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Recipient Committee Campaign Statement Cover Page

Govemmenl Code Sections 84200 5 54218


v

RECEIVED
t

Type

or

print

In Ink

CITY
a
e

p 1

Sletemen

cove

period

Date of election If

5 Pq

l 1 q

fe

tL

67

Page

Month Day Yeer


hom
7

ww

SEE IN ON REVERSE TRUCTION9

through 2

L Z

Type of Reeipiertt Committee


Q Q

An Commldoee

comamta Perm t 2 s end t

Type of Statement

OOlceholder Candldele Controlled Committee


State Candidate Elactlon Committee
Recall raaocomPrNe Pan sl General

Prtmartry Formed Ballot Measure


Committee

reelactlon Statement
annualSmtement Semi

Q Controlled Q Sponsored
mrabPeoel ramc

Ouarterry Statement Year Speelal Odd Report Supplemental Preemdion


Sretemant Attach Fonn 405

Terrtdnatlon Statement Amo Ole a Form 410 Terminetlon


Amendment

Purpose Committee Q Sponsored

Explain below

Q Q

Small Contdbutor Committee PolHleal

Pdmeriry Formed CerMidetel OOlceholder Committee


Or la tl01 en roP

Central Perry Committee

3 Committee Information

D I

GO

s Treasurer

Ili

l LIiZ r z7i5cc e rc l yltnl L iz

LilC 7

IAAILINO ADDRE59

CITY

STATE

ZIP CODE

AREA CODEIPHONE

CITY

STATE

ZIP CODE

AREA CODEIPHONE

u itwl y n do Srz
OPTIONAL FA 1NUL E ADDREb9

r Gn

rvr

4 Veriflcetion
I have used ell reasonable under

diligence
e

In

prepadng

and

reviewing

penalty

o1

perjury

under t

laws of the Slate of Califomla that the

this statement end to the best o my know foregoing la true end


ey

edge the

InformaDOn contained hereto end In the attached srhedules is Wa end

comptem

Demty

Exewted

on

j
b

ort41ct
A

1 t
1

tueorT 6qn
By

I lf l
orAU
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reaemr

Executed

on

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1

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Praporentor Reapm r5panwr OROr

EXeGded

en

Deb

616naluieolCwibo

6bb pOdwMber CarWkeb Neawn PmporeM

Exeudad

on

By

mmCemoltio

ue Cmddab tale Mea PrePemrn

FPPC To0 ree

Nelpllne

FPPC Form 460 lJanuaryl06 B88IASKFPPC 6661278 J7731 Smm of Celifomm

Campaign Disclosure Statement Summary Page

Type or print In Ink Amounts may be rounded to whole doilare

from

nt lme State Q

eovere

period

REVERSE NAME DF FILER

through

O
Calendar Year

Page

of

D I NUMBER

a l
Contributions Received
1 2

rr
Column A
TOTAL1Nn

Column B

FRONATfALI

To ro

Monetary Contributions
Loans RBCeiVed

schedule

q une

D
dt7

n y

Summary for Candidates In Both the State Primary and General Electlons

Running

Schedule e une 3
Add unea l z

7
2D COntdbudona

111

thmuah

8130

7A to Date

3
4

SUBTOTALCASH CONTRIBUTIONS

Nonmonetery Contributions
TOTALCONTRIBUTIONSRECEIVED

Received 21 Expenditures
Made

unos sdredutec 4 Addunea3

Expenditures Made
8 7 8 9

Payments

Made

schedule E une4

ZD 7O ZR
ZO
P7

Zf 70 8
D

Expenditure Limit Summery


Cendldatea

for State

Loans Made

Schedule H une 3
7 Adduneae

SUBTOTALCASHPAYMENTS Accrued Expenses Unpaid Bills

7
a
p

ZO

22 Cumulellve Expenditures Made to 9ue to vau F usatl et mn aprMprm

une3 sdreduleF

Date of Eladlon

Total to Date

10

Nonmonetary Adjustment

una3 saadulsc
lo a gddurreaa

11 TOTAL EXPENDITURES MADE

n r 70 zo

mmrddlyy

2t

70h

20
S

Current Cash Statement


12

Beginning

Cesh Balance

llnets PraWOUasummaryPe0o
cdumn q unesebove sdtedde t

0
n

To calculate Column

B add
Amounts In this section may be differentfrom amounts

13 Cash

Receipts

amounts in Column A to the

14 Miscellaneous Increases to Cash 15 Cash

uiar

corresponding amounts
from Column B of your last

Payments

lneeebove cdumnAf

fhensubhadunsl5 l4 fa AddUirostz ENDIN6CA3HIBALANCE 16


f7 this fa a remr na0on

2d g 70 gn Z4

statement Llne

16 must be

zero

report Soma amounts m Column A may be negethre figures that should be eubtrected frem previous pedod amounts If this is the first report baing filed
for this calendar year

reported

In Column B

17 LOAN GUARANTEES RECENED

schedda s Pen z

onty
If

tarty over the amounts

Cash
19

Equivalents and Outstanding Debts


Equivalents
see lnstnmaons
on

frem Linea 2 7 end 6

18 Cash

e reven

any

Outstanding Debts

unaelnCOlumneatwve Addunez

0
FPPC Toll Free

FPPC Form 460

Melpllne

FPPC 8861ASK

Jenuary105 666I275J772

nee

SCHEnI 11 F R

PART i

CneQUle C

Yal 7

Loans Received

Amounts mey be rounded llar tawnaled

Statement
ram

covare

period
D

SEE INSTR U CT I ON S ON REVERSE NAME OF FILER

th roug h

Pege

l IStt I
iIYI Y1 L r
1
y
r

n l

D I NUMBER

rr 20 s
O

i y

FULL NAME STREET ADDRESS AND ZIP CODE OF LENDER ALSO DFeouuRTEE ENTER I NUUSFx o
11

IF AN INOMDUAL ENTER OCCUPATION AND EMPLOYER


OF LO D
NAaeoF

pNDING

lei AMOUM

BALANCE BEGINNING THIS

AMOUNT PAID
OR FORGIVEN THIS PERIOD

RECENED THIS
PERIOD

eU6NEae

OUTS ANDING BALANCEAT CLOSE OF THIS

INTEREST
PAID THIS PERIOD

ORIGINAL
AMOUM OF LOAN

CUMULATIVE
CONTRIBUTIONS TO GATE
CAlENL3ARVEAR

ir CL ZQS

3 S

5n
y
G

rl2 ru z

I mo

l I

4Cttl l

PAIb

i
FORGNEN

i
MTE

i
DATE INCURRED

i
PER

G y II uf
t
IND COM

ELECTION

171C
OTH PTY

SCC

S
TE DUE

PHD i
1
RATE

CALENDAR YEM f i PER ELECTION

FORONEN
i i
DATE OUE PNO

f DATE INCURRED

IND

COM

OTH

PTY

SCC

CALENDAR VEAR i

i
RATE

i PER ELECTION

FORONEN

i
DATE DUE

i
GATE INCURRED

IND

COM

OTH

PTV

SCC SUBTOTALS S

S
on e enmr
6tlwEUe E LM3I

Schedule B
1

Summary
period b plus unitemized

Loans received this

DiJ J
loans of less than

Total
2

Column

100

tConVlbulor Codes

Loans

paid orforgiven this period Total Column c plus loans under 100 paid orforg ven Include loans paid by a third party that are also Itemized

T
on

IrWMdual IND

Schedule

A
NET

Netchange this period Subtract Line 2 from Line 1 Enterthe net here and on the Summary Page Column A Line 2
forgiven
or

U G
nbe 0einep

Recipient Committee other Man PTV or SCC OTH OMer e buslnass entlry g Political PTY Party
Small SCC ConMbutorCommlttee

COM

Amounts

paid by

enolher

party

also must be

mported

on

Schedule A

Ir required

J
FPPC Toll Free

FPPC Form OSO

Helpline

FPPC ASK BSS

06 January 7772 276 88

Schedule E Paymenu Made

type

or

print

In Ink

Amounts may be rounded


to whole tlollare

sperlod tr en ve Statem o
from

1L lJ

SEE

through

Page

01

9300
CODES
CtvP CNS

of the following codes accurately describes the payment you may enter the code Otherwise describe the payment ti18R membercemmunleatlens RAD radio airtime and productlon coats Mi0 meetings and appearances RFD returned conhlbutions CTB OFC office expenses SAL campaign workers aeledes CVC dvlc donations PEr T0 v I or cable airtime end produdlon costa petition Grculafing Fb candidate fltlnglbellot fees PHO phone banks TRC candidate treval lodging end meals FPD tundreising events FrOL potlinp end survey resaereh TRS staRlspcuse travel lodging end meals ODD ture POS postage delivery end messenger services independent expend suppoNnglopposing olhere ezplefn TSF transfer between committees of the same cendldatelaponaor lEG PRO professional services legal accounting legal detenea VOT voter reglstretlon LfT campaign literature and mailings PRT WEB Information tedmology costa Print ads Internet e malp
one

If

campaign parephemellalmisc campaign consultants contribution explain nonmonetary

NAME AND ADDRESS OF PAYEE uso suueasr rcoMUmss o I ENrerl

CODE

OR

DESCRIPTION OF PAYMENT

AMOUNT PAID

T l

2 7hc72 G
a

l2 yC L

z r L ye
1
r

ILl

wt
o

hL
era

5
se I
C
or

Lis
Payments that

c
moat also be summarized on Schedule D

eontrlbutlone

Independent expenditures

SUBTOTALS

G1 z S J
7 ZD

Schedule E

Summary
period Include all Schedule E subtotals

1 Itemized payments made this


2 Unitemized

payments made this perlod of under 100

3 Total interest
4 Total

paid this period

on

loans

Enter amount from Schedule B Part 1 Column e


on

payments made this period Add Lines 1 2 and 3 Enter here and

the

Summary Page Column A Line 6

TOTAL

T t F
Januaryl06

FPPC Form 460


FPPC To14Free

Nelpline BBBIASKfPPC a66127rn7772

Schedule E Payments AAade


SEE

type

or

print In Ink
trom J CL L7

Amounts may be rounded


to whole dollare

er v co t n me te St

period

INSTRUCTIONS

ON REVERSE

NAME OF FILER

through

de p

of

n
OD 9
following
codes accurate y describes th e paymen t you may enter the code
MBR

CODES
GAP
CtAS

If one of the

campa ign parephemetla mlea campaign eoneultents

Othervvlae describe the payment


PAD

membercommunicetlone

CfB CVC Fg
FND PD

eonhlbutlon explain nonmonatery dvic tlonetlona eanditlete ftlinglbaftot fees

MiG OF C
PET

meetings and eppearencea


offlee expenses

RFD
SAL

redlo alrtlme and productlon costa returned wnMbutlona

Nndrelsing

PFp
POL

events

E0 1 LfT

Independent expendtlure eupportlng othara ex p lain opposing legal defense campaign laereture and melOnpe

P08 PRO PRr

patltlon etrgdatlng phone banks polling and survey research pos t age d etlvary erM messenger eeMces profesefonel services legal aecountlng pdnt ads

TEL
TRC

TR6 T8F VOT VfEB

eampelgn warkere seladea v t or csDle aMime end produetlon costa candidate Vaval lodging end meals staglspouse revel lodging end meals transfer helween commllteea of the creme raplshatlon inkrmellon technology
voter

candidateleponsor

eoele

Internet e melq

NAME AND

gDORESa OF PAYEE
CODE OR

MAeae w prcowanmxAUrosure i

DESCRIPTION OF PAYMENT

AMOUMPAID

11

L Cf ul

Ci ti

Payments

that ere eoniributlona or

Independent expenditures

moat also be ummarized on 8ehedub D

UBTDTALti