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Daysog 460V 0 1 L"' 104A -1 COVER PACE ?age of For Official Use Only Type of Recipient Committee All Committees — Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Ele Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 5) ❑ General Purpose Committee [] Sponsored ❑ Primarily Formed Candidate/ [] Small Contributor Committee Officeholder Committee 0 Political Party /Central Committee Alsn Complete Part 7) 3. Committee Information I.D. NUMBER l COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) PA A%4 Sbe4 ................................ STREET ADDRESS (NO P.O. BOX) - CITY STATE ZIP CODE AREA CODE/PHONE L 01 A- 1 4 0 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX 1 E -MAIL ADDRESS Executed on Executed on .................... Date Date 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi - annual Statement: ❑ Special Odd - Year Report Termination Statement ❑ Supplemental Preelection (Also file a Form 419 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX f E -MAIL ADDRESS By Signature of Controlling OfficeholderrCandidate, State Measure Proponent By �..w.. ,,. .., .......,. ......w.....,, ...�. �.., .. ... �. _, FPPC Form 460 (January/05) FPPC Toll-Free Help line: 866/ASK-FPPC 8661275 -3772 State of California Instructions for Recipient Committee Campaign Statement— Cover Page Period Covered by a Statement: The "period covered" by a campaign statement begins the day after the closing date of the last campaign statement you filed. For example, if the closing date of the last statement was September 30, the beginning date of the next statement will be October 1. If this is the committee's first campaign statement, begin with January 1 of the current calendar year. The closing date of the statement depends on the type of statement you are filing. Gate of Election: If you are filing this statement as a preelection statement in connection with an election, enter the date of the election. Type of Recipient Committee: Check one box to indicate the type of committee filing the statement. General descriptions are provided on the cover sheet to this form, or contact your filing officer or the FPPC for assistance. Following are some additional guidelines: Controlled Committee A controlled committee is one that is controlled by a candidate, officeholder or, in the case of a state ballot measure committee, by the proponent of the measure. A committee is "controlled" if the candidate, officeholder, or proponent, his or her agent, or any other committee he or she controls, has a significant influence on the actions or decisions of the committee. Sponsored Committees A sponsored committee is one that has a sponsor —a business entity, organization, union, or other entity that meets certain criteria. Sponsored ballot measure committees and general purpose committees must include the name of the sponsor in the name of the committee. Small Contributor Committees This term is significant only if the committee makes contributions to candidates running for elective state office. Type of Statement: Check the appropriate box(es) to indicate the type of statement you are filing (or amending). Amendments: If you are filing an amendment toa previously filed statement, give a brief explanation of the amendment and list the schedules being amended. Include an amended summary page, if applicable. Be sure to enter the period covered of the statement you are amending. Termination: A committee must continue filing campaign statements each year until it is eligible to terminate and files a Form 410 Termination. Most officeholders must continue filing campaign statements until they have terminated all controlled committees and have left office. Committee I.D. Number: If the committee has not yet received an identification number from the Secretary of State, enter "Not Yet Received." File Form 410 to obtain an I.D. Number. Verification: The statement must be signed by the committee treasurer or the assistant treasurer named on the committee's Statement of organization (Form 410). An officeholder, candidate, or state measure proponent who controls the committee must also sign the statement. If two or three officeholders, candidates, or proponents control the committee, each must sign the statement. If more than three control the committee, one may sign on behalf of the others. Under certain circumstances, the responsible officer of a sponsoring organization must sign the statement. Additional Important Information: Refer to the FPPC Campaign Disclosure Manual for your type of committee for information about: • When, where, and what type of statements the committee is required to file. • Closing date of campaign statements. Sponsored committee criteria. Termination criteria. a Recordkeeping requirements and prohibitions. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Type or print in ink. COVER PAGE - PART 2 Recipient Committee Campaign Statement Cover Page — Part 2 Page I of 6. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE BALLOT ND. DR LETTER JURISDICTION [:] SUPPORT ❑ OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO, AND STREET) CITY STATE ZIP 4 4: C Identify the controlling officeholder, candidate, or state measure proponent, if any & ) i4tj r'.M0)6._ NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees N Included in this Statement List any committees not included in this statement than are controlled by you or are primarily formes! to receive OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER 7. Primarily Formed Candidate /Officeholder Committee Li names of NAME OF TREASURER CONTROLLED COMMITTEE? officeholder {s} or candidate(s) for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER DR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER DR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT E] OPPOSE COMMITTEE NAME l,D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑ YES F] NO ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPFIONE Attach continuation sheets if necessary FPPC Farm 460 Janua 105 ( rY ) FPPC Toll-Free Help line: Hel Iine• H661ASK -FPPC 8661 275 -3772 ( . .................. .....:......:.................. State of California Instructions for Recipient Committee Campaign Statement — Cover Page Officeholder or Candidate Controlled Committee: Candidates must have a separate bank account and committee to run for different elective offices. A candidate who is required to file campaign statements in connection with more than one elective office but is only receiving contributions and making expenditures for one of the offices, may include both offices on one Form 460. In Part 5 of the cover page, enter the candidate's name and under "office Sought or Held," identify each office, and state whether the candidate is seeking or holding the office. The Form 450 must be filed with the appropriate filing officer(s) for each office. For example, a city councilmember is raising funds to run for the county board of supervisors. She has no committee and is not raising or spending funds in connection with the city office, and has formed a controlled committee for the county office. To comply with the requirements to file campaign statements for both her city office and her county candidacy, she may complete one Form 450 each campaign reporting period, which she will file with the city clerk and the county elections department. In Part 5 of the Form 460 Cover Page, under "Office Sought or Held," she will state that she is holding the office of city councilmember (including the name of the city) and that she is seeking a seat on the board of supervisors (including the name of the county). Ballot pleasure Committee: Part 6 of the Form 460 Cover Page must be completed by committees that are primarily formed to support or oppose the qualification or passage of a single ballot measure or two or more measures being voted on in the same city, county, multicounty, or state election. A "general purpose" ballot measure committee (one that supports or opposes a variety of state and/or local ballot measures) is not required to complete Part 6. FPPC Farm 460 (January /05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275 -3772) Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from t 0 (-7 f IN through t' Page of NAME OF FILER V A % , C r- I.D. NUMBER Contributions Received Column TOTALTHIS PERIOD Column CALENDARYEAR Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) TOTALTO DATE Running in Bath the State Primary and g o General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ $ 111 through 6130 7l1 to Date 2. Loans Received ...................................................... Schedule B, Line 3 _ 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 7 $ $ 20. Contributions Received $ d $ 61 4. Nonmonetary Contributions Schedule C, Line 3 ..... ............................... 21. Expenditures Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED .......................... Add Lines 3 + 4 $ _ • $ ............................. ........... Expenditures Made ere, Expenditure Limit Summary for State 6. Payments Made .................. ............................... ...... Schedule E Line 4 $ $ Candidates 7. Loans Made .............................. ............................... Schedule H, Line 3 11 43 22. Cumulative Expenditures Made` Limit) S. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ $ (if Subject to Voluntary Expenditure 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 12 Date of Election Total to Date 14. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 (mmlddlyy) 31 11. TOTAL EXPENDITURES MADE . Add Lines 8+ 9+ 10 1 9 $ t ' L t 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 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ Ir If this is a termination statement, Line 16 must be zero, 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ SUMMARY PAGE To calculate Column B, add amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts from Column B of your last reported in Column B. 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). FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Instructions for Summary Page Campaign Disclosure Statement The Summary Page provides an overview of the committee's financial activities and is completed for each filing. Column A reflects activities during the current reporting period as reported on Schedules A through H. It is not necessary to attach a blank schedule if there has been no reportable activity during the period, but it is necessary to enter a zero or the word " none" on the appropriate line in Column Aof the Summary Page. Column B figures should reflect the cumulative total since January 1 of the current calendar year.* Add the totals from Column B of the committee's last campaign statement (if any) to the corresponding amounts in Column A. If this is the first report being filed for a calendar year, only carry forward the amounts reported on Lines 2, 7, and 9 of Column B (if any) from the committee's last statement. (Note: The amounts reported on Lines 2, 7, and 9 of Column B should be the same as the total outstanding amounts disclosed in column (d) of Schedules B, F, and H, respectively, of the current report.) When loans (Schedules B and H) and accrued expenses (Schedule F) are paid, the figures to be carried from the schedules to Lines 2, 7, and 9 of Column A may be negative numbers. In this case, be sure to show them as negative figures on the Summary Page (e.g., with a minus sign ( -) or in parentheses), and subtract them when totaling Columns A and B. `There are exceptions to the calendar year "cumulation period" for candidate elections and ballot measure elections held in January and early February, and for ballot measure qualification activities. Consult the FPPC Campaign Disclosure Manual for your type of committee for additional information. Current Cash Statement: Lines 12 -16 of the Summary Page should accurately reflect your current cash position. Beginning and ending cash balances should include the total amount of funds in your campaign checking and savings accounts, plus any investments that can be readily converted to cash, such as certificates of deposit, money market accounts, stocks and bonds, etc. (officeholders and candidates are subject to bank account restrictions, and all committees should read the FPPC Campaign Disclosure Manual regarding appropriate uses of campaign funds.) Line 12 (Beginning Cash Balance) must be the same as the ending cash balance reported on Line 16 of your previous statement's Summary Page. If this is your first campaign statement, enter zero on Line 12. Line 16 (Ending Cash Balance) is the total of Lines 12, 13, and 14, minus Line 15. If you are filing a termination statement, Line 16 must be zero. Cash Equivalents: "Cash equivalents" include investments that cannot be readily converted to cash, as well as the balance due on all outstanding loans the committee has made to others (from Line 7 of Column B of the Summary Page). Investments that can be readily converted to cash, such as certificates of deposit or money market funds, should be included in the cash on hand figures on Lines 12 and 16 of the Summary Page. Summary for Primary and General Elections (Lines 20 and 21): This section is only for committees that are: e Controlled by a Candidate who is being voted on in both the state primary and general elections (does not apply to controlled ballot measure committees); or • Primarily formed to support or oppose candidates being voted on in both the state primary and general elections. Complete this summary on the preelection and semi - annual statements for the general election, covering periods during the last six months of the year (July 1- December 31). Expenditure Ceiling Summary for State Candidates (Line 22): Candidates for elective state office who have accepted the voluntary expenditure ceiling for a particular election must disclose the total amount of expenditures made through the end of the reporting period that are subject to the expenditure ceiling for the election. Report the date of the election and total amount expended for that election. Report totals for the primary and general elections separately. This information is no longer required if the expenditure ceiling has been lifted. (See FPPC Campaign Disclosure Manual 1.) FPPC Form 468 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8651275 -3772) Schedule A Type or print in ink. SCHEDULE A Monetary Contributions Received Amounts may be rounded to whole dollars. Statement cover period � ' e from � through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER 1 3 z 4-A DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE,ALS[� ENTER I.D. NUMBI =R} CODE * (IF SELF - EMPLOYE, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Instructions for Schedule A Monetary Contributions Received Report monetary contributions (except loans) received during the reporting period on Schedule A. Also report on Schedule A if a contributor forgives a loan for you or a third party pays a loan for you. Loans received during the period are reported on Schedule B. Certain transfers between a state candidate's controlled committees are also disclosed on Schedule A. (See FPPC Campaign Disclosure Manual 1 .) If a total of $100 or more is received from a single contributor during a calendar year, report the name, street address, city, state and zip code of the contributor, the amount contributed this period, and the cumulative amount received from the contributor since January 1 of the current calendar year.* Include monetary and nonmonetary contributions and loans when reporting the cumulative amount. Contributions totaling less than $100 received from a single contributor during a calendar year are reported as a lump sum on Line 2 of the Schedule A Summary. *There are exceptions to the calendar year "cumulation period" for candidate elections and ballot measure elections held in January and early February, and for ballot measure qualification activities. (See the FPPC Campaign Disclosure Manuals for candidates and ballot measure committees.) Gate Received: A monetary contribution has been received when the candidate or committee, or an agent of the candidate or committee, receives or obtains control of the check or other negotiable instrument. There are special rules for reporting the date contributions are received by a committee that collects contributions through employee payroll deductions or membership dues. Contributor Codes: For each itemized contributor, check the applicable contributor code: I N D--co ntri b utio n s from any individual's personal funds. COM— contributions from other committees that receive contributions. These committees will have an identification number assigned by the Secretary of State. Examples: political action committees, other candidates' committees. (State committees should use PTY or SCC when appropriate.) OT1 -I -- business entities and other contributors. PTY -- contributions from political parties (including state and county central committees). SCC -- contributions from small contributor committees (applicable only to state candidates and committees). Contributions from individuals: When itemizing a contribution from an individual, also disclose the contributor's occupation and the name of his or her employer. If the contributor is self-employed, provide the name of his or her business. If the contributor is not employed, enter "none. It is not necessary to enter occupation and employer information for other types of contributors (such as business entities). Missing Contributor Information; A contribution of $100 or more must be returned to the contributor within 00 days if the recipient does not obtain the contributor's address, occupation and employer. Contributions from Committees: When itemizing a contribution from another recipient committee, disclose the identification number assigned to that committee by the Secretary of State in addition to its name and address. If no ID number has been assigned, provide the name and address of that committee's treasurer. Intermediaries: If you receive a contribution through an Intermediary (i.e., you have received a contribution check from a person other than the true source of the funds), disclose all of the required information for both the Intermediary and the actual contributor. Per Election to late: Candidates subject to state contribution limits (or if required by local ordinance) must disclose the cumulative amount received from each contributor during the limitation cycle in addition to the calendar year cumulative amount. (Candidates for elective state office should refer to FPPC Campaign Disclosure Manual 1 .) Additional Important Information: Referto the FPPC Cam paig n Disclosure Manual for your type of committee for important information about aggregating monetary and nonmonetary contributions, recordkeeping, prohibitions on cash contributions, returning contributions, and more. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Schedule B ummary 1. Loans receive is period ....... .......................................................................... ............................... $ (Total Column (b) p mized loans of 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. Amounts forgiven or paid by another party also must be reported on Schedule A. * If required. (Enter (e) on Schedule E, Line 3) tContributor Codes -IN D— Individual CQ — Recipient Committee (other than PTY or SCC) QTH – ther (e.g., business entity) PTY – olitical Party SCC -- mall Contributor Committee be a negative number) .. F'tnt Fv F PC Farm 460 (January/05) FPP T oll-Free H 1 line: 8fifif 5K -FPPC 86fi1275 37 ?2 C o ee e P � ) Type or print in ink. SCHEDULE B - PART 1 Schedule B — Part 1 Loans R eceived Amounts may be rounded to whole dollars. Statement covers period from s SEE INSTRUCTIONS ON REVERSE through h Page of I ' NAME OF FILER I.D. NUMBER a9 9jt? FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER OCCUPATION AND EMPLOYER a OUTSTANDING BALANCE N AMOUNT 4cj AMOUNT PAID {d) OUTSTANDING BALANCEAT W INTEREST M ORIGINAL (g) CUMULATIVE OF LENDER (IF SELF - EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS QR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS CIF COMMITTEE, ALSO ENTER I. ©. NUMBER} NAME O F BUSINESS) PERIOD PERIOD THIS PERIOD �` PERIOD PERIOD LOAN TO DATE PAID CALENDAR YEAR $ $ % $ FORGIVEN RATE PER ELECTION" Schedule B ummary 1. Loans receive is period ....... .......................................................................... ............................... $ (Total Column (b) p mized loans of 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. Amounts forgiven or paid by another party also must be reported on Schedule A. * If required. (Enter (e) on Schedule E, Line 3) tContributor Codes -IN D— Individual CQ — Recipient Committee (other than PTY or SCC) QTH – ther (e.g., business entity) PTY – olitical Party SCC -- mall Contributor Committee be a negative number) .. F'tnt Fv F PC Farm 460 (January/05) FPP T oll-Free H 1 line: 8fifif 5K -FPPC 86fi1275 37 ?2 C o ee e P � ) Instructions for Schedule B —Part 1 Loans Received All loans received or outstanding are reported on Schedule B. Loans include monetary loans and amounts drawn on lines of credit. Report loan guarantors on Schedule B - Part 2. A "guarantor" is a third party that co-signs, endorses, or provides security for a loan, or establishes or provides security for a line of credit. A guarantor is also making a contribution. When a state candidate guarantees a loan from a commercial lending institution in connection with his or her election, both the lending institution and the candidate are required to be disclosed as the lender. For each loan of $100 or more that was received or was outstanding during the reporting period, disclose the lender's name and address. Report the original source of all loans received. E.g., fora loan from a commercial lending institution for which a candidate is personally liable, report the lending institution as the lender. Column (a) — Enter the outstanding loan balance at the beginning of this period (Column (d) of last report). If the loan was received this period, this column will be blank. Column (b) — Enter the amount received from the lender during this reporting period. If this loan was received in a previous reporting period, leave blank. Column (c) — Enter the amount of any reduction of the loan during this reporting period. Check whether the loan was paid or forgiven. When the lender forgives a loan or a third party makes a payment on a loan, also report the lender or third party on Schedule A. Column (d)-- Enter the outstanding balance of the loan at the close of this reporting period. Enter the due date, if any. Column (e) — Enter the interest rate and the amount of interest paid on the loan(s) during this reporting period. Interest paid is reported separately from payments made on the loan principal. Interest payments are also transferred to the Schedule E Summary. Column (f) — Enterthe original amount of the loan and date received. If this is the first time you are reporting the loan, this will be the same amount reported in Column (b). Column (g) — Enter the cumulative amount of contributions (loans, monetary and nonmonetary contributions) received from the lender during the calendar year covered by this statement. Candidates subject to state contribution limits (or if required by local ordinance) must disclose the cumulative amount received from each contributor during the limitation cycle in addition to the calendar year cumulative amount. (Candidates for elective state office should refer to FPPC Campaign Disclosure Manual 1.) Schedule B Summary: The Schedule B Summary reflects the "net change" in your loan activity. That is, loan payments made during the period are subtracted from new loans received. When the loan payments number is larger than the amount of new loans received, Line 3 will be a negative figure. For example, if $200 is paid during the period and only $100 is received in new loans, report the net change on Line 3 as " -$100" or "($100)." Be sure to carry this figure to the Summary Page as a negative figure to be subtracted from Summary Page totals. Additional Important Information: Refer to the Instructions for Schedule A for important information about: • Contributor Codes • Contributions from Individuals • Contributions from Committees • Intermediaries A loan received from a commercial lending institution in the normal course of business is reportable on Schedule B but is not considered a contribution. Contributor codes and cumulative amounts (Column (g )} are required only for loans that are contributions. Refer to the FPPC Campaicin Disclosure Manual for your type of committee for important information about recordkeeping, prohibitions on cash contributions, returning contributions, and more. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) SCH EDULE B - PART 2 Schedule B — Part 2 Type or print in ink. Statement covers period a Amounts may be rounded Loan Guarantors to whole dollars. t� m from through e of Pag SEE INSTRUCTIONS ON REVERSE NAME OF FILER Lf- I.D. NUMBER FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER LOAN AMOUNT GUARANTEED CUMULATIVE BALANCE OUTSTANDING ZIP CODE OF GUARANTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE ��� SELF-EMf BU D, SS) NAME OF BUSINESS) THIS PERIOD TO DATE TO DATE LENDER CALENDAR YEAR [BIND ❑CoM $ ❑ Q"rH DATE (IF REQUIRED) ❑ PTY ❑SCC CALENDAR YEAR ❑ IND LENDER ❑ Com ❑ oTH DATE PER ELECTION (IF REQUIRED) ❑ PTY ❑ SCC $ CALENDAR YEAR ❑ IND LENDER ❑ coM PER ELECTION (IF REQUIRED) DATE ❑ PTY ❑SCC $ CALENDAR YEAR IND LENDER ❑ COM $ OTH DATE PER ELECTION (IF REQUIRED) ❑ PTY ❑ SCC $ Enter on SU BTOTAL e, Summary Page, Line 17 only, Y ..; r:h:; PC Form 460 Janua 105) rY `';; P!;rin' ;�orr ..:;: FPPC Toll-Free Helpline: 866E ASK -FPPC 8661 Z75 -3772 Schedule C Type or print in ink. Amounts may be rounded Nlonmonetary Contributions Received to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER SCHEDULE C through Page of Statement oWers eriod from r rrr r' n Orr a o informa a Attac additional i ❑IND ®CoM ❑ oTH ❑ PTY ❑SCC RIND ❑ CoM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ oTH ❑ PTY ❑ SCC IND ❑ M ❑ oT ❑ PTY ❑ SCC d continuation s heets. SUBTOTAL BTOTAL Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (include all Schedule C subtotals.) ............................. ............................... ....................... ............................... $ 2. Amount received this period — unitemiZed nonmonetary contributions of le s than $100 ..... ............................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4 and 10.) ...................... TOTAL $ I.D. NUMBER CUMULATIVE TO PER ELECTION DATE TO DATE CALENDAR YEAR (IF REQUIRED) (JAN 1 -DEC 31) *Cont 'butor Codes IND — 1 dividual COM — ecipient Committee other than PTY or SCC} oTH — -ther (e.g., business entity) PTY — Po 'tical Party SCC — Srn Contributor Committee FPPC Form (January/05) " -377Z l lin 66 ASK -FPPC S FPPC Toll -Free He e 8 J p � �' `` or :: � :. DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET RECEIVED ZIP CODE OF CONTRIBUTOR CODE * (IF SELF - EMPLOYED, ENTER GOODS OR SERVICES VALUE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) r rrr r' n Orr a o informa a Attac additional i ❑IND ®CoM ❑ oTH ❑ PTY ❑SCC RIND ❑ CoM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ oTH ❑ PTY ❑ SCC IND ❑ M ❑ oT ❑ PTY ❑ SCC d continuation s heets. SUBTOTAL BTOTAL Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (include all Schedule C subtotals.) ............................. ............................... ....................... ............................... $ 2. Amount received this period — unitemiZed nonmonetary contributions of le s than $100 ..... ............................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4 and 10.) ...................... TOTAL $ I.D. NUMBER CUMULATIVE TO PER ELECTION DATE TO DATE CALENDAR YEAR (IF REQUIRED) (JAN 1 -DEC 31) *Cont 'butor Codes IND — 1 dividual COM — ecipient Committee other than PTY or SCC} oTH — -ther (e.g., business entity) PTY — Po 'tical Party SCC — Srn Contributor Committee FPPC Form (January/05) " -377Z l lin 66 ASK -FPPC S FPPC Toll -Free He e 8 J p � �' `` or :: � :. Schedule D Summar of Expenditures Supportin Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE SCHEDULED T or print in ink. Statement covers period Amounts ma be rounded to whole dollars. L I 'ZAIL I> from to/ throu 2. - e of ........ NAME OF FILER I.D. NUMBER J/ DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION CUMULATIVE TO DATE PER ELECTION TYPE ❑OF PAYMENT AMOUNT THIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, ( IF REQUIRED) PERIOD ( JAN. 1 DEC. 31 ( IF REQUIRED OR COMMITTEE ❑ Monetar Contribution ❑ Nonmonetar Contribution ❑ Independent F1 Support E oppose Expenditure Monetar Contribution ❑ Nonmonetar Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetar Contribution Nonmonetar Contribution ❑ Independent ❑ Support ❑ 0 p p s e Expenditure ....................................... NEE= SUBTOTAL Schedule D Summar 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ......................... ............................... $ 2. Unitemized contributions and independent expenditures made this period of under $100 ............................................................................. ....... $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summar Pa ............ TO AL $ KPPC Form 460 (Januar F _-orm: FPPC Toll-Free Helpline: 86&�SK.FPPC ( 866/275-3772) . ............. .. .. SCHEDULE E CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP 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 filinglballot 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 supportinglopposing 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) NAME AND ADDRESS OF PAYEE (1F COMMITTEE, ALSO ENTER 1.D. NUMBER) t ,.l *4r7 CODE OR DESCRIPTION OF PAYMENT * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary SUBTOTAL $ 1. Itemized payments made this period. (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, Co u ................................................ ............................... $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ AMOUNT PAID FPPG Form 460 (January/05) FPPG Toll -Free Hel � S -FPPG B�fiJ2 ?5 -3 ?7Z line: 86 lA K n F r p t ) i ear CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describ the payment. CW campaign paraphernaIi@ /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, 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) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) / , j 4- * Payments that are contributions or indepen nt expenditures must also summarized on Schedule D. CODE OR OUTSTANDING AMOUNT INCURRED DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD OF THIS PERIOD SUBTOTALS $ $ Schedule F Summary 1. Total accrued expenses incurre this period. Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or m re, plus total uniternized accrued expenses under $100.) ...................... .... INCURRED TOTA S $ .................. 2. Total accrued expenses paid this eriod. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more; lus total uniternized payments on accrued expenses under $100.} .. .......0 .................... PAID TOTAL AL $ 3 Net change this period. (Subtract Lin 2 from Line 1. Enter the difference here and W {d} AMOUNT PAID OUTSTANDING THIS PERIOD BALANCE AT CLOSE (ALSO REPORT ON E) OF THIS PERIOD on the Summary Page, Column A, Line ............................................................................................ ............................... .......... NET $ b rive number ........... Ma ne a - • FPPC Farm 46 January /05) b'� T oll -Free He[ litre: 8661ASK - FPPC 8661275 - P : t I=art1'a;: 5±� F .... �� n . . FPPC T p CODES: if one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP 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 PE petition circulating TEL tm. 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 candidatelsponsor LEG legal defense PRO professional services (legal, accounting) VDT 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. SCHEDULE H Schedule H Type or print in ink. Statement covers period l . 9 A a Leans Made to Others* Amounts may be rounded to whole dollars, from �` . • through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER 1 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING BALANCE (h) AMOUNT �c} REPAYMENT OR ( d) OUTSTANDING BALANCE AT (e) INTEREST 4� ORIGINAL (g) CUMULATIVE OF RECIPIENT {IF SELF - EMPLOYED, ENTER BEGINNING THIS LOANED THIS PERIOD PERIOD FORGIVENESS CLOSE OF THIS RECEIVED AMOUNT OF LOAN LOANS To DATE (11= COMMITTEE, ALSO ENTER I.D. NUMBER) CE BUSINESS} PERIOD THIS PERIOD` PERIOD PAID CALENDAR YEAR N7_� [] FORGIVEN RATE PER ELECTION** * Loans that are contributions to another candidate or gbmmittee must also be summarized on Schedule D. Loans for en must- also be reported on Schedule E. Schedule H Summary \ S— r] PAID FORGIVEN $ I $ I $ SUBTC TALS I$ $ 1$ DATE DUE DATE INCURRED CALENDAR YEAR 1. Loans made this period ................................................................................................................. ............................... (Total Column (b) plus unitemized loans of less t n $100.) 2. Payments received on loans ............ ............................... . , ........................................................... ............................... $ (Total Column (c) plus unitemized payments of less than $100. 3. Net change this period. (Subtract Line 2 from Line 1.) ........................... . ........ NET $ ... .. .......... ... .... .. ..... ..... W ... .... .... (May be a negative number) (Enter the net here and on the Summary Page, Column A, Line 7.) **If Required . .... . FPP C Form 466 Ja n ua :.: ■yam_ .::::::':.::.: .: ........... ........ P rint -Free He Iin e a. O� P 61275 C -377 l : S661A51t - FP C 86 FPP Tvll p SCHIEDULE1 Pa of I.D. NUMBER 1 ;2, AMOUNT OF INCREASE TO CASH Attach additional information on appropriatel labelers continuation sheets. SUBTOTAL $ Schedule I Summar 1. Itemized increases to cash this period . .. ......................................................... .................................... ....... 2. Uniternized increases to cash of under t 0 $1 his period ...... ................................................................................ m ...... $ 1 0 this 3. Total of all interest received this period on ans made to others. (Schedule H, Column ( e).) .......................... $ . i p 0 4. Total miscellaneous increases to cash t iod. (Add Lines 1, 2, and 3. Enter here and on the Summary Line 14.) ........ m ....................... ............................................................... ...... .. . .......... TOTAL $ FPPC Form 460-(Jajjuar ........ ...... orm . . . . .. . ... . . .. .. -Free Helpline: 866/ASK-FPPC (866/27�-3772) 00 . FPPC Toll ... .... Print . ..... ... . . . . ..... ....... .