460 Pre-election 3rd ecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE through /~lr,,/~ r -~-~
1. Type of Recipient Committee: All Commttteel - Complete parts t, 2, 3, end 4.
Type or print In Ink.
OCT 3 I 2003
PERTINO CITY CLE
COVER PAGE
Officeholder, Candidate Controlled Committee
40 Slale Candidate Election Committee
O Recall
[] Gene ral Purpose Committee 0 Sponsored
O Small Contributor Committee
0 Political Party/Central Committee
[] Batlot Measuro Committee O Primarily Formed
O Controlled
O Sponsored
[] Primarily Fomqed Candidate/
2. Type of Statement:
J'~ Preelection Statement
[] Semi-annual Statement
[] Termination Statement
[] Amendment (Explain below)
[] Quarterly Slatemenl
[] Special Odd-Year Repod
[] Supplemental Preelection
Stalement - Attach Form 495
3. Committee Information I I.D. NUMBER
COMM,TTEBF____A F--~'r'//~)/L/R^ME (oR Cmb,DA, E'S .mECic410/EFj~T/'Od'" .o COM~,'rrEEJ
AREA CODE/PHONE
Treasurer(s)
NAME OF TREASURER
CITY STATE ZIP CODE
NAME OF ASSISTANT TREASURER. IF ANY
AREA CODE/PHONE
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZiP CODE
MAILING ADORESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FA~ I E-MAIL ADDRESS OPTIONAL: FAX I E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this stalement and to lhe best ~~ the intormalion conlained herein and in Ihe attached schedules is Irue and complete. I
certify under penalty ol pedury under the Jaws of the State o! California that the foregoing j~ aF4)~} .
Exe~t~ on ' By
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Contributions Received
Type or print in ink.
Amounts may be rounded
to whole dollars.
SUMMARY PAGE
Page ~ o! ~ __
Column A
1. Monetary Contributions ................... : ....................... Schedule A. Line 3
2. Loans Received ............................... ~ ...................... Schddu/e a, Line 7
3. SUBTOTAL CASH CONTRIBUTIONS ......................... AddLine$1+2 $ ~
4. Nonmonetary Contribulions .................................... Schedule C, L,ne 3
5. TOTAL CONTRIBUTIONS RECEIVED .~.: ....................... Add Lines 3 + 4 $ ~
Column B
Expenditures Made
6. Payments Made ....................................................... Schedule E. LiNe 4
7. Loans Made ............................................................. Schedule H. Line 7
8. SUBTOTAL CASH PAYMENTS .................................... AddLin~s 6. ·
9. Accrued Expenses (Unpaid Bills) ............................... Schedu/eF. Line3
10. Nonmonetary Adjustment .......................................... ScheduleC, Line3
11. TOTAL EXPENDITURES MADE ................................ Add ~e$ a * 9 * ~0
Current Cash Statement
12. Beginning Cash Balance ....................... Pre~fousSumrnaryPage. Line ~6
13. Cash Receipts ................................................... Co~ur, n,4, Llne3above
14. MiscelLaneous Increases to Cash ........................... $chddu/e ~. Line
15. Cash Payments .................................................. ColumnA. Line8above
16. ENDING CASHBALANCE .......... Add Lines f2 + t3 + t4. the~] sutaract Line ~ 5
If this is a ~errnina#on statement, Line 16 must be zero.
1 7. LOAN GUARANTEES RECEIVED ........................... Schedule e. Part 2 $
To calculale Column B, add
amounts in Column A to the
corresponding amounts
from Column B of your
report. Some amounts in
Column A may be negalive
figures that should be
subtracted Irom previous
period amounls. It Ihis is
Ihe first repod being tiled
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
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ........................................ See/n$1n,~t~ns on revere $
19. Outstanding Debts ......................... AddLjne2+Li~eg,~c~lun~nBab°ve
FPPC Form 460 (June-/01)
FPPC ToU-Free Helpllne: 866/ASK-FPPC
20. Conlributions
Received $
21, Expenditures
Made $ $
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made'
Date of Election Total to Date
(mm/dd/yy)
__l___l.__ $
__l___f__ $
__L__L__ $
__L__I.__ $
__1___1.__ $
__1____1.__ $
'Since January 1, 2001. Amounls In this seclior~ ma'/ be
diflerent from amounts ropoded in Column B
chedule B-Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
OF LENDER
~,,IND [] cam [] OTH [] PTY [] SCC
IF ,l~N INDIVIDUAl.. ENTER
Type or print In Ink.
Amounts may be rounded
to whole dollars.
t.)
OUTSTANDING
Statement covers period
,,om
tel
AMOUNT PAID
(d)
SCHEDULE B - PART 1
Page ~~' of ~' .
NUMBER
(f)
OUTSTANOING
BALANCE AT
INTEREST
PAID THIS
ORIGINAL
AMOUNT OF CONTRIBUTIONS
t~INO []cam []OTH [] pTY [] SCC
[NO [] CaM E] OTH [] PTY [] SCC
OCCUPATION AND EMPLOYER
BALANCE
BEGINNING THIS
pEI31OD
RECEIVED THIS
PERIOD
OR FORGIVEN
THIS PERIOD '
CLOSE OF THIS
PERIOD
DATE DUE
PERIOD
SUBTOTALS $ ~ $ ~ $ /,~ $ ~]
Schedule B Summary ~,~
1. Loans received this period .................................................................................................................... $
(Total Column (b) plus unitemized loans less lhan $100.)
2. Loans paid or forgiven lhis 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 Summar7 Page, Column A, Line 2.
It Contributor Codes
IND- Individual
'Amounts Iorglven or paid
another party also musl be
reported on Schedule A.
"If requJced.
CaM - Redplen~ Conaml~t e e (other than P]-Y or SCC) OTH - Other PTY - Polillc al Par[y SCC - Small ConDibulo~ Commillee]
FPPC Form 460 (June/D1)
FPPC Toll-Free Helpllne: 866/ASK-I~PPC
chedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print in Ink.
Amounts may be rounde~
to whole dollars.
SCHEDULE E
Statement covers period
NAME OF FILER
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, descdbe the payment.
QVP campaign paraphemalia~ntsc,
CNS campaign consultants
CTB contribution (explain nonmonetary)'
CVC civic donations
F-IL candidate filing/ballot fees
F~O fundraislng events
N3 independent expenditure supporting/opposing others (explain)'
LEG legal defense
UT campaign literature and mailings
I.D. NUMBER
~[~c[ member communications
MTG meetings and appearances
DFC office expenses
PET petition circulating
PPi3 phone banks
t°OL polEng and survey research
POS postage, delivery and messenger services
P~O professional services (legal. accounting)
PR]' print ads
RAD radio aldime and production cosls
SAL campaign workers' salaries
TEL t.v. or cable alrlime and production costs
TRC candldale travel, lodging, and meals
. TP.S slaff/spouse travel, lodging, and meals
TSF transfer between comrnillees el the same candidate/sponsor
VeT velar regislration
W~B infon'nation technology costs (Inlemet. e-mail)
NAME AND ADDRESS OF PAYEE
tie C{:yt,~41TTIE,~ ALSO ENTER I.O. ta. Ral~R) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS ~.~ ~ ~ · 1~.~
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, Pad 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/e1)
FPPC Toll-Free Helpline: 866/ASK-EPPC