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David Forbes for Schol Board 460. Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from __ O_c_t_o_be_r_2_0_,_2_0_0_2_ through December 31, 2002 Date of election if app (Month, Day, Year) November 5, 200Ci For Official Use Only Clerk's Of fie 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. 2. Type of Statement: 00 Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 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) l.D. NUMBER 1246825 Preelection Statement [XI Semi-annual Statement 00 Termination Statement D Amendment (Explain below) Treasurer(s) D Quarterly Statement Special Odd-Year Report D Supplemental Preelection Statement -Attach Form 495 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) David Forbes for School Board NAME OF TREASURER Lorre Zuppan STREET ADDRESS (NO P.O. BOX) CITY Alameda STATE CA ZIP CODE 94501 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY OPTIONAL: FAX I E-MAIL ADDRESS dforbes@alamedanet.net 4. Verification STATE ZIP CODE AREA CODE/PHONE 510 I 523-3513 AREA CODE/PHONE MAILING ADDRESS CITY Alameda NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX I E-MAIL ADDRESS STATE CA STATE ZIP CODE 94501 ZIP CODE AREA CODE/PHONE 510 I 384-2599 AREA CODE/PHONE I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the infor ation 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 foregoing is true a Executed on Executed on Executed on Executed on Jan 27, 2003 Date Jan 27, 2003 Date Date Date By~~~~~~--.,,,--..,~~-..,....,,,.--,,.,=""""'-.,.,---,,...--,,.,-,-,,-,....,.,-~-::-~~~~~~~~~ Signature of Controlling Officeholder, Candidate, State Measure Proponent BY~~~~~~-,,,--..,~~-..,....,,,.--,,.,=""""'-,-,___,,...--,,.,..,_,,-,....,.,-~-.,,-~~~~~~~~~ Signature of Controlling 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 .. Recipient Committee Campaign Statement Cover Page -Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE David Forbes OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Member, Board of Education, Alameda Unified School District RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE , Alameda, CA 94501 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? YES 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 [;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 CALIFORNIA 40.1'\ FORM 1.111 SEE INSTRUCTIONS ON REVERSE NAME OF FILER David Forbes for School Board Contributions Received 1. Monetary Contributions .......................................... . Schedule A. Line 3 $ ') Loans Received ..................................................... . Schedule B, Line 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. Non monetary Adjustment .......................................... Schedule c. Line 3 11. TOTALEXPENDITURESMADE ................................ AddLines8+9+10 $ Current Cash Statement '2. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 13. Cash Receipts ................................................... Column A, Une 3 above 14. Miscellaneous Increases to Cash........................... Schedule 1, Line 4 15. Cash Payments.................................................. Column A. Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, tt:ien subtract Line 15 $ 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 $ 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 2,209.11 209.11 209.11 2,772.75 2,772.75 2,563.64 209.11 2,772.75 0.00 0.00 0.00 from __ O_c_to_b_e_r_2_0_, _2_0_02_ through December 31, 2002 Page __ 3 __ of __ ? __ $ $ $ $ $ $ ColumnB CALENDAR YEAR TOTAL TODATEC 5, 113.11 0.00 5,113.11 321.77 5,434.88 5, 113.11 5,113.11 321.77 5,434.88 l.D. NUMBER 1246825 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 711 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) ___}___} __ $ ___}___} __ $ ___}___} __ $ ___}___} __ $ ___}___} __ $ ___}___} __ $ 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 *Since January 1, 2001. Amounts in this section may be from Lines 2, 7, and g (if different from amounts reported in Column B. any). FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER David Forbes for School Board FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR DATE RECEIVED (IF COMMITTEE, ALSO ENTER l.D. NUMBER) 10/22/02 California Teachers Assn./ Assn. for Better Citizenship, FPPC ID #7 41941 Burlingame, CA 94010 10/23/02 Alan R. Baskin Alameda, CA 94501 10/31/02 Natanya B. Wodinsky Alameda, CA 49501-1653 10/31/02 William and Cynthia Schaff Alameda, CA 94501 12/02/02 David Forbes Alameda, CA 94501 Schedule A Summary Type or print in ink. Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER CONTRIBUTOR OCCUPATION AND EMPLOYER CODE* (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) DINO IKJCOM DOTH DPTY DSCC IKJIND Mortage Broker DCOM DOTH KLA DPTY DSCC OOIND Legal Assistant DCOM Simmons & Ungar DOTH DPTY DSCC IKJIND CEO DCOM Bay Isle Financial DOTH DPTY DSCC OOIND Administrator DCOM Club Natique DOTH DPTY Dscc SCHEDULE A Statement covers period from __ O_c_to_b_e_r_2_0_, _2_0_02_ CALIFORNIA 4e. n FORM UU through December 31, 2002 Page 4 of AMOUNT RECEIVED THIS PERIOD 400.00 100.00 i 100.00 750.00 734.11 l.D. NUMBER 1246825 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) 400.00 100.00 100.00 950.00 759.11 *Contributor Codes IND-Individual PER ELECTION TO DATE (IF REQUIRED) 1. Amount received this period -contributions of $100 or more. (Include all Schedule A subtotals.) ........................................................................................................ $ ___ 2_,_08_4_._11_ COM -Recipient Committee (other than PTY or SCC) OTH-Other $ $ 125.00 2. Amount received this period -unitemized contributions of less than 100 ........................................... .. ______ _ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ ___ 2_,2_0_9_.1_1_ PTY -Political Party SCC-Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Type or print in ink. Statement covers period Schedule B-Part 1 Loans Received Amounts may be rounded to whole dollars. from __ O_c_to_b_e_r_2_0_, _2_0_02_ SEE INSTRUCTIONS ON REVERSE through December 31, 2002 NllME OF FILER David Forbes for School Board FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER l.D. NUMBER) David Forbes '~ • ,1ameda, CA 94501 t !XI IND D coM D OTH D PTY D sec IND o coM D orn o PTY o sec IND o coM o OTH o PTY D sec Schedule 8 Summary IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Administrator Club Nautique a (b) (c) OUTSTANDING AMOUNT AMOUNT PAID BALANCE RECEIVED THIS BEGINNING THIS OR FORGIVEN PER OD PERIOD THIS PERIOD* igJ PAID 1265.89 igJ FORGIVEN 2,000 0 734.11 OPAID D FORGIVEN 0PAID D 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 2000 none DATE DUE DATE DUE DATE DUE 0 2,000 (2,000) 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 __ % RATE 0 __ % RATE __ % RATE SCHEDULE B-PART 1 CALIFORNIA 4eA FORM UU Page __ 5 _ of __ ?_ l.D. NUMBER 1246825 (f) (g) ORIGINAL CUMULATIVE AMOUNT OF CONTRIBUTIONS LOAN TO DATE CALENDAR YEAR 500 0 PER ELECTION** 08/09/2002 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 SCHEDULEE · ScheduleE Payments Made Type or print in ink. Amounts may be rounded to whole dollars. from __ o_c_to_b_e_r_2_0_,_2_0_0_2_ Statement covers period CALIFORNIA 46"' FORM Ii.I SEE INSTRUCTIONS ON REVERSE through December 31, 200L Page 6 of __ 7 _ NAME OF FILER l.D. NUMBER David Forbes for School Board 1246825 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. C1v'P campaign paraphernalia/misc. MBR membercommunications 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 FET petition circulating TEL t.v. or cable airtime and production costs candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals .~D 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 Mark Reilly Mailer prep/printing LIT 1,262.39 San Lorenzo, CA 94580 Jane Norling Design Graphics / layout for flyer/mailer LIT 469.49 Berkeley, CA 94703 Schroeder Dent Printing flyer/mailer LIT 100.00 . .\lameda, CA 94501 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,831.88 Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) .................................................................................................. $ ___ 2 _'7 _5 _2 _·7 _5 _ 20.00 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 ).) ............................................................................... $ _____ o_.o_o_ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ ___ 2 _,_7 _72 _._7 _5 _ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Schedule E (Continuation Sheet} Payments Made SCHEDULE E (CONT.) Type or print in ink. Amounts may be rounded to whole dollars. from __ O_c_t_o_be_r 2_0_, 2_0_0_2_ Statement covers period CALIFORNIA 4en FORM UU SEE INSTRUCTIONS ON REVERSE through December 31, 200L Page __ ?_ of __ ?_ NAME OF FILER David Forbes for School Board CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. LO.NUMBER 1246825 OvP 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 FET 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 "<\JD fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals ) 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 CODE (IF COMMJTIEE, ALSO ENTER 1.D. NUMBER) OR DESCRIPTION OF PAYMENT AMOUNT PAID -~-·--~-· Statewide Information Systems List for mailing LIT 117.50 Sacramento, CA 95816 David Forbes Paper for flyer/mailer LIT 115.87 Alameda, CA 94501 Mark Reilly Postage for mailing POS 687.50 'San Lorenzo, CA 94580 ----·-· *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 920.87 FPPC Form 460 FPPC Toll-Free Helpline: 866/ASK-FPPC