Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 84216.5) SEE INSTRUCTIONS ON REVERSE State Type or print In Ink. I, _ \De -.~Ijo".,p c::. i j ; iofjest 0 CITY ella period from - ' I-..,-"'-r- --- f..p Date of election If applicabl~ :J 6 JUL 2 S PH 4: 2 (Month. Day, Year) COVER PAGE CALIFORNIA 460 FORM Page I of s= For Official Use Only 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4, ~ Officeholder, Candidate Controlled Committee State Candidate Etectlon Committee o Recall (Also Complete Part 5) o General Purpose Committee Sponsored Small Contributor Commiltee o Political PartyfCentral Committee 3. Committee Information COMMIlTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) o Primarily Formed Ballot Measure Committee o Controlled o Sponsored (A/so Complele Pert 8) D Primarily Formed Candidatel Officeholder Committee (Also Complete Perln 1. 0. NUMBER 2. Type of Statement: O. Preelection Statement o Semj~Mnual Statement o Termination Statement (Also file a Form 410 Ter~natlon) o ~mondment (Explain below) Treasurer(s) o Quarterly Statement o Special Odd-Year Report o Supplemental Preelectlon Statement - Attach Form 495 4. Verification I have used all reasonable dlligencr~,i.n preparing and reviewing this statement and to the best of under penalty of perjury u ~ der the Irws of the State of Callfornla that the foregoing Is 1 25 I~ Executed on ---'-f-t=--= -'-f.="'------ '1 /Z~ ' t~ Exe~tedon_~~:,~~O~'I~'~------ Exe~led on -------,0;;";;'------- the attached schedules Is true and complete, 1 certify Exe~ledon.o~'I~, ------ By -----".,g"'"''''''=''''''fc'''';;;;"''''''="g."oft\.,~'''... '''d;;;... 7'C';;;;''''''fd;;:;.'\o''.Sr.;;I'';;;, M"",;;;,,";;;,,",P,;;;;,,;;;;,,;;;;,,", ----- FPPC Form 460 (January/OS) FPPC Toli Free Helpline; 886/ASK FPPC (866/275.3772) Stelo of Cel1fornla
Recipient Committee Campaign Statement Cover Page - Part 2 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION SUPPORT 9S35~ Identify the controlling officeholder, candidate, or state measure proponent, If any. ---':...:..="-'-~=...:-- NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT List any committees not included in this statement that are control/ed by you or are primarily formed to receive contribut/ons or make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES o NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES o NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) 7. Primarily Formed Candidate/Officeholder Committee List namos of off/coholder(s) or candldate(s) for which this commfttee {s primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIOATE OFFICE SOUGHT OR HELD SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (JanuaryJ05) FPPC TolI Froo Holpline: 866JASK FPPC (8661275.3772) Siale of CalifornIa
Campaign Disclosure Statement Summary Page Type or print In ink. Am ounts may be rounded SUMMARY PAGE CALIFORNIA 460 FORM SEe INSTRUCTIONS ON REVERSE _NAM ~ OF (' LZ05/.cJCt -+;r fyl~de Contributions Received 1. Monetary Contributions.... 2. Loans Received.... Schedule A. Una 3 Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS......... Add Lin 1 2 4. Nonmonetary Contributions... ".".,... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED...... AddLin 3.4 Expenditures Made 6. Payments Made.... Schedule E, Line 4 7. Loans Made...,",... Schedulo H, Line 3 B. SUBTOTAL CASH PAYMENTS... Add Lino. 6. 7 9. Accrued Expenses (Unpaid Bills)... Schedufe F, Line 3 10. Nonmonetary Adjustment.......... Schedule C, Line 3 11. TOTAL EXPENOITURES MADE.......... Add Uno, 8. 9 10 TOTAl. THIS PERIOD (FROMATTACHEDSCHEDULES) 'Q ~ ~ ~ 2 4 6b z4. 24. (J1) Current Cash Statement 12. Beginning Cash Balance...,... PreviousSummelYPaga,L!ne16 19~ 3'7 13. Cash Receipts... CoIumnA,Line3ebov9 14. Miscellaneous Increases to Cash...... Schedule I. Uno 4 15. Cash Payments... Co/umnA,Line8abovo 16. ENDING CASH BALANCE... Add Lines 12 + 13 + 14, thon subtrect Lino 15 1/.p2. 3'7 If this is 8 termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED... S,hoduf. B, P.rl 2 Cash Equivalents and Outstanding Debts 1 B. Cash Equivalents...,... Soe ins/rue/ions on reverso 19. Outstanding Debts... "... "... AddLine2+L/ne9InColumnBebove Column S TpTAl TO DATE ~ ~ b 3'7 1("2-, 3'7 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B 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 Ihe amounts from lines 2, 7, and 9 (if any). I~ Page 3 of ~ t 355+z 4 Calendar Year Summary for Candidates Running In Both the Stat e Primary and General Elections 111 6130 711 to Date 20. Contributions Received _--- 21. Expenditures Mad, _--- Expenditure Limit Summary for Stat e Candidates 22. Cumulative Ex p en ditur es Made (If SubJ.tlIO Voluoliilry E)(PlIodLlure LImit) Date of Election (mmfddfyy) -----.1-----.1 Total to Date ---- "Amounts in this section may be different from amounts reported in Column 8. FPP C Form 460 (JanuaryI05) FPPC Toll-Froe Helpline: 866fASK-FPPC (866/275-3772 )
Sc hedule B - Part 1 Loans Received SEE NAME OF FILER ON REVERSE Typo or print In Ink, to wholo dollars. Slalam!"1 r v.rs Irom I f ICe Ihrough ~ /3 if I 0> SCHEDULE B - PART 1,. -, - ~'.'.;... \. - CALIFORNIA -:- 460:. FORM',.. ".... \ paga L ~ of~ FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTeR I,D. NUMBER) IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER ENTER INTEREST PAID THIS PERIOD ORIGINAL AMOUNT OF LOAN to IND 0 COM PTY 0 sec I ( 575D, (J7J o PAlO o FOROIVEN o PAlO I o FOROIVEN I gj> If!! I ' ' 11 171ft., DATEOue --,. RAn 'A RATE '-, f ~Ol>. (I "/' /'(. DATE INCURRED ;'::JW It I ' PER ElECnON u PER election ~ ~ IND 0 COM 0 PTY 0 sec DATE DUE DATE INCURReD o PAID o FOROIV'N V. RATa PE RELECTION U to INO 0 COM 0 PTY 0 sec OATEDUE OATE INCURRED SUBTOTALS Schedule B Summary \; 1. ~~o~~~ ~~~~~~~~~i;i~:r~~~t~~i~~'d'i~~~;'~'i'i~~~'t'h'~'~' 100:)",...,',...,...,...,.,...,...,."..,',",."...,.., --\z - -"<\--- 2. Loans paid or forgiven this period...,........."...""....."... "......:. (Total Column (c) plus loans under 1 00 paid or forgiven,) (Include loans paid by a third party that are also itemized on Sched ule A,) 3, Net change this period. (Subtract Line 2 from Line 1.)... "... "... "."""... "..... ""."..... ".. NET Enter the net here and on the Summery Page. Column A, Line 2.. (Mlylle l 'nlviuyi nvmbet) tconlrlbulor Code. IND -Indlvlduel COM - Reclplenl Commillee (olher Ihen PTY or SCC) OTH - Olher (e.g.. bualne.. anllly) PTY - Polilical Perty SCC - Small Contrlbulor Commillee or paid by anolher party also must be rep orted on Schedule A. FPPC Form 460 (January/OS) FPPC Toll-Free Halpllno: a06fask.i'ppc (068/21-6.3172)
Schedule E Payments Made to whole doll ars. SCHEDULEE CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE page S of 1.0. NUMBER 13 54-Z 4 CODES: If one of the following codes accurately describe 0v\P campaign paraphernalia/misc. CNS campaign consultants ete contribution (explain nonmonetary)" eve civic donations FIL candidate fillnglbahot fees FND fundraising events IND independent expenditure supporting/opposing others (explain) LEG legal defense LIT campaign literature and mailings e payment. you may enter the code. Otherwise. describe the payment. MSR MTG OFC PET PHD POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs me 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) NAME AND ADDRESS OF PAYEE OF COMMITTEE. AlSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * 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 L./- (!1) 2. Unitemized payments made this period of under 1 00........... ~=-.!... 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 -==-'-'-- 24. IP _ FPPC Form 460 (January/05) FPPC TolI Free Helpline: 866IASK FPPC (8661275 3772)
Recipient Committee Campaign Statement Cover Page period '1 from _---'_-+-_--;- Date of election (Month, Day, Year) Date Stamp h.'-i';':, I -I '- v L.. I t. t.. ) STO CITY CLlA\ JMJ 20 Ml 9: I COVER PAGE SEE INSTRUCTIONS ON REVERSE 1. of All Committees - Complete Parts 1, 2, 3, and 4. 81 Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also Complete PaIl 5J o General Purpose Committee Sponsored Small Contributor Committee o Political Party/Central Committee 3. Committee Information o PrimarJly Formed BalJot Measure Committee o Controlled o Sponsored (AJoo Complete P8rl6) o Primarily Formed Candidate! Officeholder Committee (Also Comp/et& Part 7) 2. Type of Statement: o Preelection Statement ~ Semi-annual Statement D Termination Statement (Also file a Form 410 Termination) D Amendment (Explain below) Treasurer(s) Quarterly Statement o Special Odd Year Report AREA CODE/PHONE AREA CODE/PHONE q STATE ZIP 52555 E AREACODE~HONE 4. Verification I have used all reasonable diligence In prepanng and reviewing this statement and to the best of my knowledge the information contained herein and In the attached schedules IS true and complete. certify under penalty of r;..;," ;r the laws of the State of California that the fore I Executed on I '1 By 1 Date Executed on J t Z 4 i 1'7 By Date - Signature of Conlro[lng holder. Candidate, Slate Measure Proponent or Responsible Oftlcer of Sponsor Executed on -----""'0.=,,------ Executed on ------;0"':::"------ FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov
Recipient Committee Campaign Statement Cover Page - Part 2 COVER PAGE - PART 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE.I bill 265/60<i 1~':EJ:G~~ELO CL;r:;TlOt;S;Z~;UJBE~~:) ci- J 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION o SUPPORT Y STATE ZIP _ M" ~""7""1t e-ll 96~ Identify the controlling officeholder. candidate. or state measure proponent, if any. I 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 contributions or make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES o NO COMMITTEE ADDRESS STREET ADDRESS (NO P,O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES o NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD SUPPORT o SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (Jan/20i6) FPPC Advice: advice@fppc.ca.gov (866/275~3772) www.fppc.ca.gov
Campaign Disclosure Statement Summary Page SUMMARY PAGE from --'---'-;---t---- Contributions Received, (FROM ATTACHED SCHEDULES) 1. Monetary Contributions...,... "... "...,... ScheduJeA, {jne 3 2. Loans Received... "... ScheduleB, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS... Add Lines 1+ 2 4. Nonmonetary Contributions... ".... 5. TOTAL CONTRIBUTIONS RECEIVED... Expenditures Made Schedule C, Line 3... Add Lines 3 + 4 6. Payments Made.... Schedule E, Line 4 7. Loans Made... SchedufeH, Line 3 8. SUBTOTAL CASH PAyMENTS.....,... AddUnes6+7 'l'y ~ t> 6 26/ "'3 TOTAL TO DATE b. b 0 '& lsi 1&2.. I~L. 3'1 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 6/30 7/1 10 Date 20. Contributions Received ---- 21. Expenditures Made ---- Expenditure limit Summary for State Candidates 22. Cumulative Expenditures Made (If SubJe.ct to Voluntary Expenditure Limit) g, Accrued Expenses (Unpaid Bills)... Schedule F, Une 3 10. Nonmonetary Adjustment......... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE... Add Lines 8 + 9 + 10 /3<],.31 Date of Election (mmlddlyy) Total to Date ----- Current Cash Statement 12. Beginning Cash Balance...,...,.. Previous Summary Page, Line 16 13. Cash Receipts..."...,...,... Column A, Une 3 above 14. Miscellaneous Increases to Cash..."...,... Schedule I, Une 4 15. Cash Payments...,... Column A, Une 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... Schedule B, Part 2 and Debts 18. Cash Equivalents.... See instructions on reverse I ~Z. -:;. '7 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amoun1s 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)....--1...--1 _ "Amounts in this section may be different from amounts reported in Column B. 19. Outstanding Debts... AddUne2+Line9jnCofumnBabove FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov(866/275 3772) www.fppc.ca.gov
Schedule B - Part 1 Loans Received from -''-'--l-;--'-,---- SCHEDULE B - PART 1 SEE INSTRUCTIONS ON REVERSE FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE. Al,so ENTER!.D. NUMBER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED. ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD INTEREST PAID THIS PERIOD ORIGINAL AMOUNT OF LOAN CUMULATIVE CONTRIBUTIONS TO DATE tli!llnd o COM 0 OTH 0 PTY 0 SCC,1,500. 8 o FORGIVEN o PAID o FORGIVEN -_% RATE --" RATE I 11,,,/3 DATE IN RRED PER ELECTION**.-- PER ELECTION** OTH 0 PTY sec DATE DUE DATE INCURRED to lnd 0 COM OOTH 0 PTY 0 SCC.---- o PAID o FORGIVEN DATE DUE --, RATE DATE INCURRED._--- PER ELECTION** SUBTOTALS Schedule 8 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.)... NET Enter the net here and on the Summary Page, Column A, Line 2. \ Schedule t; (May be a negative number) i 3) tcontributor Codes INO -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e,g., business entity) PTY - Political Party sec - Small Contributor Committee *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required, FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov(866/275-3772} www.fppc.ca.gov
Schedule E Payments Made OC/CI ~( tv! Zo/3 statem7t c vers period from J I J~ IZ/31 /10> CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. emp campaign paraphernalia/misc. MBR member communications ens campaign consultants MTG meetings and appearances RFD returned contributions etb contribution (explain nonmonetary)~ OFC office expenses SAL eve civic donations PET petition circulating TEL FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research TRS IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads RAD radio airtime and production costs campaign workers' salaries t.v. or cable airtime and production costs TRe candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor VOT voter registration 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 * 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 1 00..._..._... _... -=L-=--4-L-_O_ G 3. Total interest paid this period on loans. (Enter amount from Schedule S, Part 1, Column (e).)... -,-- 2Lf. 00 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/2016) FPPC Advice: advice@fppc.ca.gov(866/27s-3772} www.fppc.ca.gov
Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print In ink. from ~I-''-i+-,c-.---- Date of election If applloable: (Month, Day, Year) 7JI7 JUL 3 i SEE INSTRUCTIONS ON REVERSE 1. Type of Recipient Committee: All Commltt'" _ Compl,'e Pert' 1. 2. 3. and 4. State CandIdate Election Committee Committee o Recall Controlled (Also CompJele Pall 5) 0 Sponsored (Also Comp/fJf9 Par( 6) o General Purpose Committee Sponsored o PrImarily Formed Candldatel Small Contributor Committee Officeholder Committee (Also Compfflfe PBTI7) o Pollttcal Party/Central Committee 8 Officeholder, Candidate Controlled Committee 0 primarily Formed 8aUot Measure 3. Committee Information 2. Type of Statement: 0, Preelection Statement ~ Semi-Mnual Statement o Termination Statement (Also tile a Form 410 TermJnation) o -:'mendment (Explain below) Treasurer(s) o Quarterly Statement o Special Odd Year Report o Supplemental Preelection Statement ~ Attach Form 495 d. I,/pTATE ZIP REA CODE/PHONE ~ -e5'tl> H q 5 :355' VCif- d BOX v1 ST~ _ ZIP COD~ D -e.")ib H '-16~6 DRESS =~~~fto=r:.~:--f.':""~:!('.y.6~():':i;:l=--w- -------- AREA CODE/PHONE AREA CODE/PHONE 4. Verification! have used all reasonable diligence in preparing and reviewing this statement and under penalty of perjury u1)der th laws of the state of California that the foregoing Executed on rj I / q I., "7 Executed on ---'--.+..:00.''''.,.------ Executed on -----"0."'1.,------ nd complete, I certify Executed on ------00.''"'.,.------ BY-------~SI..,"~"~"~.'~fCn,~"~~mn~'~0~.~~h~'~.~,,.7C~,"~,~","'~~.Slli"'""~M~.. ~"~"~P",,~P,OO"..."'I------- FPPC Form 460 (January/05) FPPC TolI Free Helpline: 866JASK.fPPC (OeB1275r3772) State of California
Recipient Committee Campaign Statement Cover Page - Part 2 Type or print In Ink. 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee -r;~jof rz~e~/;~fz\ til::i:u~~ H~ rclude lc;::s:77):e~l:~le) ~ RESIDENTIAL/BUSINESS ADORE (NO. AND STREET) CITY STAlE ZIP tylb d.,+z,,ct/. '15.355' NAME OF BALLOT MEASURE BALLOT NO~ ORflETTER JURISDICTION SUPPORT Identify the controlling officeholder, candidate, or state measuro proponent. If any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees Not Included in this Statement: List any commltt.es not InclUded In this statement that are controllad by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMMITIEE NAME 1.0. NUMBER NAME OF TREASURER COMMITIEE ADDRESS CONTROLLED CDMMIITEE? DYES DNa STREET ADDRESS (NO P,O, BOX) 7. Primarily Formed Candidate/Officeholder Committee List nemes of off/oaho/derts) or candldate(s) for which this committee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT CITY STAlE ZIP CODE AREA CODEIPHONE COMMITIEE NAME I,D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF TREASURER COMMITIEEAODRESS CONTROllEDCOMMITIEE? DYES ONO STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT CITY STA1E ZIP CODE AREA CODE{PHONE Attach continuation sheets If necessary FPPC Form 46\) (January/OB) FPPC ToII Frtl& Helpline: B66/ASK FPPC (666/276..3772) State of California
