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HomeMy WebLinkAboutForm 460 Newsom 073118Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statemen/t covers period Date of election if applicable: from o11S (Month, Day, Year) through Q[0,30 ze18 JUL 3 1 2018 CITY OF ATASCADER2 ) CITY CLERK'S OFF ICE COVER PAGE Page r of /� For Oficial Use Only 1. Type of Recipient Committee: All committees -complete Parrs 1, z, 3, and 4. 2. Type of Statement: ®O holder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Preelection Statement ❑ quarterly Statement 'V' State Candidate Election Committee Committee Semi-annual Statement ❑ Special Odd -Year Report 0 Recall 0 Controlled ❑ Termination Statement (Afso C«rprore Part sr 0 Sponsored P (Also fife a Farm 910 Termination) (Also cxnprare Pert s) LlGeneral Purpose Committee ❑ Amendment (Explain below) 0 Sponsored ❑ Primarily Formed Candidatel 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also CmOde Part 7) 3. Committee Information I.D. NUMBER masandao G1 wl&l Zz& GkTY STATE ZIP CODE Al 5eadeko C� q3 VA Mnn irur_ annvrcc rIr ni«Wvrn11 NO. AND STREET OR P.O. BOX Treasurer(s) MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ E-MAIL ADDRESS I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the certify under penalty of p ury�Vr the of the State of California that the foregoing is true and correct. o.. 1 Executed on Date and in the attached schedules is true and complete. I Exewted on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jars/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE f �ea�e� I�P�oam OFFICE §OUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDE NTIALISUSINESS ADDRESS (NO. AND STREET) CITY STATE LIP �- oj3 �fG 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. I.Q. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.Q. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE - PART 2 Page - of /2' 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ 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 officeholder(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 Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers period 0. from Summary Page _ ��u der/ e SEE INSTRUCTIONS ON REVERSE through oto 30 ��r+ Page of �y NAME OF FILER I.D. NUMBER Co rn; e ee��l,e� lI/P JM_), �fas�adec� Column A Column B Calendar Year Summary for Candidates Contributions Received TOT,THIS PERIOD c,ENOARYEA (FROM ATTACHED SCMEDUlES) TOT, To DATE Running in Both the State Primary and 1. Monetary Contributions................................................... schedule A, Line 3 2. Loans Received................................................................ Schedule O, Line a 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines i+2 4. Nonmonetary Contributions ............................................ Schedule C, Linea S. TOTAL CONTRIBUTIONS RECEIVED...................................Add Lines 3+4 Expenditures Made 6. Payments Made................................................................ schedule E. Line 4 7. Loans Made....................................................................... schedule rr. Line 3 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Linea 10. Nonmonetary, Adjustment......................................................... schedule C, Linea 11. TOTAL EXPENDITURES MADE........................................Add Lines 6+9+10 Current Cash Statement 12. Beginning Cash Balance ............................Previous summary Page, Lina 16 13. Cash Receipts........................................................... Column A Line 3 above 14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 15. Cash Payments......................................................... Column A, Line a 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. $ I DSO . U9 $ /DSO.Oa U b $ /CSO •00 $ /05-0.00 D 0 $ /0f0.00 $ /U5O.00 $ U $ 17. LOAN GUARANTEES RECEIVED ................................ schedule B, Parte $ O I Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instructions on reverse $ 19. Outstanding Debts .............................. Add Lme 2+Line 9 in Column a above $ 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). General Elections 1/1 through 6/30 711 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' in Subject to voluntary Expeneaum Limn) Date of Election Total to Date (mm/dd/yy) S 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.u.gov (866/275-3772) www.fppc.ce.gov $ $ 0 $ 0 $ 17. LOAN GUARANTEES RECEIVED ................................ schedule B, Parte $ O I Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instructions on reverse $ 19. Outstanding Debts .............................. Add Lme 2+Line 9 in Column a above $ 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). General Elections 1/1 through 6/30 711 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' in Subject to voluntary Expeneaum Limn) Date of Election Total to Date (mm/dd/yy) S 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.u.gov (866/275-3772) www.fppc.ce.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received townweaouars. Statenwntcovemperiod CAUFO_NIA A from e RM 60 through /e Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER ����pp y/�p 9 O� /g`, n ( I.D. NUMBER �M j �lA. &, ! (J%G �C�1 m.' & W S&2-7 � s L" n CSC/ 1 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF OOMMRTEE. ALSO ENTER I.D. NUMBERS CONTRIBUTOR IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS} PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) I S P -ND 1 'L, ❑ COM L] OTH [I PTY A Gf� /�Q�� ��iJ,GT2J ❑ SCC P-tND ❑ COM -- uW �(s OTH ❑ PTY ��` v L0r'v t7U %, Or ❑ SCC IC1k �C�� El COM LJ oPT-y ❑ sic ❑ COM ❑ OTH /0(i, L9 /©4, U-2) ❑ PTY ❑ SCG ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ qbo . Schedule A Summary 1. Amount received this period — itemized monetary contributions. Include all Schedule A subtotals. ..... $ d6 'ad 2. Amount received this period — unitemized monetary contributions of less than $100 ............... d 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 16-50 29 'Contributor 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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Amounts may be rounded SCHEDULE B - PART 1 SCheaule t3 — Part 1 to whole dollars, Statement Covera period Loans Received a • from p�//�j� a DY a SEE INSTRUCTIONS ON REVERSE through l� Page of NAME OF FILER I.D. NUMBER �mm a 4R /�ea` W4 euvsmi A&So d ee 6/V Cep Zai FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT lel AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OFLENDER (IF COMMITTEE,ALSO NEMER I.D. NUMBER) OF SEMEOF BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR LOSEO THIS CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS BUSINESS) NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD* PERIOD PERIOD LOAN TO DATE ❑ PAID CALENDAR YEAR S ❑ FORGIVEN PER ELECTION" EEN t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC i i DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION" PATE t ❑ IND El ❑ OTH ❑PTV ❑SCC i DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ELECTION" RATEElFORGIVENPER t ❑ IND ❑COM ❑ OTH El El i DATE DUE DATE INCURRED SUBTOTALS $ $ $ $ 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. e' If required. (Enler(e)on Schedule E. Une 3) $ D tContnbutor Codes a (MW Ma negM numeep IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTV — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded SCHEDULEC Nonmonetary Contributions Received V W11U1C . Statement cove periodCALIFORNIA ' from / ?e • FORM O� SEE INSTRUCTIONS ON REVERSE [hrou9h Page of NAME OF FILER em4a, -&z W& lvtws m , �1 Sca�t'e� C zzvt I.D. NUMBER PATE FULLNAME,COD CONTRIBUTOR • IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATNE TO DATE PER ELECTION TO DATE RECEIVED OF CONTRIBUTOR ZIP CODE OF CONTRIBUTOR OF COMMnTEE. Al50 ENTER I.D. NUMBER) CODE CODE OF BEL GOODS OR SERVICES VALUE (IF REQUIRED) EOFBOSID )TER NN.IE OF BUSINESS) (JAN1-DEC 31)CALENDAR (JAN 1 -DEC 31) ❑ IND ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)......................................................................................................................$ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ..................................$ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.).....................TOTAL $ 'Contributor 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 (Jan/2016) FPPC Advice: advice@fppc.w.gov (866/275-3772) w .fppc.ca.gov Schedule D SCHEDULE D Summary or tx enaltures Amounts may De round" ry p statement covers period Supporting/Opposing Other to whole dollars. CALIFORNIA 460 •0 Candidates, Measures and Committees from or o 11/2b ta, FORM 30 /2 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILERJJ/pQ� y/y/,� Q 77Z I.D. NUMBER L tw 11 Gu 4 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTIONAMOUNT THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (.uw.1-DEC. 31) (IF REQUIRED) OR COMMITTEE ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) .......................... 2. Unitemized contributions and independent expenditures made this period of under $100 ........................... 0 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Dc not enter on the Summary Page.).......... TOTAL.. $ 6 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.w.gov (866/275-3772) www.fppc.ca.gov NAME AND ADDRESS OF PAYEE QFCWMnTEe.PLSDeNTERI.D.NUMSM) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID SCHEDULEE Schedule E Amounts may be rounded to whole dollars. Statement covers period- I , Payments Made from �� so %� l7 through " oe/ (X/ 2— Page V 12— SEE INSTRUCTIONS ON REVERSE of NAME OF FILER NAMEOFFILER (�(l /!2 %/INwc.�' '�%� %l ��',�'. r [�wr" �I V �(f� � �7 t i(%(�t J C-_ li..tt'�CA(XJ � i�r/ {'tr/ ✓L�C.Y ".� /0 I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/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 TRS staff/spouse travel, lodging, and meals IND 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, e-mail) NAME AND ADDRESS OF PAYEE QFCWMnTEe.PLSDeNTERI.D.NUMSM) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)..................................................................... 2. Unitemized payments made this period of under $100.................................................................................................. 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).).................................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ................ $ ... TOTAL $ Z FPPC Form 460 (Jan/2016) FPPCAdvice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov CODEOR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD SCHEDULE Schedule F Amounts may be rounded to whole dollars. Statement covers period71.CP0)!NUMBER ' Accrued Expenses (Unpaid Bills) from / • 1-11 ehrough OG 30 Zo/� peg"' SEE INSTRUCTIONS ON REVERSE NAME OF FILER /��L / �� �, N��7/�-fit r ' sa A� �/( ��� �GU1S� �p/t /J71 �, ur, K C/Xn/n D)')1 �Tl� yz CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/mist. 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 peteion circulating TEL t.v. or cable airtime and production costs FIL candidate filinglballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND 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, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMIREE. PISO ENTER I.D. NUMBER) CODEOR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD IIN AMOUNT INCURRED THIS PERIOD (cl AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD m^ n Payments that are contributions or independent expenditures must also be SUBTOTALS $ S $ $ wmmr"d on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................... 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.).......... 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.)................................................................................................................................. ...............INCURRED TOTALS $ ........ PAID TOTALS $ U C) NET $ 0 May be a rregahue number FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) Amounts may be rounded to whole dollars. Statement cove period from I period from through -U toC Page .4s� of 19- M y ,�mc.,r�,n'V�l CODES: If one of the following codes accurately describes the CMP campaign paraphemalialmisc. MBR CNS campaign consultants MTG CTB contribution (explain nonmonetary)' OFC CVC civic donations PET FIL candidate filingiballot fees PHO FND fundraising events POL IND independent expenditure supporting/opposing others (explain)' POS LEG legal defense PRO LIT campaign literature and mailings PRT payment, you may enter the code. member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads Payments that are contributions or independent expenditures must also be summarized on Schedule D. Otherwise, describe the payment. RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (intemet, e-mail) M Attach additional information on appropriately labeled continuation sheets. TOTAL` $ U Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460 (Jan/2016) independent contractor as reported on Schedule E. FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.a.gov SCHEDULE H Schedule H Amounts may be rounded Ststsmxrd coverts period • , ' to whole dollars. • Loans Made to Others* from Q / w • " SEE INSTRUCTIONS ON REVERSE through `�� 3 pa9! Of NAME OF FILER' n _//tet ,,� j,////��//� py IVUVX" Q��yt�/Iyr j /t /�/� �/ �� r�Lt.� TV /L, / / C.q-/ r•tez- / ' ` V i" / / / U' �- // / v' .i L' 49:iZ c-c� N 0 ✓✓ FULL NAME, STREET ADDRESS AND ZIP CODE , ST EET IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER ' OUTSTANDING lel AMOUNT I.) REPAYMENT OR lal OUTSTANDING I-) INTEREST M ORIGINAL Ipl CUMULATIVE OF RECIPIENT (IF COMMnTEE. ALSO ENTER I.D. NUMBER) (IF SELF£MPLOYED, ENTER BALANCE BEGINNING THIS LOANED THIS PERIOD FORGIVENESS BALANCE AT CLOSEOFTHIS RECEIVED AMOUNT OF LOANS NAME OF BUSINESS) THIS PERIOD• LOAN TO DATE ❑ PND CALENDAR YEAR s 1— —x s s ❑ FORGIVEN PER ELECTION•• s s $ s s DATE DUE DATE INCURRED ❑ PND CALENDAR YEAR i $ _• s s ❑ FORGNEN PER ELECMN" RAh 3 3 f 3 i DATE DUE DATE INCURRED 'Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. SUBTOTALS $ $ $ $ (Enrer(a)on Schedule I, Una 3) Schedule H Summary 1. Loans made this period........................................................ ...........................................................................................$ O (Total Column (b) plus unitemized loans of less than $100.) **If Required 2. Payments received on loans.............................................................................................................................. .............$ CJ (Total Column (c) plus unitemized payments of less than $100.) U 3. Net change this period. (Subtract Line 2 from Line 1.)............................................................................................NET $ (Enter the net here and on the Summary Page, Column A, Line 7.) (M. as a ner'we ninaaa4 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule I Amounts may be rounded SCHEDULEI Miscellaneous Increases to Cash to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period CALIFORNIA Q • from ��c+ � through 3a paw �� of %y NAME OF FILER ,{/��.� ,/�/>�� l /y/- ,�,, ,� /� /,fy�,, n ,� ,//n ,, ///�,//�,, / /1/(//' �J,,� / Vrrr rl (.a a 4V CiGu-ter'! �� ,�G/G� u.r-rte/ `�ot�I &, 261t ./ I.D. NUMBER DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (e eommm .use iaT I.e. uuMeep DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. Schedule I Summary 1. Itemized increases to cash this period ......................................... SUBTOTAL$ 2. Unitemized increases to cash of under $100 this period.................................................................................................$ G 3. Total of all interest received this period on loans made to others. Schedule H, Column (a).) $ a 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.)............................................................................................................................. TOTAL $ ep FPPC Form 460 (lan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwwAppc.ca.gov