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Home My WebLink AboutForm 460 Tom OMalley for Mayor 123112 'ecipient Committee COVER PAGE Type or print in Ink. Dale Stamp 460 Campaign Statement CALIFORNIA Cover Page REEE FORM (Government Code Sections 84200-84216,5) i1 Statement covers period Date of election if applicable: Page of_ • `t\ / 0 /`r— (Month, Day, Year) �� 2013 For Official Use Only from !1�\SS 1 I SEE INSTRUCTIONS ON REVERSE through \-1/3 /f''-2— \ \ / /IQ_ CITY OF ATASCADE RO CITY CLERK o nrrICF 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 ❑ Special Odd-Year Report Q Recall 0 Controlled (Also Recall Pert 5) 0 Sponsored ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Term(nation) Statement-Attach Form 495 (Also Complete Pert 6) ❑ General Purpose Committee ❑ Amendment (Explain below) .0 Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER V3 C\060 Treasurer(s) COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER OA y \ /C.,,c- IC \I_ (T 0_1) MA',iron nnnocce crvccr nnnococ ikin on anxl - • CI y STATE ZIP CODE AREA CODE/PNnNF C Y STATE ZIP CODE AREA COnE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADQRESS (IF DIFFERENT)NO.AND STREET OR P.O. BOX MAILING ADDRESS 1 . C�� S� �STrATE �ZIP�� AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/G-nAAI nr,nocce V \ rid OPTIONAL: FAX/ 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 the State of California that the foregoing is true an orr ct. �r Executed on 1 1/ /1 g %'Il Do t y `°" na' asurer or Assistant Treasurer Executed on \/ t--,b ! ° �No� 1 I ' Date 8y Sign... onlraliing•_.eehol.er, a a Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder,Candidate,Stale 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 Recipient Committee Campaign Statement CALIFORNIA A 6o FORM s°!� Cover Page--Part 2 L.\,\ f \'S`k C Obc) Page of ----' 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME.OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD(INCLUDE LOCATION ND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION [] SUPPORT V`y V\ C y V �S CD--)\q q) ❑ OPPOSE RESIDENTIALUausINEs ADDRRSS (No.AND STREET) CITY _ STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, If any. I 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 1 t.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 STREET ADDRESS (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.Q. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT YES ❑ 'NO ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets If necessary FPPC Form 480(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275.3772) State of Callfornia Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers/period Summary Page to whole dollars, CALIFORNIA 460 from C0 f r7 /1' FORM SEE INSTRUCTION,'}ON Ill Fir g ' p3 /�� 3 S. R8� through / Page of NAME Or FILEN QN� O`W\�` P \ c G>■� i \°1 C ��r I.D. NUMBER \ "CEO (0Q OMNI Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD CALENDAR YEAR (FROMATTACHEDSCHEDULES) TOTAL TO DATE Running in Both the State Primary and CkC\ ,-,1 L General Elections 1, Monetary Contributions Schedule A,Line 3 $ $ a `I 2. Loans Received Schedule 8,Line 3 / 1/1 through 6/30 7/1 to Date 3, SUBTOTAL CASH CONTRIBUTIONS Add Lines 1+2 $ '19 $ 4 -,3 - 20, Contributions n( Received $ $ 4. Nonmonetary Contributions Schedule c,Line 3 yG1 qc� 21, Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ 4-1 $ ?