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Home My WebLink AboutForm 460 Committee to ReElect Jerry ClayRecipient Committee Campaign Statement Cover Page (t3—arnmant Coda Sections 84200-84216 5) COMMITTEE NAME (OR CANOIOAT E'S NAME IF NO COMMITTEE) Committee to Re -Elect Jerry Clay Sr STREET ADORE 55 (NO PO BC CITY STATE Statement covers period Atascadero GA 1/1/2009 MAILING AnnRESS (IF DIFFERENT) NO ANO STREET OR PO BOX from 6/30/2009 SEE INSTRUCTIONS ON REVERSE ZIP CODE AREA CODE/PHONE through 1 Type of Recipient Committee All committees - Complatc Parts 2, 3, ane 4. ® Officeholder Candidate Con[rolied Committee [] Primarily Formed Ballot Measure Q State Candidate Election G—mittae Committee Q Racail Q Controlled (Al— Cump/ata PaT SJ Q SpOnSOr@d !/+/so com/,/era Pan SJ 0 General Purpose Committee Q Sponsored Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Oommittae Q Political Party/Central Committee (A/so c�...P/aee Pan v/ 3 Committee Information O NVMF3ER 13089'14 COMMITTEE NAME (OR CANOIOAT E'S NAME IF NO COMMITTEE) Committee to Re -Elect Jerry Clay Sr STREET ADORE 55 (NO PO BC CITY STATE ZIP CODE AREA CODE/PHONE Atascadero GA 93422 MAILING AnnRESS (IF DIFFERENT) NO ANO STREET OR PO BOX CITV STATE ZIP CODE AREA CODE/PHONE k. R E (!�r=�fPE Ol J U L 1 3 2010 I]aYe of election if applicable: (Month, Oay Year) OF ATAS CA�ERO ' CLERK'S OFFICE COVER PAGE Page � of For Official Usa Only 2. Type of Statement: F --j Preelection Statement Quarterly Statement ® Semi-annual Statement 0 Spacial Odd -Year Ra port Q Termination Statement E=j Supplemental Preelection (Also file a Form 41 O Termination) Statement Attach Form 495 ® Amendment (Explain below) Believed committee had been terminated as of the 12/31/08 460 filing, however, form 410 had not been filed i!i �f3�/G7 -% Treasure r(s) NAME OF TREASURER N/A MAILING ADDRESS CITY STATE 21P CODE AREA COpE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING An ORE55 CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL FAX / E-MAIL AOO RESS 4 Verification 1 have usad all reasonable diligence in preparing and reviewing this statement and to the bast of my knowledge tha information contained herein and in the attached schedules is true and complete 1 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. a Executed on 7/13/10 Dare or Tre .. �stant Trees 7/13/10 re rar Executed nn Uam Ry �gna[ura of Co ng oltlar Cantli eaStata u assure Proponent or R sponsibla OTi�r o} Sponsor EXa Cufed on Gate ay Signature o(Con[rdling Icanolduv Candidata. States Measure Pmponant Executed on nate Ry Signature o! Controlling Offcaholdar Cantlitlata, State Maasura Pmponant FPPC Form 460 (January/O5) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-37 2) State of Califo rnla Type or print in ink. COVER PAGE PART2 Recipient Committee Campaign Statement• ' , � � Cover Page — Part 2 O 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 7285 Sycamore Road Atascadero CA 9342 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 vour candidacv COMMITTEE NAME NAME OF TREASURER I.D. NUMBER ❑ YES [] NO COMMITTEE ADDRESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME LD NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO Page 2 of 3 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO OR LETTERI JURISDICTION F-1SUPPORT ❑ 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. COMMITTEE ADDRESS STREETADDRESS (NOPO BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary 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 0 OPPOSE 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. SUMMARY PAGE Statement covers period CALIFORNIASummary • ' Amounts may be rounded Page to whole dollars 1/1/2009 FORM from Page 3 of 3 through 6/30/2009 SEE INSTRUCTIONS ON REVERSE NAME OF FILER LD NUMBER Committee to Re -Elect Jerry Clay Sr 1308914 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDAR YEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTALTODATE General Elections 1 Monetary Contributions Schedule A, Line 3 $ $ 1l1 through 6/30 711 to Date 2. Loans Received Schedule B, Line 3 20 Contributions 3 SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2 $ $ Received $ $ 4 Nonmonetary Contributions Schedule C, Line 3 21 Expenditures 5 TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 + 4 $ $ 0 Made $ $ Expenditures Made Expenditure Limit Summary for State 6 Payments Made Schedule E, Line 4 $ $ Candidates 7 Loans Made Schedule H, Line 3 22. Cumulative Expenditures Made* 8 SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ $ (If Subject to Voluntary Expenditure Limit) 9 Accrued Expenses (Unpaid Bills) Schedule F Line 3 Date of Election Total to Date (mm/dd/yy) 10 Nonmonetary Adjustment Schedule C, Line 3 11 TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10 $ $ 0 $ �/ $ Current Cash Statement 12 Beginning Cash Balance Previous Summary Page, Line 16 $ To calculate Column B add 13 Cash Receipts Column A, Line 3 above amounts in Column A to the corresponding amounts Amounts in this section may be different from amounts 14 Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B of your last reported in Column B report. Some amounts in 15 Cash Payments Column A, Line 8 above Column A may be negative 16 ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 0 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17 LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ for this calendar year only carry over the amounts any) Lines 2, 7 and 9 (if. Cash Equivalents and Outstanding Debts 18 Cash Equivalents See instructions on reverse $ 19 Outstanding Debts Add Line 2 + Line 9 in Column B above $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)