460 Pre-election 1st ecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5}
SEEtNSTRUCTIONS ON REVERSE
1. Type of Recipient Committee: AIICommltte~.-Completspartal, 2,3, and4.
~] Officeholder, CaodidateControtledCommlttee [] BallotMeasureCommittee
O State Candidate Electio~ Committee O Primarily Formed
O Recall O Controlled
[] General Purpose ~ittee
O Sponsored []
O Small Contributor Committee
O Political Party/Central Cornmittee
I ..,od o.,. o, e,.c,io, i,
2. Type of Statement:
~ Preelection Statement
[] Semi-annual Statement
[] Termination Statement
SEP 1 5 2003
'ERTINO CITY CLEI
[] Ouadedy Statemenl
[] Special Odd-Year Repod
[] Supplemental Preelecflon
COVER PAGE
O Sponsored
Primarily Formed Candidate/
Officeholder Committee
[] Amendment (Explain below)
Statement - Attach Form 495
3. Committee Information I I.D. NUMBER
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMI1-/tF.~_) ~
STREET ADDRESS (~ P.O. BOx)
CITY ~ATE ZIP CODE EA CODE/PHONE
MA~LING ADDRESS (IF D~FFERENT) NO. AND sTREE~ OR P.O. BOX
Treasurer(s)
NAME OF TREASURER
CITY STATE ZIP CODE
NAME OF ASSISTANT TREASURER, IF ANY
A A CODE/PHONE
./~ ~.~ - i l q y
MAILING ADDRESS
CITY STATE ZIP COOE AREA CODE/PHONE
OPTIONAL: FAX I 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
Execuled on By
ecipient Committee
Campaign Statement
Cover Page -- Part 2
Type or print in Ink.
COVER PAGE - PART 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTriCT NUMBER IF APPLICABLE)
RESIDENTIAIJ~USINESS AOORESS {NO. A~O STREET) Cl~ ~A~ 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 make expendlturea on b~half of your candidacy.
COMMITTEE NAME ~ I.D. NUMBER
I
NAME OF TREASURER CONTROLLED COMMITTEE?
[] YES [] NO
COMMITTEE ADDRESS STREET ADDRESS (NO lEO. BOX)
CITY STATE ZIP COOE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE7
[] YES [] No
COMMIttEE ADDRESS STREET ADDRESS (NO P.O. SOX
CITY STATE ZIP CODE AREA CODE/PHONE
6. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER
JURISDICTION [][] OPPosESUPPORT
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 Forn~ed Committee List names of officeholder(a) or candidete{s) for
which this committee ia primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE ~FFICE SOUGHT OR HELD
I~SUPPORT
OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT
[] OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
FPPC Form 460 (June/01)
FPPC Toll+Free Helpllne: ~661AS K-FPPC
Campaign Disclosure Statement
Summary Page
SEEINSTRUCTIONS ON REVERSE
Type or print In ink.
Amounts may be rounded
to whole dollars.
SUMMARY PAGE
Page ~ of ~
NAME OF FILER
Contributions Received
1. Monetary Contributions ...................~..: .................... Schedule A, Line 3 $
2. Loans Received ...................................................... Schedule e. Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ......................... AddLinesl+2
4. Nonmonetary Contributions ....................................Schedule C. Line 3
5. TOTAL CONTRIBUTIONS RECEIVED -..; ....................... AddLInes 3 * 4 $
Expenditures Made
6. Payments Made ....................................................... Schedule E. Line
7. Loans Made ............................................................. Schedule H, Line
8. SUBTOTAL CASH PAYMENTS .................................... AddLin~se+7
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F. Line
10. Nonmonetary Adjustment .......................................... Schedule C. Line
11. TOTAL EXPENDITURES MADE ................................ AddLines8+9+ 10
Current Cash Statement
12. Beginning Cash Balance ....................... Pre~ious Summary Page, Line 16 $
13. Cash Receipts ................................................... ColurnnA, Llne3at~ove
14. Miscellaneous Increases to Cash ........................... Schedule I. Line 4
1 5. Cash Payments .................................................. Column A. Line 8 above
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14. then subtract Line 15 $
If this IS a termina#on statement. Line t6 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ........................................ See thst~ct~on$ ~1 reverse $
19. Outstanding Debts ......................... AddUne2+UneginColumneabove $
Column A Column B
/ /
$ 1la-
To calculate Column B. add
amounts in Column A to the
corresponding amounls
from Column B o! your lasl
repeal. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts. If Ihis is
the first reporl being filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
I.D. NUMBER
Calendar Year Summary [or Candidates
Running in Both the State Primary and
General Elections
20. Contributions
Received
21. Expenditures
Made
$ . $
$
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Mede*
Date of Eleclion Total Io Date
(mm/dd/yy)
/ /___ $
/ /.__ $
/ /.__ $
I /.__ $
I /.__ $
/--/ $
'Since January 1. 2001. Amounts In this section may be
dilferent hem amounls repealed in Column 13.
FPPC Form 460 (June/Oil
FPPC Toll-Frae Helpllne: 866/ASK-FPPC
chedule B- Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
t~.~ND [] COM [] OTH [] pTY [] SCC
tO IND [] COM [] OTH [] PTY [] SCC
t[] INO [] COM [] OTH O P~r' [] SCC
Type or print In ink.
Amounts may be rounded
to whole dollars.
OUTSTANDING AMOONT
BALANCE RECEIVED THIS
BEGINNING THIS
PERIOD PERIOD
$
SUBTOTALS $
Statement c verb erlod
(c)
AMOUNT PAID
OR FORGIVEN
THIS PERIOD *
[]FORGIVEN
$
~IFORGIVEN
$
(d)
OUTSTANDING
BALANCE AT
CLOSE OF THIS
PERIOD
DATE DUE
DATE DUE
DATE DUE
(')
INTEREST
PAID THIS
PERIOD
SCHEDULE B- PART 1
Page 4 of ~'~
ID. NUMBER
(~)
ORIGINAL CUMULAllVE~
AMOUNT OF CONTRIBUTtONB
LOAN TO DATE
, /dE/~ , /~
Schedule B Summary
1. Loans received this pedod ....................................................................................................................
(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.) ............................................................... NET $
Enter the net here and on the Summary Page, Column A, Line 2.
It Contributor Codes
IND- Indlvtd ueJ COM - Recipient Committee (other than PTY o~ SCC) OTH - Other PTY - Political Party SCC - Small Contributo~ Committee
I'Amounts forgiven or paid by
anolher party also musl be
reported on Schedule A.
*' If required.
FPPC Form 460 (June/01)
FPPC Toll-Free Helpllne: 8661ASK-FPPC
chedule E
Payments Made
Type or print in ink.
Amounts may be roundeo
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
CODES: If one of the following codes accuralely describes the payment, you may enter the code, Otherwise, describe the payment.
~ campaign paraphematia/mlsc. ~ member comrnunications RAO radio alrtime and production costs
CNS campaign consultants MrG meetings and appearances RFD returned contributions
OTB contribution (explain nonmonetary)* OFC elf/ce expanses SAL campaign workers' salades
CVC civic donations PET pelitlon circulating TEL I.v. or cable airtime and production cosls
F]L candidate fitingtoallot fees Pi-lO phone banks TRC candidate lravel, lodging, and meals
FND fundmising events POi_ polling and suwey research TRS staff/spouse travel, lodging, and meals
i.e. NUMBER
I',O independent expenditure supporting/opposi~.g others (explain)'
LEG legal defense
LIT campaign literature and mailings
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PR]' print ads
' TSF transler between committees of the same candldale/spon$or
VeT voter registration
WEB information lechnology costs (intemet, e-rna/l)
NAME AND ADDRESS OF PAYEE
(~ COfa~r E E, N SO ENTER I.D. k'JMS~R) COnE OR DES~IPTION OF PAYMENT A~NT PAID
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SU~]TOTAL$ / ~ o.~ --
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 4ti0 (June/O1)
FPPC 'roll-Free Helpline: 866/ASK-FPPC