATE(S) Oft OFFIC£HOLD£R(S) Off IC£ SOUGHT Oft HELD CH£CKONE
I.D.NUMBER
A-A·• ..
STATE Z,P CODE AI\EA CODE/DAYTIME PHONE
CA '\'l-'l "1 \..,
PERMANENT
~
AltEA CODE/DAmME PHONE
(Check Boxes) See definitions and Important Information on revene.
' \. _ }s this a sponsored committee? .................. lit Yes 0 No
Ill( No Is this a broad based political committee? ......... • Yes Attach additional information on appropriately labeled continuation shf!ets.
Ill Verification
I have used all reasonable diligence In preparing this statement. I have reviewed the statement and to the best of my knowledge the information contained
herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true
and correct. .r> rp A (
~_?IUNfORMATION ft[QUIMDTO l!E PIIOVIOED TO YOU PUI\SUANT TO THE INf0ftMATION PRACTICES ACT ~f 1911, SEE INfORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS Of THE POLITICAL IIEFOI\MACT.
State of Callfornl1 Fair Political Practice1 Commission
Recipient Committee
Allocation Page .
Type or print In Ink.
Amounts may be rounded
· to whole dollars. Statemer corrs p~lod
from "J I q 5
ALLOCATION PAGE .
SEE INSTRUCTIONS ON REVERSE through 11.../31 I q l Page '"2.. of '?t)
NAME OF COMMITTEE
PoL-1 t, Ac.nov GM Ml~ oFTJtE fl1n.,~ SPt,fl\.>~5 {}.,1.,te,G off, let-5
I.D.NUMBER
List contributions and independent expenditures that total $100 or more made to support or oppose officeholders, candidates, ballot measures, orcommittees.
DATE NAME OF OFFICEHOLDER OR CANDIDATE AND OFFICE, OR NAME OF CHECK ONE IND. AMOUNTTHIS CUMULATIVE TO DATE CUMULATIVE TO DATE MEASURE AND BALLOT NUMBER OR LETTER, OR NAME OF COMMITTEE EXP.• PERIOD ~LENDAR YEAR OTHER IF OTHER THAN OFFICEHOLDER, CANDIDATE, OR MEASURE COMMITTEE SUPPOIIT OP,OH AN. 1 • DEC. 31) (IF APPLICABLE)
1 )Jq, Wll.L ~l..21"-'0 I G°"V>T v. s, (1.1"'1' s , /t'\,A,'1 Q ,._ ~ 5oti~ 500 c,O
. 10}2--?> I 4r ~ ....... e; ~UZ'L-5
A.. 500~ 500~ .. p,.'-"" ~~~,~,, Cl"f\1 lo., ... c.i l
-10 l'l-) I c,5"' 5Tl'lt--(} 1)-Q N!l,:_5
I.__ Soo 0..sL 500~ p /'riv~ ( p R.11J&S,, c,r-, C(,VA,c: I
10/r)} ~ r-l?uOetL-1 ~
501)~ 5'DD~ <>~ se~•AJ&S, C 1.-1"'1 {;µIVC.4 I ,j.__
·,----1----------------------+-+--+----,1"--------1-------+-------
•see reverse regarding independent expenditures. SUBTOTAL $ ';2.boo c(a
Allocation Summary Attach additional information on appropriately labeled continuation sheets.
1. Contributions and independent expenditures of$ 100 or more. made this period. ?,QD c) O..9--
(lnclude all Allocation Page subtotals.) • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . • . . . . . . . . . . . . . . . . . . . . . $ ______ _
2. Contributions and independent expenditures under $100 made this period.
(Do not itemize:) ••......••••.....•.........•...................................•......•...•.......••..••. $ ______ _
3." Total contributions and Independent expenditures made this period. $ ,:\000 °0
(DonotcarrythistotheSummaryPage.) ............................................................. TOTAL _Ji:::. . .io.,
Recipient Committee·
Summary Page
SEE INSTRUCTIONS ON REVERSE
Contributions Received
1. Monetary Contributions •.•....•.......................
, .1~ Loans Received ........................................ .
{ ) SUBTOTAL CASH CONTRIBUTIONS ..................... .
4. 'Non-monetary Contributions ·························
5. SUBTOTAL CONTRIBUTIONS (Exclude Enforce•ble Prom/u,i,)
6. Enforceable Promises
(EKclUM Lo•n Gu•r1ntee1, Une 1B below) ...................
7. TOTAL CONTRIBUTIONS RECEIVED ················· .. ,,
Type or print In Ink.
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
(HI.OM A TT ACHED SCHEDULES>
Schedule A, Une3 S __ '.2..._.I__.0:;..O=-----
Schedule B, Uno 7 0
Add Line• r .,. 2 s _ __::'1=-:..1 o=--0=------
Schedule C, Une 3 ()
AddUnes3 +4 s ':llO 0
0
Schedule D, Une·7
Add Lines S + 6 s
Expenditures Made
B. Cash Payments (Other than Loans Made) . . . . . . . • . . . . schedule E, Lines s _ _.2=-cb'--0"-C ____ _
9. loans Made . . .. . . . . . . . . . . . . • . • . . . . . . . . . . . . . . . . . . . . . . • . . . Schedule H, Line 1 t>
10. SUBTOTAL CASH PAYMENTS •....... ... ... .•.... ........ AddUne1B.,. 9 s __ ::,i.=.O.:c...0:c.....;U~---
11. Accrued Expenses (Unpaid Bills) . .. . .. . . . . . .. . . . . . . . . . . . Schedule F, Lines 0
12. TOTAL EXPENDITURES MADE ·•·•··•· .. . ..... .. . .. .. . . Add Lines 10 .. ,, s __ '.l.-.o=-c0:.....::0=--'---
··"rrent Cash Statement
'··,~ ~'Beginning Cash Balance .................. Prevloci1SummoryPage,Llne 17 S _ _.sa.....;;o;....::S_~ ....... ----
':l.. l O 0 14. Cash Receipts ....................................... ColumnA,LlneJ•bo••
15. Miscellaneous Increases to Cash . . . . . . . ... . . . . . . . . . . . . . . Schedule 1, Lin• 4 0
16. Cash Payments .. ...... .. ... ...... ... .. . ...... .•. . . Column A, Line 10•bo•• :l. t>D 0
17. ENDING CASH BALANCE ... . . AddUne113 + 14 • is, then subtract Line 16 s 5 ( 5 '9 --= ....... .;:;....-"-----
,, thl1 l1 • term_fn1tlon lfatement, Une 17 must be zero.· ENDING CASH IALANCE SHOULD
NOT BE A NEGATIVE AMOUNT
18. LOANGUARANTEESRECEIVED ....•......... ScheduleB,Partl,Column(b) s ___ __;0:::c_ ___ _
Cash Equivalents and Outstanding Debts 0
19. Cash Equivalents .............•.................. Seelnrtructlonsonreverse S ________ _
20 ... 0utstanding Debts ..............•.. ·AddLlnel +'ilne 11/nColumnCabove s ____ ..,,Q"'-----
SUMMARY PAGE .
Statement coven period
from 7 I q)
Pige . "} of~
I.D.NUMBER
Column a• ColumnC.
