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deHaan 460R eci ie t C mmittee. Campaig Cverage (Government Code Sections 84200 -- 84216.5) COVER PAGE Type or print in ink. CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX 1 E -MAIL ADDRESS Executed can Date Executed can Date: CITY ST TE ZIP C DE AREA CODE/PHONE OPTIONAL: FAX 1 E-MAIL ADDRESS By Date election if. applicab (Month, Day, Year) 2. Type of Statement: El Preelection Statement 0 Semi - annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Quarterly Statement Special Odd -Year Report [] Supplemental Preelection Statement - Attach Form 495 NAME OF ASSISTANT TREASUJ R, IF N MAILING ADDRESS Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Cardidate, State Measure Proponent FPPC Farm 466 (January/05) FPPC Toll -Free Helpline. 866/ASK-FPPC (8661275 -3772) State of California Statement covers period 06 r 17.4 from SE INSTRUCTIONS ON REVERSE through. 1. Type o f Rec Committee All Committees — Complete Parks 1, 2, 3, and 4. Officeholder; Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall O Con (Also Complete Part 5) 0 Sponsored [l General Purpose Committee (Also Complete Part 6) 0 Sponsored. F] Primarily Formed Candidate] C Small Contributor Committee Officeholder Committee 0 Political Party /Centra Committee ( Al c�r�prr part 3. Committee informative I.D. NUMBER C0MI {TEE ' FE. (0 CA IDATE'S N ME IF NO COMMITTEE) . z0/0 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX 1 E -MAIL ADDRESS Executed can Date Executed can Date: CITY ST TE ZIP C DE AREA CODE/PHONE OPTIONAL: FAX 1 E-MAIL ADDRESS By Date election if. applicab (Month, Day, Year) 2. Type of Statement: El Preelection Statement 0 Semi - annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Quarterly Statement Special Odd -Year Report [] Supplemental Preelection Statement - Attach Form 495 NAME OF ASSISTANT TREASUJ R, IF N MAILING ADDRESS Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Cardidate, State Measure Proponent FPPC Farm 466 (January/05) FPPC Toll -Free Helpline. 866/ASK-FPPC (8661275 -3772) State of California R e ci pient r C over Pr; 5. Officeholder or Candidate Controlled Committee NAME OF QEICEHOLDER OR G NDIDAT ii__cz OFFICE SOUGHT OR HELD (INCLUDE LOPATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAL U INESS ADDRESS (NO. AND STREET) CITY STATE ZIP. F Related. Committees Not Included in this Statement: List any com not include' in this statement that are co ntr olled by you or are primarily formed to receive contributions. or make expenditures on behalf of your candidacy. COMMIT AME I.D.. NUMBER v4 NAME OF TREASURER CONTROLLED COMMITTEE? A YES ❑ N O COMMITTEE ADDRESS STREET DRESS '0 P.O. BOX) CITY S T ZIP CODE AREA CODE /PHONE 1 74 1103 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............ ........ ...... .. .......... .............. ............. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Type or print in ink. COVER PAGE - PART 2 FORM Page 6. Primarily Formed Ballet Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER ,JURISDICTION ❑ SUPPORT 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 Candidate /Off iceholder 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 SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD n SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � SUPPORT OPPOSE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline. 8661ASK -FPPC (866/275 -3772) State of California Camp Dis u re. Statement T or print in ink. ade.. ................................ .............. ........ Schedule H L 3 7. Loans.: Made.. ....,...... ............................ ine SUMMARY PAGE Summar Pa Amounts: ma be. rou to whole dollars. $ Statement -covers period I from $ Z ................................ Ddg�: Pa of . .. .... SEE INSTRUCTIONS 0 EVERS-E. NAME OF FILER: . ......... .. throu 1,D. NU q5 Contributions. Received To calculate: Column B, add C. 1. C 1 . o umn:k TOTAL THIS PERIOD. c B CALENDARYEAR Calendar Year. Sum r nary � for C BoWthe:State Primar and 1� Monetar Contributions Schedule A, Line. 3. (FROM ATTACHED SCHEDULE 7 7 TOT&TO DATE 1 El .......... 00.. 1/1 t 6/30. L CASH CONTRIBUTIONS -7-7 7 9, 100 ... fi g ures: that should subtracted irom previous .:20 Co t ib i . d unts... If this is the first report bein filed - ----- 2 21 .:::Ex nditures pe Cash E and Outstandin Debts Expenditures Made. Pa M Schedule.E, Line .4...$.. . . . ........... .. ...... 6 4 ade.. ................................ .............. ........ Schedule H L 3 7. Loans.: Made.. ....,...... ............................ ine ......... ... .. . ................. . . ?1� 2 6 1.9 8.. SUBT OTAL CASH PAYMENTS � ........ AddLines6.+7.. $ 2t3 $ �kq 1 I.:TOTAL EXPENDITURES MADE Add Lines 8 +:9 + 10 $ Z ................................ A Current� Cash Statement 12. Be Cash Balance ..... ....... ........ Previous Summary Pa Line 16. $ 7-S772:00. To calculate: Column B, add C. 1. 13. Cash Receipts ........................... Column A, Line 3 above correspondin amounts 14. Miscellaneous. Increases to Cash ... ....................... Schedule 1,: Line 4 from �c olurnn B of y our last report. Some amounts in :colu A ma be ne be 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14,: then subtract Line 15 $ ... fi g ures: that should subtracted irom previous If this is a termination statement, Line 16 must be zero. d unts... If this is the first report bein filed - ----- for this calendar y ear, onl carr over the amounts fromlines. 2,7, and 9 (if Cash E and Outstandin Debts F r»nn 460. (JanuarylOS) A T or print. in ink. ND El COM ....SCHEDULE A .Schedule ontar Contributions Received Amounts ma be rounded to whole dollars. Statement: covers pe /0 E] OTH PTY from 71 / Coto 0 throu 3 -- j Pa of . SEE INSTRUCTIONS ON.REVERSE F] . ......... . ......... NAME OF FILER dL I.D. NUMBER ❑ SCC DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR .. .. . ...... ......... . ........ .. .. . . CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED ( I F GO MM ITT E E, ALSO ENTE 1, D � N U. UBE R CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD ( JAN. I - DEC. 31 ( IF REQUIRED ❑ SCC OF BUSINESS) . . . ... ...................................... Schedule A Summar 1. Amount received this period — itemized monetar contributions. (include all Schedule A subtotals.) ... __ ...... ....... ­1 ............. ­­ ......... ........... ............. 2. Amount received this period — unitemized monetar contributions of less than $100 _ ....... _­­ ............... S 9`77e w. 3. Total monetar contributions received this period I *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e. business entit PTY — Political Part SCC — Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summar Pa Column A, Line 1.) ................. T FPPC Form 460 ( Januar y /05 ) FPPC Toll-Free Helpline: 8661ASK-FPPC (86612.75-3772) All ND El COM /0 E] OTH PTY g / Coto 0 F] ❑ SCC � � [ r-1 COM 2 � e o Iq 10 ._] OTH F F] PTY ❑ SCC f V XND [:]COM ❑ OTH 10 - lt2 0 E] PTY ❑ SCC XND F] COM 2 (0 ZeO 0 � `� ���a' ! / OTH � PTY r-1 SCC e-1 JWN D El COM F-1 OTH F-1 PTY ❑ SCC SUBTOTAL$ " ..................... ......... Schedule A Summar 1. Amount received this period — itemized monetar contributions. (include all Schedule A subtotals.) ... __ ...... ....... ­1 ............. ­­ ......... ........... ............. 2. Amount received this period — unitemized monetar contributions of less than $100 _ ....... _­­ ............... S 9`77e w. 3. Total monetar contributions received this period I *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e. business entit PTY — Political Part SCC — Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summar Pa Column A, Line 1.) ................. T FPPC Form 460 ( Januar y /05 ) FPPC Toll-Free Helpline: 8661ASK-FPPC (86612.75-3772) DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CU TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED ( IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE ( IF SELF-EMPLOYED, EN NAME. PERIOD (JAN:.1. DEC. 31) (IF REQUIRED) OF BUSINESS [:]Com ❑ It)1 4 OTH PTY ❑ SCC ❑ IND [:] com ❑ OTH E:] PTY F-1 SCC [] IND ❑ COM OTH ❑ PTY ❑ SCC ............... ❑ IND COM OTH ❑ PTY F-1 SCC ❑IND ❑ COM M OTH [ PTY SCC SUBTOTAL $ /0 0 0 f .......... *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e. business entit PTY — Political Part SCC — Small Contributor Committee FPPC Form 460 (Januar FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Sch. u le . 5 P art 1 Loans Re cei v e d SEE INSTRUCTIONS ON REVERSE NAME OF FILER FULL NAME, STREET ADDRESS AND ZIP CODE .. IF. AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNTPAID. OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER ( IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS ( IF COMMIT7EE� ALSO ENTER I.Q. NUMBER) NAME OF BUSINESS PERI OD THIS PERIOD RIOD PERIOD PERIOD. ..LOAN TO DATE A.1 . . . .. . ... D CALENDAR Y I . $ .85 $ $ FORG IV EN RATE PER ELE ON** tV/1 ❑ COM [_1 OTH E] PTY ❑ SCC. tEj IND ❑ COM ❑ OTH ❑ PTY ❑ SCC F - 1 PAID V FORGIVEN DATE DUE ❑ PAID FORGIVEN SUBTOTALS $ &00 $ b G $ DATE DUE . .. . ....................... ... ( Enter ( e ) on Schedule B Summary Schedule E, Line 3 6 4�)O 1 Loans received his period...... ............................ ............. ...... ....................................... ....... $ (Total Column (b) plus unitemized loans of less than $100.) I'Contributor Codes (Vo 0 IND — Individual L 90 2. Loans paid or for this period ......................................................... ............................. ............. $ COM — Recipient Committee (Total Column (c) plus loans under $100 paid or for ( other than PTY or SCC (Include loans paid b a third part that are also itemized on Schedule A.) OTH - Other ( e. g ., business entit PTY — Political Part SCC — Small Contributor Committee 3. Net chan this period. (Subtract Line 2 from Line 1.) ................................ ...................... __.... NET $ (Ma be a iie number Enter the net here and on the Summar Pa Column A, Line 2. 'Amounts for or paid b another part also must be reported on Schedule A. "* If re DATE DUE DATE INCURRED FPPC Form 460 (Januar FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-37.72) CALENDAR YEAR RATE PER ELECTION 10 00 $ DAJ'E INCURRED CALENDAR YEAR RATE PER ELECTION DATE INCURRED ( Enter ( e ) on Schedule B Summary Schedule E, Line 3 6 4�)O 1 Loans received his period...... ............................ ............. ...... ....................................... ....... $ (Total Column (b) plus unitemized loans of less than $100.) I'Contributor Codes (Vo 0 IND — Individual L 90 2. Loans paid or for this period ......................................................... ............................. ............. $ COM — Recipient Committee (Total Column (c) plus loans under $100 paid or for ( other than PTY or SCC (Include loans paid b a third part that are also itemized on Schedule A.) OTH - Other ( e. g ., business entit PTY — Political Part SCC — Small Contributor Committee 3. Net chan this period. (Subtract Line 2 from Line 1.) ................................ ...................... __.... NET $ (Ma be a iie number Enter the net here and on the Summar Pa Column A, Line 2. 'Amounts for or paid b another part also must be reported on Schedule A. "* If re DATE DUE DATE INCURRED FPPC Form 460 (Januar FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-37.72) SCHEDULE E FP Form 0anuaryl05) FPPC `doll -Free Helpline 8661ASKwFPPC �8��12�5- 37'72) * Payments that are contributions or independent expenditures must also be summarized can Schedule D. SUBTOTAL $ Z2, ....... ... FPPC Form 460 (Januaryf05) FPPC Toll -Free Welpline: € 366 IASIK- FPPC.(86..61Z75 -3772)