460 First Pre-Election Recipie-ht Committee
Campaign Statement
(Government Code Sections 84200-84216.5)
Type or print in Ink.
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from ~//ol =I
through ~/~/0 1
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and7.
Date of election if applicable
(Month, Day, Year)
Date Stamp
oCT 0 1 2001
2. Type of Statement:
COVER PAGE
'[~[, Officeholder, Candidate
Controlled Committee
(Also Complete Pa~t 4.)
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(Also Complete Paff 5.)
[] Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 6.)
[--I. General Purpose Committee
O Sponsored
O Broad Based
I~ Pre-election Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Pre-election
Statement - Attach Form 495
3. Committee Information
COMMii I t:E NAME
I.D. NUMBER
STREET ADDRESS ~0 P.O. BO~ ~
C~ STATE ZIP C~E
AREA CODE/PHONE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZiP CODE AREA CODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
Treasurer(s)
NAME OF TREASURER
MAILING ADDRESS "'
CITY STATE ZIP COOE
ER, IF ANY
MAIUNG ADDRESS
CITY STATE ZiP CODE
OPTIONAL: FAX/E-MAIL ADbRESS
AREA CODF_./PHO~E
AREA CODF_JPHONE
FPPC Form 460 (8/99)
For Technical Assistance: 916J3?..2-SSGO
State of California
ecipient committee
'campaign statement
cover Page -- Part 2
Type or print in ink.
COVER PAGE - PART 2
4. Officeholder or Candidate Controlled Committee
NAME OF OFFIC<EHOLDER OR CANDIDATE
PAI'/
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRIC~T NUMBER IF APPLICABLE)
RESIDENTIAI:?BUS INESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: Llstanycommitteee
not Included In this consolidated statement the t ere controlled by you or which are primarily
formed to receive contributions ar to make expenditures on behalf of your candidacy.
COMMII-I'EE NAME I.D. NUMBER
NAME O~' mEASURER CONTROLLED COMMITTEE?
[] YES [] NO
COMMI11'EEADDRESS STREET ADDRESS (NO P,O, BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
7. Verification
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR L*-I I ER JURISDICTION [] SUPPORT
[] OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
6. Primarily Formed Committee Llstnamasofofficeholder(s)orcandldete(s)
for which this committee Is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
Attach conb'nua~on sheets if necessary
OFFICE SOUGHT OR HELD
OFFICE SOUGHT OR HELD
OFFICE SOUGHT OR HELD
[]SUPPORT
i--]OPPOSE
F']SUPPORT
[] OPPOSE
F'IsuPPORT
OPPOSE
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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on. By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
Executed on By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 460 (8/99)
For Technical Assistance: 916/3:~2-5660
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from
through
SUMMARY PAGE
Page ~ of ?
NAME OF FILER
Contributions Received
1. Monetary Contributions ...................................................... Schedule A, Line 3
2. Loans Received ................................................................... Schedule B, Line 7
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 7
8. SUBTOTAL CASH PAYMENTS ................................................ Add Lines 6 + 7
9. Accrued Expenses (Unpaid Bills) ............................................ Schedule F, L/ne 3
10. Nonmonetary Adjustment ....................................................... Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ......................................... Add Lines 8 + 9 + 10
Current Cash Statement
12. Beginning Cash Balance ................................ Previous Summary Page, Line 16
13. Cash Receipts .............................................................. Column A, Line 3 above
14. Miscellaneous Increases to Cash ....................................... Schedule I, Line 4
15. Cash Payments ............................................................ Column ,4, Line 8 above
16. ENDING CASH BALANCE .............. Add Lines t2 + 13 + 14, then subtract Line 15
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................... Schedule B, Part t, Column (b)
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... see Instructions on reverse
19. Outstanding Debts ................................... Add Line 2 + Line 9 In Column C above
Column A
TOTAL THIS PERIO0
(FROM ATTACHED SCHEDULES)
$ 0
$ 0
$ 0
I.D. NUMBER
Column B* Column C
TOTAL PREVIOUS PERIOD TOTAL TO DATE
(SEE NOTE BELOW) (COLUMNS A ~- B)
* From previous statement Summary Page, Column C. However, if this
Is the first report filed for the calendar year, Column B should be blank
except for Loans Received (Une 2), Loans Made (Line 7), and Accrued
Expenses (Une 9).
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received ............ $ ~ ~/:
21. Expenditures 0 I;~F~, ~.~
Made .................. $
FPPC Form 460 (8/99)
For Technical Assistance: 916/~22-5660
Sbhed~le A Type or print In Ink. SCHEDULE A
Monetary Contributions Received ^r"°~on'w'h~;',Y~,re~."."°e* framSta[e'~'entc°versperl°dq/I/~l I~i' - .=~r~
N~E OF FILER I.D. NUMBER
IF AN INDI~DUAL ENTER AMOUNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE
DATE FULL NAME, MAILING ADDRESS AND ZiP CODE OF CONTRIB~OR CONTRIBUTOR, ~CUPATION AND ~PLOYER RECEIVED ~IS CA~NDAR YE~ OTHER
RECEIVED (IF C~MI~EE, A~O ENTERI.D. NUMBER} CODE * (IF SE~-~OYED, ENTER N~E PERIOD (JAN. 1 - DEC. 31) (IF APPLICABLE)
OF BU~NESS)
~ ~ ~ND
SUBTOTALS '~ : - - - - · _ '
Schedule A Summary
1. Amount received this period - contributions of $100 or mom.
(Include all Schedule A subtotals.) ....................................................................................................... $
2. Amount received this period - unitemized contributions of less than $100 ......................................... $
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ................... TOTAL $
'Contributor Codes
IND- Individua~
C0M - Recipient Committee
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
chedale A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT,)
Monetary Contributions Received Amounts may be rounaeO Statement covers period
NAME OF FILER ~ I I~. NUMBER
IF AN INDIVIDUAL, ENTER AMOUNT CUMU~TIVE TO DATE CUMU~TIVE TO DATE
DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR ~CUPATION AND EMPLOYER RECEIVED ~IS CALENDAR Y~R O~ER
RECEIVED (IF C~EE. A~O ENTER I,O. NU~ER) CODE * (IF $E~-~OYED, E~ ~E PERIOD (JAN 1 - DEC 31) (IFAPPLICABLE)
OF BUSINESS)
~m~ ~ ~'0~'~ ~,ND
~ ~1 ~m' ~COM
~IND
Q COM
~ OTH
~ IND
~ COM
~ OTH
~ IND ~
~ COM
~ OTH ..
~ IND
Q COM
~ OTH
~ IND
Q COM
DOTH
SUBTOTAL $ ' ' '~" I J~}~
'Contributor Codes
IND- Individual
COM- Recipient Committee
OTH - Other
FPPC Form 460 (8/99)
For Technical Assistance: 916/'J22-5660
'chedule E
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 .
rough
CODES:
If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia/misc.
CNS campaign consultants
CTB conttibufion (explain nonmonetary)'
CVC civic dona§one
FND fundraising events
IND Independenl expendilure supporting/opposing others (explain)'
LIT campaign lileralura and mailings
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio alrtime and production costs
Page ~ of ~
SCHEDULE E
I.D. NUMBER
RFD returned contribulions
SAL campaign workers salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse traval, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
rOT votar registration
WEB Information technology costs (intemet, e-mail)
NAME AND ADDRESS OF PAYEE OR CREDITOR
IIF COMMII'I'EE. ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $
Schedule E Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................................................................................... $ /~"0 ,~
2. Unitemized payments made this period of under $100 ........................................................................................................................................ $_. '__~'~"~
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) ....................................................... $
4. Total payments macJe this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ......................... TOTAL $ . ~.7~--?
FPPC Form 460 (8/99)
For Technical Assistance: 916/~22-56~0
'Ched le F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
,rom
through
SCHEDULEF
Page "'/ of' T
I.D. NUMBER
CODES: If one of ng codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and sun~ey research
POS postage, delivery and messenger se~ces
PRO professional services (legal, accounting)
PRT pdnt ads
RAD radio airtime and production costs
CMP campaign paraphernalia/misc.
CNS campaign consultants
CTB contribution (explain nonmonetary)'
CVC civic donations
FND fundraising events
IND independent expenditure suppo~ling/opposing others (explain)*
LIT campaign literature and mailings
MTG meetings and appearances
RFD returned contribu'dons
SAL campaign workere salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VOT votsr registration
WEB information technology costs (intemet, e-mail)
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D.
(a) (b) (c) (d)
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANOiNG
(IF COMMITTEE. ALSO ENTER I.D. NUMBER} DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (N. SO REPORT ON E) OF THIS PERIOD
SUBTOTALS$ 0 $ I 0 'c6 $ 0 $ I Of, oS'-
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $ .
2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on
accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................. PAID TOTALS $
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $
For Technical Assistance: 916/322-5660