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Ruben TilosRecipient Committee Campaign Statement Cover Page Type or print in ink. Date Stamp (Government Code Sections 84200-84216.5) Statement covers period from \ 0 J 17 / Ol.f ILE SEE INSTRUCTIONS ON REVERSE through I \ J 2 /olf _\ \-t--'-·Z.-1-'0-"--+---lll-JAN 3 1 2005 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. ·15t Officeholder, Candidate Controlled Committee · 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) D General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information D Ballot Measure Committee 0 Primarily Formed O Controlled 0 Sponsored (Also Complete Part 6) D Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) STREET ADDRESS (NO P.O. jOX) GITA a~() k A q~~o \ ZIP cool~ (Dj ;gRb 5~2~14 MAl~ ADDRESS (IF 61FFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE 4. Verification 2. Type of statemen : C\TY OF ALAMEDA D Pree~ectionStatemen~ffY CLERK's=oiiAC~tatement D Semi-annual StatemeM' D Special Odd-Year Report ~rmination Statement D Supplemental Preelection D Amendment (Explain below) Statement -Attach Form 495 Treasurer(s) NAME OF TREASURER • "ToJ~ Cla(/ercf; CITY -STATE ?at"\ Jose , G A NAME OF ASSISTANT TREASURER, IF ANY AREA CODE/PHONE {qif6 ( t:i :sq-2ocf) MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS !ion contained herein and in the attached schedules is true and complete. I Executed on ------,0 ,..a.,...te ______ _ BY-------------------------------Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on ------,0 ,,-a.,...te ______ _ BY-------------------_,.,---,--..,.-------Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC State of California Recipient Committee Campaign Statement Cover Page -Part 2 Type or print in ink. 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER 01CANDIDATE 21."\;t:,e/l T as ZIP 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. 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 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 officehotder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE Attach continuation sheets if necessary FPPC Fonn 460 (June/01) FPPC Toll-Free Helpline: 866/ASK·FPPC State of California Type or print in ink. SUMMARY PAGE Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 4a.n FORM UU SEE INSTRUCTIONS ON REVERSE NAME OF FILER ~i.A.b e.V) T.·/05 Contributions Received Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 1. Monetary Contributions . . . ....... .. . .. . . . . . ... ..... .. . .. .. .. . .. . .. Schedule A. Line 3 $ I, 20z .. ':Ll 2. Loans Received ................................ ...................... Schedule B, Line 3 -s tJO • (!JO 3. SUBTOTAL CASH CONTRIBUTIONS ............. ............ Add Lines 1 + 2 $ z:;. z. ':1.l 4. Nonmonetary Contributions.................................... Schedule c, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 7;;?.7·4-fl Expenditures Made 6. Payments Made....................................................... Schedule E. Line 4 $ 7. Loans Made............................................................. Schedule H, Line 3 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. TOTAL EXPENDITURES MADE ................................ AddLines8+9+ 10 $ Current Cash Statement 12. Beginning Cash Balance....................... Previous Summary Page, Line 16 $ 13. Cash Receipts . . . .. .. . . .. . . . . . . .. . . .. . . . . .. . . . . . ... .. . . . .. . . ... .. Column A, Line 3 above 7'7.7. '"II 14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4 15. Cash Payments.................................................. Column A, Line B above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 0 If this is a termination statement, Line 16 must be zero. from -~)o_l~t _7_A_o_ .. _l ___ _ through ll fa lo'1 Page _!. ot~6" __ ColumnB CALENDAR YEAR TOTAL TO DATE $ L.J J 337. 811 0 $ ~I J3 7. ~l &b_o_. 33 $ ,,., ! 'l'f 7. 7'1 $ 1-l , !37, '1 / $ '11 :!>31. '11 bb C2. .33 $ ~~ ':/._<J_I .71.../ 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 LD. NUMBER 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 Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date {mm/dd/yy) __)__) __ $ __)__) __ $ __)__) __ $ __)__) __ $ __)__) __ $ __)__) __ $ -------------------------------------1 the first report being filed 17. LOAN GUARANTEES RECEIVED ...................... . Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents........................................ See instructions on reverse $ 19. Outstanding Debts ......................... AddUne2+Line9inColumnBabove $ 0 0 for this calendar year. only carry over the amounts from Lines 2, 7, and 9 {if any). *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 Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print in ink. Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) (IF COMMITTEE, ALSO ENTER l.D. NUMBER) CODE * JO/ttf /ot..J 111;;/0tj 6e11(jdU"l'YI 6 t:'!&tt'h1... /llos A-J~,..,e..J.... 1 ca.4 '?'l~Ol Schedule A Summary ~IND DCOM DOTH DPTY DSCC DINO DCOM DOTH DPTY DSCC DINO DCOM DOTH DPTY DSCC DINO DCOM DOTH DPTY DSCC DINO DCOM DOTH DPTY DSCC SUBTOTAL$ SCHEDULE A Statement covers period from IO /17 /o"f CALIFORNIA 40 A FORM \.1\.1 through ll/,.,/o'-/ Page "/ ot II AMOUNT RECEIVED THIS PERIOD t;"oo. oo 500 .or::; 1'17. '11 l.D. NUMBER IJ,.67"{67 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) 5()0-0C> 50{)<:0 PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes IND-Individual 1. Amount received this period-contributions of $100 or more. (Include all Schedule A subtotals.) ........................................................................................................ $ __ 1~, _l'-l_7_•_'i_I_ COM-Recipient Committee (other than PTY or SCC) OTH-Other 2. Amount received this period -unitemized contributions of less than $100 ............................................ $ ___ a_o_. <9C __ _ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ __ I ,_2_;;2_7_· _~_/_ PTY -Political Party SCC -Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Type or print in ink. Schedule B -Part 1 Loans Received Amounts may be rounded to whole dollars. Statement covers period from lo /17 lo"'l SEE INSTRUCTIONS ON REVERSE through I/ h.107 NAME OF FILER FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE. ALSO ENTER l.D. NUMBER) I\ i.tkefll r.·1o 5 ' . Al~/.4-\~~, c4 '1'1.£'0} tr:st IND 0 COM 0 OTH 0 PTY 0 sec R""h c:vi -r. 'los " .41ct.,..e.J~ e""'" 'f'fs-cJt tli('f IND 0 COM 0 OTH 0 PTY 0 sec to IND 0 COM 0 OTH 0 PTY D sec IF AN INDIVIDUAL, ENTER a OUTSTANDING OCCUPATION AND EMPLOYER BALANCE (IF SELF-EMPLOYED. ENTER BEGINNING THIS NAME OF BUSINESS) PERIOD f:·hc.t.lf\.CA.'r,t/ ~tt C.yf 't-&!-Se>o,'er>NJ.u.du $ t:;"OCJ ·00 f1l...c,1Ac.,i't,V 4nf}ly$f- C..y,o..'tsS $eMh-<J~frH' (b) (c) (d) AMOUNT OUTSTANDING AMOUNT PAID BALANCE AT RECEIVED THIS OR FORGIVEN CLOSE OF THIS PERIOD THIS PERIOD* PERIOD OPAID .Q. ~FORGIVEN s 500.~o Al A. DATE DUE R)"PAID $ ;a.>~ .PJ ~FORGIVEN $ l7~f)0 $ }"/7. '11 Al~ DATE DUE QPAID 0 FORGIVEN DATE DUE SUBTOTALS $ 173· 60 $ b 7~· {)CJ $ 0 Schedule B Summary 1. Loans received this period .................................................................................................................... $ J 75'.c/o (Total Column (b) plus unitemized loans less than $100.) 2. Loans paid or forgiven this period ........................................................................................................ $ 67S. 00 (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. -500. 00 (May be a negative number) t Contributor Codes (e) INTEREST PAID THIS PERIOD _!2_3 RATE C2 __o_% RATE __ % RATE $ C> (Enter{e)on Schedule E, Line 3) SCHEDULE 8-PART 1 CALIFORNIA 4 QA FORM Q\I Page__.£.__ of _L l.D. NUMBER (f) ORIGINAL AMOUNT OF LOAN (g) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR $ 5t)o.,,o s S-~ PER ELECTION** }Oft /O'i DATE INCURRED CALENDAR YEAR $ 17~ 00 PER ELECTION** /0(1'1/01.{ $ __ _ DATE INCURRED CALENDAR YEAR PER ELECTION** DATE INCURRED *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. IND-Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other PTY -Political Party SCC-Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC ScheduleE Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 10 /17 /o'( through / f la. lo'/ CODES: If one of the following codes accurately describes the payment. you may enter the code. Otherwise, describe the payment. seHEDULEE CALIFORNIA 4e A FORM DU Page_6_ of~ l.D. NUMBER l;}.67967 QvP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions eTB contribution (explain nonmonetary)* OFe office expenses SAL campaign workers' salaries eve 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 PAYEE (IF COMMITTEE. ALSO ENTER l.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID ...-;rl~c:..11 JI OIJ 7.:<.t . q I ... CMf Ifo.yw~1 Ct<\ Cj'CS'f'"/ * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 7;>.J .'f I Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) .................................................................................................. $ ;;;?, 7 ;;J./. 'ii 2. Unitemized payments made this period of under $100 ......................................................................................................................................... $ ______ _ 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.) ............................. TOTAL $ c;/. 7 ;J. J • '1 I FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC