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Home My WebLink AboutForm 460 Committee to ReElect Jerry ClayRecipient Committee Campaign Statement Cover Page (Government Coda Sections 84200-84216 5) Type or print in in Statement covers p¢ iod from 7/1/2009 SEE INSTRUCTIONS ON REVERSE thrOU gh C/TY STATE ZIP CODE AREA GOOE/PHONE Ata scadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. ANO STREET OR PO BOX CITY 12131/2009 ZIP CODE AREA COO E/PHONE 1 Type of Recipient Committee Au commin¢¢s - com Pl¢[¢ Parts z, a, ane a. ® Offi —holder Candidate Controlled Committee Q Primarily Formed Ballot Measure Q Slate Candidate Election Committee Committee Q Recall Q Controlled (A/so Comp/a[a Part SJ Q SpOnSOrad (H/so Comp/e(a Part 6J Q General Purpose Committee Q Spo nsorad 0 Primarily Formed Candidate/ Q Small Contributor Committee Offices M1oldar Committee Q Political Party/Central Committee (A/so comp/era Pan v/ 3 Committee Information -O 1308914 NUMBER COMMITTEE NAME (OR CANOIOAT E'S NAME IF NO COMMITTEE) Committee to Re -Elect Jerry Clay Sr STREET ADORE SS (NO P O BOX) C/TY STATE ZIP CODE AREA GOOE/PHONE Ata scadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. ANO STREET OR PO BOX CITY STATE ZIP CODE AREA COO E/PHONE OPTIONAL: FAX / E-MAIL AOO RE 55 COVER PAGE nate of election if applicable J U L 1 z, 2010 Page of (Mont M1, may Year) For Official Use Only ITY OF ^TAS CACER CITV CLERK'S QFFICE 2 Type of Statement= 0 Preelection Statement Q Quarterly Statement LZI Semi-annual Statement 0 Special Odd -Year Report rI Termination Statement Q Supplemental Preelection <Also file a Form 410 Termination) Statamant Atta— Form 495 ® Amendment (Explain below) Believed committee had been terminated as of the 12/31/08 460 filing, however, form 41 O had not been filed. Trees u rar(s) NAME OF TREASVRER N/A MAILING AOOR ESS CITY STATE ZIP OOOE AREA CODE/PHONE NAME OF ASSISTANT TREASVRER. IF ANY MAILING Ap OR ESS CITY STATE ZIP COVE AREA COO E/PHONE OPTIONAL: FAX / E MAIL ADDRESS 4 Verification I haveused ail raa sonabla diliga nca in preparing and r wing this statement and to the best of my Knowledge Hie information contained herein and in the atta—ad 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 d Ex¢ct,t¢d on 7/13/1 O By YLzj T Cf �- 1 Dees or T.a ..res. or As .aaa...a. 7/1 3/1 O By Data /` .......... or co ..,y Dies. can aHstata aas...a ropo..a., or asposmla oni�ar oe sp.,so. E:¢c.aad on Data y s�y..aa.ra or co..o-ali,.g om��anolaa. wae�eata. sta.a Maas.,.a Pmpone.n --t— on Data Ry SgnaWra or contmllYng omoanolea. canGldata. state Maaau.a Ptoponena FPPC Form 460 (January/) FPPC Toll -Fr¢¢ H¢I p11n ¢: 866/ASK-FPPC (866/275-377722) 5[a[¢ oT California 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 Type or print in ink. COVER PAGE PART -2 CALIFORNIA FORM 11 •1 FP 2 of 3 6 Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO OR LETTERI JURISDICTION I ❑ SUPPORT ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Identify the controlling officeholder candidate, or state measure proponent, if any Atascadero CA 9342 NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 OFFICE SOUGHT OR HELD DISTRICT NO IF ANY contributions or make expenditures on behalf of your candidacy COMMITTEENAME I.D NUMBER CONTROLLED COMMITTEE? 7 Primarily Formed Candidate/Officeholder Committee List names of NAME OF TREASURER officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO PO BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT F-] OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME ILD NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ F]YES NO COMM ITTEEADDRESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California 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. Amounts may be rounded Summary Page to Whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Re -Elect Jerry Clay Sr Contributions Received 1 Monetary Contributions 2 Loans Received 3 SUBTOTAL CASH CONTRIBUTIONS 4 Nonmonetary Contributions 5 TOTAL CONTRIBUTIONS RECEIVED Expenditures Made 6 Payments Made 7 Loans Made 8 SUBTOTAL CASH PAYMENTS 9 Accrued Expenses (Unpaid Bills) 10 Nonmonetary Adjustment 11 TOTAL EXPENDITURES MADE SUMMARY PAGE Statement covers period CALIFORNIA from 7/1/2009 FORM through 12/31/2009 Page 3 of 3 LD NUMBER 1308914 Column B Calendar Year Summary for Candidates CALENDARYEAR TOTALTO DATE g Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20 Contributions Received $ $ 21 Expenditures 0 Made $ $ Schedule E, Line 4 $ $ Schedule H, Line 3 Add Lines 6 + 7 $ $ Schedule F, Line 3 Schedule C, Line 3 Add Lines 8 + 9 + 10 $ $ 0 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 Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ 19 Outstanding Debts Add Line 2 + Line 9 in Column B above $ 0 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* (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 IFPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) Schedule A, Line 3 $ $ Schedule B, Line 3 Add Lines 1 + 2 $ $ Schedule C, Line 3 Add Lines 3 + 4 $ $ SUMMARY PAGE Statement covers period CALIFORNIA from 7/1/2009 FORM through 12/31/2009 Page 3 of 3 LD NUMBER 1308914 Column B Calendar Year Summary for Candidates CALENDARYEAR TOTALTO DATE g Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20 Contributions Received $ $ 21 Expenditures 0 Made $ $ Schedule E, Line 4 $ $ Schedule H, Line 3 Add Lines 6 + 7 $ $ Schedule F, Line 3 Schedule C, Line 3 Add Lines 8 + 9 + 10 $ $ 0 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 Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ 19 Outstanding Debts Add Line 2 + Line 9 in Column B above $ 0 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* (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 IFPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)