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deHaan 460Recipient Commi Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period. from 114 lua through Date of election if appli le: (Month, Day, Years a, "}ate Stamp a l l Ar dj s: 55jj 'ut'?:'aw:r �Lil�'" i e :fie n. 2. Type of Statement: COVER PACE 1. Typ of Re ci p ient Committee: All Committees Complete Parts 1, 2, 3, and 4, Officeholder, Candidate Controlled Committee (j Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall O Controlled (Also Complete fart 5) O Sponsored E] General Purpose Committee {ALSO GoMpiPFe Part 6) 0 Sponsored Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee O Political Party /Central Committee ('Also Complete Part 7) NAME OF ASSISTANT TREASURER,. IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE OPT FAX f E -MAIL ADDRESS OPTIONAL: FAX I E -MAIL ADDRESS 4. Verification 1 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. a0 Executed on� By o a f Tr 8s er or Assistant Treasurer Executed on 1 51 B //Ajr/ Date Signature of Controllin n date, St e Measure Proponent or Re Officer of Sponsor Executed can 13Y Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed an By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPG Form 460 (January105) FPPG Tali -Free Helpline: 866/ASK -FPPG (8661275 -3772) State of California L J Preelection Statement 0 Quarterly Statement Semi annual Statement Special Odd -Year Report E] Termination Statement Supplemental Preelection (Also file a Form 410 Termination) Statement Attach Form 495 Amendment (Explain below) Campai Disclosure Statement T or print in ink. SUMMARYPAGE Summar Pa Amounts ma be rounded to whole dollars. Statern co 7 r period Schedule H, Line 3 8. SUBTOTAL CASH ASH PAYMENTS from T 15 SEE INSTRUCTIONS ON REVERSE Schedule F, Line 3 throu Pa g e Of NAME OFF E 11. TOTAL EXPENDITURES MADE I.D. NUMBER Contributions Column A TOTAL THI PERIOD ATTACHED SCHEDULFES� Column B CALENDAR YEAR Calend Year. S for Candidates Runnin in. Both the State Primar and 1. Monetar Contributions Schedule A, Line 3 (FROM TOTALTO DATE tZ I/ �tZ 00 General Elections 1/1 throu 6/30 711 to Date 2. Loans Received Schedule, R, Line 3 3, SUBTOTALCASH CONTRIBUTIONS Add Lines I 2 7t OD 1voY-q7- 0 0 20. Contributions Received 4. Nonmonetar Contributions Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 4 &Y 7.0/ Q 41 7 21, Expenditures Made Expenditures Made 6. Pa Made.... Schedule E, Line 4 7. Loans M Schedule H, Line 3 8. SUBTOTAL CASH ASH PAYMENTS Add LineS 6 7 T 15 9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 10. Nonmonetar Adjustment Schedule C, Line 3 11. TOTAL EXPENDITURES MADE Add Lines g+ 9 lo 78 Current Cash Statement 12. Be Cash Balance Previous Surnmaf Pa Line 16 To calculate Column B, add 13. Cash Receipts Column A, Line 3 above Z10- t amounts in Column A to the correspondin amounts 14. Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B o f y our last b 15. Cash Pa Column A, Line 8 above report. Some amounts in -7 Column A ma b e ne 16. ENDING CASH BALANCE Add Lines 12 13 14, then subtract Line 15 fi that should be subt from previous 1f this is a termination statement, Line 16 must be zero, period amounts. If this is the first report bein filed 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 for this calendar y ear, onl carry over the amounts Cash E and Outstandin Debts from Lines 2, 7, and 9 (if any 18. Cash E see instructions on reverse 19. Outstandin Debts Add Line 2 Line 9 in Column B above Expenditure Limit Summar for State Candidates 22. Cumulative Expenditures Made* If S u b ec t to Volunta Expenditure Limit Date of Election Total to Date (mm/dd/ *Amounts in this section ma be different from amounts reported in Column B. FPPC Form 460 (Januar FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) ScheduleA Monetar Contributions Received SEE INSTRUCTIONS ON REVERSE T or print in ink. Amounts ma be rounded to whole dollars. NAME OF FILER A 0 xlti DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED IF COMMITTEE, ALSO ENTER 1,0. NUMBER) AMOUNT CUMULATIVE TO CODE J���re� refired SCHEDULE A Statement s p od from 7Y, A 0 PSIND 000M pa of ,r'*'� T ��re []OTH [I PTY AMOUNT CUMULATIVE TO E]SCC JtI�I� A ln ell'd'm JKIND EICOM E10TH TO DATE PTY SCC 31) (IF REQUIRED) CDCOM d OTH PTY ❑SCC K9 ff IND com E]OTH tl [D PTY SCC t? n e IND 7 hrxi) Atl e com OOTH 2 p PTY SCC J���re� refired SCHEDULE A Statement s p od from 7Y, A 0 throu pa of I, D17 E AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JW 1 DEC, 31) (IF REQUIRED) M SUBTOTAL. Schedule A Summary r Contributor Codes 1. Amount received this period itemized monetar contributions. A-00, IND Individual include all Schedule A subtotals. COIF Recipient Committee other than PTY or SCG OTH Other e. g business entit 2. Amount received this period unitemized monetar contributions of less than $100 PTY Political Part 3. Total monetar contributions received this period. SGC Small Contributor Committee Add Lines 1 and 2. Enter here and on the Summar Pa Column A, Line I TOTAL I FPPC Form 460 Januar y /05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheets P T ype or pr int i n ink. SCHEDULE A CO NT. M onet ar y Contributions Received Amounts may be rounded to whale dollars. State c v s period a fr om n through Page of NAME DF FILER I D N UMBER DATE FULL NAME., STREET ADDRESS AND ZIP CODE. OF CONTRIBUTOR CONTRIBUTOR RECEIVED CEIVED (IFCOMMITT E, ALSO ENTER 1,D, NI.IMBER) CODE IF AN INDIVIDUAL, ENTER OCCUPATfON AND EMPLOYER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE {IF SELF- EMPL,OYCO, ENTER NAME OF BUSINESS) PERIOD JAN. I DEC. 31 CIF REQUIRED) 9 F BIND q e 5 A )le El COM o T H :x PTY [SCC IND C o M OTH el ef F PTY SCC IND CoM ,F OTH PTY r Y ❑SCC e a 6 A IND COM p :xF`.++'rN �sw i w •P ..„wfm" �'.:FW B n F 1 OTH q 1 ill PTY ❑SCC el X 9; F ]COM OTH f s Ell' Zo PTY m SCC SUBTOTAL 0 *Contributor Codes IND Individual COM Recipient Committee (other than PTY or SCC) OTH other (e.g., business entity) PTY Political Party SCC_Small Contributor Committee FPPC Form 460 (January165) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772) Schedule A (Continuation Sheet) Monetar Contributions Received T or p in ink. Amounts ma be rounded to whole dollars. NAME OF ILER MSM= DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (W SELF-FMPLOYED, ENTER NAME OF BUSINESS) 94 3 IND com El OTH from- 0 PTY SCC Pa of lalle- h pr IND E] com E] OTH CUMULATIVE TO DATE PER ELECTION RECEIVED THIS PTY TO DATE .14 EISCC (IF REQUIRED) ey 11\21,514 M. IND COM rah `m' a OTH PTY D SCC ZIND COM OTH we PTY F-1 SCC lie 12, *D IND COM 2, [:1 OTH PTY SCC �'ef i/��t Re tired, SUBTOTAL$ 1. "A6 *Contributor Codes IND Individual COM Recipient Committee (other than PTY or SCC OTH Other (e. business entit PTY— Political Part SCC Small Contributor Committee FPPC Form 460 (Januar FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772) SCHEDULEA (CONT) State ent C V r� pe iod from- throu Pa of I.D. NUMBER o AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD JAN. 1 DEC. 31) (IF REQUIRED) we SUBTOTAL$ 1. "A6 *Contributor Codes IND Individual COM Recipient Committee (other than PTY or SCC OTH Other (e. business entit PTY— Political Part SCC Small Contributor Committee FPPC Form 460 (Januar FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772) Schedule A (Continuation Sheep) Type or print in ink. SCHEDULE A (CANT.) Monetary Contributions Receive Amounts ma be rounded to whole dollars. Stateme t c vers period e .1 from through Page of NAME OF FILEtR 1 D qry NUMBER �e 'A' a.� Y vF* D e.xo� .,e ,w R';• RJ S c� F "F me Y 4 A4''4 A43 px i•` ,y N .w"' i F .H h $u' ;d N PATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (1F COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS ICALENDAR YEAR TO DATE (IF SI=I_F•E.MPI_nY .D ENTER NAME PERIOD (JAN. 1 d DEC. 31) (IF REQUIRED) OF BUSINESS) ®S% NE r$ IND COM tx q«' �E'� OTH PTY Ae I've SCC F .:M' '�•�Hw �:x, .gym wW OTH P �$d� fi R d m .a.. PTY a az SCC g IND COM El OTH E] PTY w. SCC �r 4 16; I N D EI CoM w L] OTH PTY SCC A111a 415wAly IND Com un iz 4 1 OTH eel Ej PTY SCC SUBTOTAL. p t *Contributor Codes IND Individual COM Recipient Committee (other than PTY or SCC) OTH other (e.g., business entity) PTY Political Party SCC Small Contributor Committee FPPC Form 468 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276 -3772) Schedule A (Continuation Sheet Monetar Contributions ,Received T or print in ink. Amounts. m a y be rounded to whole dollars. SCHED A. (.CONT State pe riod from corners throu Pa of NAME OF FILER I 14e �r I.D. NUMBER e ll DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF COM M ITTEE, ALSO ENTER ID, N UMBER CONTRIBUTOR CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS C UM U LAT I VE TO DATE CALENDAR YEAR PER ELECTION TO DATE A&lxjoda IF SELF-EMPLOYED, ENTER NAME of BUSINESS PERIOD JAN. 1 DEC. 31 IF REQUIRED IND M COM '00 OTH Ej PTY ,mil z 4" ae, SCC IND com OTH tv� Vr 71 PTY 41 M a S cc KIND CO OTH p PTY 1 F SCC IND Al e 4 j"7lu I 7 1? CUM OTH ggii A&lxjoda PTY El SCC IND E]CUM OTH E] PTY SCC SUBTOTA '"Contributor Codes IND Individual CUM Recipient Committee (other than PTY or SCC OTH Other e. g business entit PTY Political Party FPPC Form 460 (January105) SCC Small Contributor Committee FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetar Contributions Received T or print in ink. Amounts ma be rounded to whole dollars. NAME OF FILER DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF COMM"EE, ALSO ENTER ID, NUMBER) CODE of X1 N D ElCOM El OTH LILL S A x ee [I PTY AMOUNT C U M U LATI VE TO DATE 0 SCC RECEIVED THIS JXIND �,v e Ej COM Or OTH TO DATE PERIOD PTY SCC (IF REQUIRED D COM ZIX OTH F-1 PTY ❑SCC IND Coo JOTH "W9z__4 4�1141 PTY SCC %IND ocom E] OTH PTY El SCC V"d IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER IF SELF-EMPLOYED, ENTER NAME ©F BUSINESS) M e--.,A1x.Po6 l���r�/� /aJPd lee .......S.C.H.E.D.U.I-E A (CONT) State from throu Pa Pa of I.D, NUMBER LILL AMOUNT C U M U LATI VE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JANa 1 DEC. 31) (IF REQUIRED 'AW M *Contributor Codes IND Individual COM Recipient Committee (other than PTY or SCC) OTH Other e. g business entit PTY Political Part SCC Small Contributor Committee SUBTOTALS FPPC Form 460 (Januar FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772) �j el Schedule A (Continuati Sheet) Monetar ContributionsReceived *Contributor Codes IND Individual COM Recipient Committee (other than PTY or SCC) OTH Other (e- business entit PTY Political Part SCC Small Contributor Committee T or print in ink. Amounts ma be rounded to whole dollars. SCHEDULE A (CO FPPC Form 460 Wanuar FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) SUBTOTAL$ Schedule T print in ink. SCHEDULE A Amounts ma be rounded Staterne vers ppriod Monetar Contributions Received to whole dollars. from VO SEE INSTRUCTIONS ON REVERSE throu Pa All /_4z' /Z K'z FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUA;, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE �IF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE IF SELF-EMPLOYED, ENTER NAME PERIOD JAN. I DEC. 31) IF REQUIRED) IND El COM OTH SCC IND Com E] OTH D PTY IND ncom El OTH Fj PTY W/0 Uwe. 411 EICOM El SCC IND com E] PTY El SCC Schedule Summary ""Contributor Codes 1. Amount received this period itemized monetary contributions. (Include all Schedule Asubtota|a.) COM Recipient Committee (other- than PTY Or SCC) 2. Amount received this period —unKemized monetary contributions ofless than $1OU OTH Other e. g business entit PTY Political Part 3. Total monetary contributions received this period. SCC Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A. Line 1.) .TOTAL Fppo Form wm(J=""a rppormw==e Hmm/"mouomoK-FpPom6m2roar7o Schedule C No~mmone1aryCon±ributions Received Type or print in ink. Am"""ts m-vum,ounuou SCHEDULE C from Imam throu Pa of—M SEE INSTRUCTIONS owREVERSE NAME OF FILER oAre rm�w^M�srnEEr^oDREaS^mo RECEIVED ZIP CODE opCONTRIBUTOR IF COMMITTEE, ALSO ENTER W. NUMBER) J.D. NUMBER IF AN INDIVIDUAL ENTER AMOUNT/ CUMULATIVE TO PER ELECTION CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF FAIR MARKET DATE TO DATE CODE IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR IF REQUIRED NAME OF BUSINESS JAN 1 DEC 31 Schedule Summary el *Contributor Codes 1 Amoumreoeivedunispenod itemizeunonmonetarycnntribudono. 6 .1 7,0 7 iND Individual (include all Schedule Caubtota|a.) COM Recipient Committee 'other than PTY or SCC) 2. Amount received this period unitemized nonmonetary contributions of less than $100 OTI.-i Other e. g business entit PTY Political Part a. Total nonmonetary contributions received this period. SCC Small Contributor Committee (Add Lines 1 and 2. Enter here and onthe Summary Page, Co|umnA Lines 4 and 1O.) -------.TOTAL FppC Form wm(Januurym5) j p EICOM FJOTH t4 I EISCC t5 10 D IND E] OTH PTY F] [:]S.cc EICOM 23 [:]OTH I -A#r Z L I 400 D PTY E] PTY EIS Attach additiol7al infonnatioti oii appropriatel labeled contil7uatiO17 sheets. SUBTOTAL. Schedule Summary el *Contributor Codes 1 Amoumreoeivedunispenod itemizeunonmonetarycnntribudono. 6 .1 7,0 7 iND Individual (include all Schedule Caubtota|a.) COM Recipient Committee 'other than PTY or SCC) 2. Amount received this period unitemized nonmonetary contributions of less than $100 OTI.-i Other e. g business entit PTY Political Part a. Total nonmonetary contributions received this period. SCC Small Contributor Committee (Add Lines 1 and 2. Enter here and onthe Summary Page, Co|umnA Lines 4 and 1O.) -------.TOTAL FppC Form wm(Januurym5) CODES: if one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment CtVP campaign paraphernalia /misc. MBR member communications RAID radio airtime and production coats CNS campaign consultants MTG meetings. and appearances RFD returned contributions CTB contribution (explain nonmonetary)* CFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing /ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS 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) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e -mail) Schedule E Surnmary 1. Itemized payments made this period. (Include all Schedule E subtotals.) 6-5 q 2. Unitemized payments made this period of under $100 4401 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.) TOTA1_ FPPC Form 460 (January /05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Schedule E Type or print in ink. (Continuation She Amounts may be rounded Paymen M ad e to whole dollars. SEE INSTRUCTIONS ON REVERSE z r r. SCHEdULE E (CUNT.) Statement corners period from throu IV)OV012 Z6 Page of I,D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CM=' campaign paraphernalia /misc.. CNS campaign consultants MBR N4TG member communications meetings and. appearances RAD radio airtime and production casts RFD returned contributions CTB contribution (explain nonmonetary)* CVC civic donations OFC PET office expenses petition circulating SAL campaign workers' salaries TEL tov, or cable airtime and production costs F1L candidate filing /ballot fees FND fundraising events PHO POL phone banks polling and survey research TRC candidate travel, lodging, and meals TRS staff /spouse travel, lodging, and meals 1ND independent expenditure supporting /opposing others (explain)" LEG legal defense POS PRO postage, delivery and messenger professional services (legal, accounting) services TSF transfer between committees of the same candidate /sponsor VOT voter registration I IT Campaign literature and mailings PRT print ads WEB information. technology costs (internet, e -mail) NAME AND ADDRESS OF PAYEE ([F COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION of PAYMENT AMOUNT PAID V O 1 13 COM bpc-VJA) ��Ie IU-!; aoo-% .,OWN 0 VIC) I WOW" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL "Oe J, 33 FPPC Form 460 (January105) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) S i Type or print in ink. SCHEDULE CONT. .Amounts may be rounded Continuation Sh eet) Staterr����G p►eri�d� to whole dollars. Accrued Expenses (Unpaid Bills) Y through Page o NAME OF FILER I.D. NUMBER CODES: one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CK/P campaign paraphernalialmisca MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings. and appearances RFD returned contributions CTB contribution (explain nonmonetary)* GFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable. airtime and production costs FIL candidate filing /ballot fees PHa phone banks TRC candidate travel, lodging; and meals FND fundraising events POL polling and survey research TRS 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) VQT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e -mail) Payments that are contributions or independent expenditures must also be summarized on Schedule D 1 `1 0 0 W.9j FPPC Foram 468 (January/05) FPPC Toll -Free Helpline. 866/ASK-FPPC (8661275 -3772) Schedule G Payments Made by an Agent or Independent Contractor (on behalf of This Committee) SEE INSTRU CTIONS ON REVERSE NAME OF FILER NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes. the payment, you may enter the code. Otherwise, describe the payment. CtVP 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)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing /ballot fees PHO phone banks TRC candidate travel, lodging, arid. meals FND fundraising events POL. polling and survey research TRS staff /spouse travel, lodging, and meals END 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) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) Payments that are contributions or independent expenditures must also be summarized on Schedule D NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER 1,0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID I i Attach additional iliformatiot7 on appropriately labeled continUation sleets. Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. TOTAL* FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SEE INSTRUCTIONS ON R EVERSE throug Page of NAME OF FILER Pell I.D, NUMBER FULL NAME, STREET. ADDRESS AND ZIP CODE OF RECIPIENT 1F AN INDIVIDUAL ENTER OCCUPATION AND EMIPLOYER 4�3 (b) OUTSTANDING. AMOUNT BALANCE �3 OUTST DING INTEREST REPAYMENT OR BALANCE AT M ORIGINAL fI CUMULATIVE (IF COMMITTEE, ALSO ENTER I.I�, .NU (IF SELF- EMPLOYED ENTER NAME OF BUSI LOANED. THIS BEGINNING. THIS PFRIfi�F7 PERIPD FORGIVENESS RECEIVED CLOSE OF THIS THIS PI= R1nI7 pr:Qrryn AMOUNT OF LOAN LOANS TO DATE FPPC Form 460 (January /05) FPPC Toll -Free Helpline: 8661ASK +PPS 866 /.276 °3772) Schedule I Miscellaneous Increases to Cash (%v�7/�rlteo �'G �11� �Gl C�� d �lv Attach additional information on appropriatel labeled continuation sheets. ..Schedule I Summar 1.. Itemiz ed incre to cash this pe riod 2. Unitemized increases to cash of under $100 this period. 3jo of all interest rec this period on loans made to others. (Schedule H q r n. n.. (p).) 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the S ummar y Pa Line 14.).... TOTAL SCHEDULEI FPPG�form 460 (January/051 FPPC Toll-Free Hel 866/ASK line. P 8661275..3.772) T or print in ink. Amounts ma be ro to whole dollars, SUBTOTAL