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Committee to Elect Jeptha Boone 460COVER PAGE Recipient Committee Campaign Statement Cover Page Type or print in ink. Date Stamp "'' ;CALIFORNIA 4~A (Government Code Sections 84200-84216.5) Statement covers period from _S_/_'7"'---/ z_oo_~--- SEE INSTRUCTIONS ON REVERSE through _1 0 _H_/_z._O:.:i-t __ _ 1. Type of Recipient Committee: Alf Committees -Complete Parts 1, 2, 3, and 4. ft Officeholder, Candidate Controlled Committee D Ballot Measure Committee 0 State Candidate Election Committee O Primarily Formed 0 Recall 0 Controlled 'Also Complete Pan 5) Q Sponsored D •3eneral Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee 3. Committee Information (Also Complete Part 6) O Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) l.D. NUMBER 12 (o '83'1 '-/ COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) STREET ADDRESS (NO P 0. BOX) CITY A L-A IVi 6 DA-STATE CA ZIP CODE t'J '-/':;DI MAIUNG ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O BOX CITY STATE ZIP CODE OPTIONAL: FAX I E-MAIL ADDRESS (_ S-1 0) s z' --s °' c11- 4. Verification AREA CODE/PHONE L.n°) s21 -3'i s'-/ AREA CODE/PHONE Date of election if applicable: (Month, Day, Year) 11 / 2 /z.ooj 2. Type of Statement: zPreelection Statement D Semi-annual Statement D Termination Statement D Amendment (Explain below) Treasurer(s) NAME OF TREASURER ' 2001/02 u"' i' FORM lti ·.page ___ _ 1'8' of ___ _ For Official Use Only D Quarterly Statement Special Odd-Year Report D Supplemental Preelection Statement -Attach Form 495 5 EN::>A-rv\ I µ J. f 2 ~ €> I J.J-E~ &.. . MAILING ADDRESS ' !>/ CITY NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS STATE ell ZIP CODE C;4SDJ CITY STATE ZIP CODE bre.y-e .se.ci lti. YYl-t' cl<:.. V\-c+, n-c+- OPTIONAL FAX I E-MAIL ADDRESS AREA CODE/PHONE (S" (bJ 7'·6-7 'f"'t!) AREA CODE/PHONE I 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. certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on ---'/_o_/_j,__,_/~z_o_v'-f _____ _ Date Executed on __ l_'D_,_/_j._.{_z._co __ J.f.i.._ ____ _ Date Executed on _____ _,, 0 ,..,at_e ______ _ Executed on -----..-.,,D,-at,_e ______ _ . . . ~ ~ ' ..... .... . . . . . . . . . . . . . . . By ---------;cSi-gn-a.,-tJ-re-o"'f C'°"'o'""nt-ro""llin-g°"O"'ffi-ce..,-ho'""ld""e-r, °"'Ca-n'""di,..,-da"'°te-, S"'t-,at-e M'""e-a-su-re-,P""°ro-p-on-e-,nt,..-------. ,· .· .· .· .. ·. ·. ·. ·. . ' ....... . . . . . . . BY------------------..,---------------Signature of Con·.rolling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC State of California Type or print in ink. COVER PAGE -PART 2 Recipient Committee Campaign Statement Cover Page -Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE 5EPTi-+A 'IS.cor-J &'" / IV\. i). OfflCE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE:) RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE 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? D YES D NO COMMITTC:l:: ADDRESS STREET ADDRESS (NO PO. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE ADDRESS STREET 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. 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 SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 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 SEE INSTRUCTIONS ON REVERS[ NAME OF FILER (_(.)WllV\1.i/~ lo EL..:l:{ ::;-~f"T1-ti4 Contributions Received 1 Monetary Contributions ............... Schedule A, Line 3 Loans Received ..... .................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS 4. Nonmonetary Contributions .. 5. TOTAL CONTRIBUTIONS RECEIVED . Expenditures Made 6. Payments Made .. 7. Loans Made. 8. SUBTOTAL CASH PAYMENTS . . ...... 9. Accrued Expenses (Unpaid Bills) .. 10. Non monetary Adjustment ·11. TOTAL EXPENDITURES MADE ... Current Cash Statement 12. Beginning Cash Balance .. 13. Cash Receipts .. 