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460 Third Pre-Election ecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEEINSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from I 0/~") I~ through 1. Type of Recipient Committee: ~1 committees- Cor~plete parts 1, 2, $, and 4. Officeholder, Candidate Controlled Committee O State Candidate Election Committee C) Recall [] Ballot Measure Committee 0 Primarily Formed 0 Controlled 0 Sponsored (Also C~mplete Pmf 6) [] Pdmadly Formed Candidate/ Officeholder Committee [] General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee 3. Committee information COMMITTEE NAME (OR CANDID,~rE'S NAME IF NO COMMITTEE) Date Stamp COVER PAGE I STREET ADDRESS (NO EO. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. f~O× - Date of election if applicable:! (Month, Day, Year) ~ CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAILADDRESS 2. Type of Statement: [] Preelection Statement [] Semi-annual Statement [] Termination Statement [] Amendment (Explain below) [] Quarterly Statement [] Special Odd-Year Report [] Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER M-AILING ADDRESS ~ME OF ASSISTANT TREASURER, IF ANY LING ADDRESS CITY 8TATE ZIP CODE OPTIONAL: F~ / E-MAIL ADDRESS STATE ZIP CODE AREA CODE/PHONE 4, Verification 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~n~ coFect., j ~ Signatt~e of ,~ dl~{l"[~c~der, Ca~lda~e Meas'~ Proponent or R~ponsibie Officer of Sp~3sor Executed on By ecipient Committee Campaign Statement Cover Page -- Part 2 Type or print in ink. COVER PAGE - PARr 2 Page ~ of ~' 5. Officeholder or Candidate Controlled Committee NAME OF OFFtOEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) t R A INESS DRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any committees not Included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behaff of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? [] YES [] NO COMMITTEE ADDRESS STREET ADDRESS (NO PO. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I,D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? [] YES [] NO COMMITTEE ADDRESS STREET ADDRESS (NO PO. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 6. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION BSUPPORT 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 7. Primarily Formed Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME Of OFFICEHOLDER or CANDIDATE OFFICE SOUGHT OR HELD r-~ SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT [] OPPOSE Attach continuation sheets if necessary FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 8661ASK-FPPC 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 ,rom i0! l!OI SUMMARY PAGF Page ~) of ~' NAME OF FILER J Column A Contributions Received 1. Monetary Contributions ................................................ Schedule A, Line 3 2. Loans Received ............................................................. Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ............................. AddLineel*2 $ ! 4. Nonmonetary Contributions ........................................Schedule c, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ............................... AddLines3+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. Accrued Expenses (Unpaid Bills) .................................. Schedule F, Une 3 10. Nonmonetary Adjustment ............................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................... Add Lines 8 + g + 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 $, Line 4 15. Cash Payments ....................................................... Column A, Line $ above 1 (~. END~NG CASH aJt. L,i~CE ............ Add Lines 12 + 13 + 14, then subtract Line 15 $ If this is a termination statement, Line 16 must be zero. Column B CALENDAR YEAR TOTALT OCATE Io,,Lf'&.?? $ I% qT?,/P'~ 17. LOAN GUARANTEES RECEIVED .............................. Schedule B, Part Cash Equivalents and Outstanding Debts 18. Cash Equivalents ............................................. see instructions on reverse $ 19. Outstanding Debts ............................ AddUne2+LJneginColumnBabove $ 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 car~ over the amounts from Lines 2, 7, and 9 (if any). I.D. NUMBER Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contributions Received 21. Expenditures Made 1/1 through 6130 7/1 to Date $ $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expendituree Made* (If Subject to Votunta~ Expenditure Li~t) Date of Election (mm/ddt/y) / / / TotaltoDate $ $ *Since Janua~/1, 2001. Amounts in this section may be different fi.om amounts reported in Column B. FPPC Form 460 (Junel01) FPPC Toll-Free Helpline: 866/ASK-FPPC chedule A Type or print in ink. SCHEDULE Amounts may be rounrie~ Statement covers period Monetary Contributions Received fo whol. rio,,ars, from ~' SEE INSTRUCTIONS ON REVERSE through ,,/Ol]~ J Page~of, ' NAME OF FILER IF AN INDIVIDUAL, ENTER AMOUNT CUMU~TIVE ~ DA~ PER ELECTION DA~ FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCU~TION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DA~ RECEI~D 0F COMMIE. ~SO ~TER LD. NUMBER) CODE * (IF SELF-~PLOYED, EN~R ~E PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ~ ~~ gO~ ~ I00 ~COM )fl 12 lob IvO SUBTOTALS Schedule A Summary 1. Amount received this period - contributions of $100 or more. (Include all Schedule A subtotals.) ................................................................................................. 2. Amount received this period - unitemized contributions of less than $100 ......................................... 3. Total monetary contributions received this pedod. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ..................... TOTAL *Contributor Codes IND- Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (Junal01) FPPC Toll-Free Helpline: 866/ASK-FPPC chedule A (Continuation Sheet) Typoorprintinink. SCHEDULE A (CONF.) Monetary Contributions Received Amounts may be rounded Statementcoversperiod . · NAME OF FILER IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (m COMM~qrEE, ALBO ENTER I D NUMBER) COD E ~' (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31 ) (IF REQUIRE D) OF BUBINE$$) Ocou OCOM ~O~ OCOU ~O~ OCOM OO~ SUBTOTALS *Contributor Codes IND- Individual COM - Recipient Committee (other ~an PTY or SCC) OTH - Other FTY - Political Party SCC - Small C, ontrib~or Committee FPPC Form 460 (Junol01) FPPC Toll~Fme Helpline: 866/ASK-FPPC chedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from through Page ~) of ~' SCHEDULE NAME OF FILER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. ~ campaign paraphernalia/misc. CNS campaign consultants CT~ contribution (explain nonmonetary)* CVC civic donations candidate filing/ballot fees fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings MBR member cemmunications MI'G meetings and appearances OFC office expenses ~t:l petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PET print ads I.D. NUMBER RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IFCOMMITTEE. ALSOENTER ID. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID LiT * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS ~ 2~', ~_L~ 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 ................................................................................................................................. $ O 3. Total interest paid this pedod on loans. (Enter amount from Schedule B, Part 1, Column (e).) ......................................................................... $ 0 4. Total payments made this pedod. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC chedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print in ink. Statement covers period from iO /~o l o j through I'/0j )0 I Amounts may be rounded to whole dollars. CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Ct~P campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees ~ fundraising events IND independent expenditure supporting/opposing others (explain)* lEG legal defense Lrr campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating Pr-lO phone banks PO[. polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads PAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries SCHEDULE E (CONE.) Page ? of ~ I.D. NUMBER 'riD_ t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals '[RS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (iF COMMITTEE, ALSO ENTER I.D, NUMBER) Og8 GII5 *Payme~tsthataroc~~tributi~ns~rindepend~~texpe~ditumsmusta~s~besummarized~~schedu~eD~ SUBTOTAL $ :~; J'~.~l. ~'" FPPC Form 460 (Junel01) FPPC TolI-Frse Helpline: 866/ASK-FPPC chedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FILER CODES: If one of the following codes accurately describes the ~ campaign paraphernalia/misc. MBR CNS campaign consultants MTG CTB contribution (explain nonmoneta~)* CVC civic donations F]L candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings Type or print in ink. Amounts may be rounded to whole dollars. Statemen~ covers period from 'D/~ZI/O[ through '~/OI lo ~ Page I.D. NUMBER SCHEDULE F payment, you may enter the code. Otherwise, describe the payment. member ccmmunications PAD radio airtime and production costs meetings and appearances RFD returned contribations (DFC office expenses SAL campaign workers' salaries Pc~ petition circulating 'IEL t.v. or cable airtime and production costs PHO phone banks 'iRC candidate travel, lodging, and meals POL polling and survey research ')~S staff/spouse travel, lodging, and meals POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor PRO professional services (legal, accounting) VOT voter registration PRT pdnt ads V~c_B information technolo Iai lb) lc) Id) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT iNCURRED AMOUNT PAID OUTSTANDING (IF CONI~WTEE. ALSO EN3~R 1.0. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THiS PERIOD (ALSO REPORT ON E) OF THIS PERIOD lit o 17o o * Payments that are contributions or independent expenditures must also ba summarized on Schedule D. SUBTOTALS $ $ $ $ Schedule F Summary 1. Total accrued expenses incurred this pedod. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ......................................... INCURRED TOTALS $ ~0 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 $ ~ ..... ~' ~ FPPc Form 460 (June101) FPPC Toll-Free Helpline: 866/ASK-FPPC