01-01-04 TO 06-30-04Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from I tr)►(1 ~C> U 4
uY~_ Imo
through
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Committee
❑ Ballot Measure Committee
Q State Candidate Election Committee
Q Primarily Formed
Q Recall
Q Controlled
(Also Complete Part 5)
0- Sponsored
General Purpose Committee
(Also Complete Part 6)
Q Sponsored
❑ Primarily Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
0 Political Party/Central Committee
(Also Complete Part 7)
3. Committee Information
1. D. NUMBER
a2 B YS4
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) rq
STREET ADDRESS (NO P.O. BOX)
I\0 c)-c
CITY c STATE ZIP CODE AREA CODE/PHONE
(IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS.
Date of election if appii
(Month, Day, Year)
Date Stamp
COVER PAGE
Page, .1 of
For Official Use Only
2. Type of Statement:
❑ eelection Statement
SPemi-annual Statement
❑ Termination Statement
❑ Amendment (Explain below)
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
Treasurer(s)
I'AAMf OF TREASURER
MAILING ADDRESS
`1 ` c> ~0 .
CITY
~C v
NAME OF ASSISTAI
MAILING ADDRESS
V -
r STATE ZIP CODE AREA CODE/PHONE
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 be of my knowledge the information contained herein and in the attached schedules is true and complete. I
certify under pens of perjury under the laws of the State of California that the fore oing is d orrect.
Executed on V V
ate ~
M~ I ~,si Assistant Treasurer
Executed op By
Sianal a I to Off easure ronnnwnt nr Rwsnnnsihlw Officwr nl Snnnenr
Y, IN
Executed on By
Dal 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: 866/ASK-FPPC
Campaign Disclosure Statement Type or print in ink.
Amounts may be rounded
Summary Page to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
SUMMARY PAGE
,
Statement covers period CALIFORNIA
•
from C', C~ `1 e
through Page of
I.D. NUMBER
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTALTHISPERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and
Monetary Contributions Schedule A, line 3 $ $ General Elections
2. Loans Received Schedule e, line 7 1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 $ $ 20. Contributions
Received $ $
4. Nonmonetary Contribution's Schedule Q Linea 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ..•.....AddLines 3+4 $ $ Made $ $
Expenditures Made- Expenditure Limit Summary for State
6. Payments Made Schedule E Line 4 $ $ Candidates
7. Loans Made Schedule H, Line 7
22. Cumulative Expenditures Made"
8. SUBTOTAL CASH PAYMENTS Add lines 6 + 7 $ $ (It Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 Date of Election Total to Date
10. Nonmonetary Adjustment Schedule C, Linea E)EE (mm/dd/yy)
11. TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10 $ _ $ J-~ $
Current Cash Statement
12. Beginning Cash Balance Previous Summary Page, Line 16 $
13. Cash Receipts Column A, Line 3 above
14. Miscellaneous Increases to Cash schedule 1, 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 9 in Column B above $ D
J~ $
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
_ J' $
figures that should be
subtracted from previous
period amounts. If this is
lJ $
the first report being filed
for this calendar year, only
carry over the amounts
'Since January 1, 2001. Amounts in this section may be
from Lines 2, 7, and 9 (if
different from amounts reported in Column B.
any).
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC