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Committee to Elect Beverly Johnson, City Council 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 7 / t { 0 I through f-Z, / 3 I / D / 1. T~e of Recipient Committee: All committees -Complete Parts 1, 2, 3, and 4. Lft" ?fficeholder, Candidate Controlled Committee D Ballot Measure Committee 0 State Candidate Election Committee O Primarily Formed 0 Recall O Controlled (Also Complete Part 5) Q Sponsored {Also Complete Part 6) ] General Purpose Committee 0 Sponsored 0 Small Contributor Committee O Political Party/Central Committee 3. Committee Information STREET ADDRESS (NO P 0. BOX) D Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) l.D. NUMBER ITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification 2. Type of Statement: D Preelection Statement D Semi-annual Statement D Termination Statement D Amendment (Explain below) Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY STATE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE OPTIONAL: FAX I E-MAIL ADDRESS COVER PAGE CALIFORNIA 460 2001/02 . FORM Page ___.,,.___ of .3 For Official Use Only D Quarterly Statement D Special Odd-Year Report D Supplemental Preelection Statement -Attach Form 495 ZIP CODE AREA CODE/PHONE 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 is true and correct. Executed on ------D=-a-te ______ _ Executed on __ ___,f....,/1--"'J ......... l_,/_O"'"-.... Ze""'---l Date Executed on-------------Date Executed on-------------Date BY-------::::---:-..,..,,,.-.,....,,,-""""',,....,....,..,.-,,,--:,..,...,.-,,,..,-,,.,.--...,,---..,..-----~ Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC ~t'!'lto nf ~Q1\fnrni~ Type or print in ink. Recipient Committee Campaign Statement Cover Page -Part 2 5. Officeholder or Candidate Controlled Committee N OF OFFICEHOLDER OR CANDIDATE ---J. 1ESI EN IAUBUSINESS ADDRESS (NO. A STREE CITY STA ZIP 6. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION 0 SUPPORT 0 OPPOSE J ~ \): f-e: Sao Related Committees Not Included in this s{f;!~~ S;t~fJoit~ri '1'tfs1) I Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 NAME OF TREASURER COMMITTEE ADDRESS CITY .;OMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS CITY l.D. NUMBER CONTROLLED COMMITTEE? 0 YES 0 NO STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE AREA CODE/PHONE l.D. NUMBER CONTROLLED COMMITTEE? 0 YES 0 NO STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE AREA CODE/PHONE 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 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 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 __ 7_,_/_1_,_h_O~/ __ CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE NAME OF FILER Contributions Received 1. Monetary Contributions ....... .. .......................... ........ Schedule A, Line 3 $ 2. Loans Received ..................................... ... .............. Schedule 8, Line 7 UBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 4. Non monetary 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 7 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. TOTALEXPENDITURESMADE ................................ Addlines8+9+ 10 $ Current Cash Statement 1ginning Cash Balance....................... Previous Summary Page, Line 16 $ 13. Cash Receipts ............................... .................... Column A, Line 3 above 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, t11en subtract Line 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED .................. ......... Schedule 8, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column 8 above $ Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) C2 0 0 0 0 0 0 0 () 0 0 s: 'lz,'2. -• I through ........_/ ~Z,"-+/--""3-"l+~-=t:>'-'l.___ Page 3 of 3 $ $ $ $ $ $ Columns CALENDAR YEAR TOTAL TO DATE s-, 'f Z-b.- S", 9'2-6· - 0 0 0 0 0 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 782.. ~5" 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) $ ____/__} __ $ ____/__} __ $ ____/_~_} __ $ _ __}__} __ $ ____/__} ___ $ '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