1st 460 Semi-annual amendment A
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Type or print in ink.
Date of election if applic'
(Month, Day, Year)
Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200~84216.5)
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Official Use Only
Statement covers period
1/::r;:-Q4
from
PERTINO CITY CLERK
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Quarterly Statement
Special Odd-Year Report
Supplemental Preelection
statement - Attach Form 495
o
o
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Statement:
Preelection Statement
Semi~annual Statement
Termination Statement
(Also file a Form 410 Termination)
(Explain below)
Type of
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2, 3, and 4.
Measure
b
CommIttees - Complete Parts 1,
o Primarily Formed Ballot
Committee
o Controlled
o Sponsored
(Also CanpletePart 6)
through
SEE INSTRUCTIONS ON REVERSE
Committee
~ Officeholder, Candidate Controlled Committee
o State Candidate Election Committee
o Recall
(Also Complete Parl 5)
At
Recipient
Type of
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Primarily Fonned Candidate/
Officeholder Committee
(Also Complete Pat17)
o
o General Purpose Committee
o Sponsored
o Small Contributor Committee
o Political Party/Central Committee
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Treasurer(s)
NAME OF TREASURER
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Committee Information
(OR CANDIDATE'S NAME
COMMITTEE NAME
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NO. AND STREET OR P.O. BOX
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DRESS (IF DIFFERENT)
AREA CODE/PHONE
ZIP CODE
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AREA CODE/PHONE
ZIP CODE
STATE
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c.ertify
E-MAIL ADDRESS
Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my
Propooent FPPC Form 460 (Januaryf05)
FPPC Toll-free Helpline: 866/ASK·FPPC (866/275-3172)
State of California
By
By
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Executed on
Executed on
Statement covers period
/1
Type or print In ink.
Amounts may be rounded
to whole dollars.
Schedule E
Payments Made
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.0. NUMBER
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6
from
through
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
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candidate/sponsor
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7t
describe the payment.
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
VOT voter registration
WEB infonnation technology costs (internet
Otherwise.
the payment, you may enter
MBR member communications
MTG meetings and appearances
OFC office expenses
FEr petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
the code,
c.
following codes accurately describes
(explain)
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CODES If one of the
campaign paraphernalia/misc.
campaign consultants
contribution (explain nonmonetary)
civic donations
candidate filing/ballot fees
fundraising events
independent expenditure supporting/opposing others
legal defense
campaign literature and mailings
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expenditures must also be summarized on Schedule D,
are contributions or independent
Þ'ayments that
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Schedule E Summary
Itemized payments made this period. (Include all Schedule E subtotals.
1.
2. Unitemized payments made this period of under $1 00
Column (e).
3. Total interest paid this period on loans. (Enter amount from Schedule B. Part 1
s
FPPC Form 460 (January/OS)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
2, and 3. Enter here and on the Summary Page, Column A, Line 6.)
4, Total payments made this period. (Add Lines
Statement covers period
from I / I / yn \.I-
through ~ (iyc l)n '+
Type or print in ink.
Amounts may be rounded
to whole dollars.
Schedule E
(Continuation Sheet)
Payments Made
Page~ of~
.0. NUMBER
>r7~1
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Otherwise, describe the payment
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
WEB information technology
costs (internet. e-mail
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AMOUNT PAID
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the payment, you may enter
t.ABR member communications
MfG meetings and appearances
OFC office expenses
ÆT petition circulating
PI-K) phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
the code.
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CODES: If one of the
Q.¡p campaign paraphernalia/misc.
CNS campaign consultants
C1B contribution (explain nonmonetary)
CVC civic donations
FIL candidate filinglballot fees
fND fundraising events
IND independent expenditure supporting/opposing others (explain)'"
LEG legal defense
LIT campaign literature and mailings
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CODE OR DESCRIPTION OF PAYMENT
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FPPC Form 460 (January/OS)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
.. Payments that are contributions or independent expenditures must also be summarized on Schedule D.