Form 460 -- 10-01-04 thru 10-16-04 A'
Recipient Committee
Campaign Statement
(Government Code Sections 84200-84216.5)
from
Type or print in ink. Date Stamp
I
Statement covers period Date of election if applicable
10/01/2004 (Month, Day,Year)
COVER PAGE
1 / 12
For Official Use Only
SEE INSTRUCTIONS ON REVERSE
I through 10/16/2004
I 11/02/2004
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
X❑ Pre-election Statement
❑ Quarterly Statement
Q State Candidate Election Committee Q Primary Formed
❑ Semi-annual Statement
❑ Special Odd-Year Report
Q Recall Q Controlled
(Also Complete Part O Sponsored
❑ Termination Statement
❑ Supplemental Preelection
5.)
❑ General Purpose Committee
❑ Amendment(Explain below)
Statement Attach Form 495
(Also Complete Part 6J
Q Sponsored
❑ Primary Formed Candidate/
Q Small Contributor Committee Officeholder Committee
Q Political Party/Central Committee (Also Complete Part 7.)
3.
Committee Information 11268244ER
Treasurer(s)
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE
NAME OF TREASURER
Alice Jacobson for City Council
Louise Cohen
STREET ADDRESS(NO P.O.BOX)
MAILING ADDRESS
164 Coop Court
5705 Friars Road Unit 54
CITY STATE ZIP CODE AREA CODE/PHONE
Encinitas CA 92024-1437
CITY STATE
San Diego CA
ZIP CODE AREA CODE/PHONE
92110-1815
MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX
NAME OF ASSISTANT TREASURER,IF ANY
CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS
OPTIONAL:FAX/E-MAIL 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 complete. I certify under penalty of perj ry under the I S of the State of California
that the foregoing is true and correct.
Executed on i0 2OLL t. 1"(
BY
DA SIG URE OF TREASU R OR ASSISTANT TREASURER
Executed on 10 Z-1104 B Y
DAT SIGNATUR CONTROLLING OFFICEHO R,CANDIDATE,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
Campaign Statement
Cover Page — Part 2
Type or print in ink.
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
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
COVER PAGE-PART 2
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 W
to whole dollars.
from 1 O -� G>
through 1 C) -� -�� 3/ 12
Expenditures Made
Column A
6. Payments Made ........................................................
Column B
7. Loans Made ..............................................................
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
8. SUBTOTAL CASH PAYMENTS...................................
CALENDAR YEAR
TOTAL TO DATE
Schedule A,Line 3
$ 5096.00
$
23902.00
Schedule B,Line 7
0.00
0.00
Add Lines 1 +2
$ 5096.00
$
23902.00
Schedule C,Line 3
0.00
346.98
Add Lines 3+4
5096.00
$
24248.98
Expenditures Made
21848.60
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
jurrent 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
$ 14923.43 $
21848.60
5096.00
0.00
0.00
$ 14923.43 $
21848.60
from Column B of your last
0.00
0.00
0.00
346.98
$ 14923.43 $
22195.58
$ 11880.83
To calculate Column B,add
5096.00
amounts in Column A to the
corresponding amounts
0.00
from Column B of your last
report.Some amounts in
14923.43
Column A may be negative
$ 2053.40
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
$ 0.00
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 $ 24248.98
21. Expenditures
Made $ 0.00 $ 22195.58
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 $ 21848.60
"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
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
100.00
(IF COMMITTEE,ALSO ENTER I.D.NUMBER)
Rcpt Dt:
Real Estate
0/04/2004
Rick Reeder
❑ OTH
705 Palomar Airport Road
❑ PTY
Suite 100
❑ SCC
Carlsbad CA 92009-1060
x❑ IND
ID:
Rcpt Dt:
10106/2004
Deborah Brown
❑ PTY
2010 Noyes Street
❑ SCC
Evanston IL 60201-2578
Rcpt Dt:
10/14/2004 Jackie Brown
1766 Winthrop Road
Hiqhland Park IL 60035-3732
Rcpt Dt:
10/14/2004 Richard Campbell
630 Encinitas Boulevard
Encinitas CA 92024-3732
RcI)t Dt-
10/1 4/2bO4 Tim Clancy
PO Box 358
Cardiff By The Sea CA 92007-0358
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
100.00
OF BUSINESS)
X❑ IND
Real Estate
❑ COM
250.00 j
❑ OTH
250.00 G 04
❑ PTY
Ga bb& Ellis/BRE Commer-
❑ SCC
x❑ IND
Engineer
❑ COM
❑ OTH
❑ PTY
Robert Bosch Tool Corp.
❑ SCC
x❑ IND
Retired
❑ COM
❑ OTH
❑ PTY
N/A
❑ SCC
❑ IND
c�
❑ COM
❑ OTH
❑ PTY
❑ SCC
1K IND
Landscaper
❑ COM
❑ OTH
❑ PTY
JBK Trust
❑ SCC
SUBTOTAL $
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$
SCHEDULE A
Statement covers period
4,"J from =�5 '.
through— L'P —O 4/ 12
I.D.Number
1268244
AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED THIS CALENDAR YEAR TO DATE
PERIOD (JAN.1-DEC.31) (IF REQUIRED)
100.00 100.00 100.00 G 04
100.00
100.00
100.00 G 04
100.00
100.00
100.00 G 04
250.00
250.00
250.00 G 04
250.00 j
250.00 j
250.00 G 04
4875.00
221.00
5096.00
*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
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)
Rcpt Dt:
0114/2004 Bob Echter
1101 Leucadia Blvd.
Encinitas CA 92024
ID:
Rcpt Dt:
10/14/2004 Steven Emmet MD
773 Academy Drive
Solana Beach CA 92075-2031
Rcpt Dt-
1011 4/2bO4 Yuki Emmet
773 Academy Drive
Solana Beach CA 92075-2031
Rcpt Dt:
10/14/2004
Elaine Halliday
4285 Ibis Street
CODE*
San Diego
ID:
Rcpt Dt:
10/14/2004
Robert Halliday
4285 Ibis St
0 IND
San Diego
CA 92103-1327
CA 92103
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)
0 IND
Flower Grower
❑ COM
250.00
❑ OTH
250.00 G 04
❑ PTY
Self
❑ SCC
X❑ IND
Physician
❑ COM
❑ OTH
❑ PTY
Steven D. Emmet MD, Inc.
❑ SCC
D IND
Physician
❑ COM
❑ OTH
❑ PTY
Steven D. Emmet MD, Inc.
❑ SCC
[91 IND
Owner
❑ COM
❑ OTH
❑ PTY
Halliday Management
❑ SCC
D IND
Owner
❑ COM
❑ OTH
❑ PTY
Halliday Management
❑ SCC
SUBTOTAL $
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$
SCHEDULE A
250.00
250.00
250.00 G 04
250.00
250.00
250.00 G 04
250.00
250.00
250.00 G 04
250.00
250.00
250.00 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
r�nwunzs may oe rvunaea
Monetary ontributions Received
y to whole dollars.
Statement covers period
CALl [A
COM
from C)
(other than PTY or SCC)
through C) —I to —C)
6/ 12
SEE INSTRUCTIONS ON REVERSE
-Political Parry
SCC-
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:
X❑ IND
Retired
125.00
125.00 G04
125.00
0/14/2004
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:
X❑ IND
Financial Officer
100.00
100.00
100.00 G04
10114/2004
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
El COM
3410 Adams Run
❑ OTH
Encinitas CA 92024-7051
❑ PTY
Self
ID:
❑ SCC
Rcpt Dt:
K 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$
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 Parry
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
.+Mounts may be rounded
Monetary ontributions Received
y to whole dollars.
Statement covers period
pAt>I=
c �INIA
from �C)`
through (0-1,1C,�`�
7/ 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)
Rcpt Dt:
Insurance Broker
250.00
250.00 G04
X❑ IND
250.00
0/14/2004
John Reinhardt
❑ COM
301 Horizon Drive
❑ OTH
Encinitas CA 92024-4148
❑ PTY
❑
Self
ID:
SCC
Rcpt Dt:
X❑ IND
Real Estate Broker
250.00
250.00
250.00 G 04
10/14/2004
Jo Ann Shannon
❑ COM
1715 Oxford Ave
❑ OTH
Cardiff CA 92007
❑ PTY
Property Insights
ID:
❑ SCC
Rcpt Dt:
El IND
Real Estate Broker
0.00
250.00
250.00 G 04
10/14/2004
Jo Ann Shannon
❑ COM
1715 Oxford Ave
❑ OTH
Cardiff CA 92007
❑ PTY
Property Insights
ID:
❑ SCC
Rcpt Dt:
x❑ IND
Homemaker
250.00
250.00
250.00 G 04
10114/2004
Cathy Staver
❑ COM
345 Seeman Drive
❑ OTH
Encinitas CA 92024-2841
❑ PTY
❑
NA
ID:
SCC
Rcpt Dt:
❑ IND
100.00
100.00
100.00 G04
10/14/2004
Betsy Jacobson And Associates
El COM
363 Patty Lane
0 OTH
Encinitas CA 92024-1629
❑ PTY
Sek4
ID:
❑ SCC
SUBTOTAL $
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
wmuUms may oe rounaea
Monetary Contributions Received to whole dollars.
Statement covers period
p
CALI�tFtMA
from c) — —o 4
M
.,..-
SEE INSTRUCTIONS ON REVERSE
through _ �—�
8/ 12
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:
❑ IND
200.00
200.00 G 04
200.00
0114/2004
Encinitas Land And Cattle Co.
❑ COM
661 Melba Road
OTH
A
Encinitas CA 92024-4619
❑ PTY
❑
ID:
SCC
Rcpt Dt:
❑ IND
250.00
250.00
250.00 G 04
10/14/2004
Fred B.Weston, Inc.
❑ COM
PO Box 234214
L4_C-o5A-" Aw e_
❑ OTH
Encinitas CA 92023-4214
❑ PTY
❑
ID:
SCC
Rcpt Dt:
10114/2004
Rupp Financial Services
❑ IND
El COM
250.00
250.00
250.00 G 04
2208 14th Street
X❑ OTH
❑ PTY
Encinitas CA 92024-6809
ID:
❑ SCC
RC pt Dt:
10/14/2004
Santoro, Driggs,Walch, Kearney,Johnson &Thompson
400 S
El IND
❑ COM
� o f-41t"
250.00
250.00
250.00 G 04
4th Street
X❑ OTH
Floor 3
Las Vegas NV 89101-6201
ED PTY
ID:
❑ SCC
Rcpt Dt:
10114/2004
The Farber Family Limited Partnership
❑ IND
❑ COM
100.00
100.00
100.00 G04
991 C Lomas Santa Fe Drive
OTH
#441
Solana Beach CA 92075-2125
❑ PTY
ID:
❑ SCC
SUBTOTAL $
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
SEE INSTRUCTIONS ON REVERSE
Amounts may be rounded
to whole dollars.
Statement covers period
p �
from
through k o —(to -C,�
b
9/ 12
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
PERIOD
(JAN.1 -DEC.31)
(IF REQUIRED)
OF BUSINESS)
Rcppt Dt:
X❑ IND
Civil Engineer
200.00
200.00
200.00 G 04
9/15/2004
W.Justin Suiter
❑ COM
1240 India Street
❑ OTH
Unit 605
San Diego CA 92101-3572
El
Pasco Engineering
ID:
❑ SCC
Schedule A Summary
Amount received this period -contributions of$100 or more.
(Include all Schedule A subtotals.) ...............................................................
2. Amount received this period - unitemized contributions of less than $100 ........
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)
SUBTOTAL$ 4875.00
......................$
..............I.......$
.. 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
Type or print in ink.
SCHEDULE E
Schedule E statement covers period
Amounts may be rounded +CACNtA
Payments Made to whole dollars. from
SEE INSTRUCTIONS ON REVERSE
Alice Jacobson for City Council
through � D l(P—21 I 10/ 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
TB contribution(explain nonmonetary)*
.;VC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND independent expenditure supporting/opposing others(explain)*
LEG legal defense
LIT campaign literature and mailinqs
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 Drint ads
1268244
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 infnrmntinn tarhnnlnmi rnefe(intarnat amnill
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 92102-4,948
Ims Intermarket Manufacturing Service ID:
CMP
25 Signs 44
515.59
1504 Fayette Street
FI Cnffinn CA 92020-1527
The Gemini Group ID:
LIT
Mailer; Postage
2186.40
110 W C Street
Suite 1325
San D*Pgc) QA 92101 215PI00
* 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.).
.................................. $ 14822.20
$ 101.23
$ 0.00
..................... TOTAL$ 14923.43
FPPC Form 460(June/01)
FPPC Toll-Free Helpline:866/ASK-FPPC
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Alice Jacobson for City Council
Type or print in ink. Statement covers period
Amounts may be rounded
to whole dollars. from
through__k D 11 / 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
TB contribution(explain nonmonetary)*
.;VC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND independent expenditure supporting/opposing others(explain)*
LEG legal defense
LIT camoaian literature and mailinas
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 aric
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
WP:R info .firm fonhnnlnnv+c ri.,+e -+ ;IN
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 Dopgo CA 92101-qqnn
NORTH COUNTY TIMES ID:
PRT
6 Newspaper Advertisements
1396.59
374 N Coast Highway 101
Suite P
Fninin'tis CA 92024-2,942
Anne W. Kearns ID:
CNS
Design Walk Piece; Postcards;Ads
1450.00
7701 Knightwing Circle
Fort Myers; FE 33912-7331
* 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.
Amounts may be rounded
to whole dollars.
Statement covers period
from _�—Cq
through D l 'D
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)*
.;VC 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 Drint ads
12/ 12
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
WFR infn—tinn+—Innnlnnv nnofo 1;n++ ;11
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
Delta ID:
CMP
Rack Cards; Buttons; Labels
549.00
132 N El Camino Real
#362
Encinitas QA 92024-2801
Michael's Printing Company ID:
CMP
12,000 Walking Brochures
2909.25
6760 University Avenue
Suite 110
San Diego QA 92115-5827
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 14822.20
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