/-S-.1 Made $ $ Expenditures Made . Expenditure Limit Summary for State 6. Payments Made Schedule E,Line 4 $ t 0 0 $ —b 1b,7 Z'Candidates 7, Loans Made Schedule H,Line 3 0 22, Cumulative Expenditures 8. SUBTOTAL CASH PAYMENTS Add Lines 6+7 $ l `�0 $ �G �i2 yeXpen Made* (If Subject to Voluntary Expenditure Limit) 9. Accrued ExPenses (Unpaid Bills) Schedule F,Line 3 0 Date of Election Total to Date 10,Nonrnonetary Adjustment Schedule C,Line 3 0 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE Add Lines 8+9+10 $ 1 0 0 $ 6 36'1-- $ Current Cash Statement —J--J $ 12,Beginning Cash Balance Previous Summary Page,Line 16 $ '3S ,,9 To calculate Column B,add 13,Cash Receipts Column A,Line 3 above Gt amounts In Column A to the 14,Miscellaneous Increases to Cash corresponding amounts *Amounts In this section may be different from amounts Schedule t,Line 4 from Column B of your last reported In Column B. y 15.Cash Payments column A.Line a above 1 00— report, Some amounts In 4S Column A may be negative 16.ENDING CASH BALANCE Add Lines 12+13+14,then subtract Line 15 $ �� figures that should be if this is a termlriatJon statement, Llne 16 must be zero, subtracted from previous period amounts, If this Is .........6.—.—.—............., ze... the first report being flied 17,LOAN GUARANTEES RECEIVED Schedule B,Part 2 $ for this calendar year,only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2,7,and 9(if 18. Cash Equivalents See instructions on reverse $ 0 any)' 19. Outstanding Debts Add Line 2+Line 9 In Column B above $ OP FPPC Form 460(January/05) FPPC Toll-Free Heipiine:866/ASK-FPPC(866/275-3772) Fk Schedule A Type or print In ink. SCHEDULE A Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. P 1 CALIFORNIA from k0 1 ( ` FORA,' 460 \ SEE INSTRUCTIONS ON REVERSE through 7 9 " Page of NAME OF FILER I.D. NUMBER \ c am\ U,\ A2 V\v` `GE 1�Z.- \3 `\-q o 6,U DATE FULL NAME,STREET ADDRESS AND •• • CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED • .. CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE CODE •A' OF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1 -DEC.31) (IF REQUIRED) OF BUSINESS) ❑IND ❑COM ❑0TH PTY ❑SCC . • ❑IND ❑COM ❑0TH PTY ❑SCC ❑IND ❑COM ❑0TH ❑PTY ❑SCC ❑IND ❑COM ❑0TH [DPW ❑SCC ❑IND ❑COM ❑0TH ❑PTY ❑SCC SUBTOTAL$ Schedule A Summary "ContrlbutorCodes 1. Amount received this period itemized monetary contributions. IND—individual (Include all Schedule A subtotals.) $ COM—Recipient Committee (� (other than PTY or SCC) 2. Amount received this period—unitemized monetary contributions of less than$100 $ `4Cc OTH-Other(e.g., business entity) PTY-Political Party 3. Total monetary contributions received this period. CA9 SCC-Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866(275-3772) Schedule SGHEDULEE Type or print In ink, Statement covers period CALIFORNIA CO Amounts may be rounded I t V Payments Made to whole dollars. from \�l n / ` FORM SEE INSTRUCTIONS ON REVERSE through ` `� 7-1� Page 5 of NAME OF FILER I.D. NUMBER TO‘V\ ( *\\Y\C\\ -C tr r404---`' '\ y 1---c r)----.. MclO b O CODES: If one of the following codes accurately describes the payment, you may enter the code, Otherwise, describe the payment. OW campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants_ MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)` OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v, or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging,and meals FND fundraising events POL polling and survey research e TRS staff/spouse travel, lodging, and meals NO independent expenditure supporting/opposing others (explain)* 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 LIT campaign literature and mailings PRT print ads WEB Information technology costs (Internet, a-mall) NAME AND ADDRESS OF PAYEE (IF COMMITTEE,ALSO ENTER LD,NUMBER) CODE OR f DESCRIPTION OF PAYMENT AMOUNT PAID (A`-- -La SCE C .� C\\G1^ r tS CCY\ C.V C. CO— 'hook c)G;, 1 � b' �,-,Not4 c)-- :s cam. se C.N T34k 22__ a r.(,(\-- ?i, :fi o <-6 * Payments that are contributions or independent expendit.ires must also be summarized on Schedule D. SUBTOTAL$ \ 0 0 Schedule E Summary 1, Itemized payments made this period. (Include all Schedule E subtotals.) $ D 2. Unitemized payments made this period of under$100 $ f.,A2,5' 3. Total interest paid this period on loans. (Enter amount from Schedule B,Part 1, Column (e).) $ Y 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ 0 0 FPPC Form 460(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)