Second Pre-Election Amendment ecipient Committee
Campaign Statement
Cover Page
(Government Code Secions 84200-8421§.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
through
Date of election il
(Month, Oay, Year)
[PERTtNO CITY CL
1. Type of Recipient Committee: All Committees - Complete Part~ 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
ORec~
[] General Purpose Committee O Sponsored
O Small Cont~butor Committee
O Political peJly/Ce~tral Committee
[] Bal~o! Measure Committee
O Primarily Formed
O ControU~d
O
[] Primarily Formed Candidate/
Officeholder Committee
2. Type of Statement:
~C~ Preelection Statement
[] Semi-annual Statement
[] Terrninatio~ Statement
[] Amendment (Explain below)
COVER PAGE
I.D. NUMBER.
3. Committee information (.~_ -~g~
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMIn'EE)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE
AREA CODE/PHONE
/-~p ~-
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZiP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-IdAJL ADDRESS
Treasurer(s)
:or Olficial Use Only
[] Quarterly Statement
[-] Special Odd-Year Report
[] Supplemental Preelection
Statement - Attach Form 495
NAME OF TREASURER~ "~ ,~
MAILING ADDRESS
/0 W/L AVE
CITY 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 ADORESS
4. Verification
I have used all reasonable diligence in preparing and ~eviewing this statement and 1o the best of my knowledge the information contained herein and in the allached schedules is Irue and complete. I
cedify under penalty of perjury under the laws of the Stale of ~C~ornia that the foregoing is true and correct. /'}
Executed on By
Execuled on By
FPPC Form 460 (Ju~e/01)
ecipient Committee
Campaign Statement
Cover Page -- Part 2
Type or print in ink.
COVER PAGE - PART 2
Page "'~ of ~
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICAi~LE)
RESIDENTIAIJ~USINESS ADDRESS (NO. AND STREET) CITY ~3'A'I~ ZIP
Related Committees Not Included in this Statement: ust any committees
not included in this statement that are controlled by you or are prima~fly formed to receive
contributions or msks expenditures on behalf of your candidacy.
NAME
NAME OF TREASURER
COMMITTEE ADDRESS
LD. NUMBER
CONTROLLED COMMITTEE?
!--] ~ES [3 NO
STREETADDRESS (NO P.O. BO)
CITY STA'I~ ZIP CODE AREA CODE/PHONE
COMM~ ~ I t:E NAME I.D. NUMBER
NAME OF TREASURER.
CO.'mOU. EDCO..n-,~E?
[] *ES r-] NO
COMMI i ~ ~EAODRESS STREET ADDRESS (NO PO. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
6. Ballot Measure Committee
NAMEOFBALLOTMEASURE
BALLOT NO. OR LET[ER
IJURISDICTION
E]SUPPORT
E) OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD
IOISTRICT NO. IF ANY
7. Primarily Formed Committee List names of o~ceholder(s) or candidate(s) for
which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE )FFICE 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
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
[] SUPPORT
[] OPPOSE
[]SUPPORT
[]OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (Junef01)
FPPC Toll-Free Helpllne: 866/ASK*FPPC
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
Type or print In ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from ~'~T'
through OC-T'
SUMMARY PAGE
Page ~ of ~
NAME OF FILER
Contributions Received
1. Monetary Contributions ...................; ....................... ScheduteA, Une3
2. Loans Received ...................................................... schedule s, L/ne 7
3. SUBTOTAL CASH CONTRIBUTIONS ......................... ,~ddUnes l+Z
4. Nonmonetary Contributions ....................................SchedumC, Line3
5. TOTAL CONTRIBUTIONS RECEIVED ................. ; ......... Add Une$ 3 + 4
Expenditures Made
6. Payments Made ....................................................... scheo~e E, Une 4 $
7. Loans Made ...... ~_~t~,__._,~
8. SUBTOTAL CASH PAYMENTS .................................... ,4UdUnos6+7 $
9. Accrued Expenses (Unpaid Bills) ............................... SchdduleF. Une3
10. Nonmonetary Adjustment .......................................... sct, e~m c, t~e 3
11. TOTAL EXPENDITURES MADE ................................ AddUnesS + 9 +
