Committee to Elect Doug deHaan 460 (2)Recipient Committee
Campaign Statement
Cover Page
Type or print in ink.
(Government Code Sections 84200-84216.5)
Statement covers period
from ~J,'-"'tJ'---_..b'----"""O~L/ __
SEE INSTRUCTIONS ON REVERSE /j)_ f!../-tJi/ through ---'-/_ 1l/'-----'--I.._,__ __ _
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)
~eneral Purpose Committee
0 Sponsored
&'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)
Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
l.D.
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
f;omm1/1t?-to £/et! lJ!!Uj de/ki!J
BOX) t!I t/~I (iv~) J23-:?312
CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRFSS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAi · FAX I E-MAIL ADDRESS
4. Verification
Date of election if applica
(Month, Day, Year)
2. Type of Statement:
~reelection Statement
Semi-annual Statement
0 Termination Statement
D Amendment {Explain below)
Treasurer(s)
NAME OF TREASURER
MAILIN~~?oXss J;j/o mtJf/J
CITY
OPTIONAL: FAX I E-MAIL ADDRESS
(!d
STATE
STATE
0 Quarterly Statement
0 Special Odd-Year Report
Supplemental Preelection
Statement -Attach Form 495
f!/5J2 6-fp)JJ23-£MI/
ZIP CODE AREA CODE/PHONE
t/Jf 5ZJ I (57 v 523-3312
ZIP CODE 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 · true and orrect.
Executed on _/__,0/_2 J_,__/_tJLj~--
Executed on _/"---0+-f_i,_/+J-o__,_y ___ _
I I Date
Executed on--------------Date
Executed on--------------Date
BY------~S~ig-na~tu_ro_o~fC~o-nt~ro~llin-g~O~ffl-ce~ho~ld~e-G~Ca-n~did~a~te~,S~ta~re~M~e-as-u-re~P-ro-po-ne-n~t----~~
BY-------=--..,.,,...--...,..,,,_....,..,.._,..--,..,.......,,...........,.,..--..,,---,..------signaturc of Controlling Officeholder, Candidate, Stat~ Meosure 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
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 LD. 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
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 HE)-D ~PPORT J)ou4 deHaaru btf{/ fYlj;ia& D OPPOSE
NAME OFOFFICEHOLDER OR CANDIDATE OFFICE '§OUGHT 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 (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
from /d/6/(}i/ CALIFORNIA 4e A
FORM U\.I
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Contributions Received
Committee to Elect
Doug deHaan
1. Monetary Contributions ........................................... Schedule A, Line 3
2. Loans Received ...................................................... Schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2
4. 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 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 ................................ Add Lines 8 + 9 + 10
Current Cash Statement
$
$
$
$
$
$
12. Beginning Cash Balance....................... Previous Summary Page, Line 16 $
13. Cash Receipts ................................................... Column A, Lino 3 above
14. Miscellaneous Increases to Cash ........................... Schedule I, Line 4
15. Cash Payments.................................................. Column A, Line 8 above
16. ENDING CASH BALANCE .......... 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 ATTACHED SCHEDULES)
15[02
S; 751 {)2.
J/; 8'211 gg
K
21; ?JJ, gg
through r !J/.tl /JL/ Page 3
$
$
$
$
$
$
ColumnB
CALENDAR YEAR
TOTAL TO DATE
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).
