07-01-04 TO 09-30-04Recipient Committee
COVER PAGE
ampaign Statement
1.0
Type or print in ink.
Date Stamp
Cover Page
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(Government Code Sections 84200-84216.5)
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Stat en oQis perio
Date of election if applicable:
M
i 2
page of
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(
onth, Day, Year)
rom
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For Official Use Only
SEE INSTRUCTIONS ON REVERSE
through'"
U J ` ) 2-c!!, o
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
2. Type of Statement:
-
❑ Officeholder, Candidate Controlled Committee
❑ Ballot Measure Committee
[iKPreelection Statement
❑ Quarterly Statement
Q State Candidate Election Committee
Q Recall
O Primarily Formed
❑ Semi-annual Statement
❑ Special Odd-Year Report
(A1soCompletePart5)
O Controlled
Q Sponsored
❑ Termination Statement
El Supplemental Preelection
(Also Complete Part 6)
❑ Amendment (Explain below)
Statement - Attach Form 495
❑ General Purpose Committee
Q Sponsored
❑ Primarily Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
Q Political Party/Central Committee
(Also Complete Part 7)
S
3. Committee Information
I.D. NUMBER
2T T 4 g
Treasurers
( )
/ NAME (OR CANDIDATE'S NAME PIF NO COM
COMMIT~T/'E7E
MpI`TTEE) b
NAME OF TREASURER
~
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
C l ♦ V G. Ca-6
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
LING ADDRESS
--moo Clh 1, cL
Y STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of r
certify under penalty of perjury under the laws of the State of California that the foregoing is true
Executed on ('),cy ~ , 2O C) L- By
Dal
knowledge the information contained herein and in the attached schedules is true and complete. I
treasurer
Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on By Date Signature of Controlling Officeholder, Candidate, Stale Measure Proponent FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 666/ASK-FPPC
State of California
Type or print in ink. COVER PAGE - PART 2
Recipient Committee
Campaign Statement CALIFORNIA
~ . i ~ ~
Cover Page - Part 2
Page
5. Officeholder Or CanrliriatP Cnntrnllarl Cnmmittcn
6. Ballot Measure Committee _
of
&ME OF OFFICEHOLDER OR ANDIDA NAME OF BALLOT MEASURE
~L Nc I i2pl- c3~ i 1-1MCv~ -
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION - ❑ SUPPORT
r - ❑ OPPOSE
1 f I (T '
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Lr . ` > Jv ~ ~ . ~"(Z~
RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE? 7• Primarily Formed Committee List names of officeholder(s) or candidate(s) for
which this committee is primarily formed.
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
[:1 YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NOP.O.BOX)
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
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
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Contributions Received
1. Monetary Contributions Schedule A, Line 3 $
Loans Received Schedule B, Line 7
SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 $
4. Nonmonetary Contributions Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED AddLines 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 AddLines 8+9+10 $
(""went Cash Statement
Beginning Cash Balance Previous Summary Page, Line 16 $
13. Cash Receipts Column A, Line 3above
14. Miscellaneous Increases to Cash Schedule t, Line 4
15. 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 B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents See instructions on reverse $
19. Outstanding Debts Add Line 2 + Line s in column a above
_i
Type or print in ink.
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
Statement covers period
from _
through
Column B
CALENDAR YEAR
TOTALTODATE
$
$
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).
SUMMARY PAGE
Page of _
I.D. NUMBER
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received $ $ .
21. Expenditures
Made $ $
I 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)
L. J $
J-J $
-J~ $
- I
`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