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summa o, PaOe, Line Is
13. Cash Receipts ................................................... ~A. Llne3above
14. Miscellaneous Increases to Cash ........................... sch~/, L/ne4
15. Cash Payments .................................................. Co/umn,~, Uneeabove
16. ENDING CASHBAI.ANCE .......... Add l. ifles 12+ 13+ 14, then subtrect Une 15
If ~is Is a terminaaon statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Sc~du/e S, PanZ
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ........................................ s~ms~.:Uonson~ve~e $
19. Outstanding Debts ......................... Addl-lne2+L/ne9inColurnnBabove $
Column A
Column B
C,N. ENOAR '(EAR
I/~-, e-~
To calculate Column B, add
amounts In Column A to the
corresponding amounts
from Column B of your lasl
raped. Some amounts in
Column A may be negative
tigures that should be
subtracted from previous
period amounts. If this is
the tirst raped being tiled
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
I.D. NUMBER
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
111 through 6/30 711 Io Dale
20. Conlribufions
Received
21. Expenditures
Made
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(11 Sub~ le V~u~ta~y F.q~e~ltum Lira#)
Date of Election
(mm/dd/yy)
/ /
/ / $
/ /.__ $
/ /.__ $
/ /.__ $
~/.__/ $
Total to Dale
$
'Since January 1, 2001. Amounts In this seclion may be
dilferenl Item amoUnts reporled in Column B.
FPPC Form 460 (June/01)
FPPC Toll-Free Helpllne: 8661ASK-FPPC
chedule A Type or print in ink. SCHEDULE A
Monetary Contributions ReceivedAmounts may I)e rounaea Statement covers period
NAME OF FILER I.D. NUMBER
IF AN INDIVIDUAL. ENTER ~ C~U~TIVE TO DATE PER ELECTION
DA~ FULL NAME. STREET ADDRESS AND ZIP COOE OF CONTRI~TOR CONTRIBUTOR
(~E~ENTERI D.~R) ~CUPATION AND EMPLOYER RECEIVED ~IS CALENDAR YEAR TODATE
RECEIVED CODE * I~LF-E~OVED. ENTERN~ PERIOD (JAN. 1 - DEC. 31) (IF RE~IRED)
~ND
~COM
~O~H
~ PTY
~SCC
~OTH
~ P~Y
~SCC
~NO
~O~H
~ PTY
~SCC
~NO
~COU
~OTH
~PTV
~SCC
Schedule A Summary
1. Amoun! received this period - contributions ol $100 or more.
(Include all Schedule A subtotals.) ........................................................................................................ $
2. Amount received this period - unitemized conlribulions of less than $100 ............................................. $
3. Total monetary conldbutions received this pedod.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1 .) ....................... TOTAL $
/OD
'Conlribulor Codes
IND - Individual
COM - Recipient Commitlee
(olher than PTY of SCC)
OTH - Olher
PTY - Political Pady
SCC - Small Contributor Con'~mittee
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
chedule B - Part 1
Loans Received
SEE INS'FRUCTIONS ON REVERSE
NAME OF FILER
FUU. NAME. STREET ADDRESS AND ZIP CODE
OF LENDER
p~ coital ~ ~:~ N. sO EI~F.R LO. taJuaER)
IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
NAME OF BUSINESS)
tFI IND O COM I-I OTH [] PTY [] SCC
to INB [] COM 00TH [] P~Y [] SCC
Type or print in ink.
Amounts may be rounded
to whole dollars.
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
AMOUNT
RECEIVED THIS
PERIOD
AMOUNT PAID
OR FORGIVEN
THIS PERIOD '
[] PAID
,
[] FOFIGIVEN
[] PAID
$
Statement covers period
from ~
through
OUTST(,~DiNG
INTEREST
BALANCE AT PAID THIS
CLOSE OF THIS
PERIOD PERIOD
$
$
SCHEDULE B - PAd:IT
Page ..~ of ~
$ $
[] pAID
$
[] FO~:~1 ~ N
S
DATE DUE ,
SUBTOTALS $ $ $ $
I.D. NUMBER
(ii
ORIGINAL CUMULATIVE
Ad, BUNT OF CONTRIBUTIONS
LOAN TO DATE
~,.~ f~7 ~.~,.~ CALENDAR YEAR
$ $
DATE INCURRED
CALENDA~ YEA~
$ $
PER ELECTION e~
$
DATE INCURRED
DATE INCURRED
Schedule B Summary
1. Loans received this pedod .................................................................................................................... $
(Total Column (bi 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 .) ....................................... ;; ...................... NET $
Enter the net here and on the Summary Page, Column A, Line 2.
? Contributor Codes
lIND -I~ COU - Recipient Committee (other than PTY or SCC) OTH - Other
PTY - Political Party SCC - Small Contributor CommitteeI
(En~' (e) ~
Schedu~ ~ Um 3)
'Amounts forgiven or paid
another party also must be
repoded on Schedule A.
·' Il required.
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
chedule C
Nonmonetary Contributions Received
Type or print In Ink.
Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND
ZIP CODE OF CONTRIBUTOR
(IF CoMMnl~E, ALSO ENTER I.D, NUMBER)
CONTRIBUTOR
CODE *
f-liND
I-lO'tH
DP'fY
DSCC
D~ID
DCO~
DoTH
DPTY
DIND
Oco~
OOTH
Dm'Y
Dscc
DIND
DCOM
DOTH
DP~Y
Dscc
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF~EMPt. OYEO. ENTER
NAME OF BUSINESS)
DESCRIPTION OF
GOODS OR SERVICES
Statement covers period
',om
through
SCHEDULE C
Page._~ of ~
I.D. NUMBER
AMOUNTI
FAIR MARKET
VALUE
CUMULATIVE TO
DATE
CALENDAR YEAR
(JAN 1 - DEC 31)
PER ELECTION
TO DATE
(IF REQUIRED)
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ t . ~, .... ~:~'~f; ': . !~ , ' ~-~*'~1
Schedule C Summary
1. Amount received this period- nonmonetary contributions of $100 or more.
(Include all Schedule C subtotals.) .....................................................................................................................
2. Amount received this period - unitemized nonmonetary contributions of less than $100 ....................................
3. Total nonmonetary contributions received this period. ·
(Add Unes 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ...................... TOTAL
"Contributor Codes
IND - Individual
COM- Recipient Committee
(olher than PTY or SCC)
OTH - Olher
PTY - Political Pady
SCC- Small Conlribulor Committee
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
chedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Typo or print in Ink.
Amounts may be rounded
to whole dollars·
Ststement covers period
from
through (~CIT "2.~/Z,~::~/
SCHEDULE E
Page "7 of ~
NAME OF FILER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment·
clvP campaign paraphemaila/ralsc.
CNS campaign consultants
C1~ contflb~m (explain no~n~etary)"
crc civic donations
FI_ candidate I~lng/ballol fees
FND fundmlalng events
N) independent expenditure supporting/opposing others (explain)'
legai defense
LIT campaign Iltemlure and mailings
I.O. NUMBER
MBR member communications
MrG meetings and appearances
OFC office expenses
yt=l petition circulating
PHO phone banks
POI. polling and survey research
PO~ postage, delivery and messenger services
PRO professional services (legal, accounting)
PHi pdnt ads
PAD radio airtime and productio~ costs
returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airlime and production costs
TRC candidats travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voler registration
WEB inforrrmtion technology costs (Intemet, e-mail)
NAME AND ADDRESS OF PAYEE
p~ co~,m'r EE. ArSO B~Em.O. ~) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTALS
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: 8661ASK-FPPC
chedule I Type or print tn ink. SCHEDULE I
Miscellaneous Increases to Cash ii i''
through ~ ~ ~/ ~t Page ~ of ~
s~ ,.s..~.s o..~w~
NAME OF FILER I.D. NUMeER
DATE FULL N~E AND ADDRESS OF SOURCE DESCRIPTION OF RECEIPT ~OUNT OF
RECEIVED I~ ~EE. ~ E~TER tO. ~) INCREASE TO CASH
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Schedule I Summary
1. Increases to cash of $100 or more lhis period ........................................................................................................... $
2. Unitemized increases to cash under $100 this period ............................................................................................... $
3. Tolal of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ........................................................................................................................... TOTAL $ / 7.-'~.-'""--
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC