460 Third Pre-Election ecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from
through
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
']~ Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
O Recall
(Al~o Complete Pa~ 5)
[] General Purpose Committee O Sponsored
O Small Contributor Committee
O Political Party/Central Committee
[] Ballot Measure Committee
O Primarily Formed
O Controlled
O Sponsored
(Also Complete Part 6)
[] Primarily Formed Candidate/
Officeholder Committee
Date Stamp
COVER PAGE:
Date °' el;cti°n "applicabli,..~..y RI
(Month. Day. Year) ~[}V -- ~ ~[}[}1 Page [ of ~
For Official Use Only
( /ol OF CUPE INO
2. Type of Statement:
"J~ Preelection Statement [] Quarterly Statement
[] Semi-annual Statement [] Special Odd-Year Repod
E] Termination Statement [] Supplemental Preelection
[] Amendment (Explain below) Statement - Attach Form 495
3. Committee Information
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMI~I'EE)
Cf 'zcns rOrrin honcy
STREET ADDRESS (NO RO. BOX)
I o? 40 / (ramon't-c
OITY STATE ZIP 000[ A~EA OO~E/PHONE
CITY STATE ZIP CODE AREA CODE/PHONE
Treasurer(s)
NAME OF TREASURER
C rd n
MAILING ADDRESS
ra tc' d
CITY , STATE ZIP CODE AREA CODE/PHONE
NAME OF A881STANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL )RESS OPTIONAL: PAX / E-MAIL ADDRESS
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. I
certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on /;/[~/ /,~Q/ By
Ex,cu,edon
Date
Executed on
Executed on
Date
By
/~' / ~ ~ature~freas ..... AssistantTreasurer
By
Si~ature of Controlling O~ csl~l~der, Can(~date, State Measure Proponent
FPPC Form 460 (June/Of)
FPPC Toll-Free Helpline: 866/ASK-FPPC
State of California
ecipient Committee
Campaign Statement
Cover Page -- Part 2
Type or print in ink.
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFI HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) 'STATE ZIP
iramontc Xct, cht4
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 behalf of your candidacy.
COMMi I I bt NAME
NAME OF TREASURER
COMMI'CrEE ADDRESS
II.D. NUMBER
CONTROLLED COMMITTEE?
[] YES [] NO
STREET ADDRESS (NO PO. BOXI
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
[] YES [] NO
COMMIttEE ADDRESS STREET ADDRESS (NO RO. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
6. Ballot Measure Committee
Page 'Z. of ~)
NAME OF BALLOT ~EASURE
BALLOT NO. OR LEI lEK JURISDICTION [] SUPPORT
[] OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER. CANDIDATE. OR PROPONENT
OFFICE SOUGHT OR HELD DISTF~ICT NO. IF ANY
7. Primarily Formed Committee List names of officeholder(a) or candidate(s) for
which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
N, [] 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: 866/ASK-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.
SUMMARY PAGE
Statement covers period
from / ~/~-~'/~) l
through [ I/0~, /0~ Page 6 of 6
NAME OF FILER
O.i-h'zm Orrin
Contributions Received
1. Monetary Contributions ................................................ Schedule A, Line
2. Loans Received ............................................................. Schedule B, Line
3. SUBTOTAL CASH CONTRIBUTIONS ............................. Add Lines I +
4. Nonmonetary Contributions ........................................ Schedule C, Line
5. TOTAL CONTRIBUTIONS RECEIVED ............................... AddLines3+4
Column A Column B
TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTALT O DATE
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, Line 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 A, Line 8 above
16. ENDING CASH BALANCE ............ Add Lines 12 + 13 + 14, then subtract Line 15
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED .............................. Schedule B, Par~ 2
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ............................................. See instructions on reverse
19. Outstanding Debts ............................ Add Line 2 + Line 9 in Column B above
$ -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 negative
figures that should be
subtracted from previous
period amounts. If this is
the first repod being filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
I.D. NUMBER
Year Summary for Candidates
Running in Both the State Primary and
General Elections N '~
1/1 through 6~30 711 to Date
20. Contributions
Received $ $
21. Expenditums
Made $ $
Expenditure Limit Summary for State
Candidates ~ A
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
__J / $
/ / $
__J / $
__J / $
__J / $
__J / $
*Since January 1, 2001. Amounts in this section may be
different from amounts reported in Column B.
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
chedule A Type or print in ink. SCHEDULE A
.......... Amounts mayberounded Statement covers period I!~l ~I! ~11 ~1~
Monetary Contributions Received to who,e do,,ars, from
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER UM
I
IF AN INDIVIDUAL ENTER AMOUNT OUMU~TIVE ~ DA~ ~[R ELEOTION
DA~ FULL NAME, STREET ADDRE~8 AND ZIP OODE OF OONTRIBUTOR OONTRIBUTOR O00U~TION AND E~PLOYEB REOEIVED THIS 0ALENOA~ YEA~ TO DATE
RECEIVED 0F COMMI~EE, ALSO ENTER ID NUMBER) CODE * (IF SELF-EMPLOYED. EN~R NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED)
OF BUSINESS)
Iblz~/Ol ~2D~o J~nt'c~ Av~ Dom
~~no~ ~ ~ ~s~
~r~'no, ~ ~50~4 ~s~ HP lDO- IoO -
C~r~, cA ~Otq ~D~s~ ~la~nkev I~- lDO-
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 period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1 .) ..................... TOTAL $
z~47_ -
94?- -
I*Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other
FrY - Political Party
SCC - Small Contributor Committee
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-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
through
SCHEDULE B - PART 1
NAME OF FILER
FULL NAME, STREET ADDRE$SAND ZIP CODE
OF LENDER
(IF COMMITTEE, ALSO ENTER I.D NUMBER)
*J~ND r'lCOM []OTH []P~ []SCC
tDIND [] COM []OTH [] PTY D SCC
f• IND [] COM [] OTH [] pTY [] SCC
m honcy
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
(a)
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
(b)
AMOUNT
RECEIVED THIS
PERIOD
,5,DDD
(~)
AMOUNT RAID
OR FORGIVEN
THIS PERIOD
[] PAID
[] FORGIVEN
[] PAID
$
FORGIVEN
[] FORGIVEN
$
Id)
OUTSTANDING
BALANCE AT
CLOSE OF THIS
PERIOD
DATE DUE
DATE DUE
DATE DUE
INTEREST
PAID THIS
PERIOD
ORIGINAL
AMOUNT OF
LOAN
71z71~
DATE iNCURRED
$
DATE INCURRED
DATE INCURRED
CUMULATIVE
CONTRIBUTIONS
TO DATE
CALENDAR yEAR
PER ELECTION**
CALENDAR yEAR
$
PER ELECTION
$
CALENDAR yEAR
$
PER ELECTION*~'
SUBTOTALS
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 -
It Contributor Codes ee1
IND - Individual COM - Redpient Comma'tee (other than PTY or SCC) OTH - Other PrY - Political Party SCC - Small Contributor Committ
(Enter (e) on
Schedule E, bne 3)
*Amounts forgiven or paid by1
another party also must be
reported on Schedule A. J
** If required.
FPPC Form 460 (Junel01)
FPPC Toll-Free Hetpline: 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 \\/~)1/~ I
Page b of ~)
NAME OF FILER
Ci z ns- c rin
I.D. NUMBER
CODES:
CM= campaign paraphernalia/misc.
CNS campaign consultants
CTB contribution (explain nonmonetary)*
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
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 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 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
(IFCOMMI~EE. ALSO ENTERIID NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT R~klD
lqo 'm /T rintin
LIT
C[ ca q5050
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
SU.*O*A'$ .5 ll'SZ
Schedule ESummary
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 pedod 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 $
70
FPPC Form 460 (Junel01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
chedule E
(Continuation Sheet)
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULE E (CONT
NAME OF FILER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
I.D. NUMBER
C~Vi3 campaign paraphernalia/misc.
ChIS 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
MBR member communications
MTG meetings and appearances
OFC office expenses
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 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
WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
(IF COMMIttEE, ALSO ENTER ID NUMBER)
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL: ~}Z~ / ~. ~)"~
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
chedule F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULE F
Statement covers period
t. rou b I I/S Io I .age
NAME OF FILER
CODES: If one of the following codes accurately describes the
CMP campaign paraphernalia/misc. MBR
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
I.D. NUMBER
payment, you may enter the code. Otherwise, describe the payment.
member communications
MTG meetings and appearances
OFC office expenses
[-~-~ petition circulating
PHO phone banks
POt. polling and survey research
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
'IRS 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)
(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 BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD
* Payments that are contributions or independent expenditures must also be
summarized on Schedule D.
SUBTOT^'S$ 4 450- $ ll97-9, 005 0 $
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, tSubtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.) ....................................................................................................................................... NET $
0
May De a negal~e numDe¢
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC