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Forbes & Schaff for School Board 460Recipient Committee Campaign Statement Cover Page Type or print in ink. (Government Code Sections 84200-84216.5) Statement covers period from ___ 1_0_11_/2_0_0_4 __ SEE INSTRUCTIONS ON REVERSE through __ 1_0_/_16_1_2_00_4 __ 1. Type of Recipient Committee: All Committees·-Complete Parts 1, 2, 3, and 4. IX] Officeholder, Candidate Controlled Committee ® State Candidate Election Committee 0 Recall (Also Complete Part 5) 0 General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information 0 Ballot Measure Committee O Primarily Formed 0 Controlled 0 Sponsored (Also Complete Part 6) Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) l.D. NUMBER 1267549 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Forbes & Schaff for School Board STREET ADDRESS (NO P.O. BOX) c/o 2986 Southwood Dr. CITY Alameda STATE CA ZIP CODE 94501 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE (510) 749-1022 OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification AREA CODE/PHONE ( 510) 7 49-6790 AREA CODE/PHONE Date of election if appli (Month, Day, Year) 11/02/2004 2. Type of Statement: IX] Preelection Statement Semi-annual Statement O Termination Statement 0 Amendment (Explain below) Treasurer(s) NAME OF TREASURER Lorre Zuppan MAILING ADDRESS 2986 Southwood Dr. Alameda NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY (510) 7 49-1022 OPTIONAL: FAX I E-MAIL ADDRESS STATE CA STATE For Official Use Only 0 Quarterly Statement 0 Special Odd-Year Report 0 Supplemental Preelection Statement -Attach Form 495 ZIP CODE AREA CODE/PHONE 94501 (510) 749-6790 ZIP CODE AREA CODE/PHONE I have used all reasonable diligence in preparing and reviewing this statement and to t st of my kno edg the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the for. going 1 Executed on 10/21/04 Date By Executed on 10/21/04 By Date Executed on 10/21/04 Date By Executed on Date By ate, State Measure Proponent or Responsible Officer of Sponsor Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Junef01) FPPC Toll-Free Helpline: 866/ASK-FPPC State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page -Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE David Forbes and William Schaff OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Member, Board of Education RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP , Alameda, CA 94501 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 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 D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Junef01) 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 46 I\ FORM \ii SEE INSTRUCTIONS ON REVERSE NAME OF FILER Forbes & Schaff for School Board Column A TOTAL THIS PERIOD Contributions Received (FROM ATTACHED SCHEDULES) 1. Monetary Contributions .............. ............................. Schedule A, Line 3 $ 525 2. Loans Received ...................................................... Schedule B, Line 3 13,000 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 13,525 4. Nonmonetary Contributions.................................... Schedule c, Line 3 0 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 13,525 Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 13,346 7. Loans Made............................................................. Schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 13,346 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 0 10. Nonmonetary Adjustment .......................................... Schedule c, Line 3 0 11. TOTAL EXPENDITURES MADE ................................ Add Lines B +9 + 10 $ 13,346 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 3,880 13. Cash Receipts ................................................... Column A, Line 3 above 13,525 14. Miscellaneous Increases to Cash........................... Schedule 1, Line 4 0 15. Cash Payments.................................................. Column A, Line 8 above 13,346 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 4,059 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ....... ............... ..... Schedule a, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 4,059 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ 23,000 from ___ 1_0_11_1_2_00_4 __ _ through __ 1_0_11_6_12_0_0_4 __ Page __ 3 __ of __ 7 __ ColumnB CALENDAR YEAR TOTAL TO DATE $ 3,255 23,000 $ 26,255 360 $ 26,615 $ 22,196 0 $ 22,196 0 0 $ 22,196 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). l.D. NUMBER 1267549 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 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) __J__J __ $ __J__J __ $ __J__J __ $ ___/___} __ $ ___/___/ __ $ __J__J __ $ *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 Forbes & Schaff for School Board 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 COMMllTEE, ALSO ENTER l.D. NUMBER) 10/01/2004 Catherine Atkin 94501 10/06/04 Mary Dierking 10/16/2004 Donna Fletcher Alameda, CA 94502 Schedule A Summary CODE* ~IND DCOM DOTH DPTY DSCC il(llND DCOM DOTH DPTY DSCC IK]IND DCOM DOTH DPTY DSCC IX]IND DCOM DOTH DPTY Dscc IX]IND DCOM DOTH DPTY DSCC Attorney The Sanz Group Student Affairs/Teacher AUSD Education AUSD SCHEDULE A Statement covers period CALIFORNIA 4en from ___ 1_0_/_11_2_0_04 __ _ FORM UU through __ 1_0_/1_6_/_20_0_4 __ Page __ 4 _ of __ 7 __ AMOUNT RECEIVED THIS PERIOD 100 200 100 l.D. NUMBER 1267549 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) 100 200 100 PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes IND-Individual 100 200 100 1. Amount received this period -contributions of $100 or more. (Include all Schedule A subtotals.) ........................................................................................................ $ _____ 40_0_ COM-Recipient Committee (other than PTY or SCC) OTH-Other 2. Amount received this period -unitemized contributions of less than $100 ................. -........................... $ _____ 1_2_5_ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ _____ 5_2_5_ PTY -Political Party SCC-Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK·FPPC Schedule B -Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Forbes & Schaff for School Board Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ___ 1_0_11_/2_0_0_4 __ h h 10/16/2004 t roug -------- FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF•EMPLOYED, ENTER NAME OF BUSINESS) a (b) (c) OUTSTANDING AMOUNT AMOUNT PAID BALANCE (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIO (IF COMMITTEE, ALSO ENTER 1.D. NUMBER) William Schaff 1616 San Jose Ave. Alameda, CA 94501 tlXI IND 0 COM 0 OTH D PTY 0 sec to IND D COM 0 OTH D PTY 0 sec to IND D COM 0 OTH D PTY 0 sec Schedule B Summary Chief Investment Officer Bay Isle Financial BEGINNING THIS RECEIVED THIS OR FORGIVEN PERIOD PERIOD THIS PERIOD* 0PAID D FORGIVEN 10,000 13,000 0PAID D FORGIVEN $ _____ $ ___ _ 0PAID 0FORGIVEN SUBTOTALS $ 13,000 $ 0 $ 1 . Loans received this period .................................................................................................................... $ (Total Column (b) plus unitemized loans 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.) 23,000 12/31/2004 DATE DUE DATE DUE DATE DUE __ % RATE 23,000 $ 13,000 0 13,000 (Enter ( e) on Schedule E, Line 3) 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. (Maybe a negative number) t Contributor Codes SCHEDULE B-PART 1 CALIFORNIA 4e I\ FORM UU Page __ 5 _ of __ ?_ l.D. NUMBER 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 (Junef01) FPPC Toll-Free Helpline: 866fASK-FPPC ScheduleE Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Forbes & Schaff for School Board Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ___ 1_0_11_1_20_0_4 __ 10/16/2004 through -------- SCHEDULEE CALIFORNIA 4eo FORM U Page __ 6 _ of __ 7_ 1.0. NUMBER 1267549 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* eve civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings NAME AND ADDRESS OF PAYEE (IF COMMITIEE, ALSO ENTER l.D. NUMBER) Tramutola Company 191 Ridgeway Avenue Tramutola Company 191 Ridgeway Avenue MBR member communications MTG meetings and appearances OFC office expenses F£T petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads CODE OR Brochures LIT Postage POS RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID 7,917 3,965 Jane Norling Design Campaign literature design services LIT 480 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 12,362 Schedule E Summary 13,276 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) .................................................................................................. $ _____ _ 70 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ ______ _ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ _____ _ 13,346 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 Type or print in ink. SCHEDULE E (CONT.) Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 461"\ FORM U SEE INSTRUCTIONS ON REVERSE from ___ 1_0_/1_12_0_0_4 __ 10/16/2004 through _______ _ Page __ 7 _ of __ ?_ NAME OF FILER Forbes & Schaff for School Board CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. l.D.NUMBER ! 1267549 ctvP 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 FEf 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 PRf print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE (IF COMMITTEE, ALSO ENTER l.D. NUMBER) John A. Jensen Graphic Design 1780 Indian Way LIT 94611 Rosenblum Winery 2900 Main St. FND 94501 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. OR DESCRIPTION OF PAYMENT Production and image prep Supplies for fundraising event AMOUNT PAID 580 334 SUBTOTAL$ 914 FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC