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HomeMy WebLinkAboutForm 460 Comm to Elect Tom OMalley CC 123112 °ecipient Committee COVER PAGE Campaign Statement Typo or print in ink, Date Stomp CALIFORNIA Aso Cover Page R E C E I i FORM 'T (Government Code Sections 84200-84216.5) Statement l�ennt covers period Date of election if applicable: JAN Page of from \ 0 / / \42— (Month, Day, Year) t �U f n7 a For Official Use Only SEE INSTRUCTIONS ON REVERSE through \(1—/ '3 \/1 t r cm,OF Al A C,c,p`RO CITY rl ri ;-;-c-ir'- .- 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 Q Recall 0 Controlled Termination Statement ❑ Special Odd-Year Report (Also Complete Part 5) ❑ 0 Sponsored (Also file a Form 410 Termination) [1]le Preelection (Also Complete Part 6) Statement-Attach Form 495 ❑ General Purpose Committee ❑ Amendment (Explain below) ,Q Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 1 Committee Information I.D. NUMBER 0��,.s.-1 Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER C-o\,,`v\‘--\4.0...0 -7 �\s1 ct u C NA ck . y ( C.` cs \ 0) \\\\ 0. �,), 'w\t<v\ MAILING ADDRESS n —. '\ % C,A-- r; j\,\(_ STREET ADDRESS (NQ P.O, BOX) n CI Y� STATE P CODE ^°fONnNE CIT �� CC` k � � `rti1 STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MF>)U4JG ADpESS (IF C'OFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS sunk 'IF CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX I 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 th tate of California that the foregoing is true and correct �f (� ?! Executed on B Date By ^ `.� / _ 111 01 \I.net -of Treasurer or Assistant Treasurer Executed on (JstXJ`/ By r -,•101;. Date Signe :. ontrolling Officehold:,Candid,le,State Measure Proponent or Responsible Officer of Sponsor Executed on By Dale Signature of Controlling Officeholder,Candidate,State Measure Proponent Executed on By Date 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 Type or print In Ink. COVER PAGE-PART 2 • Recipient Committee Campaign Statement CALIFORNIA 460 Cover Page— Part 2 FORM Page of 5 5. Officeholder or Candidate Controlled Committee 6, Primarily Formed Ballot Measure Committee NAME.OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR EL' CLUDE LOCATION AND DISTRICT NUMBE IF APPLICABLE) BALLOT NO,OR LETTER JURISDICTION C--0 \4Q � ❑ SUPPORT \\ 'N "'L <' \\CO Y J SCQ`�cA] ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, if any. 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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ' ❑OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑OPPOSE COMMITTEE NAME I.D. NUMBER • NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑OPPOSE NAME OF TREASURER r CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT q YES ❑ NO ❑OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.D.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(January/05) FPPC Toll-Free Helpiine:866/ASK-FPPC(866/275-3772) State of California Type or print In Ink. Statement covers period Campaign Disclosure Statement , . yP p SUMMARY PAGE Amounts may be rounded Summary Page P CALIFORNIA ry g to whole dollars, 'O !n / '� FORM 460 from V-2--131 r 3 SEE INSTRl1CTIONS oN i �v SSE' through /I Page of NAME Of FILER I.D.NUMBER k - \11 ),q _ ContrPUUtions Received Column Column B Calendar Year Summary for Candidates ved TOTAL THIS PERIOD 'CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions Schedule A,Line 3 $ l 0300 $ p 2. Loans Received Schedule B,Line 3 '"1 t 131'02 — 1, '1 " 1i1 through 6/30 7/1 to Date ° 3, SUBTOTAL CASH CONTRIBUTIONS Add Lines i+2 $ ..__ "I� $ 3c k 20. Contributions Received $ $ 4, Nonmonetary Contributions Schedule C,Line 3 95 Of 0 21, Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ' Add Lines 3+4 $ �' 11/41:4-Q-$ 30 -- Made $ $ Expenditures Made 1 2Expenditure Limit Summary for State 6. Payments Made Schedule E,Line 4 $ $ J Candidates 7. Loans Made schedule H.Line 3 .i c2( $ '(1'' 22. Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ (If Subject to Voluntary Expenditure Llmlt) 9. Accrued Expenses (Unpaid Bills) Schedule F,Line 3 a 0- Date of Election Total to Date 10. Nonmonetary Adjustment Schedule C,Line 3 sa 0 (mmtdd/yy) 11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ PC $ \1 0 , / $ Current Cash Statement ` ___l_J $ 12.Beginning Cash Balance Previous Summary Page,Line 18 $ i To calculate Column B,add ' 13, Cash Receipts Column A,Line 3 above 1 I amounts In Column A td the d corresponding amounts 'Amounts In this section may be different from amounts 14, Miscellaneous Increases to Cash Schedule 1,Line 4 r from Column B of your last reported In Column B. 15, Cash Payments Column A,Line 8 above report. Some amounts In Column A may be negative 16, ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $ 3 t^7 f - figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts, If this Is fi the first report being filed 17.LOAN GUARANTEES RECEIVED Schedule B,Part 2 $ Y for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2,7,ands(if any). 18. Cash Equivalents See Instructions on reverse $ 19. Outstanding Debts Add Line 2+Line 9 in Column B above $ cei 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 Statement covers period CALIFORNIA to whole dollars. J from `©L r2 I' ` -- 460 SEE INSTRUCTIONS ON REVERSE through `,�l- ‘( t ^� Page of NAME OF FILER I.D. NUMBER DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IFCOMMIT7EE,ALSOENTERLD•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) --cOrAL) cA\ (-7=-0 ` ,IND /2-()/11-' NS1.61,b t , S(E ,\5o OTH 1) 000 k, 000 Sc-C w� RY\-\ CVN C\ PTY _04. 1336$`i-7 OIND • ❑COM ❑OTH PTY ❑SCC I ❑IND I DOOM ❑0TH ❑PTY ❑SCC ❑IND OCOM 0 OTH (DPW ❑SCC ❑IND DOOM 00TH ❑PTY ❑SCC SUBTOTAL$ \ 10°C-3 Schedule A Summary "Contributor Codes 1. Amount received this period-itemized monetary contributions. IND-Individual (Include all Schedule A subtotals.) 1 CC COM-Recipient Committee 2. Amount received this period-unitemized monetary contributions of less than$100 0 (other than PTY or SCC) $ OTH-Other(e•g., business entity) 3. Total monetary contributions received this period. PTY-Political Party SCC—Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ \ 000 FPPC Form 460(January/05) FPPC Toll-Free Helpllne:866/ASK-FPPC(866/275-3772) Type or print in ink, SCHgbuLE B•PART 1 Schedule B—Part '1 Amounts may be rounded Statement covers period CALIFORNIA Loans Received to whole dollars. `OI �7l `f^1 FORM ~ "VV- SEE G-_ SEE INSTRUCTIONS ON REVERSE through \(2-13k/r).--- Page 5 of 5 1 NAME OF FILER I.D. NUMBER FULL NAME,STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTS ANDING tbl (al OUTSTANDING e) ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER BALANCE AMOUNT AMOUNT PAID INTEREST. RECEIVED THIS BALANCE AT (IFCOMMITTEE,ALSOENTERID.NUMBER) (IF SELF-EMPLOYED, BEGINNING THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) - G 0* PERIOD THIS PERIOD` - C •1 PERIOD LOAN TO DATE ���� �`\1\N\ V PAID CALENDARY YEAR -N CCJ Jk,s v �`i 1, �h(y ❑FORGIVEN RATE PER ELECTION" e. IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ■ ❑PAID CALENDAR YEAR $ $ % $ $ FORGIVEN RATE PER _ CT.ON" $ $ $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑PAID CALENDAR YEAR $ $ % $ $ RATE ❑FORGIVEN PER ELECTION" $ $ $ t❑ IND ❑ COM :❑ OTH ❑ PTY ❑ SCC DATE DUE $ DATE INCURRED $ SUBTOTALS ,6-1`f 40 ( c ill tr�>t ;}*�n�'�f?rP!h�t�j 0747,f��l r h, �yl,vl $ $ $ \ g 1--) ) t51(� II t ,Sx�11i� L�'�6.i I�fI1�5��J 4� d 1iU�,,y I� (Enter(e)on Schedule B Summary Schedule E,Line 3)„ne 1. Loans received this period $ (Total Column(b)plus unitemized loans of less than$100.) tOontributor Codes •° IND-individual 2. Loans paid or forgiven this period $ I CON-RecipientCommittee (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g., business entity) y,p PTY •PoliticalParty �� ' SCC—Small Contributor Committee 3. Net change this period. (Subtract Line 2 from Line 1.) NET $ �' (May bee negative number) 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. FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275.3772)