HomeMy WebLinkAboutForm 460 Committee to Elect Roberta Fonzi 123109ecipient Committee
Campaign Statement
Cover Page
Government Code Sections 84200-84216.5)
Type or print in ink.
Statement covers period
from -7 / 09'
SEE INSTRUCTIONS ON REVERSE I through / 2 — 3 / _ Og
1 Type of Recipient Committee' All Committees — Complete Parts 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
Q Recall Q Controlled
Also Complete Part 5) Q Sponsored
General Purpose Committee (
Also complete Part 6)
Q Sponsored Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
Q Political Party/Central Committee (Also Complete Part /)
3. Committee Information 1.0 NUMBER
3O rS/az-
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
1 40'
CT
JAN 2 6 2010
Date of election if applicable:
Month, Day, Year)
CITY OF ATASCADER
CITY CLERK'S OFFICE
2. Type of Statement:
Preelection Statement
Semi-annual Statement
Termination Statement
Also file a Form 410 Termination)
Amendment (Explain below)
CITY STATE ZIP CODE
MAILING ADDRESS (IF
lel-
11
CITY
F
STATE ZIP CODE AREA CODE/PHONE
V
COVER PAGE
Page -1— of _.L
For Official Use Only
Quarterly Statement
Special Odd -Year Report
Supplemental Preelection
Statement Attach Form 495
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. ^
Executed on / ^ y
By
Date Signatur TTreesurer stan'Treasurer
Executed on g 3 L By Al 1
Date Sidnature of Contro ma d olid.(.. St asur Hent or Resoonside Officer ofSoonsor
Executed on
Date
Executed on
Date
By .-
Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
State of California
Treasurer(s)
NAME OF TREASURER
Yr9 7
MAILING ADDRESS
CITY STATE ZIP CODE
NAME OF ASSSIIISSTANT TREASURER, IF ANY
M
CITY
i'l SCJ
STTAATE ZIP C O[DE2
OPTIONAL. FAX / E-MAIL ADDRESS
AJA
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. ^
Executed on / ^ y
By
Date Signatur TTreesurer stan'Treasurer
Executed on g 3 L By Al 1
Date Sidnature of Contro ma d olid.(.. St asur Hent or Resoonside Officer ofSoonsor
Executed on
Date
Executed on
Date
By .-
Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
State of California
ype or print in ink.
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
31::)e " T
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
CITY STATE ZIP
efA
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 STREET ADDRESS (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 STREET ADDRESS (NO P.O. BOX)
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
COVERPAGE PART2
Page Z of
BALLOT NO. OR
LETTERI
JURISDICTION
I 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
officehofder(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
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460 (January/06)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)
State of California
Campaign disclosure Statement Type or print in ink.
Amounts may be roundedSummaryPagetowholedollars.
SEE INSTRUCTIONS ON REVERSE
rvr mc ter, rat
Contributions Received
1 Monetary Contributions 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
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 Bilis) Schedule F Line 3
10 Nonmonetary Adjustment Schedule C, Line 3
11 TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10
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 1, 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.
17 LOAN GUARANTEES RECEIVED
Column A
TOTALTHIS PERIOD.
FROM ATTACHED SCHEDULES)
Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents See instructions on reverse $
ff
19 Outstanding Debts Add Line 2 + Line 9 in Column B above $ Z C • 9(
SUMMARY PAGE
Statement covers period CALIFORNIA
i-/ oq . from }
through/ Page of
I.D. NUMBER
Column B
CALENDARYEAR
TOTALTO DATE
Z is,;' 9
ZZ O O
56
525
szs
01
J
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)
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received $ $
21 Expenditures
Made $ $
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
mm/dd/yy)
Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Januaryi05)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
SCHEDULER PART1
Schedule B — Part 1 Amounts may be rounded Statement covers period
1LoansReceivedtowholedollars. 7 ,_ / ._ 0from /
SEE INSTRUCTIONS ON REVERSE through Page of
NAME OF FILER
J `_
I.D. NUMBER
s'^
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
BALANCE
b)
AMOUNT
RECEIVED THIS
c)
AMOUNTPAID
OR FORGIVEN
d)
OUTSTANDING
gALANCEAT
e)
INTEREST
PAID THIS
r)
ORIGINAL
AMOUNT OF
g)
CUMULATIVE
CONTRIBUTIONS
IFCOMMITTEE,ALSOENTERI.D.NUMBER)
OF SELF-EMPLOYED, ENTER
NAMEOFBUSINESS)
BEGINNING THIS
D PERIOD THIS PERIOD"
CLOSE OF TPERIODHIS
PERIOD LOAN TO DATE
r, " PAID CALENDAR EARw,Ju
E E •
RATE
E E
d
M
FORGIVEN
1® '
PER ELECTION"
E E E E
DATE DUEKIND COM OTH PTY SCC DATE INCURRED
PAID CALENDARYEAR
FORGIVEN PER ELECTION"*
RATE
t IND COM OTH PTY SCC
E E E S E
DATEDUE DATE INCURRED
PAID CALENDARYEAR
FORGIVEN PERELECTION—
RATE
t IND COM OTH PTY SCC
E E E s s
DATE DUE DATE INCURRED
SUBTOTALS $ $ $ Z/ -S"/ `"/ $ 5
Schedule B 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 )
Enter the net here and on the Summary Page, Column A, Line 2.
Amounts forgiven or paid by another party also must be reported on Schedule A.
If required.
1(2
NET $
May be a negative number)
tnier (e) on
Schedule E, Line 3)
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
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)