14. Miscellaneous Increases to Cash. 15. Cash Payments ... Add Lines 1 + 2 Schedule C, Line 3 ... Add Lines 3 + 4 Schedule E, Line 4 Schedule H, Line 3 Add Lines 6 + 7 . ........ Schedule F, Line 3 .... Schedule C, Line 3 ... Add Lines 8 + 9 + 10 Previous Summary Page, Line 16 Column A, Line 3 above .. . .. Schedule I, Line 4 Column A, Line 8 above 16. ENDING CASH BALANCE . . . . . ... Add Lines 12 + 13 + 14. then subtract Line 1 s If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................ .. Schedule B. Part 2 Equivalents and Outstanding Debts Type or print in ink. Amounts may be rounded to whole dollars. $ $ $ $ $ $ $ $ Column A TOTAL THIS PERIOD (FROM ATC ACHED SCHEDULES) oo·c:O I cp.L/. CO 1qz."-! .(.)O -G- I ct .@ / 38/·cO 18. Cash Equivalents ... . SeA instructiens on reverse $ 19 Outstanding Debts ............ . Add Line 2 + Line 9 in Column B above $ Statement covers period 0 I Lf I ?.or.>-{ from ---------- l D /'-j ( through ______ ~-- $ $ $ $ $ $ Columns CALENDAR YEAR TOTAL TO DATE °;2'-f ·LO a-- ·c..O ..f}- -&-- .(.).:> 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 the first report being filed for this calendar year, only carry over the amounts from Lines 2. 7, and 9 (if any) LD. NUMBER /2.foZ3 qt../ Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6/30 7/1 to Dato 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) __J__J __ $ __J__J __ $ __J__J __ $ __ j _____.! __ $ __J __ L __ $ __J__J __ $ *Since January 1, 2001. Amounts in this section may b<:> different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print in ink. Amounts may be rounded to whole dollars. DATE: FlJLL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER RECEIVED (IF COMMITTEE, ALSO ENTER W. NUMBER) CODE * C· i2-1CHARJ) \S,flf2.TftLirJI . A1..AIYlrDA-c,A q L/ r:::o/ (SAR (3A (2.A-:r. f;.QI.. TON . cA- MNb)E"Lf-t fl.I), 13.Dol'-'G"' ? (, 1-t t;v f P-\.. '-} 1 IV\ 0 2D1-'iS::S L4 v 121 G' f", 1-t f) ~ f't:?R / ALA N1o;0 A-c..A-°t'-150) r?'f!..N E';:/ ;:;- c 4 °1'-t J"OJ ND DCOM C:::OTH [j PTY DSCC [ZjND 0COM DOTH 0PTY DSCC ['531ND DCOM DOTH OPTY DSCC 0',/ND 0COM DOTH DPTY oscc @;ND DCOM DOTH 0PTY oscc NAME rz. c A /..-/ o Q, rJARBD!Z Bt't'/ (2r:flt-lj F"0t-JPP.A-1.> er< C.J't P.1"-'I 0 fl_ ,;:l7 r.J rJ i<f'"c.R.vl TC'"~ (-flTf<.P b"P-A.s,s.OL . Statement covers period from __ i _,___/ '-~/~[ _z..o_o_'-f-'---- \ o l "ll 'Z£PY through -------- l.D. NUMBER AMOUNT RECEIVED THIS PERIOD /00·C>D I 00 · c>D CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 DEC. 31) I 00· ()D 100 ·oo Joo· rJD /OO·c>o PER ELECTION TO DATE (IF REQUIRED) 1. Amount received this period -contributions of $100 or more. 1:J SD. c50 (Include all Schedule A subtotals.) ........................................................................................................ $-·····------- *Contributor Codes IND-Individual COM-Recipient Committee 2. Amount received this period-unitemized contributions of less than $100 ............................................. $ __ 1-_S_'5 __ ,_cP __ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................... TOTAL $ __ 7-_'-f_o_s_._<V __ (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 Schedule A (Continuation Sheet) Monetary Contributions Received 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 (JF SELF-EMPLOYED, CNTER NAME OF BUSINESS) (IF COMMITIEE, ALSO ENTER LD. NUMBER) CODE * :i Arv\ iJ > ~ IY1'•Jf2r-l A Ni c IL-G>-)r> A I .. A.1-AMtiDA-, c A O)LJSD'Z 0 fiN 1-t· C'X\JIC:..I<-\ f\-t..J'n'V) €'Dfr cJr 0)1...j -;,!) / 'Contributor Codes IND-Individual vJ . L-AN c. c; f'u .S.>u tvl .. AUtM €"0f'T Cft.. °' '1 SOI :s I IV'\ /<. • SCH VL-Ell?. +-~ril1€"-. Sc:..1-1'1)[.G:n. .. f\'t.Av'vl GPA c.. i4 tjy $::> ) '71 € ?t-1-el'J w . v flqJ M ~crz. , IV!· o. (.t-c.-f'rvvl G'OA-c. I) 0 '-1 :;'DJ COM -Recipient Committee (other than PTY or SCC) OTH-Other PTY Political Party SCC Small Contributor Committee ~IND QCOM DOTH 0PTY oscc ND OCOM DOTH DPTY DSCC Qj'IND DCOM DOTH DPTY oscc @!.ND DCOM DOTH DPTY DSCC :tS;JIND QCOM COTH DPTY DSCC RCT11<e-.D/ !<cli{2.e'D Pr-r101'<a-l 1:;;'11 ";>C lF-~r!Y-/6'J) (..A w o (f1 lid LflrJll71ZWJJ"'1 fZ..:;-Al-"I~ r)l'J1"Z/$0~ 13,tr'-{ j2~\.."T'-'/ S fa f'-Ef"-iPLD'l(il) S"IG=PHGN w · vl'\..J fl1 tA"e:~ H·t>. Statement covers period trom _o_l _'-J_/t._cn-f~- :;) t.-J / z ro<-J through _______ _ .... Page~),,,___ of __ _ AMOUNT RECEIVED THIS PERIOD $ l DO ·cJO $ /ov· tfD l.D. NUMBER /2 0 '6'50'-/ CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. NAME OF FILER Amounts may be rounded to whole dollars. CQ\t\l\tv1 t-r1i;e-To bLb'l--r ~ <.::-r1Hl4-B.L5DaJ & DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER LO. NUMBER) CODE * )OH~ -\--:;~A~ @, (2..:+JiV A~ ~ Pr<-A t'V)!?DA cA "J"I So/ l'xl:IND OCOM DOTH DPTY DSCC :g'.j.IND H of'l 0 ~ A M ur-f'L+-j D COM DOTH • D PTY A t..Pnv'I ~A c. A C) '1 $[)) D sec IL:J.JND iV1 fi fl-'-/ A;..l 1-l Nl €/2-T?-D COM " <?.. DOTH DPTY IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER 1-1 vMAf'> 1<C.>ovrzc.-;-s, F\Dvef'l'T .'.>Df11-VA1~ SCHEDULE A (CONT.) Statement covers period from _8_1_'-i--'-/ --z_o_o_;_"{ __ . CALIFORNIA 45n FORM U through _1_0_/ _,'j_J/c._:2=-u_o_"--}_;___ Page _(e,____ of 0 l.D. NUMBER I 2(0 3 J e>if AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) A-"' Prrv\ t?OA c Pr q "I ;;oi.. D sec ._:_:_-=------+--==-=-_:__-l---------+-----+-------t------ D IND 'Contributor Codes IND Individual COM Recipient Committee (other than PTY or SCC) OTH-Other PTY -Political Pa1iy SCC -Small Contributor Committee DCOM DOTH DPTY DSCC DINO DCOM DOTH DPTY DSCC 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 ___ 8/4/2004 SEE INSTRUCTIONS ON REVERSE through __ 1_0_14_12_0_0_4 __ NAME OF FILER Committee to Elect Jeptha goor-1 ~ FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, AcSO ENTER ID NUMBER) IND 0 COM D OTH 0 PTY 0 sec IND D COM c:: OTH 0 PTY 0 sec IND 0 COM 0 OTH 0 PTY D sec Schedule B Summary IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSl~ESS) a OUTSTANDING BALANCE BEGINNING THIS PERIOD (b) (c) AMOUNT AMOUNT PAID RECEIVED THIS OR FORGIVEN PERIOD THIS PERIOD* OPAID D FORGIVEN OPAID D FORGIVEN D PAID $ ___ _ D FORGIVEN (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD DATE DUE DATE DUE DATE DUE 1 . Loans received this period ................................................................................................................. $ I LJ OC» {)::> (Total Column (b) plus unitemized loans less than $100.) 2. Loans paid or forgiven this period ......................................................................................................... $ C9 ·CC> (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) /'-f c)O· 00 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. (May be a negative number) t Contributor Codes (e) INTEREST PAID THIS PERIOD -0-% RATE __ % RATE __% RATE ~ Page ___ of l.D. NUMBER (f) ORIGINAL AMOUNT OF LOAN (g) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR s J '-foO · c5b s J'-tOO·CD PER ELECTION** o I L/ I avf DATE INCURRED CALENDAR YEAR PER ELECTION** 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 Schedule B-Part 2 Loan Guarantors SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jeptha B(.;OJJ i:;- FULL NAME, STREET ADDRESS AND ZIP CODE OF GUARANTOR (IF COMMITTEE. ALSO ENTER l.D. NUMBER) CONTRIBUTOR CODE DINO DCOM DOTH DPTY DSCC DINO DCOM DOTH DPTY DSCC DINO DCOM [:OTH CPTY DSCC DINO DCOM DOTH DPTY oscc Type or print in ink. Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) LOAN LENDER DATE I ENDER DATE LENDER DATE LENDER DATE Statement covers period from ___ 81_4_12_0_0_4 __ _ th h 10/4/2004 roug -------- LD. NUMBER Z(.p83Ct'--/ AMOUNT GUARANTEED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION W REQUIRED) CALENDAR YEAR PER ELECTION (IF REQUIRED) CALENDAR YEAR PER ELECTION (IF REQUIRED) CALENDAR YEAR PER ELECTION (IF REQUIRED) BALANCE OUTSTANDING TO DATE FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC ScheduleC Non monetary Contributions Received INSTRUCTIONS ON REVERSE OF FILER Committee to Elect Jeptha 'BDOf'J ~ DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 10. NUMBER; - -- Schedule C Summary Type or print in ink. Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER Statement covers period 81412004 from--------- 10/4/2004 through-------- SCHEDULEC CALIFORNIA 4~•1'\ FORM UU Page_::]_ of LO.NUMBER I 2(o o :5Cjt.j CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF CODE * GOODS OR SERVICES AMOUNT/ FAIR MARKET VALUE CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 ·DEC 31) PER ELECTION TO DATE DIND DCOM DOTH DPTY DSCC DIND DCOM DOTH DPTY DSCC DIND DCOM DOTH DPTY DSCC DIND DCOM DOTH DPTY DSCC (IF REQUIRED) 1. Amount received this period-nonmonetary contributions of $100 or more. § (Include all Schedule C subtotals.) ................................................................................................................... $ ______ _ *Contributor Codes IND-Individual COM -Recipient Committee 2. Amount received this period unitemized nonmonetary contributions of less than $100 ..... -f? """ ......... $ -------- (other than PTY or SCC) OTH-Other PTY -Political Party SCC -Small Contributor Committee 3. Total non monetary contributions received this period. ~ (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ..................... TOTAL $ ______ _ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jeptha f;oof'.l & DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LEITER AND JURISDICTION. OR COMMITIEE D Support D Oppose D Support D Oppose D Support D Oppose Type or print in ink. Amounts may be rounded to whole dollars. TYPE OF PAYMENT D Monetary Contribution D Non monetary DESCRIPTION (Ir REQUIRED) Contribution -D Independent Expenditure D Monetary Contribution D Non monetary Contribution D Independent Expenditure D Monetary Contribution D Nonmonetary Contribution D Independent Expenditure Statement. covers period from ___ 81_4_12_0_0_4 __ _ 10/4/2004 through -------- LD. NUMBER AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 ·DEC. 31) PER ELECTION TO DATE (IF REQUIRED) Schedule D Summary 1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) .............................................. $ __,,,!:f __ ..6.1_>.ef __ _ 2. Unitemized contributions and independent expenditures made this period of under $100 ..................................................................................... $ -,""'d;=._.#=~--- 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .............. TOTAL $ -P:~~·# ___ _ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC ScheduleD (Continuation Sheet) Summary ofExpenditures Supporting/Opposing Other Candidates, Measures and Committees NAME OF Committee to Elect Jeptha \3,t)orJ G DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETIER AND JURISDICTION, OR COMMITTEE O Support D Oppose D Support D Oppose D Support O Oppose O Support O Oppose Type or print in ink. Amounts may be rounded to whole dollars. TYPE OF PAYMENT D Monetary Contribution D Nonmonetary Contribution D Independent Expenditure D Monetary Contribution D Nonmonetary Contribution D Independent Expenditure Monetary Contribution D Nonmonetary Contribution D Independent Expenditure D Monetary Contribution D Nonmonetary Contribution D Independent Expenditure DESCRIPTION (IF REQUIRED) Statemenrcovers period from 8/4/2004 10/4/2004 through _______ _ l.D. NUMBER 12 b'31.~~ AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 ·DEC. 31) PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC ScheduleE Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILC:R Committee to Elect Jeptha B.oo..i t? Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ___ 8_14_12_0_0_4 __ _ 10/4/2004 through ------- CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Cl\IP 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 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 literatJre and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO E~ TER l.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID !3ALU>T I Fc""F3 COL>tJl'-f o~ ALA-M eoA--C..OUNI'-/ CLG1<K.1 s QFF1c~ ... FIL1N(:{ !f. I O ?-'-f I OA\C..LA1-J P or-C;'-/ /Pl I f"'1 L.. roR c. fl i--.l 0\ Dft'I iS' S/ ft/ c::: VI~ ;J/ vole-R '> I N F CJR/\1 tT)i OrJ G/vl oc Pt<1N/ ADS +-MA I L.G'l(S $ EJ-r;~ AL frrvl tfP fl C....:Vf'f77 0::-'l\..i 'O c.(L,4-r1 L f lh'21i prz_-r \,.\-IT'/ hi flt" 1'.2. 0 I c.. A- ------- * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ I q '2 ~ Schedule E Summary 1. Payments made this period of $100 or more. (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, 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 $ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule E (Continuation Sheet) Payments Made Committee to Elect Jeptha '[X:DNy;- Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ___ 8_1_4_12_0_0_4 __ 10/4/2004 through _______ _ Page~ l.D. NUMBER I 2(p 83CA.tj CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. OVP CNS CTB eve FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)' civic donations candidate filingiballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER 1.D. NUMBER! }JONb *Payments that MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads CODE OR - RAD RFD SAL TEL TRC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID - FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule F Accrued Expenses (Unpaid Bills) Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ___ 8_1_4_12_0_0_4 __ 10/4/2004 through _______ _ SCHED\,JLE F NAME OF FILER l.D. NUMBER Committee to Elect Jeptha '{ScON ~ J z~ 'BJ.c;f CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. ClVlP 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, 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) (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITIEE, ALSO ENTER ID. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ONE) OF THIS PERIOD t00NG ~ ----- * Payments that are contributions or independent expenditures must also be SUBTOTALS$ $ $ $ Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for p ~ accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $ ______ _ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................. PAID TOTALS $ ______ _ 3. ~r~~~:~r:;~,~h~~:~:~~: ~s:i~~~~, L~~:e 2 9 :~~~. ~'.~.~ .1 ..... ~.~~~~. ·t·~·~· .~.i~~~.~.~~~. ~~~~. ·~·~·d·· .............................................................................. NET $ -="'j!/~·""#~-,---,,--May be a negative number FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule F (Continuation Sheet) Accrued Expenses (Unpaid Bills) NAME OF FILER Committee to Elect Jeptha Mi-.)&"" Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ___ 8_14_1_20_0_4 __ _ 10/4/2004 through-------- l.D. NUMBER 1208'3.0~ CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. OVP CNS CTB eve FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)' legal defense campaign literature and mailings MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads *Payments that are contributions or independent expenditures must also be summarized on Schedule D. (a) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING OF THIS PERIOD -e- --e--' --e-- --e- -· -· SUBTOTALS$ $ RAD RFD SAL TEL TRC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries t. v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) (b) (c) (d) AMOUNT INCURRED AMOUNT PAID OUTSTANDING THIS PERIOD fHIS PERIOD BALANCE AT CLOSE (ALSO REPORT ONE) OF THIS PERIOD $ -e-$ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK·FPPC ScheduleG Payments Made by an Agent or independent Contractor (on Behalf of This Committee) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jeptha NAME Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULEG Statement covers period from ___ 8_14_1_2_0_0_4 __ through __ 10_1_4_12_0_0_4 __ l.D. NUMBER 12 0 33°1'-j CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP CNS CTB eve FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)' civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads *Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR (IF COMMITTEE. ALSO ENTER l.D. NUMBER) -e Attach additional information on appropriately labeled continuation sheets. * 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. RAD RFD SAL TEL TRC TRS TSF VOT VVEB radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging. and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID --e---e- TOTAL* $ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule H Made to Others* SEE INSTRUCTIONS ON REVERSE Committee to Elect Jeptha \3001-1 r:; FULL NAME, STREET ADDRESS AND ZIP CODE OF RECIPIENT (IF COMMITTEE, ALSO ENTER l.D. !\UMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. Schedule H Summary Type or print in ink. Amounts may be rounded to whole dollars. (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD (b) AMOUNT LOANED THIS PERIOD SUBTOTALS $ Statement covers period from ___ 8_/4_12_0_0_4 __ _ th I 10/4/2004 roug1 _______ _ (c) REPAYMENT OR FORGIVENESS THIS PERIOD* D PAID D FORGIVEN 0 PAID 0 FORGIVEN $ (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD DATE DUE DATE DUE $ $ (e) INTEREST RECEIVED __ % RATE __ % f~TE -e-1. Loans made this period ... .. ..................................................................................................................................... $ ______ _ (Total Column (b) plus unitemized loans less than $100.) -er 2. Payments received on loans .......................................................................................................................................... $ ______ _ (Total Column (c) plus unitemized payments less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) ........................................................................................ NET $ ------(Mcly be a negative number) (Enter the net here and on the Summary Page, Column A, Line 7.) (0 ORIGINAL AMOUNT OF LOAN DATE INCURRED DATE 11\CURRCD (g) CUMULATIVE LOANS TO DATE CALENDAR YEAR PER ELECTION** $ ___ _ CALENDAR YEAR PE'R FLECTl:)N** **If Required FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule I Miscellaneous increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Jeptha ~,..., G" DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER l.D. NUMBER) Attach additional information on appropriately labeled continuation sheets Schedule I Summary Type or print in ink. Amounts may be rounded to whole dollars. from ___ 8_14_1_2_00_4 __ _ 10/4/2004 through ______ _ DESCRIPTION OF RECEIPT SUBTOTAL$ -8-1. Increases to cash of $100 or more this period ........................................................................................................... $ ______ _ -e 2. Unitemized increases to cash under $100 this period ......................................................................................... $ _____ _ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $ ------- 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the __.e-- Summary Page, Line 14.) ........................................................................................................................ TOTAL $ _____ _ ID. NUMBER I 2bi?1.t:)~ AMOUNT OF INCREASE TO CASH 0 FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC