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Home My WebLink AboutForm 460 Committee to Re-Elect Jerry Clay Sr 100608Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from 07/01/2008 Date of election if applicable: (Month, Day, Year) Date Stamp RECEIVED 4 2,008 COVER PAGE Page _!— of For Official Use Only 3. Committee Information I.D. NUMBER 1308914 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Re -Elect Jerry Clay Sr. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Treasurer(s) NAME OF TREASURER Angela Clay MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE 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 information 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 true and correct.1 1 .7 Executed on 10/06/2008 Date Executed on 10/6/2008 Date Executed on Date By By By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on BY Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 4611 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of California 09/30/2008 11/04/2008 CITY OF ATASCADER SEE INSTRUCTIONS ON REVERSE through CITY CLERK'S OFFICE 1. Type of Recipient Committee: All Committees – Complete Parts 1, 2, 3, and 4. 2. Type of Statement: ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd -Year Report Q Recall Q Controlled ❑ Termination Statement ❑ Supplemental Preelection (Also Complete Part 5) Q Sponsored (Also file a Form 410 Termination) Statement -Attach Form 495 ❑ General Purpose Committee (Also Complete Part 6) ❑ Amendment (Explain below) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1308914 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Re -Elect Jerry Clay Sr. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Treasurer(s) NAME OF TREASURER Angela Clay MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE 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 information 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 true and correct.1 1 .7 Executed on 10/06/2008 Date Executed on 10/6/2008 Date Executed on Date By By By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on BY Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 4611 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Jerry L. Clay Sr. OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Atascadero City Council Member RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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. COMMITTEE NAME I D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page � of I2 BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO, IF ANY 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 OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Campaign Disclosure Statement Type or print in ink. Schedule E, Line 4 $ SUMMARYPAGE Summa Pae g 8. SUBTOTAL CASH PAYMENTS .................................... Amounts may be rounded 9. Accrued Expenses (Unpaid Bills) ............................... Statement covers period 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ to whole dollars.CALIFORNIA 6255.74 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 from 07/01/2008 • - • Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 09/30/2008 /17 ! y SEE INSTRUCTIONS ON REVERSEthrough Page J _ of NAME OF FILER I.D. NUMBER Committee to Re -Elect Jerry Clay R, 1308914 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTODATE Running in Both the State Primary and 1. Monetary Contributions ........................................... Schedule A, cine 3 $ 6753.88 $ 6753.88 General Elections 2. Loans Received ...................................................... Schedule 8, Line 3 1500.00 1500.00 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 8253.88 $ 8253.88 20. Contributions 4. Nonmonetary Contributions .................................... Schedule C, Line 3 854.11 854.11 Received $ $ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 9107.99 $ 9107.99 Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 7. Loans Made............................................................. Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines s + s + 1 o $ 6255.74 $ .00 6255.74 $ .00 .00 6255.74 $ Current Cash Statement 12. Beginning Cash Balance ..............•........ Previous Summary Page, Line 16 $ .00 13. Cash Receipts ................................................... Column A, Line 3 above 8253.88 14. Miscellaneous Increases to Cash.... ........... ___ ...... Schedule 1, Line 4 .00 15. Cash Payments .................................................. Column A, Line 8 above 6255.74 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1998.14 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ .00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ .00 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 6255.74 .00 6255.74 .00 .00 6255.74 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" (lf Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) J�1 $ c j 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC; Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A Type or print in ink. SCHEDULE A Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period ' 4601 07/1)1/2008 from 09/30/2008 Y through Page of ` SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Committee to Re -Elect Jerry Clay SR. 1308914 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER NUMBER) CODE (IF SELF•EMPLOYED,ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ® IND Corliss Thomas []COM Retired 119.88 119.88 08/19/2008 ❑ OTH 7 PTY ❑ SCC ® IND Bonnie Wilkins ❑COM Self Employed 100.00 100.00 08/19/2008 70TH Wilkins Printing �■ ❑ PTY ❑ SCC ® IND Ted Jacobson ❑COM Self employed 100.00 100.00 08/19/2008 !�� 70TH California Merdian ❑ PTY Insurance ❑ SCC Wl IND Jerry McDaniel []COM SLO CO Sheriffs Dept 225.00 225.00 08/19/2008 �� 7OTH ❑ PTY 7 SCC IND ®❑COM Madalyn McDaniel NONE 125.00 125.00 08/19/2008 �� 7OTH ❑ PTY ❑ SCC SUBTOTAL$ 669.88 Schedule A Summary 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.) ...... .........I .............. $ ........................ $ .,...... .. TOTAL $ 3566.88 3187.00 6753.88 *Contributor Codes 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Tvoe or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 07/01/2008 FORM from 09/30/2008 i v through Page of I.D. NUMBER NAME OF FILER Committee to Re -Elect Jerry Clay I= 1308914 FULL NAME, , STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) IF REQUIRED ( ) OF BUSINESS) John D. Nelson ®IND ❑COM Self Employed 100.00 100.00 08/19/2008 �� ❑0TH Glen's Repair ❑ PTY ❑ SCC Cody Ferguson IND ICOM Retired 100.00 100.00 08/19/2008 M ❑OTH — ❑ PTY ❑ SCC Margaret Vandergon ®IND E-] COM Retired 150.00 150.00 08/19/2008 ❑0TH ❑ PTY ❑ SCC ❑IND Dos Nabos LLC ❑COM 1100.00 100.00 09/01/2008 ®OTH ❑ PTY ❑ SCC Don Idler ®IND ❑COM Self Employed 500.00 500.00 09/01/2008 ❑OTH Idlers Appliance ❑ PTY ❑ SCC SUBTOTAL$ 950.00 *Contributor Codes 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Tvoe or orint in ink. SCHEDULE (CONT) Monetary Contributions Received Amounts may be rounded to dollars. Statement covers period CALIFORNIA ' whole 07/01/2008 FORM • from Page k of through 09/30/2008 NAME OF FILER I.D. NUMBER Committee to Re -Elect Jerry Clay 3 Q- 1308914 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Vicky Morse ❑COM Retired 100.00 100.00 09/10/2008 70TH ❑ PTY ❑ SCC William Jack ®IND Retired 250.00 250.00 09/10/2008 ❑0TH 7 PTY ❑ SCC Sand Silveria y ®IND ❑COM Retired 100.00 100.00 09/10/2008 ❑ OTH ❑ PTY ❑ SCC Gar Smith y00 ®IND ocom00 Retired 09/10/2008 ❑ OTH l(1� ❑ PTY 7 SCC Mary Roberts OCOM IND Teacher/AUSD 100.00 100.00 09/10/2008 70TH ❑ PTY ❑ SCC SUBTOTAL $ 650.00 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) 0TH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULEA (CONT.) Moneta %oon'Er uilons Kecelvea Amounts may be rounded Statement covers period to whole dollars. CALIFORNIA 46 from 07/01/2008 FORM Page �_ of through 09/30/2008 NAME OF FILER I.D. NUMBER Committee to Re -Elect Jerry Clay SR 1308914 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Diana Bacon IND �CoM Teacher/AVSD 09/10/2008 ❑ OTH 100.00 100.00 ❑ PTY ❑ SCC L De Knight �CoM IND Retired ' 09/10/2008 100.00 100.00 ❑OTH ❑ PTY ❑ SCC 09/10/2008 Elizabeth Wingett ICOM IND Retired [_1 OTH 250.00 250.00 ❑ PTY ❑ SCC Cheryl Burbach ®IND El COM Retired 09/10/2008 � ❑ OTH 200.00 200.00 ❑ PTY ❑ SCC 09/10/2008 Jamie Kirk ®IND ❑COM Self employed 0OTH Kirk Consulting g 249.00 249.00 PTY ❑ SCC SUBTOTAL $ 899. "Contributor Codes 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 (January/05) FPPC Toll -Free Heipiine: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULEA (CONT) monetary ContriautionS Keceivea Amounts may be rounded Statement covers period to whole dollars. - ' from 07/01/2008 - • page of I through 09/30/2008 NAME OF FILER I.D. NUMBER Committee to Re -Elect Jerry Clay SR 1308914 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) OIND Douglas Baird ICOM Retired 09/22/2008 �� ❑ OTH 100.00 100.00 ❑ PTY ❑ SCC David Low ®IND Self Employed 09/22/2008 ooTH Landlords 100.00 100.00 ❑ PTY ❑ SCC Michael Fredricks IND ®❑COM Self Employed 09/30/2008 f_1 OTH Michael Fredricks Paving 198.00 198.00 ❑ PTY ❑ SCC ❑IND _ ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 398.0() *Contributor Codes 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) SCHEDULE B - PART 1 Schedule B —Part 1 type or Pnnc 111 1111%. Amounts may be rounded i Statement covers period CALIFORNIA Loans Received to whole dollars. 07/01/2008 •t from 09/30/2008 page through g of SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER Committee to Re -Elect Jerry Clay 1308914 a (b) (c) (d) (e) ( FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE AMOUNT AMOUNTPAIO OUTSTANDING gALANCEAT INTEREST PAID THIS ORIGINAL AMOUNT OF UL CUMULATIVE CONTRIBUTIONS OF LENDER NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN CLOSE OF THIS PERIOD LOAN TO DATE (IFCOMMITTEE, ALSO ENTER I.D. NAMEOFBUSID,EN ERI THIS PERIOD" PE IOD ❑ PAID CALENDAR YEAR Jew .Clay Sr. Retired $ $ 1500.00 0 1500.00 $ 1500.00 , $ ❑ FORGIVEN PER ELECTION - RATE 0 $ 1500.00 $ 12/31/200 $ 0 7/18/200 $ 0 DATE DUE DATE INCURRED f [o IND ❑ COM ❑ OTH [I PTY F-1 SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION ** RATE DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION"" RATE DATE DUE DATE INCURRED #❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 1500.00$ 0.00 $ 1500.00 $ 0.00 (Enter (e) on Schedule B Summary Schedule E, Line 3) 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.) .................. Enter the net here and on the Summary Page, Column A, Line 2. 1500.00 NET $ 1500.00 (May be a negative number) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) 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. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule C Type or print in ink. Sr.HF=nI II F r Onmone ary Uontributions Received to whole dollars. Statement covers period from 07/01/2008 CALIFORNIA FORM 460 Page 0of SEE INSTRUCTIONS ON REVERSE 09/30/2008 throw gh NAME OF FILER I.D. NUMBER Committee to Re -Elect Jerry Clay SR 1308914 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I. D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME OF GOODS OR SERVICES VALUE CALENDAR YEAR TO DATE IF REQUIRED BUSINESS) (JAN 1 - DEC 31) 9/06/2008 McGee's Caterin ❑IND ❑COM appetizers �l &Z OTH 114.33 114.33 ❑ PTY ❑ SCC ❑IND 9/06/2008 Portola Event Planning ❑COM event planning, ®OTH tables, chairs, 5010.00 500.00 F-1 PTY decorations and ❑SCC entertainment 9/06/2008 Brent Win ett g ®IND ❑COM Appetizers, wine, NE "M ❑OTH soft drinks 109.78 109.78 ❑ PTY ❑Scc ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 724.11 Schedule C Summery 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.).............................................................................................. 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ............. 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ............ 724.11 130.00 854.11 r "Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY—Political Party SCC — Small Contributor Committee J FPPC Foran 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E Type or print in ink. Statement covers period Amounts may be rounded Payments Made to whole dollars. from 07/01/2008 SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Re -Elect Jerry Clay _S'e. through 09/30/2008 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment Page i I of py I.D. NUMBER 1308914 CNP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC 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 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 (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads 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 City of Atascadero �-� FIL 250.00 Al Signs CMP 2702.71 Wilkins Printing LIT 478.76 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3431.47 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. .................. $ 6135.47 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 120.27 3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e).) $ 0.00 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 6255.74 FPPC Form 460 (January/05) FPPC: Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E (Continuation Sheet) Payments Made SEE REVERSE ME OF FILER Committee to Re -Elect Jerry Clay S'j' Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 07/01/2008 through 09/30/2008 SCHEDULE E (CONT) Page 11 of I.D. NUMBER 1308914 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned Contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC 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 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 (legal, accounting) VOT voter registration I IT ramnainn IitPrature and mailinas PRT print ads 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 California Voter Guide LIT 1600.00 Atascadero News PRT 1104.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2704.00 FPPC Form 460 (January/05) FPPC, Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)