460 Recipient Committee Campaign Statement - Termination 7-1-17 to 12-31-17COVER PAGE
Recipient Committee atem V
Campaign Statement i `_ ' •
Cover Page An
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 07rot~t r
through
kz_3(-[
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
tg Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
Q Recall
rAlso Complete Part 5)
❑ General Purpose Committee
O Sponsored
O Small Contributor Committee
O Political Party/Central Committee
❑ Primarily Formed Ballot Measure
Committee
O Controlled
O Sponsored
{ksc Complete Part 6)
❑ Primarily Formed Candidatel
Officeholder Committee
(Also Complefe Part 7)
3. Committee information I.D. NUMBER
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
onr1N a of +0V C � 1 CC&"Cn ! 2-01(.0
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/E-MAILADDRESS
- F JAN 3 I 2 �� 1 of J
(Month, Day, Year)LY r Official Use Only
C PERTINC CITY CLERK
2. Type of Statement:
❑ Preelection Statement ❑ Quarterly Statement
❑ Semi-annual Statement ❑ Special Odd -Year Report
® Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
a lei B kawJ&,"k.
MAILING ADDRESS
[
NAME OF ASSISTANT TREASURER, 1 F ANY
MAILING ADDRESS
AREA CODEIPHONE
CITY
STATE
. ZIP CODE
OPTIONAL: FAX IE -MAIL ADDRESS
4. Verification
l have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the informati n contained erein and in the attached schedules is true and complete. I
certify under penalty of perjury under the laws of the State of California that the foregoing
Executed on a r r `4) By ,
pate Signature of Controlling Officeholder, Candfdate, State Measure Proponent or Responsible Officer of Sponsor
Executed on BY
Date Signature of Control4ing Officeholder, Cantlitlate, State Measure Proponent
ExecutedBy Signature of Controlling Officeholder, Canditlate, State Measure Proponent
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
-
C Paae — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFF ECEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (ENCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
CVpeK4*10 C1+ C(utnc�
CITY
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 expenditures on behalf of your candidacy.
LO.NUMBER
NAME OF TREASURER
❑ YES ❑ NO
Comm ITTEEADDRESS STREETADDRESS (NO
CITY STATE ZIP CODE AREA CODEIPHONE
COMMITTEE NAME LD. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEEADDRE55 STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
COVER PAGE - PART 2
Page 2— of
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION
❑ 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 CandidatelOfFiceholder Committee Listnames of
officeholder(s) at 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 ifnecessary
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summar, (Page
SEE INSTRUCTIONS ON
NAME DF FILER f)
a
Contributions Received
1. Monetary Contributions— .... — ... ..................................... Schedule A, Line
2. Loans Received................................................................ Schedule a, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2
4. Nonmonetary Contributions ............................................ Schedule C, Line3
5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4
Expenditures Made
6. Payments Made................................................................
Schedule E, Line 4
7. Loans Made... ...... ....... ......................... ...........
........ _ Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS ..........................................
Add Lines 6+7
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line 3
1C. Nonmonetary Adjustment........................................................
schedule C, Line 3
11. -TOTAL EXPENDITURES MADE ........................................
Add Lines s + 9 + 10
Amounts may be rounded
to whole dollars.
Column A
70TAL TH IS PERI OC
(FROM ATTACHED SCHEDULES)
SUMMARY PAGE
Statement covers period
from
through il— 31 `177 Page '?> of
Column B
CALENDARYEAR
TOTALTO DATE
O
$ 2l(o�ci.�j
O
$ Q $ II US5.54
$ 2Z
0
O
$ Zt (9K'511
O
$
d
$ .59-fg-2-2— $ 11t.Q7? -15,
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ �� �`'f{ L�' `� L
�"
13. Cash Receipts........................................................... Column A, Line 3 above
14. Miscellaneous Increases to Cash .................................. Schedule r, 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.
17. LOAN GUARANTEES RECEIVED ................................ schedules, Pane $ � - --
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ See instructions on reverse $
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $
To calculate Column B,
add amounts in Column
A to the corresponding
amounts from Column 3
of your last 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).
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
111 through 6130 7t1 to Date
20. Contributions
Received $ $
21. M pdeenditures $ lJ $ 2 � If rIEL
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(If Subjectto Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 464 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedlule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Amounts may be rounded
to whole dollars.
SCHEDULE E
Statement covers
from r— N-1-7
t2_-3l_r7
through Page 11 of
NAME OF FILER i.v. rv�rvic�r5
P � vWaw
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. � 5Ytz� `tri
CMP
campaign paraphernalialmisc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)"
QFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
RL
candidate fiilinglballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
stafflspouse travel, lodging, and meals
IND
independent expenditure supportinglopposing 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 comm=E.AL$0 ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
[ �F�J � oo
�t�h Purl o
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.)............................................................................................................. $ GG
2. Unitemized payments made this period of under $100.......................................................................................................................................... $5 J
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ y
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 (Jan/203.6)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule E
CODE OR DESCRIPTION OF PAYMENT
SCHEDULE E (CONT.)
C
4 YL� WO
Amounts
may be rounded
to whole dollars.
Statement covers period
C,� e-
(Continuation Sheet)
2-4 Lt, 2-
-7--at— 17
Payments Made
from
q Z-31-17
SEE INSTRUCTIONS ON REVERSE
through
Page of
NAME 00 FILER
LVQVVim
I.D. NU
1��r2�
CODES: If one of the following codes accurately describes
the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalialmisc.
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 candidatelsponsor
LEG legal defense
PRO
professional services (legal, accounting)
VDT voter registration
LIT campaign literature and mailings
PRT
print ads
WEB information technology costs (intemet, e-mail)
�4
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.O. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
C
4 YL� WO
� ��
C,� e-
2-4 Lt, 2-
Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $
FPPC Form 460 (lan/203.6)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
N