TOTAL PREVIOUS PERIOD TOTAL TO DATE
CHE NOTE BELOW) (ADD COLUMNS A • I)
s 50s, · s "1 I S13
0 -c
s §OS-i s 11 5 "8
C 'C
s 505.j s -,, s-'8
Q 0
s 5 O S-'i s its~
s 0 s "')..00-0.
0 Q
s 0 s ;).'C~"D
0 'C
s 0 s ;l.OC"O
• From previous Statement Summary Page, Column C. However. if
this is the first report filed for the co lend.or year. Column B should be
blank except for Loans Received (Line 2), EnforcHble Promises (Line
6), Loans Made (Line 9), and Accrued Expenses (Line 11).
Summary for ~on-Controlled Committees
Primarily Formed to Support or Oppose
Candidates In Both June and November
Elections 1/1 through 6130 7/1 to Date
21. Contributions 5 Received.... ____ _
Schedule A
Monetary Contributions Received
Type or print In Ink.
Amounts may be rounded
to whole dollars.
SCHEDULEA ·
Statement c vers period
SEE INSTRUCTIONS ON REVERSE through Page· ':f
NAME OF COMJAJ,.TTEA • C prfo A I.D.NUMBER
DATE
RECEIVED
-~ C)
V. J.I i-JF ~
FULL NAME AND ADDRESS OF CONTRIBUTOR
(IF COMMITTEE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, lNUR l,D. NUMBER
Oft,, If NO 1.D. NUMBEft HAS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS)
~ ~IN , ~ ~ Ol'A '1:.'"11-5 As So
5,.,_.a Co .. rt,.d\-m,111.s
Monetary Contributions Summary
1. Amount received this period-contributions of $100 or more.
OCCUPATION AND EMPLOYER
(If SElf•EMPLOYED, ENTER
NAME OF BUSINESS)
SUBTOTAL $
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN.1 •DEC.31)
(Include all Schedule A subtotals.) ...........• , . . . . . . . . . . . . . . . . . . . . . . . . . . • . • . . . . . . . . . • . . • • . . . . • • . • . . . . . • . • . . . . $ ______ _
2. Amountrecelvedthisperlod-contrlbutlonsoflessthan$100. $ '2 l O 0
• (Do not Itemize.) • . . . . . • . . • • • • • . • . . . . . . • • . . . . . . . . • . . . . . • . . . . . . . . . . • • . . . . . . . . . • . • . . . . . . . . . . • • . • . • . . . . • . . . . . . . ---'-;;._ __ _
3 Total monetary contributions received this period.
· (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, line 1.) ~lDD . ................•............ TOTAL $ __ ;:._ __ _
CUMULATIVE TO DATE
OTHER
(IF APPLICABLE)
..
Schedule B -Part II
Repayments Made on Loans Received, Loans
Forgiven, and Loans Repaid by a Third Party
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE
DATE OF
REPAYMENT
OR
• FORGIVENESS
DATE OF
ORIGINAL LOAN · FULL NAME OF LENDER
Type or print In Ink,
Amounts may be rounded
to whole dollars.
SCHEDULE B • Part 11.
INTEREST
RATE
(If CHANGED)
Statemenyoven period
from i/, ~f"
through I v{ 1 I I~ L Page f
1.0.NUMBER
AMOUNT REPAID OR
FORGIVEN ON PRINCIPAL*
{EXCLUDE PAYMENT OF INTUIHT)
OUTSTANDING
PRINCIPAL
of ,0
INTEREST
PAID
,,~--""-.,, ' .----t------+----------------:---lf----+-----------1-------1-------... _ _,.,,,
,•
<)--i----r--------------1---•-------+----+-----
,(....__....
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
*IMPORTANT: If any part of a loan is forgiven or repaid by a third party, also itemize the transaction on Schedule A,
including the na.me and address of the person forgiving the loan or the third party making the payment, and the amount
forgiven or paid.
TOTAL INTEREST
PAID THIS PERIOD $
(de) •
Enter the ,mount In column (d) In the
summ,,y Jtdlon of Schedule£, line 3. Do
not carry th/1 tot,lto the 1ummary section of
Schedulo 8.
" Schedule B -Part I (Continuation Sheet)
Loans Received
NAME OF COMMITTEE p Pr C'
DATE
RECEIVED
() \ ___ /
LENDER OR GUARANTOR'S FULL NAME AND ADDRESS
(If COMMITTEE, ENTEII FULL NAME, ADDMSS ANO 1.D. NUM!IEll IF NO I.D,
NUMBER HAS BEEN ASSIGNED, ENTEi\ THE TftfASUAEl\'S NAME AND ADDAfSS)
D Lender • Guarantor•
D Lender D Guarantor•
D Lender • Guarantor•
D Lender D Guarantor•
D Lendor D Guarantor•
Type or print In Ink.
Amounts may be rounded
to whole dollars.
LENDER/GUARANTOR'S
OCCUPATION ANO lMPLOYEII (If SELF•
EMPLOYED, ENTU BUSINESS NAME)
•see important instructions on reverse of page 1 of Schedule B, Part I.
,..,.,
SCHEDULE B • Part I (cont.)
Statement covers period
from ,{, I 'fr
through / ,,,f l 1 / (j { Page 7
I.D.NUMBER
LENDER INFORMATION GUARANTOR INFORMATION
DUE DATE/ AMOUNT CUMULATIVE AMOUNT CUMULATIVE
INTEM:ST fl.ATE OF LOAN TO DATE GUARANTEED TO DATE
DUE DATE CAUNDAllYEM CA.LINDAii YEAR
I I
INTER.EST RAU
OTHEII DTHEII .. I I
DUE DATE WENDAii YEAR CAL~NDAII UAII
INTEREST RATE I I
OTHlll OTHlll .. I I
DUE DATE CALENDAII YUA UlENDAll YEAR
I I INTEREST ftATE
OTHIR OTHER .. I I
DUE DATE CAUNDARYE.fJl CA.LINDAii Y!Aft
I I
INTEREST lUTE
OTHfft OTHfll
.. I I
DUfDATf CALENDAR YEAR CAUNDAll YEAR
I I
INTfllUTMTf
OTHfll OTHH
.. I
l•l $ !o lnte, (b) on SUBTOTAL $ -0 lumm•ry h9e,
line lllonl,-.
I.
Schedule B -Part I
Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE P, A . C
e
DATE
RECEIVED
LENDER OR GUARANTOR'S FULL NAME AND ADDRESS
' ' )
(IF COMMITTEE, ENTER FULL NAME, ADDkt:SS AND I.D. NUMDllt If NO I.D,
NUM8fl\ HA5 HEN ASSIGNED, ENTEII THE TR£A5Ullfll'S NAME AND ADOI\ESS)
D Lendor • Guarantor*
D Lender • Guarantor•·
D Lender • Guarantor•
. Type or prlntln Ink.
Amounts may be rounded
to whole dollan.
LENDER/GUARANTOR'S
OCCUPATION AND EMPLOYER (If SELF•
EMPLOYED, ENTER BUSINESS NAME)
Statement covers period
from_l..-_./~1 /~q_,.,..-__ _
1 i-/1, / 'i < through __ ~--~-----
LENDER INFORMATION
DUE DATE/ AMOUNT CUMULATIVE
INTEflfST llATE OF LOAN TODA.TE
OUEDATl CAllNOA" YEAR
' INTEMST RATE
OTHUl
II ' DUE DATE CA.LINDAii YEAR
lNTEAEST RATE ' OTHEII
II ' DUE DATE CALENDAR YEAR
' INTEREST RATE
OTHEII
II
· \iee important Instructions on revene.
loans Received -Part I Summary
SUBTOTAL $
(I)
b 1. Loans of $100 or more received this period. (Include all Loans Received -Part I (a) subtotals.) ••••••.••. $ ______ _
2. Loansunder$100receivedthlsperiod. (Do not Itemize.) ........................................... $ __ ~0:::---
3. Totalloansrecelved this period. (Add Lines 1 and 2.) ....................................... TOTAL $ ___ Q __ , __
Loans Received -Part II Summary
4. Loans of $100 or more repaid, forgiven, or paid by a third party this period. (Include all Part II (c)
subtotals. If forgiven or paid by a third party, a/so Itemize the transaction on Schedule A.) .............. S ______ _
5. Loans under $100 repaid, forgiven, or paid by a third party. (Do no itemize.) If forgiven or
• paid by a third party, include this amount on Schedule A Summary, Line 2. . . . . . . . . . . . . • . • • . . . . . . . . • . . $ ______ _
6. Total loans repaid, forgiven, or paid by a third party this period. ( Q , )
(Add Lines4 + 5.) •••..••... , , , , , , .....•.•..•.•..•.....•.......•....................•..... TOTAL $ ~-~~-~
7. Net change this period. (Subtract Line 6 from Line3.) · Q
• · NIT$ __ ~-~~-Enter the net here and on the Summary Page, Column A, Line 2. . ......................•.......
May bf I n~lllve numbu
SCHEDULE B • Part I·
I.D.NUMBER
GUARANTOR INFORMATION
AMOUNT CUMULATIVl
GUAMNTHD TODAU
CAUNOAII YEA.II
' OTHEII
'
CALfNDAIII YEA.II
' OTHH
' CAUNDAAYl!AII
' OTHEII
'
$ % lnter (bJon
Summa~•••
Line 11 only.
Schedule A (Continuation Sheet)
Monetary Contributions Received
NAME OF COMMITTEE
V.A.C P, foft
FULL NAME AND ADDRESS OF CONTRIBUTOR
Type or print In Ink.
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
(If COMMITTEE. IN ADDITION TO COMMITTEE'S NAMf AND ADDRESS, ENTER I.D. NUMIIER
Oft,, If NO 1.D. NUMBfll HAS BEEN AHIGNED. ENTEII TREASURER'S NAME AND ADDRESS)
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, !.NUii
NAME OF BUSINESS)
C)
SUBTOTAL S
.... ,
SCHEDULE A (cont.)
Statemen cov s period
from -, 'i'J
through l ?111 l &; .) Page of ·w
I.D.NUMBER
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVETO DATE
CALENDAR YEAR
(JAN.1-DEC.31)
CUMULATIVE TO DATE
OTHER
(IF APPLICABLE)
,•
Schedule B -Part Ill .
Annual Report of Outstanding Loans Received
SEE INSTRUCTIONS ON REVERSE
NAMEOFCOMMITT~A-(_. Po ft
FULL NAME OF LENDER ORIGINAL DATE OF LOAN
\
Attach additional information on appropriately labeled continuation sheets.
..
.... ,.,
Tvpe or print In Ink.
Amounts ma)' be rounded
to whole dollars.
AMOUNT OF ORIGINAL LOAN
TOTAL $
UNPAID PRINCIPAL
NOTE: Thlllotalshou/dbe
th, same amount ar entered
on rhe Summary P•ge,
Column C, line 2 .
SCHEDULE B • Part Ill
:il!il1f :i;:J!li)
' Page
I.D.NUMBER
UNPAID INTEREST
Schedule C
Non-Monetary Contributions Received
T~P• or print In Ink.
Amounts may be rounded
to whole dollars.
SCHEDULEC.
Statement covers period
from -,/ / /'Ir
SEE INSTRUCTIONS ON REVERSE through / 'vi?, I I ,f s-' Page_/1? __ of ';).iJ
NAME OF COMMITTEE (),A. C.
DATE
RECEIVED
_j
FULL NAME AND ADDRESS OF CONTRIBUTOR
(IF COMMITTEE, IN ADDfTION TO COMMITTEE'S NAME AND ADDRESS,
(NTlll I.D. NUMllll Oft., If NO I.D. NUMDEII HAS BEEN ASSIGNED,
ENTEII ll\fASUMl\'S NAME AND AOOllUS)
OCCUPATION AND EMPLOYER DESCRIPTION OF
(IF SllMMPlOYED, '""" NAME Df GOODS OR SERVICES IUSINEH)
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Non-Monetary Contributions Summary
FAIR MARKET
VALUE
0
I.D.NUMBER
CU MULA Tl VETO
DATE
CALENDAR YEAR
(JAN. I -DEC. 31)
CUMULATIVETO
DATE OTHER
(IF APPLICABLE)
,• '
' ~ , ~ ..
> ' • • ,' ', • ' ,·
' , : . . ., .
1. Amount received this period-non-monetary contributions of S 100 or more.
(Include all Schedule C subtotals.) ........................ : · ........................................ : ................. S ______ _
2 .. Amount received this period-non-monetary contributions of less than S 100.
(Do not itemize.) ........................................................................................................ S -------
'3. Total non-monetary contributions received this period. re) a
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ....................... TOTAL $ _' _____ _
Schedule D
Enforceable Promises Received (Other than Loan
Guarantees, Loan Endorsements, and Loan Security)
Type or print In Ink. ·
Amounts may be rounded
to whole dollar1.
NOTE: Loan guarantees, loan endorsements and loan security are "enforceable promises• that must
be reported on Schedule B -NOT Schedule D. SEE INSTRUCTIONS ON REVERSE Page I/
I.D.NUMBER
SCHEDULED-
~ of..:;,_ __
DATE
RECEIVED
FULL NAME AND ADDRESS OF CONTRIBUTOR
(IF Cl;)MMITTH, IN ADDmON TO COMMITTH'S NAME AND ADDRESS,
ENHll 1.0. HUMBEi\ 01\. If NO 1.0. NUMSUl HAS If EN ASSIGNED,
ENTEII TREAS UM ft'!, NAME AND ADDftfSS)
OCCUPATION AND EMPLOYER AMOUNT PROMISED AMOUNT PAID
THIS PERIOD
(ALSO ENTU\ ON
SCHEDULE A)
CUMULATIVE TO DATE CUMULATIVE TO
(If SEU-EMPLOYfD,ENTlft.NAME Of THIS PERIOD
BUSINESS)
CALENDAR YEAR DATE OTHER
(JAN. 1 • DEC. 31) (IF APPLICABLE)
.-
-----------·,ttach additional Information on appropriately labeled continuation SUBTOTALS $
...iteets.
• > • • • .,, • " ' "
Enforceable Promises Received Summary 0
1. Promlsesreceived ofS 100 or more this period (Column (a)). . ..................... S ------
2. Promises received under S 100 this period.
(Do not itemize.) ................. ; ....•.......•.....•.......•.........•..... S ------
3. Total promises received this period.
(Add Lines 1 and 2.) .................................................. TOTAL $ ------
4. Payments received on promises of $100 or more this period.
(Column (bl). . .................................................................................. S -----
5. Payments received on promises under S 100 this period.
(Do not itemize. Also include on Schedule A Summary, Line 2.) .........•.............•.............. S _____ _
.6. Total payments received. S ( ~ )
(Add Lines 4 and 5.) . .. . . . . • .. . • • • • • • .. • . . . . . • . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . • . • • . . . . . TOTAL
7. Net change this period. (Subtract Line 6 from Line 3. Enter the difference here and on
theSummaryPage,ColumnA,Line6.) ........ ~\ ..............•.................. _ ........... NET S--,----,-
M•r ~ • neg1Uvt m,~r.
Schedule E
Payments and Contributions
(Other Than Loans) Made
SEE INSTRUCTIONS ON REVERSE
NAMEOFCOMMITTEE n
rf\(. of
Tvpe or print In Ink.
Amounts mav be rounded
to whole dollars,
CODES FOR CLASSIFYING EXPENDITURES
SCHEDULE E
Statement covers period
from '"J), !fr
through ,;/},/ fiJ Page / '2--~ of __ _
I.D.NUMBER
If one of the following codes accurately describes the expenditure, you may enter the code and leave the "Description of Payment• column blank. Refer to the
back of Schedule E-Continuati.on Sheet for detailed explanations of each category.
,•c• -MONETARY AND IN-KIND (NON-MONETARY)
,I CONTRIBUTIONS TO OTHER CANDIDATES
AND COMMITTEES
•1• . -INDEPENDENT EXPENDITURES
"L" -LITERATURE
"B" -BROADCAST ADVERTISING
"N" -NEWSPAPER AND PERIDDICALADVERTISING
•o• -OUTSIDE ADVERTISING
•s• -SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS
"F" -FUNDRAISING EVENTS
"G" -GENERALOPERATIONSANDOVERHEAD
"T" -TRAVEL,ACCOMMODATIONSANDMEALS
(MUST BE DESCRIBED)
•p• -PROFESSIONALMANAGEMENTANDCONSULTING
SERVICES
,•
NAME AND ADDRESS OF PAYEE, CREDITOR,OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OFTHE SUMMARY SECTION BELOW. (If COMMITTH, IN ADDnlOH 10 COMMrrTH"S NAME AND ADDIV:SS, INTEII 1.D, NUMIHI OR. If NO I.D,
NUMllll HAS HIN ASSIGNID, INTH, TU:ASUltlllt'S NAME AND ADDftl!SS)
CODE OR DESCRIPTION OF PAYMENT
tv,u. ~Le,~n•~• fQ'/l l'\A-'t oil
un ()Pr)'eO El,.. }'\ ~ 11\-0 Cl 1t . G () l'r\.,M SPt-1-..>GS, CPI ~'),"). Cc "l--
.::J'\::."'ANtve ~-~1ve~1#v {-b(l Co ...... ,; I
Cf'Jo-A ft'tl.ve,..e' • ~ ~I'll.,~ S(>t.,....,<.~, CA-~l,.:,...&2,.. -
'~~ ~M. .... 1::5 n"1i-C.-..C,\ .,)
, \ ST" e; VI-, 01,,) -lt,(,0 \ G-~ A-,.M. S'~f.11\l <,(, Q\,-~')I.).(.. "'L..
Important: Contributions and e1tpend1tures made out of campaign funds to or on behalf of officeholders,
candidates, committees, or ballot measures must also be entered on the Allocation Page.
Payments and Contributions Made Summary
AMOUNT PAID
s-oo~
5DD l>C -
.)1JP c;>'C
SUBTOTAL $ I !lu D
-:lOD-0 1. Payments made this period ofS100 or more. (Include all Schedule E subtotals.) ...................................................... S -'------
<) 2. Paymentsmadethisperiodofunder$100. (Do not itemize.) ..•..•..•.. _ ............................................................ $ _____ _
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) •••.•.••..•........••••••••... s ___ D ___ _
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) .•.....••.....•...................... S ___ D __ -=_
5. T.otal payments made this period. (Add Lines 1, 2:3, and 4. Enter here and on the Summary Page, Columri A, Line 8.) ........... TOTAL S ':l-ODO ~
-
Schedule E
(Continuation Sheet)
Payments and Contributions
(Other Than Loans) Made
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE
·c· -MONETARY AND IN-KIND (NON-MONETARY)
CONTRIBUTIONS TO OTHER CANDIDATES
AND COMMITTEES
·e· -
•N• -
·o•.-
Tvpe or print In Ink.
Amounts mav be rounded
to whole dollars.
CODES FOR CLASSIFYING EXPENDITURES
BROADCAST ADVERTISING
NEWSPAPER AND PERIODICAL ADVERTISING
OUTSIDE ADVERTISING
Statement covers period
from '7 / ' / fr , I
through I z-/'"JI fr
SCHEDULE E (cont.) .
Page t'} of ~
I.D.NUMBER
"G" -GENERALOPERATIONSANDOVERHEAD
"T" -TRAVEL,ACCOMMODATIONSANDMEALS
(MUST BE DESCRIBED)
·1· -INDEPENDENT EXPENDITURES
•t• -LITERATURE
·s· -
•F• -
SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS
FUNDRAISING EVENTS
•p• -PROFESSIONALMANAGEMENTANDCONSULTING
SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
(IF COMMITTEE, IN ADDITION TO COMMITTEE'S NAME AND ADDI\HS, ENTEII 1.D. NUMBER Oft. If NO 1.D.
NUMIEI\ HAS IEEN ASSIGNED, ENTlll 11\lASUMR'S NAME ANDADDI\HS)
AMOUNT PAID CODE OR DESCRIPTION OF PAYMENT
~o(} l,~ fv-<t. (.p.ii..c. i I .
tt.:io IAJDf ,\' ,._, ,W,.-L <... G-51)0~ t)~ 5pe,1..-6S 1 U\ '\ ').. ")..lt 1-
·,
I
I
·-..
"','I SUBTOTAL S .Q)O qg_
·schedule F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE PAc () .po it
Tvpe or print In Ink.
Amounts may be rounded
to whole dollus.
CODES FOR CLASSIFYING EXPENDITURES
SCHEDULE F
Statement covers period
from ?/ t /1r I
through t i-(11/9' L Page · /'-( of · 2-b
I.D.NUMBER
· If one of the following codes accurately describes the expenditure, you may enter the code and leave the "Description of Payment• column blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations of each category. .
'-,.
1 -MONETARY AND IN-KIND (NON-MONETARY) "B• -BROADCAST ADVERTISING
CONTRIBUTIONS TO OTHER CANDIDATES
AND COMMITTEES "N" -NEWSPAPERANDPERIODICALADVERTISING
•o• -OUTSIDE ADVERTISING
"G" -GENERALOPERATIONSANDOVERHEAD
"T" -TRAVEL, ACCOMMODATIONS AND MEALS
(MUST IE DESCRIBED)
•1• -INDEPENDENT EXPENDITURES
"L• -LITERATURE
•s• -SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS •p• -PROFESSIONAL MANAGEMENT AND CONSULTING
SERVICES • F" -FUNDRAISING EVENTS
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION IMPOIITANf1 DO NOT ITIMIU THE PAYMINTOf ACCkUED IJIPENSES ON SCHEDULES I OR f. MPOI\T ONLY THE LUMP SUM OF PAYMENTS
(V COMMITTEE, IN ADDITIOHTO COMMITTEE'S NAME AND ADDI\ESS, ENTllll.D. NUM!lfll Oil, If NO 1.0. ON SCHEDULE f, llNE 4 AND ON SCHEDULE I, LINE 4. 00 NOT M-nlMIZE ACCIIUID IXPENHS IUPOI\UD IN A PI\EVIOUS PEllllOO.
NUl-'IEII HAS, IEEN ASSIGNED, ENTtll TUASUl\fll'S NAME AND ADDl\fSS)
CODE OR DESCRIPTION OF OUTSTANDING PAYMENT AMOUNT ACCRUED
)
..
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL S
Accrued Expenses Summary
1. Accrued expenses this period ofS 100 or more. (Include all Schedule F subtotals.) ...... .-.............................................. S _____ _
2. Accrued expens!!S this period of under $100. (Do not itemize.) ..................................................................... $ _____ _
-0 3. Total accrued expenses Incurred this period. (Add Lines 1 and 2.) .. . . . .. . .. .. .. .. . .. . .. .. .. .. .. .. . .. .. . . . .. .. .. . . . INCURRED TOTAL S ---=---
4. Total accrued expenses paid this period. (Do not itemize. Enter here and on Schedule E Summary, Line 4.) . . . . . . . . . . . • . . . . . PAID TOTAL S J( __ -0 ___ ~)
5. N!!t change this period. (Subtract Line 4 from Line-3. Enter the difference here and on tt,e Summary Page, Column A, Line 11.) ...... NET S _____ _
·schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of a Committee)
SEE INSTRUCTIONS ON REVERSE
NAMEOFCOMMITTEE PA'( r>F
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Tvpe or print ln Ink.
Amounts m•v be rounded
to whole dollars.
CODES FOR CLASSIFYING EXPENDITURES
Statement cov rs period
from ,r'f
through _ _,_/ '-'-+-{..,11'-l/"--"i_,,f.__
SCHEOULEG
P1g1 / r'° of l'{)
I.D.NUMBER
lf_o __ ne of the following codes accurately describes the expenditure, you may enter the code and leave the "Description of Payment• column blank. Refer to the
. hack of Schedule E-Continuatlon Sheet for detailed explanations of each category.
'
' )
.
"L" -LITERATURE
"B" -BROADCAST ADVERTISING
"N" -NEWSPAPER AND PERIODICAL ADVERTISING
•o• -OUTSIDE ADVERT!SING
•NAME AND ADDRESS OF PAYEE OR.CREDITOR
(lf COMMml(, IN ADDITION TO COMMITTEE'S NAME AND ADDA.EH, INTER I.D. NUMIIEflOA. If
NO 1.D, NUMIUlHAiS IHN ASSIGNED. ENTER TREASUAlll'S NAME AND AD DAUS)
•'
•s• -SURVEYS, SIGNATURE GATHERING, OOOR-TO•DOOR SOLICITATIONS
"F" -FUNDRAISING EVENTS
"T" -TRAVEL, ACCOMMODATIONS AND MEALS
(MUST IE DESCRIBED)
CODE· OR DESCRIPTION OF PAYMENT
I
Attach additional Information on appropriately labeled continuation sheets . ..... ~ TOTAL*
AMOUNT PAID
s 0
• Do nor lr•nsfer 10 •ny otMr J<Mdu/e or lo IM Summ•ry P•g•. This tot•/ m•y nor equ•l tM •mount paid lo tM agent or Independent contr•ctor •• reported on Schedule Eby tM committee.
Tvpe or print In Ink. Schedule H -Part I
Loans Made to Others Amounts mav be rounded
ta whale dollars. Statem nt cavers period
from 1 ( 'if"
SEE INSTRUCTIONS ON REVERSE. through I ?1 JI / 'I er--
NAME OF COMMITTEE
DATEOFLOAN
()sPo f-\
FULL NAME AND ADDRESS OF RECIPIENT
(If COMMITTEE, IN ADDrTION TO COMMITTEE'S NAME AND ADDRESS, ENTER I.D. NUMBER
Oft. If NO 1.0. NUMIElll HAS DEEN ASSIGNED, ENTEII TkEASUREll'S NAME AND ADDRESS)
,•-1,.ns Made to Others -Part I Summary
INTEREST RATE DUE DATE
SUBTOTAL S
. •oans of $100 or more made this period. S
-'(Include all Loans Made-Part I subtotals.) , ..............••......•...•.••......••.•...•.•••..••••••.•• , ------
2. Loans under $1_00 made this period.
(Do not Itemize.) ••......•.•......•••............•........•.•....•....••...... ; •.••.•...•.•••••....... S _____ _
3
• [t~~I lr~:: ta~~e ::sis !~~i~--....•.•••.••.•..............•..........•.....•.••....•.... · ·.; ..... TOTAL $ __ -_C) ___ _
Loans Repayments Received -Part II Summary
4. Payments received on loans of $100 or more. (Include all loan payments received and all loans of $100 or more
wliich have been for~lven by this committee -Part II (a) subtotals. S
lfforgiven, a/so itemize on Schedule E.) . . • • . . . . . . . . . . . . . . . . . . . . . . . . . . . • • • . . . . . . . . . . . • . • . . • • . . . . • . . . . . . • --~---
5. Payments received on loans under S 100. ·
(Including a forgiveness. Do not Itemize.) ....••..........•................•.........•.••....•.•.....••. S ---=---!!-Total loan payments received this period. :::0
(AddLlnes4and5.) ••.....•••.....•..••••.•..•...•••............••..••.•..•.•..•.••....••.••• TOTAL$..,('-___ ..._)
7. Net change this period. (Subtract Line 6 from Line 3. b-
E!"ter the net here and on the Summary Page, Colamn A, Line 9.) •...........•.........•...••....... _.. NET S __ -_c;, ___ _
May~ 1 n~•tlve nurnb@r.
SCHEDULE H, Part I .
Page Ii.
I.D.NUMBER
AMOUNT ·
.•.
a
Schedule H -Part I
Loans Made to Others
(Continuation Sheet)
NAME OF COMMITTEE
FULL NAME AND ADDRESS OF RECIPIENT
Type or print In Ink.
Amounts may be rounded
to whole dollars.
DATEOFLOAN (If COMMITTEE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, ENTER 1.0. NUMDEI\
OR. If NO I.D. NUMl[II HAS IHN ASSIGNED, ENTEi\ TI\EASUI\Ell'S NAME AND ADDI\US)
'°";'/"
.--------,---St ate me nt covers period
from 1/1/Qr
through
1
1'11( 1, r 'il
INTEREST RATE DUE DATE
SUBTOTAL $
SCHEDULE H • Part I (cont.) •
Pago \J of ~
I.D.NUMBER
AMOUNT
,•'
Schedule H -Part II Type or print In Ink. SCHEDULE H -Part II
Loan Repayments Received on Loans Made
to Others (Including Payments Received
from Third Parties) and Loans Forgiven
Amounts may be rounded
to whole dollars. Statement covers period
from 1(// ', J
SEE INSTRUCTIONS ON REVERSE thr~ugh I 21 }1 / 9l° ·19
Page O of 2-C>
NAME OF COMMITTEE
DATE OF
REPAYMENT OR
FORGIVENESS
• I -_,
PAc.
DATE OF
ORIGINAL
LOAN
o-r
FULL NAME OF RECIPIENT OF LOAN
Attach additional information on appropriately labeled continuation sheets.
INTEREST
RATE
llfDtANGEDJ
SUBTOTAL $
AMOUNT REPAID OR
FORGIVEN ON PRINCIPAL*
(E>cCLUDE IUCEIPT Of INTEltfST)
I
*IMPORTANT: If any part of a loan is forgiven, also itemize the forgiveness on Schedule E. If a repayment is received from a
third party, enter the name and address ofthird party in the -FuiL NAME OF RECIPIENT OF LOAN" column above, along with the
name of the recipient of the loan.
I.D.NUMBER
OUTSTANDING
PRINCIPAL
TOTAL INTEREST $
RECEIVED THIS PERIOD
INTEREST
RECEIVED
Enter the amount In column (b) In the
,ummo,y sect/on of Schedule I, Une 3. Do
not c•rry this tot•I to the summary section
of Schedule H.
. . '
Schedule H -Part Ill
Annual Report of Outstanding Loans Made
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE P, A .c ..
FULL NAME OF RECIPIENT OF LOAN ORIGINAL DATE OF LOAN
T~pe or print In Ink.
Amounts ma~ be rounded
to whole dollars. Statement covers period
from J{1(9£"
through n,{ ,,( q L
AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL
SCHEDULE H-Part Ill
Page t "i' °' ~o
I.D.NUMBER
UNPAID INTEREST
;------------------t--------t---:--------+--------+--------
,••
-~. ( ,,~------------------t---------+-----,.-----t-----------il---------_ _,,.
Attach additional Information on appropriately labeled continuation sheets. TOTAL $
·'
o-
NOTE: Thlrtolllshouldbe
the same amount ,s entered
on the Summi1,y P•ge,
Column C, line 9.
---------
. . ..... '
Schedule I
Miscellaneous Increases to Cash
Type or print In Ink.
Amounts m1v bl rounded
to whole dollars.
SCHEDULE I '
Statement covers period
from -~Z{~•~f_,_$" __ _
'Z. 0 SEE INSTRUCTIONS ON REVERSE through I i,I. '\ I ) '1 S'" Page
NAME OF COMMITTEE P, -~-C. I.D.NUMBER
DATE
RECEIVED
or
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE, IN ADDITION TO COMMITTEE'S NAM[ AND ADDI\ESS, ENTUi't.D. HUMBEi\
If NO I.D. NUM!IU HAS IEEN ASSIGNED, ENTER TREASUNR.'S NAME AND ADDftlSS
DESCRIPTION OF RECEIPT AMOUNT OF
INCREASE TO CASH
.----+----------------------------+-----------------+-------'-------·,
I
j
Attach additional information on appropriately labeled continuation sheets.
Miscellaneous Increases to Cash Summary
SUBTOTAL S
1. Increases to cash of$100 or more this period. . . . . . . .. . . . . . . . . . . . . . . . . . . . . • . . . . . . . . • . . . . . . . . . . . . . . . . . . . • . . . . S ______ _
2. lncreasestocashunderS100thisperiod. (Donotltemize.) .•............... ; ......•......................... s _____ _
3. Total of all Interest received this period on loans made to others. (Schedule H, Part II (b).) . . . . . . . . . . . . . . . . . . • . . S --=----
4. ~~~~~~c~~:~.e~~~ir~~)e~~~s-~~ ~~~~-t-~i~ ~-~r~~: /~~~ -~i~~s. ~•-~•-~~~-~--~-~t~.'-~~~~ ~~-~ ~~-~~~ ........... JOTAI; S -=10±:r:-:__
✓
_/
/
.-
Amendment to
Campaign Disclosure Statement
Type or print in ink Date-Stamp
AMENDMENT
This form must be used to amend statements filed pursuant to Government Code Sections B4200-84216.S, and must be filed with all
filing otfic_ers who received the statement being amended. NOTE: Do not use this form to amend a Statement of Organization, Form
RECEIVED
JAN 16 1997
CITY CLERK
4 10, Candidate Intention, Form 501, or a Campaign Bank Account, Form 502. Use the actual Form 41 0.501 or 502, respectively, to make
amendments.
The information required in Part I must correspond lo the information provided on the campaign statement being amended.
Name of Filer (Seeim ortantinformationonreverse.
NAME O(Fli.ER l,f, cql ;1-q_-1i'o >') Co.WI n, jf-fe I.D. NUMBER
(lf APPLICABLE}
VF t!tr:. f'q/,,,,· Sfr,r'>J 5 ft i e sSl!Ciq-l-16~ ~s S'f I
MILING ADDRESS OF FILER . ---
200 S. c.,vic / fO-½ /&7/
CITYq,
1
_ '
rr,. ,, ser,,,~s
STATE ZIP CODE
AREA CODE/DAYTIME PHONE NUMBER
Cr:, 1C/) 3 z '2,,-'?II I,,
NAME DF TREASURER IF RECIPIENT COMMITTEE
::](oo STua,T
PERMANENT ADDRESS OF TREASURER: (IF APPLICABLE) (NO. AND STREET)
.2oo s. c; i1,c: / lo -&~ /6?/
STATE ZIP CODE
7?2-C,_5
AREA CO~E/DAYTIME PHONE NUMBER
(/41r J 32:~-81i1o.
Ve rifi cation (See important information on reverse.)
II Amendment Information
A. The following information amends campaign disclosure
statement, Ferm No. '(,PO ,
executed on /~/z/95 · for the period 7-/-9 5 through
(MO. DAY, YFL) (MO, DAY, YR.}
B. The amended information affects items on the:
/';?.-31-9.5
(MO, DAY, YR.)
D Cover Page O Allocation Page ~Summary Page
[S"schedule{s) _l}_·_J:. ______ _ D Part{s) ----------
C. Describe the changes below. Include in detail all information you wish to
become a part of your official campaign statement. Please attach a cover
page, summary page and/or appropriate schedule(s) to this Form 405 if ·
necessary for clarification. Include additional information on appropri-
ately labeled continuation sheets. (Number of sheets attached. ---.)
Co,<-e.e,-t'" Co1.1 f-,-/ but-1'on· 7o,ftl.L5 .,. C.o.s/i ba./q,7a.s.
I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the information contained herein and in the attached schedules is
true and complete. I certiiy under penalty of perjury under the laws of the State of Cal. ifornia that the foregon is true and correct.
Executedon I I 11,J 't7 At p1*,\n,:,,S6?J,1r,1/,S, CB By _,-<.o,.,)al(i2=PG<••o ~c,.. st I DATE CITY ANolTATE 'itGNATURE Of TREASURE!\ ORHLER
Officeholder, candidate, state measure proponent, or sponsored committee responsible officer verification: I have used all reasonable diligence and to the best of my knowledge the treasurer
has used all reasonable diligence in preparing this stlltement. I have reviewed the statement and to the best of my knowledge the information contained herein is true and complete. I certiiy
under penalty of perjury under the laws of the State of California that the foregoing is true and correct. ·
Executed on At By
DATE CITY ANO 5TATE SIGNATURE Of OfflC'EHOLOER. CANDIDATE. PROPONEN1, OR RESPONSIBLE OFFICER
Executed on At By
DATE CITY AND STATE SIGNATURE Of OFFICEHOLDER, CANDIDATE, OR PROPONENT
Executed on At By
DATE CITY AND 51 A TE SIGNATURE 0, OfFICEHOLDER. CANDIDATE.OR PROPONENT
IOll.1NfORMATION l'l(QUIRED 10 DE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT Of 19'77. SEE 1NfORMATION-MANUAL ON CAMPAIGN DISCLOSURE PROVl510N5 OF TH( POLITICAL RH ORM ACT.
Recipient "committee
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE /
oli /-1 c..o. L f!c-t-'!D ('\
Contributions. Received
·,
Type or print In Ink.
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PEI\JOD
(fl\OM ATTACHED SCHEDULES)
)., Monetary Contributions .......•............•.......... S<heduleA,Une3 S _ _..,2""8"'3=0 _____ _
, ,'Loans Received ..•....................•...•....... :..... ScheduleB,Unel 0
3. SUBTOTAL CASH CONTRIBUTIONS ...................... AddUne•.I +2 s _3:;..:ag...;1,'-0_, ____ _
4. Non-monetary Contributions ......................... Schedule C, Une 3
5. SUBTOTAL CONTRIBUTIONS ~xc/ude Enforceable Proml•e•> AddUneJ3 +4 s 3°830
6. Enforceable Promises . D
(Exclude Loan Gu•rantees, Une 18 below) ................... khedulo D, Une 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddLlne,s + 6 s 333D
. · Expenditures Made
8. Cash Payments (Other than Loans Ma.de) . . . . . . . . . . . . . Schedule E, Une s S -~2~o~o~o-~--~~
9. Loans Made ................. ·,·.......................... Schedule fl, Une 7 0
10. SUBTOTAL(:ASH PAYMENTS ...........•....•........... AddUne,B + 9 s -~k=Q~O_O ____ _
11.-Accrued Expenses (Unpaid Bills) .......... :............. scheduleF,UneS ---"-•------
• •~ TOTAL EXPENDITURES MADE ............•............ AddUne,10 + 11 S -=Zi_o_b_o _____ _
~-rrent Cash Statement
13. Beginning Cash'Balance ....•..........•.. Prevlou,summaryPage,Une il·
14. Cash ReceipU ...•.......•..•....................... ColumnA,Une3above
15. Miscellaneous Increases to Cash . . . . . . . . . • . • • . . . . . . . . . . . schedul• 1, Une 4
16: Cash Payments . . . . • . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . Column A, Line 10 above
17. ENDING CASH BALANCE ..... Add Line, 13 + 14 + 15, then,ubtraetUne I~
rt this IJ a term.ination Jtat,ment, Une 17 mu.st be zero.·
18. LOAN GUARANTEES RECEIVED . . . . . . . . . . . . . . Schedule B, Part I, Column (b)
s Sos1!
/0 "3
2000
S b'1'1\. -~-------
EN 01 NG CASH llAlANCE SHOULD
NOT SE A NEGATSVEAMOUNT
s ___ 11+-,/,_'4 ____ _
Cash Equivalents.and Outstanding Debts
19. Cash Equivalents ..............................•. SeelnJtruetion,onrevene S ___ ,r-1_/_,1 _____ _
20. Ouutanding·Debu ······•·····•·•·· ·AddLlne2 + Line lllnCofumnCabove s __ ,r,.,_/r't-~----
s
·S
statement covers period
from 7-1-'fS
ihrough /J-3 r-f J"'
ColumnB*
TOTAL PI\EVIOUS PERIOD
CSEE NOTE BELOW)
.s,ostr·
0
St>.58
2>
s . soss·.
7)
s 5oS8'
s
s
s
SUMMARY PAGE'
Page '/
LO.NUMBER
5·/~1/J
ColumnC
TOTAL Tb DATE
CADD COLUMNS A • D)
s zg~g-
0
S' ~ggg
s _,::.8',:::.,8'8':c_e( ___ _
$ 2000
s 2,oou
s fl. t;Of) ·
• From previous Statement.Summary Page; Column C. f:iowever, if
this is the first report filed for the calendar yea"r, Column a.should be
blank except for Loans Received (Line 2), Enforceable Pron,ises (Line
6), Loans Made (Line 9), arid Accrued Expenses (Line 11).
Summary for Non-Controlled Committees
Primarily Formed to Support or Oppose
Candidates in Both June and November
Elections 1/1 through 6/30 7/1 to Date
21. Contributions 0 Received . . . . s ---'=<----
;.oDO·
r~ •'
Schedule I
Miscellaneous Increases to Cash
Type or print In Ink.
Amounts may ~ rounded
to whole dollars. Statement covers period
from 7-J-'ls'
SCHEDULE I
SEE INSTRUCTIONS ON REVERSE through /.;;I· 31-'iS Page __ .;1..__ of 2
NAME OF COMMITTEE . I.D.NUMBER
~
DATE
RECEIVED
.,'jihs
To
i1-h1/15
;,-" '\
FULL NAME AND ADDRESS OF SOURCE
(If COMMITTEE, IN ADDITION TO COMMITTEE'S NAME AND ADDI\ESS, ENTER 1.0. NUM9EI\
0 If NO 1.0. NUMBER HAS BEEN ASSIGNED. ENTER TI\EASUIII.Eft'S NAM£ AND AODI\ESS
fe.lfl'I :Sfr,11rs ere ;-/-u '1l011
f.o. .fut-q J'1 I
P ~ 9-z,u3
DESCRIPTION OF RECEIPT AMOUNTOF
INCREASE TO CASH
s.
.,, ____ f----------'---------------------+------------------11----------.____.J
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Ji>'!>,
Miscellaneous Increases to Cash Summary
1. Increases to cash of $100 or more this period. . ............................................. ·: ....•.......... $ _~J~o~.?,~~--
2. Increases to cash under.$100 this period. (Do not itemize.) ..............•................................... $ -------
3. Total of all interest received this period on loans made to others. (Schedule H, Part II (b).) ······················s ____ _
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the /O 2 Summary Page, Line 15.) ......................................................................... TOTAL $ -~'"----
·-
.., •·· -
' '·
Schedule A
Monetary Contributions .Received
Type or print In Ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from ?-/-?.>
SCHEDULE A
SEE INSTRUCTIONS ON REVERSE through I 2.-:JI-l J Page·· 3 ot 3
NAME OF COMMITTEE I.D.NUMBER
C ion e0t'IM\+~e.. ~ '-r/,,e. ~).., . S-1'6</,
. DATE
RECEIVED
FULL NAME AND ADDRESS OF CONTRIBUTOR
CIF COMMmn. IN ADDITION TO COMMITTEE'S NAME AND AODI\ESS, ENTER 1.0. HUMBEi\
. 01\, II NO I.D. NUMBEJI. HAS eEEN ASSIGNED, ENTU TI\EA.SUJI.El'\'S NAME AND ADDRESS)
OCCUPATION AND EMPLOYER AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN.1-DEC.31) ,·
l
_Monetary Contributions Summary
(IF SELF-EMPLOYED, lNTEI\
NAME OF IUSINUS)
SUBTOTAL $
1. Amount received this period~ contributions of $100 or more. . -· .3€2.o
(Include all Schedule A subtotals.) .......................................•......................•.............. $ -=-'~~--
2. Amount received this period-contributions of less than $100. $
(Do not itemize.) .•...............................•..... • ... • • • • • • • • • ~ • • · •.• • · • • · · · · · · · · · · · · · · · · · · · · · · · · · · · · · -------
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $~3~8~=0~--..............................
CUMULATIVE TO DATE
OTHER
(IF APPLICABLE).
l
';?a(e;:;-,~nt of Or~anizatio~
Recipient Committee
WHERE TO FILE: ~-------S_TA_TEMENT OF ORGANIZATION
(Government Code Sections 84101:941_03)
Type or print in ink
SEE INSTRUCTIONS ON REVERSE
Committee Information
Date Qualified as
Committee (Month, Day. Year)
Amendment
D Check. box if an Amendment
and enter I.D. number:
II
File original and one copy of this form with:
Secretary of State
Political Reform Division
P.O. Box 1467
Sacramento, CA 95B12-1467
And, if applicable, file one copy of this form with:
The city or county officer, if a11y, who receives the
committee's original campaign disclosure
statements.
Date Stamp
RECEIVED
OCT 2 r.; 1995
CITY CLERK
ll·Treasurer and Other Principal Officers.
~ Check box if not yet qualified
NAMf,OFTREASURER
Kt>µP\\..,l) Sl\J Mt, I
For Official Use Only
1---'?~AMEOFCOMMI_TT~E r;..
0
C
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ADDREssoFcoMMITTEE (NOTP.o Box)NO.ANDSTREET 5 · Vln...M <;'()~ 1N~s I c A '1).:2.<.3 (A~ -J),,J-;/JS 7
;l 00 5. C[ t/L.( 0~ P. Q. 1)~ / (, 71 NAMEANDPOSITIONOFOTHERPRINCIPALOFFICER(S)
Cl}i'
YA-LM
COUNTY OF DOMICILE
R \,ve-e..S IQ~
STATE ZIP CODE AREA CODE/ PHONE NUMBER
CA 'i').J. <.J C.l')' -3:Z.3-8'1 IL.-
COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
MAl~NG ADDRE!i (IF DIFFERENT) NO. AND STREET OR P.O. ~ox
y. o. 1)-ox. e t ~ 7 , ,
CITY OJ\.-, · CI} 0 • ~ ,.SJ.l"TE ZIP CO~ AREA CODE/ PHONE NUMBER
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MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE
'I•.
Attach additional information on appropriately labeled continuation sheets.
"1 Disposition of Surplus Funds You must specify what disposition will be made of leftover campaign funds, if any, at termination .
._,, 1--)u M.u t-..ie"f · lv \ l 1.... {)Q" l.J.:::---Ff'l>\I\:~ / fhv'1 LAl,\)AA. u S E"
IV Verification
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 ~f perjury under the lawQ ofthe State of California that the foregoing is true and correct. .
Executedon I0-9'.'t~ At f>n.W-. S°'1R..w~S Cflr By ·
Executedon £0-~.ti,--. At p~ <;:pi~N,( C;.f->J-By __ ~=~'-"'=~4'~===-====~::,,..,,,:.,=..,o:=:,:,=.!....:.!..
OAT[ CITY ANO STATE
Executed o At By
OAT[ CITY ANO STATE ' \1 ' \
Executed on At By
DAlE CITY AND STATE
SIGNATURE OF CONTROLLING OFFICEHOLOER,CANOIDATE,OR STAT[ MEASURE PROPONENT
SIGNATURE Of CONTROLLING OFflCEHOLDER, CANDIDATE, OR STAT£ MEASURE PROPONENT
~OR INFORMATION !\[QUIRED TO BE PROVIDED TO YOU PURSUANTTOTHE INfORMATION PRACTICES ACT Of 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS Of 1:HE POLITICAL REFORM Ag.
State of California Fair Political Practices Commission
.... ·---. ...
St~te
0
m~nt of Or~anization ·
Recipient Committee
Typ~ or print in ink
NAME OF ~MMITTEE
·yo 1,..1, 11( Pc\,.
STATEMENT OF ORGANIZATION
Page 2
1.D. NUMBER (IF AMENDMENT)
V Type of Committee Completing This Statement: COMPLETE THE APPLICABLE SECTION(S). MORE THAN ONE CATEGORY MAY BE APPLICABLE TO YOUR COMMITTEE.
SEE REVERSE FOR IMPORTANT INFORMATION AND DEFINITIONS OF THE COMMITTEES LISTED BELOW.
I Controlled Committee I
,..,r,• If this committee is controlled by one or more officeholder(s) or candidate($), list the name, of each controlling officeholder or candidate. Also list the elective office sought or held, and district
number, if any, for each Individual. ·
• If this committee is controlled by one or more officeholder(s) or candidate(s) for partisan office, list the political party with which each officeholder or candidate Is affiliated. An officeholder or
candidate not holding or seeking a !)artisan office must indicate "non-partisan."
• If this committee is controlled by a state measure proponent, list the name of the state measure proponent. If this committee is controlled by more than one state measure proponent, list the
name of each state measure proponent. ! ·
• If 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/COMMITTEE PARTY ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE)
I Primarily Formed Committee If primarily formed to support or oppose specific candidates or measures, list the candidates or measures below: -,
CANDIDATE'S OFFICE SOUGHT OR HELD OR MEASU~E'S JURISDICTION
CANDIDATE'S NAME OR MEASURE'S FULL TITLE (INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
I i SUPPORT OPPOSE
' SUPPORT OPPOSl
•
,. General Purpose Committee I
• .J,Jf not formed to support or oppose specific candidates or measures, check ONE box to indicate if this is a: ~ CITY Committee or ~ COUNTY Committee or • STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
S onsored .Committee Provide the na~e and address of the sponsor. If the committee has more than one sponsor, provide names and addresses on appropriately labeled attachment.
NAME OF SPONSOR:
ADDRESS OF SPONSOR: NO. AND STREET CITY
Broad Based Committee I
STATE ZIP CODE
INDUSTRY GROUP OR AFFILIATION OF
SPONSOR:
If this is a broad based committee and wishes to make contributions to candidates in excess of the $2,500 contribution limit in connection with a special election, check the box below and enter the
date on or before which the committee qualified as a broad based committee. (If the committee is not a broad based committee, or does not wish to make contributions in excess of the S2,500 limit,
do not complete this section.)
·O Check box if this is a broad based committee. Enter the date on or before which the committee qualifiCd as a broad based committee: fMqnlh, Day, Year)
D Check box lf this committee no longer qualifies as a broad based committee.