DeHaan 460Recipient Committee
.. Campaign Statement
Cover Page
Type or print in ink. Date Stamp
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE through CJz/3J /tJ5
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4.
D Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
0 Recall
(Also Complete Part 5)
~General Purpose Committee
Q §Ponsored
GJ-Small Contributor Committee
O Political Party/Central Committee
3. Committee Information
D Ballot Measure Committee
0 Primarily Formed
0 Controlled
0 Sponsored
(Also Complete Part 6)
D Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
LO. NUMBER/ 2h b
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
711/tJ/3
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX I E-MAIL ADDRESS
4. Verification
Date of election if applicable:
(Month, Day, Year)
2. Type of Statement:
D Preelection Statement
D Semi-annual Statement
D Termination Statement
D Amendment (Explain below)
Treasurer(s)
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY
OPTIONAL: FAX I E-MAIL ADDRESS
STATE
D Quarterly Statement
D Special Odd-Year Report
D Supplemental Preelection
Statement -Attach Form 495
ZIP CODE AREA CODE/PHONE
Executed on ------=Date.,._------BY------,,,--,--,,,,....,-,,,.-,,,,,,....,,...,..,-..,,--,,.,--=__,..,.-__,,,__..,_ _____ _
Signature of Controlling Officeholder. Candidate. State Measure Proponent
. Executed on ------:::-Date..,.-------BY------------------------------~ Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (June/01}
FPPC Toll-Free Helpline: 866/ASK-FPPC
State of Cellfoml11
Type or print in ink.
Recipient Committee
Campaign Statement
Cover Page -Part 2
5. Officeholder or Candidate Controlled Committee
STATE ZIP
CIJ f1fb)
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.
COMMITIEE NAME 1.D. NUMBER
. NAME OF TREASURER CONTROLLED COMMITTEE?
DYES D NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME l.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
DYES D NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
6. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION D SUPPORT
D OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
7. Primarily Formed Committee List names of officeholder(s) or candidate(s) for
which this committee is primarily formed.
OFFICE SOUGHT OR HELD
U~ UJv,.(/OIL--
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
D SUPPORT
D OPPOSE
D SUPPORT
D OPPOSE
D SUPPORT
D 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
Type or print in ink. '
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Contributions Received
1. Monetary Contributions . . . ... . . . .. . .. . .... .. ... . . .. . .. . . . . . .. .. . .. Schedule A. Line 3 $
2. Loans Received ............ .......... .......................... ...... Schedule B, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ................. ........ Add Lines 1 + 2 $
Nonmonetary Contributions . . .. .. .... ... . .. . . . ... . ... ... . . . . . . . Schedule c, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED ................. ; ......... Add Lines 3 + 4 $
Expenditures Made
.6. Payments Made ............................................... ........ Schedule E, Line 4 $
7. Loans Made............................................................. Schedule H, Line 7
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. TOTALEXPENDITURESMADE ................................ Addlines8+9+ 10 $
Current Cash Statement
12. Beginning Cash Balance....................... Previous Summary Page, Line 16 $
3. 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. ENDINGCASHBALANCE .......... 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, Part 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 $
Column A
TOTAL THIS PERIOD
(FROM ATIACHED SCHEDULES)
$
$
$
$
$
$
Columns
CALENDAR YEAR
TOTALTODATE
To calculate Column .8, 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).
SUMMARY PAGE
CALIFORNIA 460
FORM
Page _2 ... · '----of 3
l.D. NUMBER
!Zr6bC/ 95
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Electio~s 1 1 {~I
yintirough ~ 7/1 to Date
20. Contributions
Received
21. Expenditures
Made·
$--+--rP
$--1=-¢
$ ____ _
$ ____ _
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(If Subject to Voluntery Expenditure Unlit)
Date of Election Total to Date
(mm/dd/yy)
__;__; __ $
__; $
__; $
__; $
__; $
__; $
*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