460 Recipient Committee Campaign Statement - Amendment 10-1-14 to 10-18-14Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200 - 84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period Date of election if applicable:
from— � 0 " I — ZU y- (Month, Day, Year)
through l d - f c7 - 2`0 y y"
'I . Type of Recipient Committee. All Committees - Complete Parts 1, 2, 3, and 4.
�j Officeholder, Candidate Controlled Committee ❑
Primarily Formed Ballot Measure
Q State Candidate Election Committee
Committee
Q Recall
Q Controlled
(Also Complete Part 5;
Q Sponsored
El General Purpose Committee
(Also Complele Part 6)
Q Sponsored ❑
Primarily Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
Q Political PartylCentral Committee
(Also Compfete Part 7)
3. Committee Information
I.D. NUMBER
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
STREET ADDRESS (NO P.O. BOX)
COVER PAGE
Date Stam
Date ReC p iVed
JAN 2 9 ')015 I Page of �--
For Official Use Only
1 f _ �e ._ 7_0 J V__ Processed by
2. Type of Statement:
X Preelection Statement ❑ Quarterly Statement
❑ Semi - annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
(Also fie a Form 410 Termination ❑ Supplemental Preelection
Statement - Attach Form 495
! Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
'5�'u F- ,4
MAILING ADDRESS
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE CITY
OPTIONAL: FAX I E -MAIL ADDRESS OPTIONAL: FAX I E -MAIL ADDRESS
STATE ZIP CODE AREA CODFIPHONE
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
Date
Executed on 1 2 fr
Date
Executed on
Dale
By
By
By
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772)
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
rv.vlwc �r rILEK
Contributions Received
1. Monetary Contributions ............ ............................... schedule A, Line 3
2. Loans Received ...................................................... schedule B, Line 3
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 F Line 4
7. Loans Made .............................. ............................... schedule N, Line 3
8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 5 + 7
9. Accrued Expenses (Unpaid Bills) ............................... scheduie 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 1, Line 4
15. Cash Payments ................... ............................... Column A, Line a 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.
Type or print in ink.
Amounts may be rounded
to whole dollars.
Column A
TOTALTHIS PERIOD
(FROMATTACHED SCHEDULES)
$ /
U
$ r
SUMMARYPAGE
Statement covers period
from / d "! — -)- 14
through — 10 —IR . :;�-o J I Page -)— of
Column B
CALENDARYEAR
TOTALTO DATE
$
0
$ ✓
I.D. NUMBER
1 3zf�— d_!�-
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
111 through 6130 711 to Date
20. Contributions
Received $ $
21. Expenditures
Made $ $
Expenditure Limit Summary for State
$ $�'�f-. a� y Candidates
D
D p
$ (L7 2-, he 44(FtV v z
$ _L46 9 71
614,E
0
xoVTz, �
$ kz-3, 6b
17. LOAN GUARANTEES RECEIVED ........................... schedule B, Part 2 $ 0
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ......... ............................... see instructions on reverse $ 0
19. Outstanding Debts ......................... Add Line 2+ Lino 9 in Column B above $
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
carry over the amounts
from Lines 2, 7, and 9 (if
any).
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mmlddlyy)
__1 $
I $
*Amounts in this section may be different from amounts
reported in Column B.
FPPC f=orm 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK -FPPC (8661275 -3772)