Johnson 460Recipient Committee
Campai Statement
Cover Pa
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
T or print In ink. te Stamp R
Rt 1A
�A_ OMNI!
2W
Statement covers period Date of election if applicAle:
(Month, Da Year)
fro m C; WM 11_'h
0 HT
F
il
through o
1. T of Recipient Committee*, All Committees Complete Parts 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee
E] Primaril Formed Ballot Measure
OState Candidate Election Committee
Committee
0 Recall
0 Controlled
Also Complete Part 5
0 Sponsored
(Afso Complete Part 6)
General Purpose Committee
0 Sponsored
E] Primaril Formed Candidate/
0 Small Contributor Committee
Officeholder Committee
0 Political Part Committee
Also Complete Pail 7
3. Committee Information
I.D. NUMBER
C/
COMMITTEE NAME OR CANDIDATE'S NAME IF NO COMMITTEE
VT Y •J
L
STREET ADDRESS NO P.O. BOX
CITY STATE
ZIP CODE AREA CODE/PHONE
ZVI
MAILING ADDRESS IF DIFFERENT NO. AND STREET OR ROa BOX
CITY STATE
ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX E-MAIL ADDRESS
Executed on
Date
Executed on
Date
2. T of Statement:
0 Preelection Statement
Semi-annual Statement
Ej Termination Statement
Also file a Form 410 Termination)
F_� Amendment (Explain below)
COVER PAGE
e _J_ of
For Official Use Onl
0 Quarterl Statement
El Special Odd-Year Report
El Supplemental Preelection
Statement Attach Form 495
Treasurer(s)
NAME OF TREASURER
El L L
MAILING ADDRESS
CITY STATE ZIP CODE
AREA CODEIPHONE
NAME OF ASSISTANT TREASURER, IF ANY
C) L_ L 11
MAILING ADDRESS
CITY STATE ZIP CODE
AREA CODEfPHONE
4V 1
i
S C �4
OPTIONAL: FAX E-MAIL ADDRESS
B N� i
Si of Co6f(611in!� I r, Candidate, State Measure Proponent
By Si of Controllin Officeholder, Candidate, State Measure Proponent FPP-C Form 460 (Januar
FIPPC Toll-Free Helpline: 866/ASK.FPPC (8661275-3772)
State of California
COMMITTEE NAME
I.D. NUMBER
NAME OF TREASURER
CONTROLLED COMMITTEE?
7a Primarily Formed Candidate/Offic Committee List names of
officeholder(s) or candidate (s) for which this committee is primarily formed.
YES ND
COMMITTEE ADDRESS
STREET ADDRESS (NO P.O. BOXY
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR .HELD
S UPPO
POSE
CITY
STATE ZIP CODE AREA CODE/PHONE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
OPPOSE
COMMITTEE NAME
I.D. NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT. OR: HELD
El SUPPORT
OPPOSE
NAME OF :TREASURER
CONTROLLED COMMITTEE?
NAME OFOFFICEHOLDER OR CANDIDATE.
5
SUPPORT
YES NO
OPPOSE
COMMITTEE ADDRESS
STREET ADDRESS NO P.O. BOX
..CITY
STATE ZIP CODE AREA CODE/PHONE
Attac con s hee ts f
carp �nua rvn necessary
F PPC Fvrm 46 .lanua 1Q5
FPPC Toll e Hel line: 8661ASK -FPF 8661275 -3772
A
5Iate of California
NAME OF FILER
l.D, NUMBER
6EV E ff L Y J0.
Is
ontributions �►ec ed
Cciunn A
column B
Calendar Year Summary fo Cand
TOTAL THIS PER] OD
ATTACHED SCHEDULES}
CALENDAR YEAR
TOTALTO DATE
0 n C Cl g n.:: .o th e.. take: Primary and
.1. Monetary Contributions
Schedule A, Line 3
Sched
0011 006
Gener E ions
2. Loans. Rec
Schedule B, Line 3
r
1/1 through 6130 7l t o Date
3. SUBTGTALCASH CONTRIBUTIONS
Add Lines 1 2
20. Contributions
4. No
Received:
Centributi
Schedu Line I
21.: Expenditures
5. TL7TAL CONTR1 B[JTIC7NS RECEIVED
Add Lines 3 4
Made
E w end
r1 u�'e !fit �i�ma�►' for t�Itl�
6, Payments Made
Schedule EE, Line 4
3� Z
Can didates
Lo n
a s: Made......
Schedule H, Line 3
8. SUBTOTAL A
CASH PAYMENTS
Ad e s
A dd Lin 7
22 Cumulative Ex
ditu ade
(If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid gills)
Sch edule ,Line 3
Date of Election Total to Date
4. No monetary
Schedule C Line 3
�mmiddiyy)
11. TOTAL EXPENDITURES MADE ..........................AddL
s+ s
Ines o
Ji
urrr' a sh a iemen
2: Beginning .Cash: Balance Previous Summaty Page, e.1 fi
?4�
.Li
T n.B, add
v calculate Cvlum
'13: Cash Receipts Column A, Line ab ove
mvun
a is in :C v umn A to the
14: MSCellaneaus l ncreases to Cash
Schedul 1, Line 4
C rrespan ing arrloun s
f rvm Column B of your' Last
A in h' m be rent from amounts
15. Cash Payments column A, Li 8 above
report. 5nme amvun s in
t
reported i vl B .1
rte n
v n um
l mnAm
u a e ne a !We
9
16� ENDING CASH BALANCE: Add Lines 12 13 14,
then subfract Line 15
frgures; that shvuNd be
subtracted fro m previous
If this is a termination statement, Line 16 m be zero,
period amounts. if this is
the first report being filed
7. LOAN GUARANTEES: RECEIVED
Schedule B Part 2
far this c a lendar year, onl
carry. over the amounts
frarn Lines 2 7 and 9 (if
sh E uiya en "[s and u srand n e is a
any
I& Cash Equ ee in uc e
str (ions on revers
9.. Outstanding Debts...,. Add Lane 2 Line s in Column B above
FPP C Form 460 (January/05)
FPPG Toll -Free Helpr 8s6iASK F PPC .(8 661275 -3772)