HomeMy WebLinkAboutForm 460 Committee to Re-Elect Jerry Clay Sr 102308Recipient Committee
Campaign, Statement
Coven Page -
(Government Cotte Sections 84200-84216 5)
Type or print in ink.
Statement covers period'
from __-- 10/01/2008
-----..--
SEE INSTRUCTION&ON REVERSE
C
through __.___�10/18-12008
1 Type of Recipient Committee All Committees - Complete Parts 1 2,3, an6;4.
RJ Officeholder,,Candidate Controlled Committee
'L -Ballot Measure Committee
I j State Candidate Election Committee
PrimarilyFormed
") Recall
! ; Controlled
IArsoComplowPau 5)
(—) Sponsored,
(luso comple le Pall l:!
General Purpose Committee
`1 Sponsored
[ Prima0v Formed Candidate/
Small Contributor Committee
Officeholder Comrnittee
1)
�- -
PoliticatParty/Central.Corrlmlttee
(Alio C'r.)Plete Pan
3. Committee Information (.D NUMBER
_13089.14_
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMIT rEE)
Committee to Re -Elect .ferry Clay Sr
ate of election it applicable-,
(Month, Day Year.)
11/04/2008
R�'CrIVED
A18
CITY OF ATASCADi
CITY CLERK'S OFFI
2 Type of Statement:
C
Preelection Statement
J
Semi-annual Statement
(l
Termination Statement
F
Amendment (Explain oelowl
CALIFORNIA
2001102
FORM
For Official' Use Only
El Quarterly Statement
01 Special Odd -Year Report
[] Supplemental Preelection
Statement Attach Form 495
Treasurer(s)
NAME OF TREASURER .r.._.._..__.__._.._..._..— _`
h Angela Clay
MAILING7 ADDRESS
STREET ADDRESS' (NO PO BOX)
CITY STATE a ZIP CODE _AREA,_cODEIPHONE
MAILING ADDRESS (IF DIFFERENT) NO AND STREET OR R.O :BOX
CITY; y _
ZIP`CODE_ AREA
CITY' STATE ZIP CODE AREA CODEIPHONE
MAILING ADDRESS ~~ ~-
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL. FAX I E-MAIL ADDRESS OPTIONAL. FAX i E-MAIL ADDRESS
t
4 ` Verification _
J have used all reasonable diligence in, preparing and'.reviewing.this Statement and to the best of my knowledge the information rcontained 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 nd correct: , ��
10/21 Date /2008 y sG
Executed on / ~ Sign of Tr er r sistant Treaur
se
-. °' t
10/21/20081
gY
Executed on
Date Aign6yr t C6ntrollirK�0 icenold 4 CandiaaTeState Measure f° pone or Respaisible Offi� _r of Sponsor
Executed on
'Date,
By
y
Executed on By c,
Form FPPC F 460 (June/01)
Date Signature ofControAirgOflicsnolrler C.arv�rdale„tateMeaaureP;uuorwr
FPPC Toll -Free Helpline* 866/'ASK-FPPC
State of'California ,T
Recipient, Committee
Campaign, Statement
Cover Page -- Part 2
Type or print in ink.
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
RESIOENTIAL!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 ILD NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
jrf YES [� NO
COMMITTEE ADDRESS STREETAODRESS ;NOPU BOX)
CITY STATE ^ ZIP UDE AREA CODE!PHONE
COMMITTEE NAME 1'I,D NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
L7 YES NO
COMMITTEE ADDRESS
CITY
STREETAODRESS (NOPO
STATE Zip CODE
AREA CODE!PHONE
6 Ballot Measure Committee
NAME OF BALLOT MEASURE.
COVER PAGE PART2,
'Page __ Z. _— of
BALLOT NO .OR LETTER JURISDICTION T C] SUPPORT
[] OPPOSE
Identify the controlling officeholder candidate or state measure proponent, if arty
NAME OF OFFICEHOLDER CANDIDATE. OR PROPONENT
OFFICE SOUGHT OR HELD
DISTRICT NO. IF ANY
7 Primarily Formed 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
C) SUPPORT
[] OPPOSE
NAPAE. OF OFFICEHOLDER OR CANOIOATF_
OFFtCF SOUGHT OR HELD
[] SUPPORT
[:j OPPOSE
NAAAE OF OFFICEHOLDER UR CANDIDATE `^
t FFICF
SOUc;HT OR HELD
E]SUPPORT
I
LJ OPPOSE
NAME OF uFFICEHOi.DER OR CANDIDATE;
OFFICE SOUGHT OR HELD
❑SUPPORT
OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 1June1011
FPPC Toll -Free Helpllne: 866/ASN-FPPC
_ State of California
Campaign Disclosure Statement
Sutnmar
y Mage
SEE: INSTRUCTIONS ON REVERSE"
NAME Of FILER
Committee to Re -Elect Jerry Clay Sr
Type or print in ink.
Amounts may be rounded
to whole dollars.
-- _---- __—_ -- _� SUMMARY PAGE
Statement Covers periodCALIFORNIA
60.:..�
from _- 10/01/2008 — ` t: /,
Through __... 10/18/2008-- Page �3..._-- of
.I..
,g Column Column B
Contributions Received 'r07A). THIS PERIOD CALENDAR YEAF
1 Monetary Contributions
2. Loans Received
3 SUBTOTAL CASH CONTRIBUTIONS
4 Nonri-lonetary Contributions
5 TOTAL CONTRIBUTIONS RECEIVED
Expenditures Made
6 Payments Made
7 Loans Made.
8 SUBTOTAL CASH PAYMENT'S
9 Accrued Expenses (Unpaid Bills)
10 Nonmonetary Adjustment
'1.1 TOTAL EXPENDITURES MADE
(FROMATTACHED SCHEDULES) TOTAL. TO BATF...
108300 u 783688
Schedule A, tine 3
Schedule a, Eine 3 __ 00 - ___15000.0
Lines 7 2 $
Htl1083 00 933688
il—---_----.—.._� � ..
Schedure C. Line 3 __..._00� - ^- 854 11`
Aud Lines 3 * 4 $ 108300 - �_-10190 99-
Schedule E, Line 4
$ _.
Schedule H, Line 3
Add cines 6 +- 7
$ ._._`___.
Scheoule F Line 3
_
Schedule C Line 3
_
ACIMLiaeS 8 *'9 * 70
$. ._
- 22262 $ 64 78 36
00 00
-
22262 $ i _ ~ -6478 36-
00 _00_
00 00
22262 $ -_` _ 64 78 36
Current Cash Statement
12 Beginning Cash Balance Previous Sunrrriary Page, Line 16
$ ._._`___.
1998 14
To calculate Column B add
3 Cash, Receipts Column A„ Line 3 above
_—___�
1083 00
amounts in Column A to the
w
00
00
corresponding amounts
14 Miscellaneous Increases_ to Cash t Schedule 1.-Line;4
from Column. B of your last
— _
15 Cash Payments Colurno A_UL?e 8 above
62
report. Sorne amounts in
•-
-" --_—_222
Column.A maybe negative
1.6 ENDING CASH BALANCE 400 Liras Q - 13 14: wren subtract .Pre rb
$ ______..__
2861 52
figures that should be
subtracted .from previous
if this is a termination statement, Line 16 must be zero.
period amounts )t this is
the first report tieing filed
'17 LOAN GUARANTEES RECEIVED Scnetrule e Pan• 2
$ __.
00
for this calendar year only
carry over the amounts
Cash Equivalents and, Outstanding Debts
from Lines < 7 and 9 (itally)
18 Cash Equivalents See instructions on reverse
$
i 9 Outstanding Debts Add tine Eine 9 in Column 8 above
$
I.D NUMBER.
1308914
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/ I through 6130 711 to Date
20 Contributions
Received $
21 Expenditures
Mstde $
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made
(if Subject to voluntary Expenditure Limit)
[late of Election Total to Date
(mm/dd/yy)
I --- ---�---- -- $ -_
"Since January •t 2001 Amounts in this section may be
differew from amounts reported in Column B
FPPC Form 460 (June/o1).
FPPC Toll -Free Helpline 866fASK-FPPC
I �
Schedule A,
Monetary Contributi®ns-Rciceived
SEEMSTRUC NONS ON REVERSE
NAME OF FILEiZ-- ----
Committee to Re -Elect Jerry Clay Sr
Type or prinN in -ink.
Amounts may be, rounded
to whole dollars
fUC.I_ NAME STREET ADDRESS AND 21P CODE OF CONTRIBUTOR I CONTRIBUTOR IF AN INDIVIDUAL. ENTER
DATE I !EET ADDRESS
ZILG Numeer. OCCUPATION AND EMPLOYER
RECEIVED COL1E R (IF SELF-EMPLOYED ENTER NAME
OF aUSINES5�
10115/2008 Donrr Clickard &NDL-jcoM Retirred
DOTH
(_j PTY
— [_; SCC
[]IND
10/16/2008 Tem Teton Feed & Grain ! COM,
s [] OTH
M -B
� PTY
! ❑SCC
j]IND
[_10TH
(-I PTY
SCC
[j COM
❑ OTH
I n PTY
❑ SCC
I DIND
i C] Com
i ❑ OTH
E] PTY
,LSCC
Schedule A Summary
1 Amount received this period - contributions of $100 onmore
(Include all Schedule A subtotals.)
2 Amount -"received this period- unitemized contributions of less than $1.00
3 Total rnonetary contributions received this period
�(Add'Lines 1 and 2 Enter here and on- theSummary Page Column A, Line 1 )
SUBTOTAL$
Statement covers period
from __.______ 10!01!2008_'
10/18/2008 4
through - ._.... - - Page __
AMOUNT
RECEIVED THIS
PERIOD
10000
100 01)
20000
$ __.._ ._.-----_ 20000-
$
88300
TOTAL S .___. 108300
--- I D NUMBER- ..._.__..._.._._
1308914
.®®
CUMULATIVE TO DATE PER ELECTION
CALENDAR YEAR TO DATE
(.JAN. r DEC 31) (IP REQUIRED)
10000
1000
r 'Contrik,utor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other
PTY - Political Party
SCC - Small Contributor Committee
FPPC'Form 460 (June/01)
FPPC Tol4ree Helpline 866/ASK-FPPC
f
Sarhedule:B -- Part 1
Loans Receiver!
SEL INS T RUCTIUNS ON REVERSE_
NAME OF FILER �- ____ _.._._..•-- -----
Committee to Re -Elect Jerry Clay Sr
FUL.i,, NAME. STREET ADDRESS AND ZIP CODE
OF LENDER
AIA1(TFE,ALSOEMEPIA.NUN13EPt
Jerr L ;Cla - Sr
W"
Type or print in ink.
Amounts may be rounded.
to whole dollars.
SCHEOUZE'8_, PART 1
Statement covers period
CALIFORNIA-
from
10/01 /2008 e •
-.- • -
RM
10/18/2008 5 ,
through _. Page -_ of
__..._. 1.D NUMBER i
1308914 E
IF AN INDIVIDUAL, ENTER (a) lb) I {cI (dl te) (t) (g)
OUTSTANDING STANDING AMDUNI" OUTSTANDIta('� INTEREST ORIGINAL I CUMULATIVE
OCCUPATION ANDEMPLOYER-AMOUNT PAID
$MANCE RECEIVEIJ THIS BALANCEAT
pF:>ELF EMPLr"IEO ENTEF' BEGINNING THIS OR FORGIVEN CLOSE_ OF THIS ' PAID THIS AINOUNTOF CONTRIBUTIONS
rIAMECiFEVS'NESSt P RI D THIS,PERIOO ��SZ 1 PERIOD I LOAN TO DATE
1 ER100
Retired (i
PAID CALENOAR YEAR
I 1500 00 0 _ s .150000 150000
(-] F{ M;1Vr:N I I ii hTE f
I
150000 00 ! 12/31/2008 7/18/2008 00
T(j INCL Q COM, `] OTH Lj PTY r] SCC I i Or.rE )Uf. -- DtiIEINCURRED
PAID I GAL.ENDM 1 40<
I
PEN',
I I
I ,I IND [:] COM 0 OTH ❑ PTY 0 SCC; l � j i r.•�;r r �r D�,TE INruizrten
('[il PAIp t.ALENDAR YEAR ,
1
FORGwr:N
1 .-- � � ._ .'— ' PER iLF.L710N "" ,e
I .
T] J IND I] L.OM CJ OTH (] PTY r] SCC 1 I oATF LUL: ; vATti INcuAREO
SUBTOTALS $ 00'$ 00 $ 150000 $ 00
Schedule B Summary IeW,, (e Lin
�}r11eC1uh: F. Lind SI
1 Loans received this period _._.. -__0-0 -
(Total Column (b) plus unitemized loans less than $100) Amounts forgiven or paid by
another party also must be
2 Loans paid orforgiven this period $ __ __ — OU
reported on Schedule A.
(Total Column (c) plus loans under $1.00 paid or forgiven.) If required.
(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 $u0
Enter the net here and on the Summary Page Column A Line 2 ""'°o-'"-'""- '
�t'ontrivLttor Codes —.---•.____._._�.-----•_-_
Nn--indivd6al COM Recipient Committee (other than PTY of SCC) OTH - Other PTY - Political Party SCC - Small Contributor Comr1litte
FPPC Form 460 (JUr1e/01)'
FPPC Toll -Free Helpline 866/ASK-FPPC`
4
Schedule C
Nonmonetary Contributions Received
SEE INSTPUU11CINS'ON REVERSE.
NArnE
FILE. F1
Committee to Re .Elect Jerry Clay Sr
DATE FULL NAME STREET ADDRESS AND
RECEIVED ZIP CODE OF CONTRIBUTOR
1 (IF COMMI rTEE, AISO ENTER I.D .NUMBER)
Type or print in ink.
Amounts may be rounded
to whole dollars,
-.... - --.._.._.....- -- ------ I SCHEDULE C Statement covers period 1
from .. 10!01 /2008 a '.�.
through 10/18/2008 6
- --...-—.._..... Page of A_
CONTRIBUTOR 1F AN INDIVIDUAL. ENTER
OCC UPATIONANDEMPIOYEr� DESCRtPlION OF
CODE * GOODS OR SERVICES
gFSEI.FEMPLOrEG ENTER
NAME OF SUSINESSI
(_IND
[_]CONI
Cj OTH
PTY
SCC
❑IND
❑CONI-
LJOTH
[7j PTY
[] SCC
!.,JCOM
!.:JOTH
1--.1 PTY
[] SC(,
[JIND`
.:]COM
;JC)TH.
q[] PTY'
Attach additional information on appiopr)atelly labeled continuation sheets
Schedule C Summary
Amount received this period — nonmonetary contributions of $100 or more
(Include all Schedule C subtotals )
2 ArTIOUntreceived this period — unitemized nonmonetary contributions of less than $100
3 Total nonmonetary contributions received this,penoq
(Add Lines 1,and 2 Enter here and on the. Summary Page Column A, Lines 4 and 10 j
I,D NUMBER— - -
1308914
AM11CtUNT CUMULATIVE TO r'ER ELEC'rtnN
FAIR MARKET 1 DATE TO DATE
VALUE ; CALENDAR YEAR
I (JAN 1 DEC 31) %IF REQUIRED)
I I
- -----------
ii
r ;
i
SUBTOTAL $
00
TOTAL _.. - 00
Contributor Codes
1 11 - Individual
CUM - Recipient Committee
(other than PTY or (CC)
OTH - Other
PTY - Political Party +
SCC - Small Contributor Committee
FPPC Form 460 (June/0,1)�
FPPC Toll -Free Helpline- 866/ASK-FPPC
ff SCHEDULEE
S>OedtJle- Type or print in ink.
Statement trovers period
�r�j
v p� Amouhts ;may be rounded
Ray menta Made to Whole dollars ,A e
tram _ ... 10/01/2008 0
......
i /0/1812008 7
oEL 1NSYRUUR01\15'ON'RF-VERSE:
_ -- -
- ..._. -•- - -- -
y-_through
Page of _.. _.
NAME OF`FltEF,_..__.____
i.11 NUMBER -----
Committee to Re -Elect Jerry Clay Sr
1308914
CODES If one of the following, codes accurately describes
the payment, you may enter the code._ Otherwise describe the payment.
CIVP
campaign paraphernalia/mise.
MBR
member communications
RAD
radio airtime and production costs
CNS`
campaign consultants
WG
meetings and appearances
RFD
returned contributions
CT6
contribution'=(explain nonmonetary)`
OFC
office expenses
SAL
campaign workers salaries
CVC
civic donations
PEf
petition circulating
JEL
t.v or cable airtime and production costs
FA:
candidate filing/ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POC
,polling and survey research
TRS
staffrspouse travel. lodging, and meals
IIVD
independent expenditure, supporting/opposing others texpfain)
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
7 LIT
campaign literature and mailings
PRT
=print ads
VVES
Information technology costs (internet, e-mail)
NAME AND ADDRESS OF' PAYEE
pF COMMITTEE, ALSO ENTER: LD NUMBF.60
Homa':Depot
Atascadero News.
t
CODE OR
CMP
PRT
DESCRIPTION OF PAYMENT
AMOUNTPAID
122.62
100.00
Payments that are contributions or independent' expenditures musCalso be ,summarized on Scnedule E) SUBTOTAL $ 22262
t -
Schedtfle E Surmtlaiy
1 Payments made this erlod'of $1 OO or more include alt Schedule E subtotals. 222.62
2 Unitemized:payments :made this period of under $100 $ _ ___.._._00
3 Total,interest paid this period on loans (Enter arnount from Schedule B Part 1 Column (e)) 00
222.62
4 Total payments,made`this period (Add Lines V 2 and 3 Enter here and on the Summary Page Column A, Line 6) TOTAL
FPPC Form 460 (June101)
FPPC Toll -Free Helpline 866/ASK-FPPC