Campaign Disclosure Statement Summary Page Contributions Received 1. Monetary Contributions... "...,... Schedule A, Une3 2. loans Received... -....,. Schedule B, Une 3 3. SUBTOTAL CASH CONTRIBUTIONS... AddLinesl+2 4. Nonmonetary Contributions...,... Schedule C, Une 3 5. TOTAL CONTRIBUTIONS RECEIVED....... Add lines 3 + 4 ) TOTAL TO DATE ~ \, Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 6/30 711 to Dale 20; Contributions Received 21. Expenditures Made Expenditures Made 6. Payments Made... "... Schedule E, Une 4 7. Loans Made... Schedule H, Une 3 8. SUBTOTAL CASH PAyMENTS... AddLineso+7 9. Accrued Expenses {Unpaid Bills}... ScheCiule F, Une 3 10. Nonmonetary Adjustment..... Schedule C, Une 3 11. TOTAL EXPENDITURES MADE.... AddLin.. 8+9+10 Current Cash Statement 12. Beginning Cash Balance... Previous Summary Page, Une 16 13. Cash Receipts... ColumnA, Line 3 above 14. Miscellaneous Increases to Cash... ScheCiule J, Une 4 15. Cash Payments... "... CoIumnA,Line8above I 3~. 3"1 16. ENDING CASH BALANCE... Add Lines 12 + 13 + 14, then subtract Line 15 If this is a tennination statement, Une 16 must be zero. --------------------------------------t this ~7;. L;OiA~NfcG~UA~RA~N;T~EiE;S~R~E~CrE~IV~E~D~.. ~... ~... ~ ~ and Outstanding 18. Cash Equivalents... See instructions on reverse 19. Outstanding Debts... Add Line 2 + Une 9 in Column B above 13K", '3'7 131>. '3'1 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Same amounts in ColumnA may be negative figures that should be subtracted from previous period amounts. If is the first report being filed for this calendar year,.. ~ ~ i ~ l 5 ; ~ ~ ~s~ch:e:du:'.~b,:.:pa:d:2:...~~======::.i only carry over the amounts from Lines 2,7. and 9 (if any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mmlddlyy) ---.1---1 Total to Date ----- "Amounts in this section may_be different from amounts reported In Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@!ppc.ca.gov(866/275-3772) www.fppc.ca.gov
Schedule B - Part 1 Loans Received ON REVERSE pagel Of~ NUMBER 13.oSQZ4 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER W. NUMBER) to INO COM 0 OTH 0 PTY 0 sec sec to INO 0 COM 0 OTH 0 PTY 0 sec Schedule B Summary... ',SlSb, SUBTOTALS REceiVED THIS PERIOD._--- o PAID o.--- FORGIVEN DATE o PAID D FORGIVEN DATE DUE DUE DATE DUE 1. Loans received this period...,... _,,-\- (Total Column (b) plus unitemized loans of less tha,/ 100.) 2. Loans paid or forgiven this period... ~... (Total Column (c) plus loans under 100 paid or for~iven.) (Include loans paid by a third party that are also iteljnized on Schedule A.)! 3. Net change this period. (Subtract Line 2 from Lin~11.)... NET Enter the net here and on the Summary Page, col'1mn A, Line 2. * Amounts forgiven or paid by another party also must be reported ~n Schedule A. U If required.. (May be a negallve number) INTEREST PAfDTHIS PERIOD -_% RATE._---- -_.% RAOE.----- -_.% RAOE.-----, Schedule i 3) ORIGINAL AMOUNT OF LOAN I!bh DATE INCURRED DATE INCURRED DATE INCURRED tcontributor Codes CUMULATIVE CONTRIBUTIONS TO DATE.---- PER ELECTION" PER ELECTION** PER ELECTION'" 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 (Jan/20I61 FPPC Advicle~ advice@fppc.ca.gov (866/27S~3772) www.fppc.ca.gov
Schedule E Payments Made CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. emp campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs ens campaign consultants MTG meetlngs and appearances RFD returned contributions CTS contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries eve 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 FNO fundrais!ng events POL polling and survey research TRS staff/spouse travel, lodging, and meals INO 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 AN~ ADDRESS OF PAYEE (IF CQMMITTEE.ALSO ENTER i.o. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * 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.)... --:-"7""-=-- 2. Unitemized payments made this period of under 100... -''-'-'- "74: Ci6 _ 3. Total interest paid this period on loans. (Enter amount from Schedule S, 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 -''..._-'-' rj4. 01 _ FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/27S~3772) www.fppc.ca.gov
Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE instructions ON REVERSE Statement covers period 07/01/2017 from 09/23/2017 Date of election if applicab\ft:... ~.r...'.. ~, (Month, Day, Year) _._ 11/0712017 '; }:( Date Stamp COVER PAGE CALIFORNIA 460 2001/02 FORM Page 1 of 9 For Official Use Only 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. IXI Officeholder, Candidate Controlled Committee State Candidate Election Committee o Recall (Also Complete Part 5) o Genera! Purpose Committee Sponsored Small Contributor Committee o Political Party/Central Committee o Primarily Formed Ballot Measure Committee o Controlled o Sponsored (Also Complete Part 6) o Primarily Formed Candidatel Officeholder Committee (AISQ Complete Part 7) 2. Type of Statement: [)(I Preelection Statement o Semi-annual Statement o Termination Statement (Also file a Form 410 Termination) D Amendment (Explain below) D Quarterly Statement o Spec'lal Odd-Year Report D Supplemental Preelection Statement - Attach Form 495 3. Committee Information 1.0. NUMBER Treasurer(s) COMMITTEE NAME (OR candidate's NAME IF NO COMMITTEE) Bill Zoslocki for Modesto City Council District 4, 2017 NAME OF TREASURER Cathy Gatewood MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY Modesto STATE ZIP CODE CA 95355 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX AREA CODE/PHONE CITY Modesto NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS STATE ZIP CODE AREA CODE/PHONE CA 95356 CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the j ormation contained herein 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 is tru./1 lijirect File '- Executed DO -'0...;9::./:;;23"'1,::.2"'0..,;1.:.7 Date 'i..l!.i.,;'d.!:i.<a'!'>, -I1~,)~()l-I!-7f-- Executed DO - Date-I Executed on ------,0"""'------ Executed on ------,o"";;:--e------ 8y 8y ~_--.~~~~~~~~~~--. ------ Signature of Controlling Officeholder, Candidate, Stale Measure Proponent 8y ~~~~~~~~~~~~~~~----- Signature of Conlrolling Officehokler, Candidate, Slate Measure Proponent FPPC Form 460 (January/05) FPPC TolI~Free Helpline: 866/ASK-FPPC (866/275--3772) State of California
Recipient Committee Campaign Statement Cover Page - Part 2 COVER PAGE - PART 2 2 of 9 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Bill Zosiocki 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Sought: City Council Member City- City of Modesto - District 4 4 RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STAlE ZIP Modesto CA95355 BALLOT NO. OR LEDER JURISDICTION SUPPORT 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 contributions or make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMMITTEE NAME I.D. NUMBER NAME OF TREASURER COMMITTEE ADDRESS CITY COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS CONTROLLED COMMITTEE? DYES DNa STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE AREA CODE/PHONE I.D. NUMBER CONTROLLED COMMITIEE? DYES DNa STREET ADDRESS (NO P.O. BOX) 7. Primarily Formed Candidate/Officeholder Committee List names of officehojder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFlCE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary /1 lijirect File '-- FPPC Form 460 (January/OS) FPPC TolI~Free Helpline; 866/ASK~FPPC (866/275-3772) State of California
Campaign Disclosure Statement Summary Page Statement covers period 07/01/2017 from SUMMARY PAGE CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bill Zoslocki for Modesto City Council District 4, 2017 09/23/2017 3 Page 1.0. NUMBER 1398025 of 9 Contributions Received 1. Monetary Contributions...,... SchedufeA, Line 3 2. Loans Received... "...,.". Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS... Add Unes 1 + 2 4. Nonmonetary Contributions... "... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED........AddUnes3+4 ColumnA TOTAL THIS PERIOD (FROMATTACHED SCHEDULES) 6897.00 8000.00 14897.00 238.19 15135.19 ColumnS TOTALTOOATE 6897.00 8000.00 14897.00 238.19 15135.19 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 6/30 7/1 to Date 20. Contributions Received 0.00 15135.19 21. Expenditures Made 0.00 8791.92 Expenditures Made 6. Payments Made.... Schedule E, Line 4 7. Loans Made... "."... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS... AddUnes6+7 9. Accrued Expenses (Unpaid Bills)... ScheduleF,Line3 10. Nonmonetary Adjustment...,... Schedule C, Une3 11. TOTAL EXPENDITURES MADE... AddLines8 +9+ 10 8553.73 0.00 8553.73 0.00 238.19 8791.92 8553.73 0.00 8553.73 0.00 238.19 8791.92 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Lim!t) Date of Election (mm/dd/yy) Total to Date ---- Current Cash Statement ---..1---..1-- ---- "Amounts in this section may be different from amounts reported in Column B. 17. LOAN GUARANTEES RECEIVED... Schedule B, Part 2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents...,...,... See instructions on reverse 19, Outstanding Debts... AddLine2+Line9inCofumnBabove /? lljirect FIle '- 0.00 0.00 8000.00 FPPC Form 460 (Januaryf05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule A Monetary Contributions Received Statement covers from 0~7~1O~1~/~20~1~7 SCHEDULE A CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE 09/23/2017 Page 4 of 9 Bill Zoslocki for Modesto City Council District 4, 2017 J.D. 1398025 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRiBUTOR CONTRIBUTOR (lfcommitiee,alsoenteri.d.number) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER I>F AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE (JAN. 1 ~ DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 08103/2017 Florsheim Homes, LLC 1000.00 1000.00 1000.00 S 17 Stockton, CA 95207 08/04/2017 BFC Properties, INC Modesto, CA 95356 IND COM ~OTH PTY osee 1000.00 1000.00 1000.00 S 17 08/04/2017 Romano, LLC Modesto, CA 95354 OIND oeom!)<loth OPTY osee 1000.00 1000.00 1000.00 S 17 08/17/2017 Christopher Tyler Modesto, CA 95355 IZJIND oeom OPTY osee Investment Manager Terravest Capital Partners 1000.00 1238.19 1238.19 S 17 08/23/2017 Ken Vogel Stockton, CA 95215 IZJIND oeom OPTY osee Farmer N/A 250.00 250.00 250.00 S 17 Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.)... 6_5_50_._00_ 347.00 2. Amount received this period - un itemized 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.)... TOTAL 6_8_97_._0_0 /? /l)irect File... "Contributor Codes!ND -Individual COM - Recipient Committee (other than PTY or SeC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule A (Continuation Sheet) Monetary Contributions Received 07101/2017 from SCHEDULE A (CONT.) CALIFORNIA 4SA FORM U 09/23/2017 Page 5 of 9 NAME Bill Zoslocki for Modesto City Council District 4,2017 1398025 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (lfcommlnee, ALSO ENTER 1.0, NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 09/06/2017 George Reed Inc Modesto, CA 95352 DlND DCOM [i(joth DPTY DSCC 1000.00 1000.00 1000.00 S 17 09/06/2017 G.F.F. & R Modesto, CA 95355 DIND DCOM [i(j OTH DPTY Dsec 300.00 300.00 300.00 S 17 09/06/2017 Sandra Lucas Modesto, CA 95357 [i(jind DeoM DPTY osee Counselor 250.00 250.00 250.00 S 17 09/06/2017 Scott Usseny Modesto, CA 95354 IZlIND DeOM DPTY osee Retired N/A 100.00 100.00 100.00 S 17 09/14/2017 Dennis Cummins Modesto, CA 95351 IZlIND DeoM DPTY osee Retired N/A 200.00 200.00 7 SUBTOTAL 1850.00 Il *Contributor Codes lnd-lndividual COM - Recipient Committee (other than PTY or SeC) OTH - Other (e.g., business entity) PTY - Political Party sec - Small Contributor Committee FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866IASK-FPPC (8661275-3772)
Schedule A (Continuation Sheet) Monetary Contributions Received covers from 07/01/2017 _ SCHEDULE A (CaNT.) CALIFORNIA 460 FORM 09/23/2017 Page 6 of 9 Bill Zoslocki for Modesto City Council District 4, 2017 1398025 OATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (lfcomm!tiee,alsqenteri.d.number) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) Curtis Grant 09/14/2017 I M()desto, CA 95354 OOIND DCOM DPTY DSCC Retired N/A 100.00 100.00 100.00 S 17 09114/2017 Claudia Krausnick Modesto, CA 95355 OOIND DCOM DPTY DSCC Retired N/A 200.00 200.00 200.00 S 17 09/18/2017 Jeff Perine Woodbrige, CA 95258 OOIND DCOM DPTY DSCC Teacher CDRC 150.00 150.00 150.00 S 17 DIND DCOM DPTY DSCC DIND DeOM DPTY Dsec SUBTOTAL 450.00 "Contributor Codes IND-Individual COM - Recipient Committee (other than PTY or sec) OTH - Other (e.g., business entity) PTY - Political Party sec - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule B - Part 1 Loans Received 07/01/2017 covers period from SCHEDULE 8- PART 1 CALIFORNIA 460 FORM SEE INSTRUCTIONS NAME OF FILER Bill Zoslocki for Modesto City Council District 4, 2017 09/23/2017 page_7 01_9 1.0. 1398025 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER J.D. NUMBER) IF AN!NDIVIDUAL, ENTER OCCUPATION AND EMPLOYER {IF ENTER INTEREST PAIDTH!S PERiOD ORJGJNAL AMOUNT OF LOAN Bill Zoslocki Modesto, CA 95355 IND 0 COM 0 OTH 0 P1Y 0 scc 0.00 8000.00 o PAID o FORGIVEN 8000.00 12/31/2018 DATE DUE 0.00% RATE 0.00 8000.00 8000.00 PER ELECTION*"" 07/27/2017 8000.00 S 17 DATE INCURRED o PAID o FORGIVEN,--- --'"" RATE PER ELECTION ** to IND 0 COM 0 OTH 0 P1Y 0 scc to IND 0 COM 0 OTH 0 P1Y 0 SCC._- DPAID._---.---- o FORGIVEN SUBTOTALS 8000.00 0.00 DATE DUE DATE INCURRED -_% RATE._--- PER ELECTION*",---- DATE DUE DATE INCURRED 8000.00 Schedule B Summary 1. Loans received this period... (Total Column (b) plus un itemized loans of less than 100.) 2. Loans paid or forgiven this period... (Total Column (c) plus loans under 100 paid or forgiven.) (Include IDans 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 Summary Page, Column A, Line 2. 8000.00 0.00 8000.00 (May be a negahvenljmbef) tcontributor Codes!ND -Individual COM - Recipient Committee (other than PTY or SeC) OTH - Other (e.g" business entity) PTY - Political Party sec - Small Contributor Committee *Amounts forgiven or paid by another party also must be reported on Schedule A ** If required. /? /FJirect File '- FPPC Form 460 (JanuaryI05) FPPC Toll-Free Helpline: 866IASK.FPPC (8661275 3772)
ScheduleC Nonmonetary Contributions Received Statement covers from, 0~7~/o~1~/2:.:0_1.:..-7 SCHEDULEC CALIFORNIAA60 FORM "to 09/23/2017 Page_8 of_9 Bill Zoslocki for Modesto City Council District 4,2017 1.0. NUMBER 1398025 DATE RECEIVED FULL NAME, STREET ADDRESS AND l!p CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF self-employed, ENTER NAME OF BUSINESS) DESCRIPTION OF GOODS OR SERVICES AMOUNTI FAIR MARKET VALUE CUMULATIVE TO DATE (JAN 1 - DEC 31) PER ELECTION TO DATE (IF REQUIRED) 08/30/201 Christopher Tyler Modesto, CA 95355 IZJIND OCOM OOTH OPTY OSCC Investment Manager Capital 238.19 1238.1 1238.19 S 17 OIND OCOM OOTH OPTY OSCC OIND OCOM OOTH OPTY OSCC OIND OCOM OOTH OPTY OSCC Attach additional information on labeled continuation sheets. SUBTOTAL 238.19 Schedule C Summary 1. Amount received this period - itemized nonmonetary contributions. 238.19 (Include all Schedule C subtotals.)... 2. Amount received this period - unitemized nonmonetary contributions of less than 100... --=-0:.:.0:.:0 ""Contributor Codes!ND -Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party 3. Total nonmonetary contributions received this period. SCC - Small Contributor Committee 238.19 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.)... TOTAL FPPC Form 460 (January/05) FPPC Toll-Free Helpline: B66/ASK-FPPC (866/275-3772)
ScheduleE Payments Made to whole doliars. Statement covers period from 0_7_10_1_/2_0_1_7 SCHEDULEE CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE NAME OF FILER 09/2312017 9 Page I.D. NUMBER Bill Zoslocki for Modesto City Council District 4, 2017 1398025 of 9 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CI'v1P 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 PET petition drculating TEL t.v. or cable airtime and production costs F[L 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, denvery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (Iega!, accounting) VOT voter registration UT campaign literature and mailings PRJ print ads WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTrON OF PAYMENT AMOUNT PArD City of Modesto Modesto, CA 95350 VoteSwing Modesto, CA 95352 Directfile Fresno, CA 93721 FIL 500.00 LIT 7408.73 PRO 595.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL 8503.73 Schedule E Summary 8503.73 1. Itemized payments made this period. (Include all Schedule E subtotals.)... 50.00 2. Unitemized payments made this period of under 1 00... "... 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)... 0_.0_0 8553.73 4. Total payments made this period. (Add Lines 1,2, and 3. Enter here and on the Summary Page, Column A, Line 6.)... TOTAL /'? 19lrect File L- FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Statement covers period 09/24/2017 from Date of election if applicable:... r ~ " (Month, Day, Year), \.. i Date Stamp [! ; ~. I, COVER PAGE CALIFORNIA 46ft 2001/02 U FORM Page 1 of 9 For Official Use Only SEE INSTRUCTIONS ON REVERSE 10/21/2017 11/07/2017 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. IX! Officeholder, Candidate Controlled Committee o Primarily Formed Ballot Measure State Candldate Election Committee Committee o Recall o Controlled (Also Comp/ete PariS) D General Purpose Committee Sponsored Small Contributor Committee o Political Party/Central Committee o Sponsored (Also Comp/etePatt6) o Primarily Formed Candidatel Officeholder Committee (Also ComplelfJ Part 7) 2. Type of Statement: 00 Preelection Statement o Semi~annua! Statement o Termination Statement (Also file a Form 410 Termination) o Amendment (Explain below) o Quarterly Statement D Special Odd-Year Report D Supplemental Preelection Statement - Attach Form 495 3. Committee Information!.D. NUMBER Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Bill Zoslocki for Modesto City Council District 4, 2017 NAME OF TREASURER Cathy Gatewood MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY Modesto STATE ZIP CODE CA 95355 AREA CODE/PHONE CITY Modesto NAME OF ASSISTANT TREASURER, IF ANY STATE ZIP CODE AREA CODE/PHONE CA 95356 MAILING ADDRESS (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: FAX f E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statemen under penalty of perjury under the laws of the State of California that the foreg 10/25/2017 Executed on ----..:.:."'0.,:"',,------- Executed DO 1... 0 1"'2,:5"./2_0_1_7 Date Executed on -----'0;,;;";;' ------- Executed on -----'0;,;;''':;:------- hed schedules is true and complete. I certify -------- e~,~~~~~~~~ ficer of Sponsor By ~~~~~~~~~~~~~~==~------ Signature of Controlling Officeholder, Candidate, Slate Measure Proponent By ~~~~~~~~~~~~~~""----------... Signature of Controlling Officeholder, Candidate, Slate 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 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Bill Zoslocki 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Sought.. City Council Member City- City of Modesto - District 4 4 RESIDENTlALfBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Modesto CA 95355 BALLOT NO. OR LEITER JURISDICTION SUPPORT Identify the controlling officeholder, candidate, or state measure proponent, if any, NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees Not Included in this Statement: Ustanycommitt.es 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. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMMITIEE NAME LD. NUMBER NAME OF TREASURER COMMITTEE ADDRESS CITY COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CONTROLLED COMMITTEE? o VES DNa STATE ZIP CODE AREA CODE/PHONE STREET ADDRESS (NO P.O. BOX) 1.0. NUMBER CONTROLLED COMMITTEE? OVES DNa 7. Primarily Formed Candidate/Officeholder Committee List names of offlcehojder(s) or candfdate(s) for which this committee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets If necessary /1 lfjirect File '-- FPPC Fonn 460 (January/OS) FPPC TolI~Free Helpline: 866/ASK FPPC (866/275.3772) State of California
Campaign Disclosure Statement Summary Page SUMMARY PAGE Statement covers period CALIFORNIA 46" from 09/24/2017 ~~ FORM " SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bill Zoslocki for Modesto City Council District 4,2017 Contributions Received ColumnA TOTAl.. THIS PERIOD (FROM ATIACHED SCHEDULES) ColumnB TOTAL TO DATE 1, Monetary Contributions... Schedule A, Line 3 7572.00 14469.00 2. Loans Received... ScheduleB, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS...... Add Unes 1 + 2 4. Nonmonetary Contributions... Schedule G, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED... AddUnes3+4 0.00 8000.00 7572.00 0.00 22469.00 238.19 7572.00 22707.19 10/21/2017 Page 3 LO. NUMBER 1398025 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections of 1/1 6/30 7/1 to Date 20. Contributions Received 0.00 22707.19 21. Expenditures Made 0.00 10151.07 9 Expenditures Made 6. Payments Made... Schedule E, Line 4 7. Loans Made... Schedule H. Line 3 8. SUBTOTAL CASH PAYMENTS... AddUnes6+7 9. Accrued Expenses (Unpaid Bills)... ScheduleF, Line 3 10. Nonmonetary Adjustment... Schedule C, Line 3 11. TOTALEXPENDITURESMADE... AddUnes8+9+10 1359.15 9912.88 0.00 0.00 1359.15 9912.88 0.00 0.00 0.00 238.19 1359.15 10151.07 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made'" (If Subjecllo Voluntary Expenditure limit) Date of Election (mm/dd/yy) Total to Date ---- Current Cash Statement 12. Beginning Cash Balance... Previous Summary Page, Line 16 13. Cash Receipts "... ColumnA,Line3above 14. Miscellaneous Increases to Cash... Schedule f. Line 4 15. Cash Payments...... Column A, Line 8 above 16. ENDING CASH BALANCE... Add Lines 12 + 13 + 14, then subtract Une 15 If this is a termination statement, Line 16 must be zero. 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 8 abovo 6343.27 7572.00 0.00 1359.15 12556.12 0.00 0.00 8000.00 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B 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). ---- "Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK~FPPC (866/275~3772)
Schedule A Monetary Contributions Received SCHEDULE A covers from 0_9_/2_4_1_20_1_7 CALIFORNIA A6ft FORM... U SEE INSTRUCTIONS ON REVERSE 10_/2_1_1_20_1_7 Page 4 of 9 Bill Zoslocki for Modesto City Council District 4, 2017 1.0. NUMBER 1398025 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMlnEE, ALSO ENTER I.D. NUMBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 09/27/2017 GDR Ceres, CA 95307 OIND oeom ixjoth OPTY osee 100.00 100.00 100.00 S 17 09/29/2017 ixjlnd oeom OPTY osee PresidentlCFO DF Engineering 200.00 200.00 200.00 S 17 09/29/2017 m DeMartini Modesto, CA 95358 ixjlnd oeom OPTY osee Farmer Self-Employed 500.00 500.00 500.00 S 17 09/29/2017 09/29/2017 Grewal 2012 Hospitality Group LLC Modesto, CA 95356 i Modesto, CA 95354 i OIND oeom ixjoth OPTY osee OPTY osee Self-Employed Self-Employed 250.00 1000.00 250.00 1000.00 250.00 S 17 1000.00 S 17 Schedule A Summary 1. Amount received this period - itemized monetary contributions. (Include all Schedule A subtotals.)... 6_7.:..50.:...:..00.:.. 2. Amount received this period - unitemized monetary contributions ofless than 100... 8_2_2_.0_0_ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)... TOTAL 7.:..5_72.:..:..0.:..0./7 w,rectfile '- *Contributor Codes IND-Individua! COM - Recipient Committee (other than PTY or SCe) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC ToU-Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule A (Continuation Sheet) Monetary Contributions Received from 09/24/2017 _ SCHEDULE A (CaNT.) CAI..IFORNIAJI 60 FORM -+ 10/2112017 Page 5 9 01 I Bill Zoslocki for Modesto City Council District 4,2017 1398025 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OF SELF-EMPLOYED, ENTER NAME OFBUSINESSj AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 09/29/2017 Craig Lewis Modesto, CA 95355 IXlIND DeoM DPTY DSCC RE Broker Lewis Capital Advisors 100.00 100.00 100.00817 09/29/2017 Steve Madison Ripon, CA 95366 Il(JIND DeoM DPTY Dsce Executive Director Stanco 100.00 100.00 100.00 S 17 09/29/2017 Sandra Mesenhimer Modesto, CA 95357 Il(JIND DeoM DPTY Dsce Retired N/A 100.00 100.00 100.00817 09/29/2017 Glenn Mount Modesto, CA 95354 IXlIND DCOM DPTY DSCC Retired N/A 100.00 100.00 100.00 S 17 09/29/2017 Eugeinia Ruegg Berkeley, CA 94705 COM DPTY Dsce Retired N/A 100.00 100.00 100.00 S 17 *Contributor Codes IND-Individual COM - Recipient Committee (other than PTY or sec) OTH - Other (e.g.) business entity) PTY - Political Party see - Small Contributor Committee FPPC Form 460 (Januaryf05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) /? 19irec~ 'ile '-
Schedule A (Continuation Sheet) Monetary Contributions Received to whole dollars, SCHEDULE A (eont) from 0_9_/2_4_/2_0_1_7 CALIFORNIAA60 FORM "+ th roug 10/21/2017 h Page 6 of 9 I Bill Zoslocki for Modesto City Council District 4, 2017 1398025 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMrTTEE, AlSO ENTER 1.0. NUMBER) CONTRIBUTOR CODE * IF AN INDiVIDUAL, ENTER OCCUPAllON AND EMPLOYER (IF AMOUNT CUMULAT1VETO DATE PER ELECTION RECEIVED THIS TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 09/29/2017 Robert Saunders Modesto, CA 95354 OPTY osee Retired N/A 100.00 100.00 100.00 S 17 09/29/2017 Wine Cellar Investments Inc Fresno, CA 93729 IND COM liqoth OPTY osee 100.00 100.00 100.00 S 17 10/16/2017 Modesto Police Officers Association PAC Modesto. CA 95354 ID :910228 OIND 1)(1 COM OPTY osee 2000.00 2000.00 2000.00 S 17 10/16/2017 PG&E Corporation San Francisco, CA 94105 OIND OCOM I)(IOTH OPTY osee 500.00 500.00 500.00 S 17 10/19/2017 Lyons' Investments LP Modesto. CA 95358 OIND oeom I)(IOTH OPTY osee 500.00 1500.00 *Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SeC) OTH - Other (e,g., business entity) PTY - Political Party sec - Small Contributor Committee FPPC Form 460 {January/05} FPPC TOil-Free Helpline: 866/ASK-FPPC (866/275-3772) /7 lfjirect File '-
Schedule A (Continuation Sheet) Monetary Contributions Received Statement covers 09/24/2017 from SCHEDULE A (CONT.) CALIFORN1AA60 FORM '"+ 10/21/2017 7 of 9 Bill Zoslocki for Modesto City Council District 4, 2017 1398025 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR {IF COMUITIEE, ALSO ENTER LD. NUMBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 10/19/2017 Lyons Land Management LP Modesto, CA 95358 500.00 1500.00 1500.00 S 17 10/19/2017 Mape's Ranch Modesto, CA 95358 ixl OTH DPTY DSCC 500.00 1500.00 1500.00 S 17 DIND DeOM DPTY osee DIND DeOM DPTY osee DIND DeOM DPTY Dsec "Contributor Codes!ND-Individual COM - Recipient Committee (other than PTY or SeC) OTH - Other (e.g., business entity) PTY - Political Party sec - Small Contributor Committee FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) /7 lijirecr File...
Schedule B - Part 1 Loans Received covers period 09/24/2017 from SCHEDULE B - PART 1 CALIFORNIAA60 FORM.. SEE INSTRUCTIONS ON NAME OF FILER Bill Zoslocki for Modesto City Council District 4, 2017 10/21/2017 Page _8 of _9!.D. NUMBER 1398025 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IFCQMMITTEE, ALSO ENTER 1.0. NUM8ER) IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS PERIOD INTEREST ORIGINAL I PAIDTH[S AMOUNT OF CONTRIBUTIONS PERIOD LOAN TO DATE Bill Zoslocki Modesto, CA 95355 o PAID o FORGIVEN 8000.00 0.00, 8000.00 8000.00 RATE PER ELECT!QN** tr l INO 0 COM 0 OTH 0 P1Y 0 scc 8000.00 0.00 12/31/2018 0.00 07/27/2017,8000.00S 17 DATE DUE DATE INCURRED o PAID D FORGIVEN -_% RATE PER ELECTiON "'* to INO OTH 0 P1Y 0 scc OATEDUE DATE INCURRED DPA!D o FORGIVEN c, flate PER ElECTION** to INO 0 COM 0 P1Y 0 scc DATE DUE SUBTOTALS 0.00 0.00 8000.00 DATE INCURRED Schedule B Summary 1. Loans received this period""""""." ""... """.. """.. ".".. " "" ",,"""" ",,"""""" """".. """"... """ (Total Column (b) plus un itemized loans of less than 100.) 2. Loans paid or forgiven this period "" ".. ".. """" ""... " "".. ".. ".. "."... ""."""... """"".. " ".. ".. """.. "".. (Total Column (c) plus loans under 1 00 paid orforgiven.) (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 Summary Page, Column A, Line 2. 0.00 0.00 0.00 (May be a l1egatlyenl.lmoor) SchedllleE,Une3) tcontributor Codes [NO - Individual COM - Recipient Committee (other than PTY or SeC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. /'? lijirect File... FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
ScheduleE Payments Made Statement covers period from 0_9_/2_4_/2_0_17 SCHEDULEE CALIFORNIA A 61\ FORM.. U SEE INSTRUCT!ONS ON REVERSE NAME OF FILER 10/2112017 9 9 Page of LD. NUMBER Bill Zoslocki for Modesto City Council District 4, 2017 1398025 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. C1vIP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs ens campaign consultants MTG meetings and appearances RFD returned contributions GTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries eve civic donations PET petition circulating ill t.v. or cable airtime and production costs FIL candidate filing/babot fees PHD phone banks TRe candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and mea!s!nd independent expenditure supporfmg/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 UT campaign literature and mailings PRJ print ads WEB information technology costs (internet, e~mail) NAME AND ADDRESS OF PAYEE (IF COMMIITEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Events Unlimited Modesto, CA 95357 FND 1359.15 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL 1359.15 Schedule E Summary 1359.15 1. Itemized payments made this period. (Include all Schedule E subtotals.)... 2. Unitemized payments made this period of under 1 00... 0_.0_0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Par! 1, Column (e).)... 0_.0_0 1359.15 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)... TOTAL /""J lfjirecf'file '- FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866IASK-FPPC (8661275-3772)
Recipient Committee Campaign Statement Cover Page Date.of election if applicable: (Month, Day, Xea,) '...!, ~ 1 SEE INSTRUCTIONS ON REVERSE 1. of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. IKJ Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also Complete Part 5) o General Purpose Committee Sponsored Small Contributor Committee o Political Party/Central Committee 3. Committee Information o Primarily Formed Ballot Measure Committee o Controlled o Sponsored (A/o ~te PiJ//6) o Primarily Formed Candidate! Officeholder Committee {Also Comp/afe Pari l} 2. Type of Statement: o..,..preelection statement l2f Semi-annual Statement o Termination Statement (Also file a Form 410 Termination) o Amendment (Explain below) Treasurer(s) o Quarterly Statement o Special Odd-Year Report ~Il Zb3/6C/~-t.1 Mlc.sbC; AREA CODE/PHONE ~p ODE.AREACODsPHONE ~5i-=-5 2.tJ"-51"7 -/Zz./ AREA CODEJPH 4. Verification.1. I+-''-;...;:...J-i)li;;; Executed on... ~ Date Executed on -----.,6",,:;:',------ Executed on -----.,0".1""------ chedules is true and complete. I ;;;,- nsor FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov
Recipient Committee Campaign Statement Cover Page - Part 2 COVER PAGE - PART 2 5. Officeholder or Candidate Controlled Committee ~:'7rHZbO;7;A~/:,. r/j~cz;lrc,includelc~~~;i/number~2c;j 4 IYIoJ;iz, 14753 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION SUPPORT ntify 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 contributions or make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES ONO COMMITTEE ADDRESS STREET ADDRESS (NO P.O, BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME 1.0, NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES ONO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) 7. Primarily FormedCandidatefOfficeholder Committee List names of officeholder(s) or candidate(s) for which this committee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD SUPPORT o SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT CITY STATE ZIPCQDE AREA CODE/PHONE Attach continuation sheets if necessary FPpe Form 460 (Jan/20I6) FPpe Advice: advice@fppc.ca.gov(866/275 3712) www.fppc.ca.gov
Campaign Disclosure Statement Summary Page period from --'--f--.,...--- Contributions Received 1. Monetary Contributions...,... Schedule A, Une3 2. Loans Received... Schedule B, Une 3 3. SUBTOTAL CASH CONTRIBUTIONS... Add Unes 1 + 2 4. Nonmonetary Contributions... Schedule C, Une 3 5. TOTAL CONTRIBUTIONS RECEIVED... Add Unes 3 + 4 Expenditures Made 6. Payments Made...,...,... Schedule IE, Line 4 7. Loans Made...,...,..,...,...,... ScheduleH, Une3 8. SUBTOTAL CASH PAyMENTS... Add Unos 6 + 7 24. LJb 9. Accrued Expenses (Unpaid Bills)... chedul. F. Un. 3 10. Nonmonetary Adjustment..... "...,... Schedule C, Une 3 11. TOTAL EXPENDITURES MADE.... Add Lin., 8 + 9 + 10 24. c::8 Current Cash Statement 12. Beginning Cash Balance..,... "... Previous SummaryPaga, Line 16 {P4. 3'7 13. Cash Receipts...,...,... ColumnA, Une 3 above 14. Miscellaneous Increases to Cash... Schedule!, Une4 15. Cash Payments...,...,.. ColumnA, Une 8 above 16. ENDING CASH BALANCE....,... AddLines 12 + 13 + 14, then subtractune 15 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTE~S RECEiVED... ScheduleB. Partz 18. Cash Equivalents..., See insfructions on reverse 19. Outstanding Debts... AddUne2+Une9inColumnBaboV8 Column B CAlENDAR YEAR TOTAl TO DATE (s) ~ --, ~ &.4 3'7 &4: 37 46. 37 To calculate Column B, add amounts in Column A to the corresponding amounts from Column 8 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 20. Contributions Received 21. Expenditures Made 1/1 6/30. 7/1 to Date ---- ---- Expenditure Limit Summary for State Candidates 22. CUrylulative Expenditures Made (If Subjllct to Voluntary Expenditure Limit) Date of Elect]on (mm/dd/yy) Total to Dale ---- "Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov
Schedule B - Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE from _'1-"--l-.~-+ SCHEDULE B - PART 1 Page - of~ FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMlnEE, ALSO ENTER 1.0. NUMBER) INO o COM SCC INO 0 COM OTH 0 PTY 0 SCC SCC IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED, ENTER NAME OF BUSINESS) /.'5t1I....---- SUBTOTALS RECEIVED THIS PERIOD.----.---- ~'~~~~?'i:::::;;;;';';;;;;;;i,;;;;;;;"ooj... m o PAID If I.~. o FOR'1VEN h/zt>z.1 o PAID o FORGIVEN o PAID D FORGIVEN ~ DATE DUE._--- DATE DUE DATE DUE 2. Loans paid or forgiven this period... :... ----'=1-+---- (Total Column (c) plus loans under 100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 1355""-1 ORIGINAL AMOUNT OF LOAN -It>.. -_% /.!::J, RA.TE._-% RAn; -_% RATE uf.1f,"!!j DATE INCURRED DATE INCURRED DATE INCURRED tcontributor Codes CAlENDAR YEAR PER ElEcnON** PER ELECnONi1< PER ELECTION"" INO - Individual COM - Recipient Committee (other than PTY or sec) OTH - Other (e.g., business entity) pry - Political Party 3. Net change this period. (Subtract Line 2 from Line 1.)... NET ' --+ sec - Small Contributor Committee Enter the net here and on the Summary Page, Column A, Line 2. galive!'lumber) "'Amounts forgiven or paid by another party also must be reported on Schedule A. U If required. FPPC Form 460 (lan/2016) FPPC Advice: advlce@fppc.ca.gov (866/275-3772) www.fppc.ca.gov
Schedule E Payments Made - - page~of~ CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. emp campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs ens campaign consultants MTG_ meetings and appearances RFD retumed contributions ete contribution (explain nonmonetary)'" OFC office expenses SAL campaign workers' salaries eve civic donations PET petition circulating TEL tv. or cable airtime and production costs Fil candidate filinglbauot fees PHD phone banks TRe candidate travel, lodging, and meals FND tundra/sing events POL polling and survey research TRS staff/spouse travel, lodging, and meals INO 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) VaT voter registration LIT campaign literature and mailings PRT print ads WEB infprmation technology costs Ontemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * 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.)... :... -Z-Jf-~tJe-I.f:.-'-- 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).)... -2-'-I:-o,-&>--::7)7-'-':-'~ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, line 6.)... rotal...!'.=-"-'---'-- FPPCForm 460 (Jan/2016) FPPC Advice: advlce@fppc.ca.gov(866/275-3772) www.fppc.ca.gov
Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Statement covers period from 10/22/2017 Date of election if applicabl,e: (Month, Day, Year),., 1"), Date Stamp COVER PAGE CALIFORNIA4 S 0 2001/02 FORM " Page 1 of 9 For Official Use Only SEE INSTRUCTIONS ON REVERSE 12/31/2017 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4,!Xl Officeholder, Candidate Controlled Committee State Candidate Election Committee o Recall (Also Complete Part 5) o General Purpose Committee Sponsored Sma!! Contributor Committee o Political Party/Central Committee o Primarily Formed Ballot Measure Committee o Controlled o Sponsored (Also Complete Part 6) o Primarily Formed Candidatel Officeholder Committee (Also Complete Part 7) 2. Type of Statement: o Preelection Statement 00 Semi~annual Statement o Termination Statement (Also file a Form 410 Termination) D Amendment (Explain below) o Quarterly Statement o Special Odd-Year Report D Supplemental Preelection statement - Attach Form 495 3. Committee Information l.d. NUMBER Treasurer(s)... UIVIIVIlI I ~c. 1'II"""vlE (OR CAND!DATE'S NAME IF NO COMMITTEE) Bill Zoslocki for Modesto City Council District 4, 2017 NAME OF TREASURER Cathy Gatewood MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY Modesto STATE ZIP CODE CA 95355 AREA CODE/PHONE CITY Modesto NAM ::.QF AssistANT fr"easure'r--;-if ANY STATE ZIP CODE AREA CODE/PHONE CA 95356 MAILING AobR-E"SS (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: FAX I E-MAIL ADDRESS OPTIONAL: FAX I E-MAiL ADDatss 4. Verification I have used all reasonable diligence in preparing and reviewing this stateme under penalty of perjury under the laws of the State of California that the fore ached schedules is true and complete. I certify Executed 00 01/30/2018 Dale Executed on Date Y Signature of ControUmg Officeholder, CanOldal&, Stale Measure Proponent or ResponSible Officer of SponsO!' Executed on Date By Signatureo! Controlling Officeholder. Candidate, State Measure Proponent,SI;re~ile '- Executed on Date By Signature of Controlling Officeholder. Candidate, State Measure Proponent FPPC Form 460 (January(05) FPPC Toll-Free Helpline: 866/ASK~FPPC (866f275~3772) State of California
Recipient Committee Campaign Statement Cover Page - Part 2 COVER PAGE - PART 2 2 of 9 55 C., 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Bill Zosiocki 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DfSTRICT NUMBER IF APPLICABLE) Sought: City Council Member City City of Modesto - District 4 4 RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Modesto CA 95355 BALLOT NO. OR LEITER JURISDICTION SUPPORT 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 contributions or make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMM1TIEE NAME 1.0. NUMBER NAME OF TREASURER COMMITTEE ADDRESS CITY COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CONTROLLED COMM!TIEE? o YES ONO STATE ZIP CODE AREA CODE/PHONE STREET ADDRESS (NO P.O. BOX)!.D. NUMBER CONTROLLED COMMITTEE? o YES ONO 7. Primarily Formed Candidate/Officeholder Committee List names of officeho/der(s) or candidate(s) for which this committee ;s primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT NAME OF OFFICEHOLDER OR CANDJDATE OFFICE SOUGHT OR HELD SUPPORT CITY STAlE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary mire~/e '--- FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866fASK-FPPC (866/275..3772) State of California
Campaign Disclosure Statement Summary Page Statement covers period from 10/22/2017 SUMMARY PAGE CALlFbRNIA 4 6 0. FORM SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bill Zoslocki for Modesto City Council District 4, 2017 Contributions Received 1. Monetary Contributions»... n.,, Schedule A, Line 3 2. Loans Received... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS... Add Lines 1 + 2 4. Nonmonetary Contributions... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED... Add Lines 3 + 4 ColumnA TOTAL THIS PER!OD (FROM ATTACHED SCHEDULES) ColumnS TOTAL TO DATE 7048.00 21517.00-100.00 7900.00 6948.00 29417.00 -- 0.00 238.19 6948.00 29655.19 1213112017 Page 3 of 9 LD. NUMBER 1398025 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 6/30 711 to Date 20. Contributions Received 0.00 29655.19 21. Expenditures Made 0.00 20767.29 Expenditures Made 6. Payments Made Schedule E, Line 4 7. loans Made.... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS... AddUnes6+7 g, Accrued Expenses (Unpaid Bills)... "... "...,ScheduleF, Lim:d 10. Nonmonetary Adjustment... """."...,... ScheduleC, Une3 11. TOTAlEXPENDITURESMADE... AddLines8+9+10 5616.22 15529.10 _-,0",.0"",0 0.00 5616.22 15529.10 5000.00 5000.00 _--,0"".0",,0 238.19 1 0616.22 20767.29 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expend!ture L!mit) Date of Election (mm/dd/yy) ----.1----.1 Tota! to Date ---- Current Cash Statement 12. Beginning Cash Balance... Previous Summary Page, Line 16 13. Cash Receipts Column A, Line 3 above 14. Miscellaneous Increases to Cash Schedule J, 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. 12556.12 6948.00 50.00 5616.22 13937.90 17. loan GUARANTEES RECEIVED Schedule B, Parl 2 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents... "... See instructions on reverse 0.00 19. Outstanding Debts.... Add Line 2 + Une 9 in Column 8 above 12900.00 1!I;,.,.,"'7,:,le '- To calculate Column B, add amounts in Column A to the corresponding amounts from Column B 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). ----.1----.1-- ---- *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (JanuaryI05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule A Monetary Contributions Received covers period from 10/22/2017 SCHEDULE A C.ALlFbRNIA i A 6. 0...' FORM........ SEE INSTRUCTIONS ON REVERSE 12/31/2017 Page 4 of 9 Bill Zoslocki for Modesto City Council District 4, 2017 1.0, NUMBER 1398025 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR I CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER NAME AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 10/2612017 10/26/2017 California Real Estate Political Action Committee -California Association of Realors Los Angeles, CA 90020 10 :890106 Collins Electric Company Stockton, CA 95215 OIND OCOM 1XI 0TH OPTY OSCC OCOM IXIOTH LlPTY OSCC 1000.00 1000.00 3500.00 1000.00 3500.00 S 17 1000.00 S 17 10/3012017 Robert Calcagno Santa Cruz, CA 95060 IXlIND OCOM OPTY osec Retired N/A 500.00 500.00 500.00 S 17 10/30/2017 Madison Ripon, CA 95366 IXlIND oeom OPTY OSCC Retired N/A 150.00 150.00 150.00S 17 10/31/2017 1 Modesto, CA 95353 10:890637 OIND IKiCOM OPTY Osce 500.00 500.00 500.00 S 17 SUBTOTAL 3150.00 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.) f/}ire;;;k,e '" *Contributor Codes INO -Individual 6850.00 COM - Recipient Committee (other than PTY or sec) 198.00 OTH - Other (e.g., business entity) PTY - Political Party sec - Small Contributor Committee TOTAL 7048.00 FPPC Form 460 (January/OS) FPPC TolI.Free Helpline: 866/ASK FPPC (866/275-3772)
Schedule A (Continuation Sheet) Monetary Contributions Received Statement covers period from 10/22/2017 SCHEDULE A (eont.) SAUFORNIA/4'.6.1\. FORM.... U 12/31/2017 Page 5 of 9 Bill Zoslocki for Modesto City Council District 4, 2017 11398025 DATE RECEIVED I FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYEO, ENTER NAME OF BUSINESS) AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS TO DATE PERIOD (JAN. 1 ~ DEC. 31) (IF REQUIRED) California Real Estate Political Action Committee 11/0212017 I-California Association of Realors 1111312017 Los Angeles, CA 90020 ID:890106 Kelly Howard Lathrop, CA 95330 DIND DeOM fi(]oth DPTY osee fi(]ind DeoM DPTY osee Retired NIA 2500.00 3500.00 100.00 100.00 3500.00817 100.00 S 17 Horizon Consulting Services 1211812017 I Modesto, CA 95350 DIND DeoM fi(]oth DPTY osee 100.00 I I 100.00817 100.00 1211812017 JKB Energy Corp Turlock, CA 95381 DIND DeoM fi(]oth DPTY osee 250.00 I I 250.00817 250.00 1211812017 Modesto Fire Fighters Association PAC Modesto, CA 95354 10 :74550 DIND lzieom DPTY osee 750.00 I 750.00 SUBTOTAL 3700.00 *Contributor Codes [NO-Individual COM - Recipient Committee (other than PTY or SeC) OTH - Other (e.g., business entity) PTY - Political Party sec - Small Contributor Committee FPPC Form 460 (January/OS) FPPC TolI Free Helpline: 866/ASK-FPPC (866/275-3772) mire;;3;,e '-
Schedule B - Part 1 Loans Received Statement covers period from 10/22/2017 SCHEDULEB- PART 1 CALIFORNIA 4 FORM. 6..0. ON REVERSE 12/31/2017 Page _6 of 9 NAME OF FILER!.D. NUMBER Bill Zoslocki for Modesto City Council District 4, 2017 1398025 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) Bill Zoslocki Modesto, CA 95355 INO 0 COM 0 OTH 0 POY 0 sec IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING I AMOUNT I AMOUNT PAID BALANCE RECEIVED THIS OR FORGIVEN PERIOD THIS PERIOD * ~PAID 100.00 o FORGIVEN uu I b IANUINI,j BALANCE AT CLOS~R?F THIS PE 100 INTEREST PAID THIS PERIOD, 7900.00 0.00" RATE ORIGINAL AMOUNT OF LOAN CUMULATIVE CONTRIBUTIONS TO DATE 8000.00 7900.00 PER ELECTION** 8000.00 I. 0.00 I. 12/31/2018 0.00 07/27/2017 8000.00 S 17 o PAID DATE DUE DATE INCURRED o FORGIVEN -_% RATE PER ELECTION ** to INO 0 COM 0 OTH 0 POY 0 sec DATE DUE DATE INCURRED DPAID o FORGIVEN -_% RATE I PER ELECTION ** to INO 0 COM 0 OTH 0 POY 0 sec SUBTOTALS 0.00 DATE DUE 100.00 7900.00 I DATE INCURRED Wic.ViifAi'c4 Schedule B Summary 1. Loans received this period (Total Column (b) plus un itemized 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. NET 0.00 100.00-100.00 (May be a negative number) tcontributor Codes IND -Individual COM - Recipient Committee (other than PTY or SeC) OTH - Other (e.g., business entity) PTY - Political Party sec - Small Contributor Committee "Amounts forgiven or paid by another party also must be reported on Schedule A. "" If required. /7 lijirec~file '- FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK FPPC (866/275.3772)
ScheduleE Payments Made Statement covers period from 10/22/2017 SCHEDULEE CAUFORNIA ia~o.. FORM &.fu. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bill Zoslocki for Modesto City Council District 4,2017 12/31/2017 Page _7 of 9 J.D. NUMBER 1398025 CODES; If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 0v1P campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions etb contribution (explain nonmonetary)~ OFC office expenses SAL campaign workers' salaries eve civic donations F T petition circulating TEL t.v, or cable airtime and production costs FIL candidate filing/bauot fees PH:) phone banks lre 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 (!egal, accounting) VOT voter registration UT campaign literature and mailings PRT print ads WEB information technology costs (internet, e~mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER LD, NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPA!D VoteSwing Modesto, CA 95352 LIT...._--- -- 5435.65 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL 5435.65 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) 2. Unitemized payments made this period of under 1 00 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 5435.65 180,57 0.00 5616.22 EJ;re~/e '- FPPC Form 460 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule F Accrued Expenses (Unpaid Bills) to whole doliars. Statement covers period from 10/22/2017 SCHEDULEF CALIFORNIA A 6 0, FORM,... SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bill Zoslocki for Modesto City Council District 4, 2017 12/31/2017 8 9 Page of l.o.number 1398025 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 0vlP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs ens campaign consultants I\I1TG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries eve civic donations PET petition circulating TEL t.v. or cable airtime and production costs RL candidate filinglballot fees Pl-IO phone banks me candidate trave!, lodging, and meals FND fund raising events POL polling and SUlvey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (expjain)* 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 UT campaign literature and mailings PRr print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE. ALSO ENTER ].0. NUM8ER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) (e) (d) AMOUNT INCURRED AMOUNT PAID OUTSTANDING THr8PER[OD THI8PERIOD BALANCE AT CLOSE (ALSO REPORT ON E) OF THIS PERIOD Mike Lynch Consulting Modesto, CA 95354 CNS 0.00 5000.00 0.00 5000.00 ---_..- -~- - " payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS 0.00 5000.00 0.00 5000.00 Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of 100 or more, plus total un itemized accrued expenses under 100.)... INCURRED TOTALS 5000.00 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of 1 00 or more, plus total unitemized payments on accrued expenses under 100.) 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) I.9ire;;;;:,Ye '- PAID TOTALS 0.00 NET 5000.00 May be a negative number FPPC Form 460 (JanuaryI05) FPPC TolI Free Helpline: 866IASK FPPC (8661275.3772)
Schedule I Miscellaneous Increases to Cash Statement covers period 1 0/22/2017 f rom SCHEDULE I C"'.LlfOR~IA ia. 6 t\.. FORM... ~ SEE INSTRUCTIONS ON REVERSE NAME OF FILER Bill Zoslocki for Modesto City Council District 4, 2017 12/31/2017 Page 9 1.0. NUMBER 1398025 of 9 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COM1i'1lnEE. ALSO ENTER!.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL 0.00 Schedule I Summary 1. Itemized increases to cash this period. 0.00 2. Unitemized increases to cash of under 100 this period... 50.00 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).)... 0.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) /7 I!Jkect File '- TOTAL 50.00 FPPC Form 460 (January/05) FPPC Toil~Free Helpline: 866JASK~FPPC (8661275~3772)
Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period 10/22/2017 from --'---'--' _-,-12-,1-,3-,1/-,2-,0_1-,7 Date of election if applicable:, I'" F-'r,' (Month, Day, Year) I >. L 1'< Date Stamp COVER PAGE CALIFORNIA 460 2001102 FORM c. '). n 1 9! ;, (., ~p~a~g~e:.::===-~o~f~==::.j For Official Use Only 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. [j(] Officeholder, Candidate Controlled Committee State Candidate Election Committee o Recall (Also CornpletePart 5) o General Purpose Committee Sponsored Small Contributor Committee o Political Party/Centra! Committee 3. Committee Information o Primarily Formed Ballot Measure Committee o Controlled o Sponsored (Also Complete Part 6) o Primarily Formed Candidate/ Officeholder Committee (Also CompfetePart 7) 1.0. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Bill Zoslocki for Modesto City Council District 4, 2017 2. Type of Statement: o Preelection Statement 00 Semi-annual Statement D Termination Statement (Also fde a Form 410 Termination) IX! Amendment (Explain below) Missing Signature Treasurer(s) NAME OF TREASURER Cathy Gatewood MAILING ADDRESS D Quarterly Statement o Special Odd-Year Report o Supplemental Preelection Statement - Attach Form 495 STREET ADDRESS (NO P.O. BOX) CITY Modesto STATE ZIP CODE CA 95355 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX AREA CODE/PHONE CITY Modesto NAME OF ASSISTANT TREASURER. IF ANY MAILING ADDRESS STATE ZIP CODE AREA CODE/PHONE CA 95356 CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX' E MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the in under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Execo.ed on -'0:..2_10"2::;/c;:2:,:0..:.1.:,8 Date Execo.ed on -"0.;.21,,0"'2:;,/::2.:,0.;.1.:,8 D,~ efefrrarn:hn1:he-a«ac~du!es is true and complete. I certify /1 l!jirectrle "- Executed on ------;Da~~:------- Executed on -----'0,.".'------ By ~~~~~~~~~~~~~~~.----------- Signature of Controlling Officeholder, Candidate, State Measure Proponent By ~~~~~~~~~~~~~~~.----------- Signature 01 Controlling Officeholder, Candidate, Slate Measure Proponent FPPC Form 460 (Januaryf05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) State of Cal1fomia