Ca paign Statement Cover Page
Govemment Code Sections 84200 84218 5
Stateme from
rent
Committee
Type
oven
Ink
7o 7 eov period
Date of eleetlon If appllc Month Day Year
CC 2
S 33
Page c
e For Official Use Only y
SEE INSTRUCTIONS ON REVERSE
through
Z
2 Type of Statement
Us
1 Type of Recipient Committee All Committees Complete Parts 1 2 3 and 4
Officeholder Candidate Controlled Committee Primarily Formed Ballot Measure
Committee
Q State Candidate Election Committee
preelectlon e Statement
annual Semi Statement TenninaBon Statement
Quarterly Statement Special Odd Year Report Supplemental Preelection
Statement Attach Form 495
Q Recall
Also Compere Pena
O Controlled O Sponsored
Almcomperepsd5
C General Purpose Committee Q Sponsored Q Small Contributor Committee Q Political PartyCentral Committee
3 Committee Information
Also file a Form 410 Termination Amendment Explain below
Primarily Formed Candidate
Officeholder Committee
Arise Compete Part r
D NUMBEk
3DO
s Treasurer ri547r C
Z
t ri ZoSa
55 C kno d rri
STREET ADDRESS NO P BOX O
A C
FD12G
STATE ZIP CODE
26
9Z6a7d
E3L
5 ri i7
Cif
7z rl
NAME OF ASSISTANT TREASURER IF ANY
M
MAILING ADDRESS
CITY n
STATE
ZIP CODE
AREA CODE PHONE
CITY
STATE
ZIP CODE
AREA CODEPHONE
IS r P fit 50 C I l e e rl 20 L D j Cbtn
r
OPTIONAL FAX EMAIL ADDRESS
Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of under penalty ofperjury under the laws of the State ofCalifornia that the foregoing Is true and col
Executed on
the Information contained herein and In the attached schedules is true and complete I certify
Executed on lb Lo
Executed on
Executed on
Oats
rte
By
BY By
By
SIpnM
Sgnelure atControOinp OlhcelwMer Canddate Stale Measure Pmpomnt
FPPC Form 180 January105
State of California
FPPC TollFree Helplins 888 8881275 FPPC ASK 3772
C0aign
NAME OF FILER
Disclosure Statement
Summary Page
Amounts may be rounded
to whole dollars
Type
In Ink
Statement covers period
from
SEE INSTRUCTIONS ON R
through v
of
Contributions Received
1
2
Column A
THISPER100 TOT
Column B
CALENDARYEAA
TOTALTo DAIS
FROMATTACHED SCHEDULEe
Calendar Year Summary for Candidates Running in Both the State Primary and
General Elections
111 through 6 30
1 7 to Dale
Monetary Contributions
Loans Received
schedule A Line 3
schedule e Linea
Add Lines I 2
SUBTOTAL CASH CONTRIBUTIONS
20 Contributions
Received
4
5
Nonmonetary Contributions
TOTAL CONTRIBUTIONS RECEIVED
Schedule C Linea
Add Lines 3 4
qg
br S
21 Expenditures
Made
Expenditures Made
6
7 8
Expenditure Limit Summary for State
Candidates
Payments Made
Loans Made SUBTOTAL CASH PAYMENTS
schedule E Line 4
schedule H Linea
22 Cumulative Expenditures Made
Add Lines 6 7
IN 80tedto Voluntary ExpnEllure Llmlt Date of Election Total to Date
9 Accrued Expenses Unpaid Bills 10 Nonmonetary Adjustment
11 TOTAL EXPENDITURES MADE
schedule F Line 3
schedule C Line 3
Addunesa s lo
ddlyy mm
R
I
Current Cash Statement
12 Beginning Cash Balance
13 Cash Receipts
14 Miscellaneous Increases to Cash
PrevloussummaryPage Line 1s
Column A Line 3above schedule 1 Line 4 Column A Line a above Add Lines 12 13 14 then subtract Line 15
To calculate Column 8 add
amounts in Column A to the
corresponding amounts
15 Cash Payments
16 ENDING CASH BALANCE
DnC
Q
If this is a termination statement Line 16 must be zem
17 LOAN GUARANTEES RECEIVED
schedule s Part 2
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
Amounts in this section may be different from amounts reported in Column B
Cash Equivalents and Outstanding Debts
18 Cash Equivalents
19 Outstanding Debts
sea instmoaons on reverse
from Lines 2 7 and 9 if
any
Add Dne 2 Line sin Columneabove
FPPC Form 460 January
FPPC Toll Free Helpline 8661ASK FPPC 866 3772 276
SAP
NAME OF FILER
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
towwhhole Amo
Arint
In Ink
be
CHEOULE
statemalt o vero period
I
arsaea
from
through
LG 30
FULL NAME STREET ADDRESS AND LP CODE OF CONTRIBUTOR
IFCOMMr RALSOE MBER M O RI
NM 7
oT
DATE RECEIVED
CONTRIBUTOR CODE
IND
IF AN INDIVIDUAL ENTER OCCUPATION AND EMPLOYER
EUreR MFLOreo eFSFis NAA1E OFBUSMSS
RECEIVED THIS AMOUNT
PERIOD
CUMULATNETO DATE
CALENDAR YEAR
PER ELECTION TO DATE
JAN 1 DEC 31
IF REQUIRED
yyJJ
3 7O 0
ir 113
Lp r
on
scc COM OOTH
PTY
aa te s
1S 4
yQM L y 6 Z bna CD 4 I G
08CC
IND COM
OTH PTY
SCC IND
COM
OTH PTY
SCC
IND COM OTH
PTY
SCC SUBTOTAL
q 9S
Codes
Schedule A Summary
1 Amount received this period itemized monetary contributions Include all Schedule A subtotals
7
IND
Individual
COM OTH PTY
Recipient Committee
other than PTY or SCC
Other e business entity g Political Party
SCC Small Contrtbutw Committee
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
TOTAL S
FPPC Form 400 January 06
FPPC TollFree Helpllne 86S ASKFPPC 888 2763772
ule Ad
NAME OF FILER
Payments Made
SEE INSTRUCTIONS ON REVERSF
Type or Amounts may
prWk
SCHEDULEE
rounded
Statement covers period
e
of to whole dollars
from
through
r 20 S ct
IVER member communications
Page
D I NUMBER
of
936d
RAD
RFD
CODES If one of the following codes accurately describes the payment you may enter the code Otherwise describe the payment
CMP CNS CTB
CVC
campaign paraphemalialmisc campaign consultants contribution explain nonmonetary
civic donations
radio airtime and production costs
returned contributions
FL FND M LEG LIT
candidate filinglballot fees fundraising events independent expenditure supporting others explain opposing legal defense campaign literature and mailings
MTG OFC PET PHO POL S PO PRO FAT
meetings and appearances office expenses petition circulating phone banks polling and survey research postage delivery and messenger services professional services legal accounting print ads
SAL campaign workers salaries TEL l or cable airtime and production costs v TRC candidate travel lodging and meals TRS staffspouse travel lodging and meals TSF transfer between committees of the same candidatesponsor VOT voter registration WEB Information technology costs Internet amall
NAME AND ADDRESS OF PAYEE IF COMMnraa OEN a NUMeex D I
CODE
OR
DESCRIPTION OF PAYMENT
AMOUNT PAID
ct gz
V 3 m
Lf
Ll
7YIt7 vt YLQ
rc w n
J
92
z IJ I r k 6 W K 0
4 Doev
c
32P
74 11 f
1
o
Lt
SUBTOTALS
Payments that are contributions or Independent expenditures must also be summarized on Schedule D
Schedule E Summary
1 Itemized payments made this period Include all Schedule E subtotals 2 Unitemized payments made this period of under 100
4
p
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
FPPC Form 460 January 05 FPPC TollFree Helpllns 866IASKFPPC 8661276 3772
Sloule Sheet Continuation
E
Type or Amounts may be rounded
to whole dollars
pr6k
Payments Made
Page
of
D I NUMBER
CODES If one of the following codes accurately describes the payment you may enter the code Otherwise describe the payment
CNP CNS CTS
CVC
campaign paraphernalialmisc campaign consultants contribution explain nonmonetary
civic donations
MISR
member communications
RAID
RFD
radio airtime and production costs
returned contributions
FIL
FND W LEG LIT
candidate filing fees ballot
fundraising events Independent expenditure supporting opposing others explain legal defense campaign literature and mailings
NAME AND ADDRESS OF PAYEE IF COMMnTEE ALSO ENTER I NUMBER D
MTG OFC PET PHO POL POS PRO PRT
meetings and appearances office expenses petition circulating phone banks polling and survey research postage delivery and messenger services professional services legal accounting print ads
CODE
OR
SAL TEL
TRC TRS TSF VOT VBEB
campaign workers salaries v t or cable airtime and production costs
candidate travel lodging and meals staffspouse travel lodging and meals transfer between committees of the same candidate sponsor voter registration information technology costs Internet e mail
AMOUNTPAID
DESCRIPTION OF PAYMENT
32 C s a r eS fog l s
Payments that are contributions o ind e mustalso besummarized on Schedule D r itures d n xp
SUBTOTALS 32
FPPC Form 460 January 05 FPPC TollFree Helpllne 866 ASKFPPC 866 2764772
