460 Recipient Committee Campaign Statement 10-22-2011Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200- 84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
Date of election if appli
from a
(Month, Day, Year)
through w�—/
vv z`
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
VOfficeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
0 State Candidate Election Committee Committee
0 Recall 0 Controlled
(Also Complete Part 5) 0 Sponsored
(Also Complete Part 6)
F General Purpose Committee
0 Sponsored F Primarily Formed Candidate/
0 Small Contributor Committee Officeholder Committee
0 Political Party /Central Committee (Also Complete Part 7)
3. Committee Information I I.D. NUMBER
COMMITTEE NAME (O C ANDIDATE'S NAME IF NO COMMITTEE)
t -f`?rti f
cTOCET n -
MAILING ADDFtESS (IF DIFFERENT) NO - AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX / E -MAIL ADDRESS
OCT 2 7
PERTINO CITY C
COVERPAGE
L of !s_�
Official Use Only
2. Tyr of Statement:
Measure Preelection Statement ❑ Quarterly Statement
❑ Semi - annual Statement ❑ Special Odd -Year Report
❑ Termination Statement ❑ Supplemental Preelection
(Also file a Form 410 Termination) Statement -Attach Form 495
❑ Amendment (Explain below)
Treasurer(s) 1/ fe 6;�
NAME OF TREASURER
Al
MAILING ADDR
/!�=
NAME OF ASST TANT TREASURER, IF A '
MAILING ADDR�S
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the
By
- Signature of Controlling Officeholder, Candidate, Slate Measure Proponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
State of California
Recipient Committee
Campaign Statement
Cover Page — Part 2
COVER PAGE - PART 2
Page Z of
U. VIIILANIVIUGI VI LlQII U IUCILU %1U11L1 VII %IU1111111LLM: 6. Primarily Formed Ballot Measure Committee
NAME OF OFF EHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
o e .,,r 7o4
OFFICE SOUGHT OR HELD (INCLUDE LOC ION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION E] SUPPORT
❑ OPPOSE
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STAT ZIP
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
contributions or make expenditures on behalf of your candidacy.
COMMITTEENAME I.D. NUMBER
"A' "" v' " R " " "
""C CFTEAC„RCO ,,��, ", EDC0 11.1.1 TEE? 7. Primarily Formed Candidate /Officeholder Committee List names of
YES vV ' "' I I ' officeholder(s) or candidate(s) for which this committee is primarily formed.
❑ ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEENAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
p YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
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
CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets if necessary
Type or print in ink.
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772)
State of California
Campaign Disclosure Statement Type or print in ink.
Amounts may be rounded
Summary Page to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
i/
SUMMARYPAGE
Statement covers period CALIFORNIA 4
from F
through �C f� Page — of
I.D. NUMBER
D-4 7 6 l'.) 6 6?
U V
Contributions Received
Column Column B
Schedule E. Line 4
Calendar Year Summary for Candidates
Schedule H, Line 3
8. SUBTOTALCASH PAYMENTS ..... ...............................
TOTALTHISPERIOD CALENDARYEAR
(FROMATTACHED SCHEDULES) TOTALTO DATE
9. Accrued Expenses (Unpaid Bills) ...............................
Running in Both the State Primary and
10. Nonmonetary Adjustment ........... ...............................
Schedule C Line
/ 4 -
�
Add Lines 8 +9 +10
General Elections
1. Monetary Contributions ............ ...............................
Schedule A, Line 3
Eb T � $
$ 4
2. Loans Received ....................... ...............................
Schedule a, Line 3
�
ey v e
1/1 through 6/30 7/1 to Date
3. SUBTOTALCASH CONTRIBUTIONS .........................
Add Lines 1 +2
$ —� 46 oa $
20. Contributions
7�i
0 ! 9 c' `
Received $ $
4. Nonmonetary Contributions ..... ...............................
Schedule C, Line 3
21. Expenditures
�G
5. TOTAL CONTRIBUTIONS RECEIVED ...........................
Add Lines 3 +4
$ �. 7 � 0C $
Made $ $
Expenditures Made
6. Payments Made ........................ ...............................
Schedule E. Line 4
7. Loans Made .............................. ...............................
Schedule H, Line 3
8. SUBTOTALCASH PAYMENTS ..... ...............................
Add Lines 6 +7
9. Accrued Expenses (Unpaid Bills) ...............................
Schedule F, Line 3
10. Nonmonetary Adjustment ........... ...............................
Schedule C Line
11. TOTAL EXPENDITURES MADE ................................
Add Lines 8 +9 +10
$ I _� , -' � P $
$ $
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)
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16
13. Cash Receipts .................... ............................... Column A, Line 3above
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4
15. 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.
�/� 46,c
$ 0 J b P
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 $
r
$
To calculate Column B, add
amounts in Column A to the
corresponding amounts "Amounts in this section may be different from amounts
from Column B of your last reported in Column B.
report. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts. If this is
the first report being filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772)
Schedule A Type or print in ink. SCHEDULE A
Amounts may be rounded
Monetary Contributions Received to whole dollars.
Statement covers eriod
p
C ALIFORNIA ,
m- r �� "//
fro
•- •
through C d, 4' 1 C /!
Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
( IFCOMMIT7EEALSOENTERI.D.NUMBER)
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
CODE *
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
OF BUSINESS)
�•
WIND
�
��
D
'ntinC,`4/ r rC;�/�'r'
/ /
❑SCC
��
❑COM
❑ OTH
�o
❑ PTY
/rn % /tita �c ye �t
❑SCC
❑IND
❑COM
�t�ni'e / o
❑OTH
4- ,
Irllr'
❑ PTA
❑SCC
fer
r
/
❑ COM
❑ OTH
lie
❑ PTY
❑SCC
1 a) c v * T' -fLS
f'
L
%
❑COM
OTH
l
❑
Y
1 f 2 4 V`
� P + TY
❑S CC
SUBTOTAL$
Y
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.) ........................................... ...............................
2. Amount received this period — unitemized monetary 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.) ......
$ v,aG
.........................$
............ TOTAL $ / G
Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY— Political Party
SCC — Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule A (Continuation Sheet) Type or print in ink. SCHEDULEA (CONT.)
Monetary Contributions Received Amounts may be rounded
Statement covers period
•
to whole dollars.
• _ •
from a��10 /�
through
Page of _[P
NAME OF FILER
I.D. NUMBER
DATE
FULL NAME STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
,
(IF COMMITTEE ENTER I.D.NUMBER)
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED
,ALSO
CODE
(IF SELF-EMPLOYEE), ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
-
[:]COM
E] OTH
❑ ❑SCC
�1
❑ IND
[]COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
I1 PTY
o SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$
*Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC —Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
SCHEDULE B - PART 1
. ... r .....- ... ......
Schedule — art Amounts may be rounded
Statement covers period
CALIFO � 1
Loans Received to whole dollars.
� _ •
from - 0
ct' ✓/ 2 i �C
Page
SEE INSTRUCTIONS ON REVERSE
through .
of
NAME OF FILER
I.D.
i
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL ENTER
,
OCCUPATION AND EMPLOYER
a)
OUTSTANDING
BALANCE
(b)
AMOUNT
(0
AMOUNT PAID
(d)
OUTSTANDING
BALANCEAT
(e)
INTEREST
(f)
ORIGINAL
(g)
CUMULATIVE
OF LENDER
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF ENTER
NAME OF BUSINESS)
BEGINNING THIS
PERT D
RECEIVED THIS
PERIOD
OR FORGIVEN
THIS PERIOD
CLOSE OF THIS
PERIOD
PAID THIS
PERIOD
AMOUNT OF
LOAN
CONTRIBUTIONS
TO DATE
�,r {y'?E � � C ! �/) ;�
1. � f�• - �i� �� �
❑ PAID
CALENDAR YEAR
_
$
E
S
S
S
�"
t El IND El COM El OTH [01 PTY [ SCC
C��7(� &
DATE DUE
DATE INCURRED
N
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION **
RATE
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
E
$
$
$
E
DATE DUE
DATE INCURRED
Lj PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION**
RATE
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
S
S
S
S
E
DATE DUE
DATE INCURRED
SUBTOTALS $ $ $ $
Schedule B Summary
1. Loans received this period .......................................... ...............................
(Total Column (b) plus unitemized loans of 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.
*Amounts forgiven or paid by another party also must be reported on Schedule A.
** If required.
(tnter (e) on
c tdule E, Line 3)
............ ............................... $
...........I .................. NET $ �(� xx
(May e a negative numbed
tContributor Codes
IND—Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
Schedule C Type or print in ink.
scuFnl n F c
ramouncs may ue rounueu
Nonmonetary Contributions Received to whole dollars.
Statement covers period
1 ir
from
• '
.-
through 4Z _2� � l
page_ of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
DATE
FULL NAME. STREET ADDRESS AND
CONTRIBUTOR
]FAN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
DESCRIPTION OF
AMOUNT/
FAIR MARKET
CUMULATIVE TO
DATE
PER ELECTION
TO DATE
RECEIVED
ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.O. NUMBER)
CODE *
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
GOODS OR SERVICES
VALUE
CALENDAR YEAR
(JAN 1 - DEC 31)
(IF REQUIRED)
HIND
❑ COM
/��
kur�L
o °n�;
��
� �� a
❑SCC
/01,(F
❑IND
❑COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ uT H
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
./
Schedule C Summary
1. Amount received this period — itemized nonmonetary contributions.
(Include all Schedule C subtotals.) ................... ...............................
2. Amount received this period — unitemized nonmonetary contributions of less than $100 .........
3. Total nonmonetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ........
......................$ 9Uv,
...................... $
........ TOTAL $ 6 er r: I v C
'Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC —Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule E
Payments Made
SE E INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded
to whole dollars.
NAME OF FILER
Statement covers period
from
through
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment
SCHEDULEE
Page �L__ of
I.D. NUMBER
CMP
campaign paraphernalia /misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)'
OFC
office expenses
SAL
campaign workers' salaries
CVC
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
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
1A
X
,-:
/0
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
SUBTOTAL$
Schedule E Summary
1. Itemized payments made this period. (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 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
x
X