McCormack 460Recipient Committee
Campaign Statement
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
from -'-+-''-->'-b-'---+----
through ~/:je//7,/
1. Typy of Recipient Committee: AllCommittees-CompleteParts1,2,3,and7.
[(;:j/6tticeholder, Candidate D Primarily Formed Candidate/
Controlled Committee Officeholder Committee
(Also Complete Part 4.) (Also Complete Part 6.)
u Ballot Measure Committee
O Primarily Formed
D General Purpose Committee
O Sponsored
O Controlled O Broad Based
0 Sponsored
(Also Complete Part 5.)
STRE·E·T. Ac;f?RE$S,OP.O.BO.X) . . 1z
/
/
ST/\TE ZIP CODE ,, Al\EACODE/PHONE 'j~d)7l-( d4.'. L-;: C) ;!5/ ~/ {5/.l'.) 6 'Jlf ··7~17
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX I E-MAIL ADDRESS
Date of election if ~~icable:
(Month, Day, Y~lf fy I erk' s Off ice For Official Use Only
_1~/2/r?c:J
2. Type of Statement:
D Pre-election Statement
[9/Semi-annual Statement
D Termination Statement
D Amendment (Explain below)
Treasurer(s)
D Quarterly Statement
D Special Odd-Year Report
D Supplemental Pre-election
Statement -Attach Form 495
MA}INGADDRESS I I , // A
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS ___...
CITY
OPTIONAL: FAX/E·MAILADDRESS
STATE ZIP CODE AREA CODE/PHONE -·
FPPC Form 460 (8199)
For Technical Assistance: 916/322-5660
State of California
Type or print in ink.
Recipient Committee
Campaign Statement
Cover Page -Part 2
4. Officeholder or Candidate Controlled Committee
OFFICE SOUGHT O.R HELD (INC UDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) C1~ t-'· tt.;,1>17(·1 /117-t:'/Jl Pc
Related Committees Not Included in this Statement: List any committees
not Included In this consolidated statement that are controlled by you or which are primarily
formed to receive contributions or to make expenditures on behalf of your candidacy.
COMMITTEE NAME W.NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
/ DYES ONO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) .,.....-·
CITY STATE ZIP CODE AREA CODE/PHONE
5. 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 Q.EEICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD ,,.----DISTRICT NO. IF ANY
6. Primarily Formed Committee List names otofflceholder(s) or candldate(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 D OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT D OPPOSE
Attach continuation sheets it necessary
7 Verification
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. I certify under penalty of perjury under the laws of the tate of California that the foregoing i.~ true and correct.
Executed on I /3/ ;{>/ B / /
I/ DATE/I I
Executed on __ J'-+/_?J'-..... !_.,,_/:.,../_')_' ._/ __ _ f DAT!{
Executed on ___________ _
DATE
Executed on ___________ _
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
BY~----------------------------------~ SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
NAME 9F FILER /') Pkcf: /f; ?I )/1.~
Contributions Received
1. Monetary Contributions...................................................... Schedule A, Line 3
2. Loans Received................................................................... Schedule a, Line 7
3. JBTOTAL 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. TOTAL EXPENDITURES MADE ......................................... Add Lines B + 9 + 10
Ct•rrent Cash Statement
1 ;.. Jginning Cash Balance................................ Previous Summary Page, Line 16
13. Cash Receipts .............................................................. Column A, Line 3 above
14. Miscellaneous Increases to Cash....................................... Schedule I, Line 4
1 5. 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 a, Part 1, Column (bJ
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... See instructions on reverse
19. Outstanding Debts ................................... Add Line 2 +Line 9 In Column C above
Column A
TOTAL THIS PERIOD
(FROM ATIACHED SCHEDULES) -----
$ ,,.--........_.
~---------
$ __ ;?.;....+-:...1_-5__;f::;._y; __
$ _ _.....;;~· ~-.5:c.....:::;?_' -
·---$ __ ~-------
~&-$ ____ ~-----
$ __ ~ff ...... ·~· ---
Statement covers period
from I/' ( 4:2 / I I
through tr 713 o)J;; Page .::;
Column B*
TOTAL PREVIOUS PERIOD
(SEE NOTE BELOW)
----:.__
-
_____..-
$
Column C
TOTAL TO DATE
(COLUMNS A + B)
/1/i :lf $ /9/~Y -/9/c2(/ $ / 1Y-ez <I
(
*From previous statement Summary Page, Column C. However, if this
is the first report filed for the calendar year, Column B should be blank
except for Loans Received (Line 2), Loans Made (Line 7), and Accrued
Expenses (Line 9).
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/1 to Data 20. Contribution
Received ............ """""-----
21. Expenditures
Made .................. $ -----~-
FPP Form 460 (8199)
For Technical Assistance: 916fJ22·5660
Schedule F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
SCHEDULEF
CALIFORNIA 4co
FORM U
Page 4 of'4
l.D.NUMBER
11/ ,·0 ,;ld
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
eMP campaign paraphernalia/misc. OFC office expenses
CNS campaign consultants PET petition circulating
eTB contribution (explain nonmonetary)* PHO phone banks
eve civic donations POL polling and survey research
FN D fundraising events POS postage, delivery and messenger services
independent expenditure supporting/opposing others (explain)* PRO professional services (legal, accounting)
campaign literature and mailings PRT print ads
MTG meetings and appearances RAD radio airtime and production costs
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
CODE OR (a)
NAME AND ADDRESS OF PAYEE OR CREDITOR OUTSTANDING
(IF COMMITTEE, ALSO ENTER l.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING
OF THIS PERIOD c 1/1, ,,{-;fkl/71-(' ,£,:I'. :,1.111cl!?/I-~
;:?( ;1z<--~--0M1 ~j11JV ~~!a ~ c-//L-fl! '-l5J 1 f-t'7 )Z-cl0~~ bt:J
SUBTOTALS $ I lf';.,;) t/ $
I
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
RFD returned contributions
SAL campaign workers salaries
TEL t. v. or cable airtime and production costs
TRC candidate travel, lodging and meals (explain)
TRS staff/spouse travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponso'r
VOT voter registration
WEB information technology costs (internet, e-mail)
(b) (c) (d)
AMOUNT INCURRED AMOUNT PAID OUTSTANDING
THIS PERIOD THIS PERIOD BALANCE AT CLOSE
(ALSO REPORT ON E) OF THIS PERIOD
~ /t9~a
$ $
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 negalille number
FPPC Form 460 (8199)
For Technical Assistance: 916/tJ22·5660