1.0. NUMBER
l~t'1f'1S
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30
20. Contributions
Received $ _____ _
21. Expenditures
Made $ _____ _
111 to Date l!J/21/tt/
$ Pl Iv rJ tj, t!J./
$ t1; 1Y-tfft
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)
__}__} __ $
__}__} __ $
__}__} __ $
__}__} __ $
__}__} __ $
__}__} __ $
*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 Type or print in ink. SCHEDULE A
Monetary Contributions Received Amounts may be rounded
to whole dollars. Statement covers period
from !15/6 /o7f CALIFORNIA 46 A
FORM \I
SEE INSTRUCTIONS ON REVERSE Committee to Elect
Doug deHaan
through 16/~/o1 Page !f__ of / 3
NAME OF FILER •
CLitddftWM
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
Schedule A Summary
CODE*
D
DCOM
DOTH
OPTY
DSCC
DIND
DCOM
DOTH
0PTY
DSCC
01ND
OCOM
DOTH
DPTY
DSCC
DIND
0COM
DOTH
DPTY
oscc
DIND
DCOM
DOTH
OPTY
Dscc
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
ffdm1 fJ tsf rattJ r
11 /tlJ»e~ U;;,;,/!td
St/1~01 JJ1stncl
AMOUNT
RECEIVED THIS
PERIOD
1. Amount received this period -contributions of $100 or more. '{)
(Include all Schedule A subtotals.) ........................................................................................................ $ __ /i_~_._t/,~~~-
2. Amount received this period -unitemized contributions of less than $100 ............................................. $ __ (c.~Q;'-'-/_,~t/ .... Z.~-
3. Total monetary contributions received this period. f1 ;::-(
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ __ l_~.:.J~f' '-'-'t)~]._-
l.D. NUMBER !J!;~tjfS'
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 ·DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
*Contributor Codes
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
Type or print in ink. SCHEDULE B -PART 1
Schedule B -Part 1
Loans Received
Amounts may be rounded
to whole dollars.
Statement covers period
from /()jltJ@t.f CALIFORNIA 4 I:!. I'\
FORM U\I
SEE INSTRUCTIONS ON REVERSE through _li__,_!J/2_· 1~/o~lf-Page S of __l.j__
NAME OF FILER
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
(IF COMMITTEE, ALSO ENTER l.D. NUMBER)
t~ND D COM D OTH 0 PTY 0 sec
IND D COM D OTH 0 PTY 0 sec
to IND D COM 0 OTH D PTY 0 sec
Schedule B Summary
Committee to Elect
Doug deHaan
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
a
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
ff
(b) (c)
AMOUNT AMOUNT PAID
RECEIVED THIS OR FORGIVEN
PERIOD THIS PERIOD*
QPAID
J1
D FORGIVEN
$ 5Jl/J.ao I $ y
0PAID
D FORGIVEN
0PAID
0 FORGIVEN
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.)
(d) OUTSTANDING
BALANCE AT
CLOSE OF THIS
PERIOD
$ ~!Jjt)_,{j)
/16t!-7~05"
DATE DUE
DATE DUE
DATE DUE
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 De a negative number)
t Contributor Codes
IND-Individual COM -Recipient Committee (other than PTY or SCC) OTH -Other PTY -Political Party SCC -Small Contributor Committee
(e)
INTEREST
PAID THIS
PERIOD
RATE
__ %
RATE
__ %
RATE
l.D. NUMBER
(!)
ORIGINAL
AMOUNT OF
LOAN
DATE INCURRED
DATE INCURRED
(g)
CUMULATIVE
CONTRIBUTIONS
TO DATE
CALENDAR YEAR
PER ELECTION**
CALENDAR YEAR
PER ELECTION**
CALENDAR YEAR
PER ELECTION**
*Amounts forgiven or paid by
another party also must be
reported on Schedule A.
** If required.
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
tRtWJ'-'
FULL NAME, STREET ADDRESS AND
ZIP CODE OF GUARANTOR
(IF COMMIITEE, ALSO ENTER 1.D. NUMBER)
Type or print in ink.
Amounts may be rounded
to whole dollars.
Committee to Elect
Doug deHaan
CONTRIBUTOR
CODE
DINO
DCOM
DOTH
DPTY
DSCC
OIND
DCOM
DOTH
DPTY
DSCC
DINO
DCOM
DOTH
DPTY
oscc
DINO
DCOM
DOTH
OPTY
DSCC
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
LOAN
LENDER
DATE
LENDER
DATE
LENDER
DATE
LENDER
DATE
SCHEDULE B-PART 2
Statement covers period CALIFORNIA 461'\
FORM \I from j ()j b/01{
through ~; {)-1-/:t__,_I ~-0 f,__· _ Page~ of _j3__
AMOUNT
GUARANTEED
THIS PERIOD
l.D. NUMBER
CUMULATIVE
TO DATE
CALENDAR YEAR
$ ___ _
PER ELECTION
(IF 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 (Junef01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
ScheduleC
Nonmonetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
--------------·-···----NAME OF FILER Committee to Elect
Doug deHaan
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND
ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE. ALSO ENTER LO. NUMBER)
IF AN INDIVIDUAL, ENTER
CONTRIBUTOR OCCUPATION AND EMPLOYER CODE*
OIND
OCOM
DOTH
DPTY
oscc
OIND
DCOM
DOTH
OPTY
oscc
OIND
OCOM
DOTH
0PTY
oscc
OIND
DCOM
DOTH
DPTY
oscc
(IF SELF-EMPLOYED. ENTER
NAME OF BUSINESS)
Attach additional information on appropriately labeled continuation sheets.
Schedule C Summary
SCHEDULEC
Statement covers period
from /~}¥/jt( CALIFORNIA 40. n
FORM UU
I
through _/'---l~'---'t2-r-=-!/0-1--7'-· . _ Page L of _}3~
DESCRIPTION OF
GOODS OR SERVICES
AMOUNT/
FAIR MARKET
VALUE
SUBTOTAL$ ff
LO.NUMBER
/Jv/;I ff:)
CUMULATIVE TO
DATE
CALENDAR YEAR
(JAN 1 -DEC 31)
*Contributor Codes
IND-Individual
PER ELECTION
TO DATE
(IF REQUIRED)
1. Amount received this period -nonmonetary contributions of $100 or more.
(Include all Schedule C subtotals.) ..................................................................................................................... $ --~ff~1 ___ _
COM -Recipient Committee
(other than PTY or SCC)
OTH-Other 2. Amount received this period -unitemized nonmonetary contributions of less than $100 ............. ____ ................... $ ---,,"'ff~---PTY -Political Party
3. Total nonmonetary contributions received this period. y
(Add Lines 1 and 2_ Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL $ ______ _
SCC -Small Contributor Committee
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
ScheduleD
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
Type or print In ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER Committee to Elect
Doug deHaan
DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION,
ORCOMMITIEE
D Support 0 Oppose
0 Support 0 Oppose
0 Support 0 Oppose
Schedule D Summary
TYPE OF PAYMENT
0 Monetary
Contribution
0 Nonmonetary
Contribution
0 Independent
Expenditure
0 Monetary
Contribution
0 Non monetary
Contribution
0 Independent
Expenditure
0 Monetary
Contribution
0 Non monetary
Contribution
0 Independent
Expenditure
DESCRIPTION
(IF REQUIRED)
SCHEDULED
Statement covers period CALIFORNIA 461'\
FORM U trom /0/6/ ~L/ II
through j () /2J //J 0 I I PageL of /;J
AMOUNTTHIS
PERIOD
l.D. NUMBER l~~tt/15"'
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1-DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
SUBTOTAL$
1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) .............................................. $ _____ _
2. Unitemized contributions and independent expenditures made this period of under $100 ...................................................................................... $ __ l}_tj"--, t1_t:J __
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .............. TOTAL $ __ tf_9~· ~"--"--?' __
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
SCHEDULEE ScheduleE
Payments Made
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from ---"'-#/~Ii~~+-'-) Jo_,__'-/_ CALIFORNIA 4e.n
FORM UU
r1
SEE INSTRUCTIONS ON REVERSE through /~ /21jtflf Page L of _/_J_ _
Committee to Elect
Doug deHaan
l.D. NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP 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 campnign 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)
!Hamedtl J/jJIL/
CODE OR
PRT
PRT
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
Schedule E Summary
DESCRIPTION OF PAYMENT AMOUNT PAID
SUBTOTAL$
1/31/J ,/b 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) .................................................................................................. $ Jfl-fJ/ 3g 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $
3. Total interest paid this period on loans. (Enter amount from Schedule 8, Part 1, Column (e).) ............................................................................... $ ____ ff~--
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................ TOTAL $ .J./f';?}' S-ff
FPPC Form 460 (Junel01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
SCHEDULE F
Schedule F
Accrued Expenses (Unpaid Bills)
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statemen covers period
from /() {p ~ CALIFORNIA 45n
FORM U
SEE INSTRUCTIONS ON REVERSE
through_/ q,__r/21_,_/~-+1-Page~ of_/$__
Committee to Elect
Doug deHaan ID.NUMBER
/2b61JIJ5'
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries
CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs
FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals
FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals
IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
CODE OR (a) (b) (c) (d)
NAME AND ADDRESS OF CREDITOR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER 1.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE
OF THIS PERIOD (ALSO REPORT ONE) OF THIS PERIOD
··--··-
* Payments that are contributions or independent expenditures must also be SUBTOTALS$ g $ ff $ $ g-summarized on Schedule D.
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
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. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and ~
on the Summary Page, Column A, Line 9.) ................................................................................................................................................ NET$~~-~---May be a negative number
FPPC Form 460 (Junef01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
· ScheduleG
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
Type or print in ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Committee to Elect
Doug deHaan
SCHEDULE G
CALIFORNIA 461'\
FORM _\I
through _/q,__Yli~J &__,0Jj_ Page _}L of _JS_
LO.NUMBER /lv~'1t;;s
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
(IF COMMITTEE. ALSO ENTER 1.D. NUMBER) CODE OR
*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
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 Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule H
Loans Made to Others*
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
NAME OF FILER
0aM aeHaavv
Committee to Elect
Doug deHaan
FULL NAME, STREET ADDRESS AND ZIP CODE
OF RECIPIENT
(IF COMMITTEE. ALSO ENTER LO. NUMBER)
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
(a)
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
SUBTOTALS $
(b)
AMOUNT
LOANED THIS
PERIOD
Statement c vers period
from--/./ a=-<-~ __,_'t!/ __
through __,_f #_'J,f+-=-/tif_,___
(c)
REPAYMENT OR
FORGIVENESS
THIS PERIOD*
0 PAID
$ ___ _
0 FORGIVEN
0 PAID
0 FORGIVEN
$
(d)
OUTSTANDING
BALANCE AT
CLOSE OF THIS
PERIOD
DATE DUE
DATE DUE
$ $
(e)
INTEREST
RECEIVED
__%
RATE
__ %
RATE
3)
1. Loans made this period .................................................................................................................................................. $ ______ _
(Total Column (b) plus unitemized loans less than $100.)
2. Payments received on loans ........................................................................................................................................... $ ______ _
(Total Column (c) plus unitemized payments less than $100.) ff
3. Net change this period. (Subtract Line 2 from Line 1.) ........................................................................................ NET $ ~~-~---(May be a negative number) (Enter the net here and on the Summary Page, Column A, Line 7.)
SCHEDULEH
CALIFORNIA 461'\
FORM U
Page~ of_/}__
l.D. NUMBER
(~
ORIGINAL
AMOUNT OF
LOAN
DATE INCURRED
DATE INCURRED
(g)
CUMULATIVE
LOANS
TO DATE
CALENDAR YEAR
PER ELECTION**
CALENDAR YEAR
PER ELECTION**
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
· Sctr~dufe I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE
RECEIVED
Committee to Elect
Doug deHaan
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.
Statement covers period
from /~bj@
through /oft ~/j~
DESCRIPTION OF RECEIPT
SUBTOTAL$
1. Increases to cash of $100 or more this period ........................................................................................................... $ _____ _
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. ~~~mrr::~~~~ne~o~~~n~~~)a.~-~-~.~.~ .. ~.~~.~ .. ~~'.~ .. ~~~'.~~: .. ~~~~-·~·i·~·~-~ .. ~.' .. ~'..~~~ .. ~.".:~~~~~-~~~~-~.~.~ .. ~~-~~~······· TOTAL $ /f
SCHEDULE I
CALIFORNIA 460
FORM
Page /3 of /3
l.D.NUMBER
AMOUNT OF
INCREASE TO CASH
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC