Form 460 -- 10-01-04 thru 10-16-04 Recipient Committee
Campaign Statement
(Government Code Sections 84200-84216.5)
Type or print in ink.
Statement covers period
from 10/01/2004
SEE INSTRUCTIONS ON REVERSE I through 10/16/2004
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 Primary Formed
Q Recall
Q Controlled
(Also Complete Part 5.)
O Sponsored
❑ General Purpose Committee
(Also Complete Part 6.)
Q Sponsored
❑ Primary Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
Q Political Parry/Central Committee
(Also Complete Part 7.)
3. Committee Information
I.D.NUMBER
1268244
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE
Alice Jacobson for City Council
STREET ADDRESS(NO P.O.BOX)
164 Coop Court
CITY STATE ZIP CODE AREA CODE/PHONE
Encinitas CA 92024-1437
MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL:FAX/E-MAIL ADDRESS
f'I t1
N 3 1 F ' * '4 3
Date of election if appli6able:
(Month,Day,Year)
11/02/2004 1
2. Type of Statement:
M Pre-election Statement
❑ Semi-annual Statement
❑ Termination Statement
❑X Amendment(Explain below)
COVER PAGE
1 /12
For Official Use Only
❑ Quarterly Statement
❑ Special Odd-Year Report
❑ Supplemental Preelection
Statement-Attach Form 495
Amending Form 460 originally filed 10/21 /04.
Record additional itpms! $900 from Candidate ;
Signs($900 ) ;Void check $549 ;Add' l Contrib. $244.
Treasurer(s)
NAME OF TREASURER
Louise Cohen
MAILING ADDRESS
5705 Friars Road Unit 54
CITY STATE ZIP CODE AREA CODE/PHONE
San Diego CA 92110-1815 619-291-6550
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 my knowledge the information contained herein and in the attached schedules
is true and complet I certify under penalty of perjury undpc the laws of the State of California that the foregoing is true and correct.
Executed on 3 O S By
�Ab�.1 � IGNATURE O REASURER OR ASSISTANT TREASURER
Executed on l By `
TE SIGN CONTROLLING O6/
I EHOLDER, DIDAT ,STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,STATE MEASURE PROPONENT
Executed on By FPPC Form 460(June/01)
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,STATE MEASURE PROPONENT FPPC Toll-Free Helpline:866/ASK-FPPC
State of California
Recipient Committee Type or print in ink. COVER PAGE PART 2
�
Campaign Statement
9
Cover Page — Part 2 "�
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Alice Jacobson
OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Sought: City Council Member
City Encinitas
RESIDENTIAL/BUSINESS ADDRESS(NO.AND STREET) CITY STATE ZIP
164 Coop Court Encinitas CA 92024-1437
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
contributions or to make expenditures on behalf of your candidacy.
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
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
6. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO.OR LETTER I JURISDICTION I❑ 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 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
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
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
NAME OF FILER
Alice Jacobson for City Council
Contributions Received
1. Monetary Contributions .............................................
Loans Received .........................................................
3. SUBTOTAL CASH CONTRIBUTIONS............................
4. Nonmonetary Contributions ...................................
5. TOTAL CONTRIBUTIONS RECEIVED...........................
Type or print in ink. SUMMARY PAGE
Amounts may be rounded Statement covers period /� ��
to whole dollars. Q `11
q
from 3
through - 3/12
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 8+9+ 10
urrent 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 I, Line 4
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
$ 15274.43 $
Column A
6240.00
Column B
0.00
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
22199.60
CALENDAR YEAR
TOTAL TO DATE
Schedule A, Line 3
$ 5340.00
$
24146.00
Schedule B, Line 7
900.00
900.00
Add Lines 1 +2
$ 6240.00
$
25046.00
Schedule C, Line 3
0.00
346.98
Add Lines 3+4
6240.00
$
25392.98
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 8+9+ 10
urrent 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 I, Line 4
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
$ 15274.43 $
22199.60
6240.00
0.00
0.00
$ 15274.43 $
22199.60
from Column B of your last
0.00
0.00
0.00
346.98
$ 15274.43 $
22546.58
$ 11880.83
To calculate Column B,add
6240.00
amounts in Column A to the
corresponding amounts
0.00
from Column B of your last
report.Some amounts in
15274.43
Column A may be negative
$ 2846.40
figures that should be
subtracted from previous
period amounts.If this is
the first report being filed
$ 0.00
for this calendar year,only
carry over the amounts
from Lines 2,7,and 9(if
any).
$ 0.00
$ 900.00
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
I20. Contribution
Received $ 0.00 $ 25392.98
I21. Expenditures
Made $ 0.00 $ 22546.58
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)
11/02/2004 $ 22199.60
*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
Schedule A Type or print in ink. SCHEDULE A
Amounts may be rounded Statement covers period '
Monetary Contributions Received to whole dollars. P
from
COM
NO r _O
SEE INSTRUCTIONS ON REVERSE through 4/ 12
NAME OF FILER
I.D.Number
Alice Jacobson for City Council
PTY-
Political Party
1268244
DATE
FULL NAME,MAILING ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL,ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
AND ZIP CODE OF CONTRIBUTOR
CODE*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
(IF SELF-EMPLOYED,ENTER NAME
OF BUSINESS)
PERIOD
(JAN.1-DEC.31)
(IF REQUIRED)
X❑ IND
Rcpt Dt:
0104/2004
Real Estate
100.00
100.00
100.00 G04
Rick Reeder
❑ COM
705 Palomar Airport Road
❑ OTH
Suite 100
Carlsbad CA 92009-1060
❑ PTY
Grubb& Ellis/BRE Commer-
ID:
El SCC
cial
Rcpt Dt:
10106/2004
X❑ IND
Engineer
100.00
100.00
100.00 G 04
Deborah Brown
❑ COM
2010 Noyes Street
❑ OTH
Evanston IL 60201-2578
❑ PTY
Robert Bosch Tool Corp.
ID:
❑ SCC
Rcpt Dt:
10/14/2004
❑ IND
Retired
100.00
100.00
100.00 G 04
Jackie Brown
❑ COM
1766 Winthrop Road
❑ OTH
Highland Park IL 60035-3732
❑ PTY
❑
N/A
ID
SCC
Rcpt Dt:
10114/2004
X❑ IND
Real Estate
250.00
250.00
250.00 G 04
Richard Campbell
❑ COM
630 Encinitas Boulevard
❑ OTH
Encinitas CA 92024-3732
❑ PTY
❑
Self
ID:
SCC
Rcpt Dt:
10114/2004
X❑ IND
Landscaper
250.00
250.00
250.00 G 04
Tim Clancy
❑ COM
PO Box 358
❑ OTH
CD:ardiff By The Sea CA 92007-0358
JBK Trust
E-1 SCC
Schedule A Summary
1. Amount received this period -contributions of$100 or more.
(Include all Schedule A subtotals.) ........................................................................
2. Amount received this period - unitemized contributions of less than $100 ............
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)
SUBTOTAL$
.............$
.............$
TOTAL $
4875.00
465.00
5340.00
*Contributor Codes
IND
Individual
COM
Recipient Committee
(other than PTY or SCC)
OTH-
Other
PTY-
Political Party
SCC-
Small Contributor Committee
FPPC Form 460(JUNE/01)
FPPC Toll-Free Helpline:866/ASK-FPPC
Schedule A Type or print in ink. SCHEDULE A
. e+mvunw niay ue rvunae°
Monetary Contributions Received
y to whole dollars.
Statement covers period
p
from lo - 1 - C)i
3 ,
SEE INSTRUCTIONS
through D —< (e'
5/ 12
ON REVERSE
NAME OF FILER
I.D.Number
Alice Jacobson for City Council
1268244
DATE
FULL NAME,MAILING ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL,ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
AND ZIP CODE OF CONTRIBUTOR
CODE`
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
(IF SELF-EMPLOYED,ENTER NAME
OF BUSINESS)
Flower Grower
PERIOD
250.00
(JAN.1-DEC.31)
250.00
(IF REQUIRED)
250.00 G 04
Rcpt Dt:
X❑ IND
10114/2004
Bob Echter
❑ COM
1101 Leucadia Blvd.
❑ OTH
Encinitas CA 92024
❑ PTY
Self
ID:
❑ SCC
Rcpt Dt:
X❑ IND
Physician
250.00
250.00
250.00 G 04
10114/2004
Steven Emmet MD
❑ COM
773 Academy Drive
❑ OTH
Solana Beach CA 92075-2031
❑ PTY
Steven D. Emmet MD, Inc.
ID:
❑ SCC
Rcpt Dt:
10114/2004
Q IND
Physician
250.00
250.00
250.00 G 04
Yuki Emmet
❑ COM
773 Academy Drive
❑ OTH
Solana Beach CA 92075-2031
❑ PTY
Steven D. Emmet MD, Inc.
ID:
❑ SCC
Rcpt Dt:
10/14/2004
X❑ IND
Owner
250.00
250.00
250.00 G 04
Elaine Halliday
❑ COM
4285 Ibis Street
❑ OTH
San Diego CA 92103-1327
❑ PTY
Halliday Management
ID:
❑ SCC
Rcpt Dt:
10114/2004
❑ IND
Owner
250.00
250.00
250.00 G 04
Robert Halliday
❑ COM
4285 Ibis St
❑ OTH
San Diego CA 92103
❑ PTY
Halliday Management
ID:
❑ SCC
SUBTOTAL$
15,,
Schedule A Summary
1. Amount received this period - contributions of$100 or more.
(Include all Schedule A subtotals.) ........................................................................
2. Amount received this period - unitemized contributions of less than $100 ..........
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)
.... TOTAL$
*Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH-Other
PTY-Political Party
SCC-Small Contributor Committee
FPPC Form 460(JUNE/01)
FPPC Toll-Free Helpline:866/ASK-FPPC
Schedule A
Type or print in ink.
SCHEDULE A
Monetary Contributions Received
Amounts may be rounded
to whole dollars.
Statement covers period
from '
SEE INSTRUCTIONS ON
through l D _ 6/ 12
REVERSE
NAME OF FILER
I.D. Number
Alice Jacobson for City Council
1268244
DATE
FULL NAME,MAILING ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL,ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
AND ZIP CODE OF CONTRIBUTOR
CODE*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
(IF SELF-EMPLOYED,ENTER NAME
OF BUSINESS)
Retired
PERIOD
125.00
(JAN.1 -DEC.31)
125.00
(IF REQUIRED)
125.00 G 04
Rcpt Dt:
Q IND
10/14/2004
Carol Jensen
❑ COM
744 Snapdragon St
❑ OTH
Encinitas CA 92024
❑ PTY
NA
ID:
❑ SCC
Rcpt Dt:
❑ IND
VP
200.00
200.00
200.00 G 04
10/14/2004
Stefan LaCasse
❑ COM
710 Rihley Place
❑ OTH
Encinitas CA 92024
❑ PTY
Shoreline Communities
ID:
❑ SCC
Rcpt Dt:
❑ IND
Financial Officer
100.00
100.00
100.00 G 04
10/14/2004
Pauline Lessman
❑ COM
815 America Way
❑ OTH
Del Mar CA 92014-3915
❑ PTY
❑
Western Planning Financi-
al Corporation
ID:
SCC
Rcpt Dt:
X❑ IND
General Contractor
200.00
200.00
200.00 G 04
10/14/2004
Craig Lewis
❑ COM
3410 Adams Run
❑ OTH
Encinitas CA 92024-7051
❑ PTY
Self
ID:
❑ SCC
Rcpt Dt:
X❑ IND
President/Owner
100.00
100.00
100.00 G 04
10/14/2004
Janet Price
❑ COM
3416 Red Rock Road
❑ OTH
Oklahoma City OK 73120-5625
❑ PTY
Kamber's
ID:
❑ SCC
SUBTOTAL$ '
3
r
4 3
Schedule A Summary
*Contributor Codes
1. Amount received this period - contributions of$100 or more.
IND -Individual
(Include all Schedule A subtotals.) .........................................................................
...............................$
COM -Recipient Committee
(other than PTY or SCC)
2. Amount received this period - unitemized contributions of less than $100 .............
...............................$
OTH-Other
3. Total monetary contributions received this period.
PTY-Political Party
SCC-Small Contributor committee
(Add Lines 1 and 2. Enter here and on the Summary Page, Column
A, Line 1.) .................... TOTAL$
FPPC Form 460(JUNE/01)
FPPC Toll-Free Helpline:866/ASK-FPPC
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Alice Jacobson for City Council
DATE FULL NAME,MAILING ADDRESS
RECEIVED AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
Rcppt Dt:
10114/2004 John Reinhardt
301 Horizon Drive
Encinitas CA 92024-4148
Rcpt Dt:
10/14/2004 Jo Ann Shannon
1715 Oxford Ave
Cardiff CA 92007
Rcpt Dt-
10/14/2004 Cathy Slaver
345 Seeman Drive
Encinitas CA 92024-2841
Rcpt Dt:
10/14/2004 Betsy Jacobson And Associates
363 Patty Lane
Encinitas CA 92024-1629
Rcpt Dt:
10/14/2004 Encinitas Land And Cattle Co.
661 Melba Road
Encinitas CA 92024-4619
Type or print in ink.
Amounts may be rounded
to whole dollars.
CONTRIBUTOR
IF AN INDIVIDUAL,ENTER
OCCUPATION AND EMPLOYER
CODE*
(IF SELF-EMPLOYED,ENTER NAME
250.00
OF BUSINESS)
x❑ IND
Insurance Broker
❑ COM
200.00
❑ OTH
200.00 G 04
❑ PTY
Self
❑ SCC
x❑ IND
Real Estate Broker
❑ COM
❑ OTH
❑ PTY
Property Insights
❑ SCC
x❑ IND
Homemaker
❑ COM
❑ OTH
❑ PTY
NA
❑ SCC
❑ IND
❑ COM
D OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
Schedule A Summary
1. Amount received this period - contributions of$100 or more.
(Include all Schedule A subtotals.) ....................................................................
2. Amount received this period - unitemized contributions of less than $100 ........
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)
SUBTOTAL $
..........................$
..........................$
............. TOTAL$
SCHEDULE A
Statement covers period
from
through D— ( Le — `7 7/ 12
I.D.Number
1268244
AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED THIS CALENDAR YEAR TO DATE
PERIOD (JAN.1 -DEC.31) (IF REQUIRED)
250.00 250.00 250.00 G 04
250.00
250.00
250.00 G 04
250.00
250.00
250.00 G 04
100.00
100.00
100.00 G 04
200.00
200.00
200.00 G 04
*Contributor Codes
IND
-Individual
COM
-Recipient Committee
(other than PTY or SCC)
OTH-
Other
PTY-
Political Party
SCC-
Small Contributor Committee
FPPC Form 460(JUNE/01)
FPPC Toll-Free Helpline:866/ASK-FPPC
Schedule A Type or print in ink. SCHEDULE A
Amounts may be rounded
Monetary Contributions Received to whole dollars.
Statement covers period
p
`' '
from y — — O
3 33
_
through
8/ 12
SEE INSTRUCTIONS ON REVERSE
-_
NAME OF FILER
I.D.Number
Alice Jacobson for City Council
1268244
DATE
FULL NAME,MAILING ADDRESS
CONTRIBUTOR
IF AN INDIVIDUAL,ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
AND ZIP CODE OF CONTRIBUTOR
CODE
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
(IF SELF-EMPLOYED,ENTER NAME
OF BUSINESS)
PERIOD
(JAN.1 -DEC.31)
(IF REQUIRED)
Rcppt Dt:
250.00
❑ IND
250.00
250.00 G 04
10/14/2004
Fred B. Weston, Inc.
❑ COM
PO Box 234214
❑ OTH
Encinitas CA 92023-4214
❑ PTY
❑
ID:
SCC
Rcpt Dt:
❑ IND
250.00
250.00
250.00 G 04
10/14/2004
RUPP Financial Services
❑ COM
2208 14th Street
[K] OTH
Encinitas CA 92024-6809
❑ PTY
❑
ID:
SCC
Rcpt Dt:
❑ IND
250.00
250.00
250.00 G 04
10/14/2004
Santoro, Driggs,Walch, Kearney,Johnson&Thomps
400 S
n ❑ COM
4th Street
OTH
Floor 3
PTY
Las Vegas NV 89101-6201
❑
ID:
SCC
Rcpt Dt:
El IND
100.00
100.00
100.00 G 04
10/14/2004
The Farber Family Limited Partnership
❑ COM
991C Lomas Santa Fe Drive
X❑ OTH
#441
PTY
Solana Beach CA 92075-2125
❑
ID:
SCC
Rcpt Dt:
❑ IND
Civil Engineer
200.00
200.00
200.00 G 04
10/15/2004
W.Justin Suiter
❑ COM
1240 India Street
❑ OTH
Unit 605
San Diego CA 92101-3572
El
Pasco Engineering
ID:
❑ SCC
SUBTOTAL$ 4875.00
Schedule A Summary
1. Amount received this period -contributions of$100 or more.
(Include all Schedule A subtotals.) ...............................................................................
2. Amount received this period - unitemized contributions of less than $100 ...................
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ........
...................$
...................$
........ TOTAL $
*Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH-Other
PTY-Political Party
SCC-Small Contributor Committee
FPPC Form 460(JUNE/01)
FPPC Toll-Free Helpline:866/ASK-FPPC
r% r%___� T..____ SCHEDULE B-PART 1
%J%F1 AYIG L7 - rC&11. 1
Loans Received
-+r- -. r••••-.... ....
Amounts may be rounded
to whole dollars.
Statement covers period '
`�
�1 41"S"o
from l� -l - o
SEE INSTRUCTIONS ON REVERSE
through
9/ 12
NAME OF FILER
I.D.NUMBER
Alice Jacobson for City Council
1268244
FULL NAME,STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL,ENTER
(a)
OUTSTANDING
(b)
AMOUNT
(c)
AMOUNT PAID
(d)
OUTSTANDING
(e)
INTEREST
(fl
ORIGINAL
(g)
CUMULATIVE
OF LENDER
OCCUPATION AND EMPLOYER
BALANCE
RECEIVED
OR FORGIVEN
BALANCE AT
PAID THIS
AMOUNT OF
CONTRIBUTION:
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
(IF SELF-EMPLOYED,ENTER
BEGINNING THIS
THIS PERIOD
THIS PERIOD*
CLOSE OF THIS
PERIOD
LOAN
TO DATE
NAME OF BUSINESS)
PERIOD
PERIOD
Western Financial Plannin-
❑PAID
CALENDAR YEAR
'ice Jacobson
g
.;4 Coop Court
$
900.00
$
0.00 %
900.00
$
900.00
FORGIVEN
PER ELECTION-
Manager
RATE
Encinitas CA 92024-14
900.00 G 04
ID:
$ 0.00
$ 900.00
$
$ 0.00
10/15/2004
❑X IND ❑COM❑OTH ❑PTY ❑SCC
DATE DUE
DATE INCURRED
SUBTOTALS $
Schedule B Summary
1. Loans received this period.
(Total Column (b) plus unitemized loans less than $100.)
2. Loans paid or forgiven this period
(Total Column (c) plus loans under$100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.)
Enter the net here and on the Summary Page, Column A, Line 2.
*Contributor Codes
IND-Individual COM-Recipient Committee(other than PTY or SCC) OTH-Other
900.00 $ 0.00 $
900.00 $ 0.00
(Enter(e)on
900.00 Schedule E,Line 3)
M
Net$ 900.00
(may be a negative number)
*Amounts forgiven or paid by
another party also must be
reported on Schedule A.
** If required.
FPPC Form 460(June/01)
PTY-Political Party SCC-Small Contributor Committee FPPC Toll-Free Helpline:866/ASK-FPPC
SCHEDULE E
Type rint in ink. Statement covers period 'r
Pa ments Made Amounts may be rounded 14
y to whole dollars. from _ — Al
,
T yp or
Schedule E p
1 —� tP 10/ 12
SEE INSTRUCTIONS ON REVERSE through ` D
NAME OF FILER I.D.NUMBER
Alice Jacobson for City Council
1268244
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalia/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
:TB
contribution(explain nonmonetary)*
OFC
office expenses
SAL
campaign workers'salaries
:,VC
civic donations
PET
petition circulating
TEL
t.v.or cable airtime and production costs
FIL
candidate filing/ballot fees
PHO
phone banks
TRC
candidate travel,lodging,and meals
FND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel,lodging,and meals
IND
independent expenditure supporting/opposing others(explain)*
POS
postage,delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
PRO
professional services(legal,accounting)
VOT
voter registration
LIT
campaiqn literature and mailings
PRT
Drint ads
wFR
infnrmnfinn fachnnlnnv nnctc(intamot amnil)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Complete Campaigns ID:
OFC
Fees from Credit Card Contributions
116.50
610 Gateway Center Way
Suite K
San Diego CA 92102-4548
Ims Intermarket Manufacturing Service ID:
CMP
25 Signs 4x4
515.59
1504 Fayette Street
Fl Cnaon CA 92020-1527
The Gemini Group ID:
LIT
Mailer; Postage
2186.40
110 W C Street
Suite 1325
San Diego CA 92101-qqno
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
1. Payments made this period of$100 or more. (Include all Schedule E subtotals.) ..........................................................
2. Unitemized payments made this period of under$100. ...............................................................................................
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) .....................
4. Total payments made this period. (Add lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)......
............................. $ 15173.20
$ 101.23
0.00
............... TOTAL $ 15274.43
FPPC Form 460(June/01)
FPPC Toll-Free Helpline:866/ASK-FPPC
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAMt Uh FILER
Alice Jacobson for City Council
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from d"'
through 1 D —� �0 c)q 11 /12
I.D.NUMBER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia/misc.
CNS campaign consultants
;TB contribution (explain nonmonetary)*
PVC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND independent expenditure supporting/opposing others(explain)*
LEG legal defense
LIT campaign literature and mailings
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage,delivery and messenger services
PRO professional services(legal,accounting)
PRT nrint ads
1268244
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers'salaries
TEL t.v.or cable airtime and production costs
TRC candidate travel,lodging,and meals
TRS staff/spouse travel,lodging,and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
VUPQ mfnr +Inn+e..1,...,1.. ..+..r.,.,. ..• ..:n
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
The Gemini Group ID:
CNS
Voter Data
484.87
110 W C Street
Suite 1325
San Dopan CA 92101-2900
NORTH COUNTY TIMES ID:
PRT
6 Newspaper Advertisements
1396.59
374 N Coast Highway 101
Suite P
Encinitas CA 92024-2942
Anne W. Kearns ID:
CNS
Design Walk Piece; Postcards;Ads
1450.00
7701 Knightwing Circle
Fort Myers FI 23912-7qIl
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
1. Payments made this period of$100 or more. (Include all Schedule E subtotals.) ...........................................................................................
$
2. Unitemized payments made this period of under$100. ................................................................................................................................
$
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ...................................................... $
4. Total payments made this period. (Add lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.).......................... TOTAL $
FPPC Form 460(June/01)
FPPC Toll-Free Helpline:866/ASK-FPPC
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Alice Jacobson for City Council
Type or print in ink. Statement covers period
Amounts may be rounded
SCHEDULE E
to whole dollars.
from — �
3
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
through ® — -U
12/12
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia/misc.
CNS campaign consultants
713 contribution (explain nonmonetary)*
CVC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND independent expenditure supporting/opposing others(explain)*
LEG legal defense
LIT campaign literature and mailings
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage,delivery and messenger services
PRO professional services(legal,accounting)
PRT orint ads
NUMBER
iPk1*yZ1I!l
RAID radio airtime and production costs
RFD returned contributions
SAL campaign workers'salaries
TEL t.v.or cable airtime and production costs
TRC candidate travel,lodging,and meals
TRS staff/spouse travel,lodging,and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WFR infnrmatinn tarhnnlnnv rnete(intarnat amain
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
CMP
Printing Lge Postcards; Bumper Stickers
5214.00
Delta ID:
132 N El Camino Real
#362
Fnewn't,gn CA 92n24-2801
Michael's Printing Company ID:
CMP
12,000 Walking Brochures
2909.25
6760 University Avenue
Suite 110
San Dmpgn CA 92115-5827
Surf City Times ID:
PRT
900.00
132 N El Camino Real
#337
Encinitas CA 92024-2801
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 15173.20
Schedule E Summary
1. Payments made this period of$100 or more. (Include all Schedule E subtotals.) ...........................................................................................
$
2. Unitemized payments made this period of under$100. ................................................................................................................................
$
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ...................................................... $
4. Total payments made this period. (Add lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.).......................... TOTAL $
FPPC Form 460(June/01)
FPPC Toll-Free Helpline:866/ASK-FPPC