460 Termination ecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
through
'1. Type of Recipient Committee: All Commit'toes -Complete Pacts f, 2, 3, and 4.
"'~ Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
O Reca,
(~so C~ete Pan 5)
[] Ballot Measure Committee O Primarily Formed
O Controlled
O Sponsored
(A/so Core, ere Pa~t 6)
[] Primarily Formed Candidate/
Officeholder Committee
fA/so c~,~wete P~f 7)
[] General Purpose Committee O Sponsored
O Small Contributor Comn'{ittee
O Political Party/Central Committee
3. Committee Information
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
STREET AD[~RESS (NO PO. BOX) .
0 40 & a Orlt¢
MAILING ~BBRESS (IF BIFFERENT) ~O. ANB STREET OR RO, BOX
CITY STA~ lIP CO~E
AREA CODE/PHONE
4oB--/25-17 -7
AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
Date of election if applit
(Month, Day, Year)
JPERTINO CITY ClL
COVER PAGE
Jag
~ )r Official Use Only
2. Type of Statement:
[] Preelection Statement
S
emkannual Statement
[~ Termination Statement
[] Amendment (Explain below)
[] Quarterly Statement
[] Special Odd-Year Report
[] Supplemental Preelection
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
CiTY STATE ZiP CODE
Ct r 'pD CA 95014
NAME OF ASSISTANT TREASURER, IF ANY
AREA CODE/PHONE
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my know~edge 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 / //~/~.--'Date By ~~ ~~r A~s~s~nt~Tr~surer~ ~// ,,J~/~,/~.~
· ' Date S~rature of Cont~lling Office~:~d~a~id ata, State Measure ~:Yop~ent ~ Responsible O~cer of Sp~msor
Executed on By
Date Signature of Controlhng O~ceholder. Cancidata. State Measure Pmporent
Executed on By
Date Signatem of Co~troll~g Offic~hddar, Candidate. State Measure Proponent FPPC Form 460 (Junel01)
FPPC Toll-Free Helpline: 8661ASK-FPPC
State of California
ecipient Committee
Campaign Statement
Cover Page -- Part 2
Type or print in ink.
COVER PAGE - PART 2
Page % of ~
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE L6CATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAL~BUSINESSADDRESS (NO. ANDSTR~ET) ~ITY ' STATE ZIP
Related Committees Not Included in this Statement: List any committees
not included In this statement that are contmlled by you or are primarily foxed to receive
contributions or make expenditures on behalf of your candidacy,
COMMII~EE NAME
NAME OF TREASURER
I.D. NUMBER
CONTROLLED COMMITTEE?
[] YES [] NO
COMMITTEE ADDRESS STREET ADDRESS (NO PO. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITFEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
[] YES [] NO
COMMITTEE ADDRESS
STREET ADDRESS (NO RD. BOX)
6. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETrER 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 Listnames ofofficeholder(s) or candidate(s) for
which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
OFFICE SOUGHT OR HELD
[~SUPPORT
[] OPPOSE
[~]SUPPORT
[]OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ~'-]SUPPORT
[--]OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ~-lSUPPORT
[]OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE
Attach continuation sheets if necessary
FPPC Form 460 (Junal01)
FPPC Toll-Free Helpllne: 8661ASK-FPPC
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Contributions Received
1. Monetary Contributions ................... , ....................... Schedule A, Line 3
2. Loans Received ......................................................Schedule B, Line 7
3. SUBTOTALCASHCONTRIBUTIONS ......................... Add LInes I +2
4. Nonmonetary Contributions .................................... Schedule C, Une 3
5. TOTAL CONTRIBUTIONS RECEIVED ................. ; ......... AddLines 3 + 4
Expenditures Made
6. Payments Made .......................................................Schedule E, Line 4
7. Loans Made ............................................................. Schedule H, Lime 7
8. SUBTOTAL CASH PAYMENTS .................................... AddLines6+ 7
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3
10. Nonmonetary Adjustment .......................................... scheduie c. Line 3
11. TOTAL EXPENDITURES MADE ................................ Ad~ Unes S + 9 + ~ 0
Type or print in ink.
Amounts may be rounded
to whole dollare.
Statement covers period
,rom /olz to
through o/0
Column A Column B
TOTN. THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCH E DULES) TOTAL TO DATE
$ q:2bg,OG $ 17,4ZS,0G
$ 5:20B.00 $ 17 425,0¢
Current Cash Statement
12. Beginning Cash Balance ....................... Prev~ousSummaryPage, Une,6 $ '~"~ 91'-76
13. Cash Receipts ................................................... C~u,~A. uneaa~ove ~ ;2 66.0~::)
14. Miscellaneous Increases to Cash ........................... Schedule l, Line 4 (~
15. Cash Payments .................................................. ColumnA. UneSat~ove 1~9C~· ~-~
16. ENDING CASH BALANCE .......... AddLInes 12+ 13+ 14, then subtract Line 15 $ 0
ff this is a terminaR)n statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Scheduie B, Pe, 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ........................................ see ~stn~ons on reverse $
19. Outstanding Debts ......................... AddLine2+UneginColumnBabove $
O
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 negafive
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).
SUMMARY PAGE
Page .~ of
I.D. NUMBER
IZ5704-
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections ~x~ ~
111 through 6/30 7tl to Date
20. Contributions
Received $ $
21. Expenditures
Made $ $
Expenditure Limit Summary for State
Candidates ~ ~
22. CumuleUve Expenditures Made'
(If SulY~cl Io VMunlll~y Ex~endilure Llrna)
Date of Election Total to Date
(mm/dd/yy)
/_____/__ $
/ /__ $
__/ / $
__/ / $
__/ /
/ / $
*Since January I, 2001. Amounts in this section may be
different from amounts reporled in Column B.
FPPC Form 460 (June/01)
FPPC Toll-Free Helpllne: 8661ASK-FPPC
chedule A Type or print In Ink. SCHEDULE A
Amounts may De rounaea Statementcovers period
Monetary Contributions Received to whole dollars. -~ I I I I l ~ ~ M ~11
,rom
SEE INSTRUCTIONS ON REVERSE through 121:51/0i I,,ege Z~ o, c~
/
DA~ FU~ N~E, STREET ADDRE~ AND ZIP CODE OF CONTRIBUTOR ~ CONTRIB~OR IF AN INDIVIDUAL, ENTER ~ CUMU~TIVE TO DATE PER ELECTION
~CUPATION AND EMPLOYER RECEIVED ~IS CALENDAR YEAR ~0 DATE
RECEIVED OF~,~E~ERI.O.~R) CODE * (IFSELF-E~OYED, ENTERN~E PERIOD (JAN. 1 - DEC. 31) (IF REQUIREO)
'~COM ~ --
~ND
Lc~ ~ ~co~
~ PTY
~'"~ bfrecbr~Research
~l~De~flO, Ck %01~ Dsoo ~har~ ~ceufl'~l,S
~e,(a~: ~h ~50tgD~cc
SUBTOTALS
Schedule A Summary
1. Amount received this pedod - contributions of $100 or more.
(Include all Schedule A subtotals.) ........................................................................................................ $
2. Amount received this pedod - unitemized contributions of less than $100 ............................................. $
3. Total monetary contributions received this pedod.
(Add Lines I and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $
44~L-
'Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other
PTY - Political Party
SCC - Small Contribulor Committee
FPPC Form 460 (Junel01)
FPPC Toll-Free Helplins: 8661ASK-FPPC
chedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.)
Monetary Contributions Received Amountsmayberoundedtowholedollars. Stat~e.tcoversperlod~ i ~ ~1'~ I
NAME OF RLER ~ I.DNUMBER
IF AN I~OlVIDUAL, ENTER ~OUNT CUMU~TIVE TO DATE PE~ ELECTION
DA~ FU~ NA~E, STRE~ ADDBE$S AND ZIP CODE OF CONTBIS~TOR CONTBIB~TOR OCCUPATION AND RBPLOYEB ' RHCEIVRD THIS CALENDAR YEAR 10 DATE
RECEIVED ~ ~EE. ~ ENTER I.D. IR) CODE * (IF SE~-EMPLOYED. ENTER N~ PERIOD (JAN. 1 - DEC. 31 ) (IF REQUIRE D)
OF BU~NESS)
cg fle l H- ac rd
~M
r ~ OTH
~ D f~v
~ ~scc
~ DIND
Dcou
DOTH
~ PTY
Dscc
~IND
~co~
~OTH
~ PTY
~scc
~IND
~COM
~OmH
~ PTY
~scc
SUBTOTALS ~D,
'Contributor Codes
IND- Individual
COM- Recipient Committee
(other than PTY or SCC)
OTH - Other
PTY- Poli~c~,l Pady
$¢~- 8n'mll C, ontrfbutm' ~:m'm'ittea
FPPC Form 460 (Junel01)
FPPC Toll-Free Helpline: 8661ASK-FPPC
chedule B - Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
frore [OlZl/l~J
through 12j5//~)1
SCHEDULE B - PART 1
Page ~) of ~
NAME OF FILER
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
(~F COMMI'CrEE, ALSO ENTER ID. NUMBER)
tD~ND []COM []OTH []PTY EIscc
ti--] IND [] COM [] OTH [] PTY E] scc
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
(a)
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
AMOUNT
RECEIVED THIS
PERIOD
AMOUNT RAID
OR FORGIVEN
THIS PERIOD ~l
roW . 41
$
,r'
(d)
OUTSTANDING
BALANCE AT
CLOSE OF THIS
PERIOD
s O
DATE DUE
DATE DUE
INTEREST
PAID THIS
PERIOD
%
%
I.D. NUMBER
125-7o4-B
(t) Ig)
ORIGINAL CUMULATIVE
AMOUNT OF CONTRIBUTIONS
LOAN TO DATE
CALENDAR YEA~
PER ELECTION**
71z~/o i
- ~1
DATE INCURRED
DATEINCURRED
DATE INCURRED
DATE DUE
,5:000
$. S $
su.ToT^,s $ 5,000- $
100- $ 0
s 0
C~AI_ENDAR YI[AR
$
PER ELECTION *'*
CALENDAR YEAR
S
PER ELECTION*'*
Schedule B Summary
1. Loans received this period ............................................................................................................ $
(Total Column (b) plus unitemized loans less than $100.)
2. Loans paid or forgiven this period .................................................................................................. $
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) ........................................................... NET $
Enter the net here and on the Summary Page, Column A, Line 2.
5,000 -
~1 ~200 -
It Contributor Codes
IND - Individual COM - Recipient Committee (other than P'FY or SCC) OTH - Other PTY - Political Party SCC - Small Contributor Committe{
(Enter (e) on
Sched~e E, Line 3)
*Amounts forgiven or paid by]
another party also must be
reported on Schedule A,
** If required.
FPPC Form 460 (Junel01)
FPPC Toll-Free Helpline: 8661ASK-FPPC
chedule E
Payments Made
SEEINSTRUCTtONS ON REVERSE
NAME OF FILER
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from
through
Page 7 of (~
I.D, NUMBER
1 670z
CODES:
ClVi° campaign paraphernalia/misc.
CNS campaign consultants
CTB contribution (explain nonmonetary)*
CVC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND independent expenditure supporting/opposing others (explain)*
LEG legal defense
LIT campaign literature and mailings
If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition cimulating
PHO phone banks
POL polling and survey mseamh
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers'salaries
TEL t.v. or cable airtime and production costs
'iRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE. ALSO ENTERI.D. NUMBER} CODE OR DESCRIPTION OF PAYMENT AMOUNT RAID
io,nd Win n Co
~ln ,~Y-~e~ CA 9511~
cA S 5050
on, e
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
Schedule E Summary
1. Payments made this period of $100 or more. (Include all 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 $
1'2, 25.54
74,3D
O
FPPC Form 460 (Junel0i)
FPPC Toll-Free Helpline: 8661ASK-FPPC
chedule 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
,rom
through [2l 31/0 I
CODES: I! one of the following codes accurately describes the payment, you may enter the code. Otherwise,
~ campalgn paraphemalia/misc. IvlBl:lmembercommunications
ON8 campaign consulfants IvlrB meetings and appearances
OTB contribution (explain nonmonetary)* Off(:: office expenses
OVO civic donations ~ potition circulating
RL candidate filing/ballot fees PHO phone banks
FND fundraising events POL polling and survey research
~ independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services
SCHEDULE E (CON'[
Page 5 of ~
I.D. NUMBER
describe the payment.
PAD radio airtime and production costs
FV--D returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airlime 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
LEG legal defense PRO professional services (legal, accounting) VDT voter registration
UT campaign literature and mailings I-'HI print ads WEB information technology costs (interact, e-mail)
NAME AND ADDRESS OF PAYEE
(IF CONIMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
er no,c 95o Fo8 7o -
Payments that are contributions or independent expenditures must also be summar,zed on Schedule D.
su-m-rA, $ -7 (7155.0%
FPPC Form 460 (June/D1)
FPPC Toll-Free Helpline: 8661ASK-FPPC
CHEDULE F
Schedule F Type or print in ink.
Amounts may be rounded
Accrued Expenses (Unpaid Bills) towholedollars.
SEE iNSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
QVP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
CTB contribution (explain nonmonetary)* DFC office expenses SAL campaign workers' salaries
CVC civic donations H:~ petition cimulating 7EL t.v. or cable airtime and production costs
FIL candidate filing~ballot fees PHO phone banks 'I~C candidate travel, lodging, and meals
FND fundraising events POL polling and survey research 3~S staff/spouse travel, lodging, and meals
IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting) VDT voter registration
Lff campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
(a) (b) (c) (d)
NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING
(IF COMMITTEE, ALSO ENTER ID. NUMBER) DESCRIPTION OF PAYMENT BALANCEBEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD
~ab~n ?ulfdo
I~o bc~acidt~C-~~l LI'C 3,000- 1,1_Oo- 4,ZoO- 0
~ on ~oor~
19z5 Rainbpw >r LiT I 460- 729,&0 7~119.¢0 0
summarized* Payments that are contributions or independent expenditures must also been Schedule D. SUBTOTALS $ 4 ~ 4 ~ 0 -- $ / )(~'~-$ ' ~J)0 $ L/~ ) ~'5'~ 9' (J~0$ O
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 4 4 50
on the Summary Page, Column A, Line 9.) ....................................................................................................................................... NET $
FPPC Form 460 (Junel01)
FPPC Toll-Free Helpline: 8661ASK-FPPC