10-14-04 TO 12-31-04Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print In Ink.
Statement covers period ;j %Date of election If applicabi
(Month, Day, Year)
T _ lo 7-6 V
from OTt
through
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee
0 State Candidate Election Committee 0 Primarily Formed
0 Recall 0 Controlled
(Also Complete Part 5) 0 Sponsored
❑ General Purpose Committee
0 Sponsored
0 Small Contributor Committee
0 PoiI;al Party/CeQttr IC
( Ik") ('t,,n C' _-P
3. Committee Information
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
I.D. NUMBER
\ CIS
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)`` -
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
AILING ADDRESS (IF DI
OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL' FAX I E-MAIL ADDRESS
Date Stamp
1_ - R
JAN 3! I g
2. Type of Statement:
O Preelection Statement
0-geml-annual Statement
❑ Termination Statement
p Amendment (Explain below)
COVER FhGE
Page of
For Official Use Only
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
R c_v r_e_e_yn Vky k r
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
aVro P, 2C) J_ CI
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
STATE ZIP CODE AREA CODEIPHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. 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 =v-, 'der the laws of the (State of California that the foregoing Executed on D-7 By I/ tof reaVeror Assistant Treasurer
Executed on ( AL n ~ V By 77
(Also Complete Part 6)
Executed on ale By
Signature of Controlling er, Candidate, State Measure Proponent FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 666/ASK-FPPC
State of California
By
Signature of Controlling officeholder, Candidate, Slate Measure Proponent
Campaign Disclosure Statement Type or print In Ink.
Amounts may be rounded
Summary Page to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Statement covers period CALIFORNIA / ' •
from )-J7-0V
through 1 31 ` U 7 Page a of
I.D. NUMBER
Contributions Received
Column A
TOTALTHISPERIOD
(FROM ATTACHED SCHEDULES)
1.
2.
netary Contributions
Loans Received
Schedule A, Line 3
Schedule e, Line 3
$ V' O 0
3.
SUBTOTAL CASH CONTRIBUTIONS
Add Lines 1 + 2
$ Q 4
4.
Nonmonetary Contributions
Schedule C, Line 3
5.
TOTAL CONTRIBUTIONS RECEIVED
......Add Lines 3 + 4
$ g y
Column B
CALENDAR YEAR
TOR ACT O GAT E
Expenditures Made
6. Payments Made Schedule E. Line 4 $ ;L 3~ 3 S a $
7. Loans Made Schedule H. Line 3
8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ oL~ 4 3 • S $
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 $ ~4 • $
Current Cash Statement
12. Beginning Cash Balance Previous Summary Page. Line 16 $ To calculate Column B, add
13. Cash Receipts column A. Line 3 above a` S O o . o b amounts in Column A to the
corresponding amounts
14. Miscellaneous Increases to Cash schedule 1. Line 4 from Column B of your last
15. Cash Payments Column A. Line a above kL I report. Some amounts in
01
Column A may be negative
16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ $ figures that should be
subtracted from previous
If this is a termination statement, Line 16 must be zero. period amounts. If this Is
17. LOAN GUARANTEES RECEIVED Schedule. n. Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents See instructions on reverse $
19. Outstanding Debts Add Line 2 + Line 9In Column a above $
the first report being filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6130 7/1 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)
I$
11 $
1-~ $
1~ $
1-1 ~ $
'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
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