1.., &1/- (]t) j'd--,

Transcription

1 Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200~ ).SEE INSTRUCTIONS ON REVERSE Statement covers. period GOVER PAGE Type or print In Ink. ~!e m. / -- i -- Uj1z. /~- MIt.-- through ";~"-- Date of election If applicable: (Month, Day, Year)- CITY Of Sl~fl VALLEY' FORM I II JUl 2; PH S: OBt- P _. ag_e:;:~/::;.::~o_f ~'::-_-I For Official Use Only fff E, YI't4-~~~ 1. Ty'pe of Recipient Committee: All Committees - Complete Parts , and 4. ~ Officeholder, Candidate Controlled Committee 0 Primarily Formed Ballot Measure State Candidate Election Committee Committee. o Recall Controlled (Also Complele Parl6) 0 Sponsored (Also Complete Part 6) o General Purpose Committee Sponsored o Primarily Formed Candidate! Small Contributor Committee Officeholder Committee (Also Complete Part 7) o PolitiCal Party!Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) 1t41t,j/tA WIU-//ht//$od ;::a;.e:. CITY' CCJtI/lIv/~. :uj1z- 2. Type of Statement: o Preele9tion Statement ~ Semi-annual Siatemant.0. Termination Statement ' (Also l1ie a Form 410 Termination) o Amendment (Explain below) Treasurer(s) IZ/JtJG,f.f' MAILING ADDRESS o Quarterly Statement. 0. Sp~cl~1 Odd-Year Report o Supplemental Preelection Statement - Attach Form 495 STREET ADDRESS (NO P.O. BO?,l STATE ZIP CODE AREA CODE/PH9NE CITY NAME OF ASSISTANT TREASURER, IF ANY. STATE ZIP CODE.- ARE'<\' r.ooi'!iphone MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.o. BOX MAILING ADDRESS CITY. STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E MAIL ADDRESS OPTIONAL: FAX / E MAIL ADDRESS 4. Verification I have used ail reasonable diligence In preparing and reviewing this statement and to the best of under penalty of perjury underthe laws of the State of California that the foregoing I u and 1- Z?- ZlP)iz-. Executed on ----~O~a~te Executed on 1.., &1/- (]t) j'd--, Date holder, Candidate, State Measure Proponent or Responslbla Officer of Sponsor Executed on.----~o~a~te By ~~~~~~~~~~~~~~~~~ Signature Of Controtnng Officeholder, Candidate, Slate Measure Proponent Executed on------=d~a~te By --=~~~~~~~~~~~~~ ~ ~ Signature of Conlrolfing Officeholder. Candidate, Slate Measure Proponent FPPC Form 460 (Janua,y/05) FPPC Toll-Free Helpline: 866IASK FPPC ( ) state of Callforn la

2 Recipient Committee. Campaign Statement Cover Page..;..,.. Parf 2 Type or print in ink. 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE jl/~"4.,. J DJ/ (,t-f Ij-"/II/$OIU (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) ca/!ij;lt /l4g'"/ii/8at Cllj(J? },II// t.i4?tey RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET). CITY STATE ZIP 6. Primarily Formed Ballot Measure Comm ittee NAME OF BALLOT MEASI,JRE BALLOT NO. OR LETTER JURISDICTION, 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 Inciuded In this statement that are controlled by you or are prlmarlfy formed to receive contributions or make expenditures on behalf of your candidacy. DISTRICT NO. 'IF ANY COMMITIEE NAME I.D. NUMBER CONTROLLED COMMITTEE? DYES DNO COMMITTEE ADDRESS STREET ADDRess (NO P.O. BOX) COMMITTEE NAME CONTROLLED COMMITTEE? DYES DNO COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX) 7. Primarily Formed Candidate/Officeholder Committee List names of '. o'fflceholder(s) or candldate(s) for which this committee Is primarily formed. ' NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE ' NAME OF OFFICEHOLOER OR CANDIDATE o OPPOSE, o SUPPORT NAME OF OFFICEHOLDER OR CANOIDATE o SUPPORT Attach continuation, sheets If necessary, FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK FPPC (866/ ) State of California

3 Campaign Disclosure Statement Summary Page SSE INSTRUCilONS ON REveRSE Contributions Received Type or print In Ink. ColumnA TOTAl. THIS PERIOD (FROMAiTACHEDSCHEDULES) 1. Monetary Contributions... :... ;... Schedule A, LIne 3 $ /IO:J. O{) $ 2. Loans Received... Schedule B, LIne 3.- 4; Nonmonetary Contributions...,...:... ~. Schedule C, LIne 3-3. SUBTOTAL CASH CONTRIBUTIONS... Add Lines 1+2 $ Ll..t 1 6', I1d $ 5. ~OTAL CONTRIBUTIONS RECEIVED... Add Lines $ LiP'.2. () a. $ ColumnB CALENDARVEAR TOTM. TO DATE /1 ~ if.(.7/),- 1105', do,-' i/o"';. (}() Statement covers period -/ -.: / - A:-' / Z- through '~.-j>(j -llj/1--, SUMMARYPAGE FORM j ~ Page 9z.-Z-3.s7 Calendar Year Summary for Candidates Running In Both the State Primary and. General Elections. 20. Contributions Received 21. Expenditures M",de 1/1 through 6/30 7/1 to Date $ $ $ $ Expenditures M~de. 6. Payments Made... ~... Schec(ule.c, LIne 4 $ $ - '7. Loans Made...:...:..."... ScJhedu/~ H, LIne 3 8, SUBTOTAL CASH PAYMENTS... Add Lines $ $.'- 9, Accrued Expenses (Unpaid Bills)...:... ScheduleF,Llne3 10. Nonmonetary Adjustment... Schedule C, Line TOTAL EXPENDITURES MADE... "... Add LInes $ Current Cash statement 12. Beglnnln~ Cash Balance Previous Summary Page, Line Cash Receipts... "... :... ColumnA,l.lne3above $ 1(..'IZ.OtJ IllyfptJ 14. Miscellaneous Increases to Cash...;... ~... Sohedule I, Line Cash Payments...,. Column A, Line 8 above tf-.()tj. 16. ENDING CASH BALANCE... Add Lines , then subtract LIne 15 $ 7f2,tu If this is a termlnat/on statement, Una 16 must be zero..-'. Expenditure Limit Summary for State Candidates Cumulative Expenditures Made (If Sublacllo Voluntary Expenditure Limit) Date of Election (mm/dd/yy) Total to Date $---- $----- FPPC Form 460 ~JanuaryI05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/ )

4 Schedule A Monetary Contributions Received Type or print In Ink. r :Staitem9ntco.~iPEiriOCI:""--' covers period. /- 1-' 2eJlv A I.1 through -.::?t? - 2f) I~'~!!II_ SCHEDULE A DATE RECeivED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE. ALSO ENTER ) CODE it IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED. ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) ItJti.tJtJ Schedule A Summary COM OTH osce %lind o COM osce OIND, DeOM osee DIND OCOM OSCC SUBTOTAL $ I/O!). CO 1.. Amount received this period - itemized monetary contributions. (Inc.lude all Schedule A subtotals.)..."..."... ~... $' II tj~, tf l) 2; Amount received this period -Linitemized monetary contributions of less than $ $ (J,O() 3. Total monetary contributions received this period. /' (Add Lines 1 and 2. Enter here and on the S~mmary Page, Column A, Line 1.)... :... TOTAL $ /10':/. t) tj Contrlbutor Codes ':.',!,'. INO-Indivldual COM - Recipient Committee (other than PTY or SCC) 0TH.;.. 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/ )

5 ScheduleE. Payments Made Type or print in ink. Statem.ent covers period /- /- 2O/Z.~ SCHEDULEE FORM SEE INSTRUCTIONS ON REVERSE ~ --..so - ;It) I 'Z-- through _--'- 9Z-Z:357 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. OIIP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs ens campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries eve civic donations PEr petition circulating iel' t.v. or cable airtime and production costs FiL candidate filing/ballot fees PHO phone banks ire candidate travel, lodging, and meals FND fundralsln'g events POL polling and survey research irs 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, ) NAME AND ADDRESS OF PAYEE (IF COMMITIEE,ALSO ENTER ) CODE OR ' DESCRIPTION OF PAYMENT AMOUNT PAID - /If}lf}tJ tl/lf / IE //UJ/I-10 TI& 1../"5 "/!lg f/iij~ he,/tjr 5t-le.)r:',. C/v/~ CIt1~ 52%. O{) 79. ~tj * Payments th~t are contributions or independent expenditures must also be summarized on Schlldule D. 5U,BTOTAL$ 107, () t> Schedule E Summary...;7~._t);:;..,::.t)_...:...,...,...:... $ _--,-~.:=.tf...;.-,t,- 1. Itemized payments made this period. (Include all Schedule E subtotals,)... $ _'fo,j...' 2. Unitemized payments made this period of under $100 ' 3. Total interest paid this period on loans. (Enter amount Schedule B,Part 1, Col\Jmn (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 $ tfz. ()tj,_t>_ L...=::..=.-.:-.:::...o:..-_ FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866JASK-FPPC (866/ )