HomeMy WebLinkAboutForm 450 Atascadero Professional Firefighters 063009Recipient Committee
y Campaign Statement —Short Form
SEE INSTRUCTIONS ON REVERSE
For use by recipient committees that have.not,received a
contribution or other receipt that must be'itemized,'have not
received or made loans, and have no outstanding accrued
expenses: I }
I'
'.'Type of Recipient Committee:
Type or print in ink.
Statement covers period '
from 2/2/09
through 7/31/09. -
❑ 'Ballot Measure Committee ® General Purpose Committee
Q Primarily formed I Q Sponsored
Q Controlled Q Small Contributor Committee
Q S onsored -
Date of election if applicable:
(Month, Day, Year)
R'E'ftIVE
JUL 3 1
CITY OF ATA;
2. Type of Statement:
❑ Pre-election Statement
'® Semi-annual Statement
❑ Termination Statement
FORM
2009 Page t of 2
For Official Use Only
9
❑ Quarterly Statement
❑ Special Odd -year Report
❑ Supplemental Pre-election
Statement - Attach Form 495
P
-O 'Primarily Formed Candidate/
❑ Amendment (Explain)
Officeholder Committee
(Also check type of statement you are amending)
3. Committee Information NUMBER
Treasurer(s)
1312619
COMMITTEE NAME
NAME OF TREASURER
Atascadero. Professional Firefighters L3600
Matt Vierra
MAILING ADDRESS._
STREET ADDRESS (NO P.O. BOX)CnY
STATE ZIP CODE AREA CODE/PHONE
6005 Lewis Avenue
Atascadero CA 93422
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Atascadero CA 93422
Bill White, President
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
MAILING ADDRESS'
CITY STATE ZIP CODE AREA CODE/PHONE
CITY STATE ZIP CODE AREA CODE/PHONE
Atascadero CA 93422
OPTIONAL: FAX/ E-MAIL ADDRESS
OPTIONAL: FAX/ E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to thesof
novel a orma n co ined herein is true and complete. I certify
under penalty of perjury the laws of the State of California that the foregoing is a
dc cf '
under
Executed on �? 3y ^, By
_ _
DAT ,.
Executed � a /q By ,
SIGNATUREOFT U RERORASSISTANTTREASURER
on
r DATE SIGNATURE OF CQfJTROL
FFICEHOLDER. CANDIDATE, STATE MEASURE PROPONENT. OR RESPONSIBLE OFFICER OF SPONSOR
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,' CANDIDATE, STATE MEASURE PROPONENT
Executed on _ By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. STATE MEASURE PROPONENT
"
FPPC Form 450 (January/05)
_
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Recipient Committee
-Campaign Statement
Summary Page
NAME OF COMMITTEE
Type or print In ink...
Amounts may be rounded
to whole dollars.
Statement covers period
from 2/2/09
through
7/31/09
SHORTFORM
Page "L of 2
I.D. NUMBER
1312619
Expenditures Made
1. Expenditures of $100 or more made this period......................................................................................................................................
$
2. Expenditures under $100 made this period (Not itemized.) ..................................................................................................................
3. SUBTOTAL'EXPENDITURES MADE THIS PERIOD.........................................................................................................................
Add Lines 1 + 2
$
a
4. Nonmonetary Adjustment ..........................................................................................................................................
From Line 8 Below
'5. Total expenditures made from previous statement .................... ............................
Previous Summary Page, Line 6
$
(If this is the first statement for the calendar year, enter zero.)
a
6. TOTAL EXPENDITURES MADE TO DATE ....................................
...........Add Lines 3 + 4 + 5
$
Zero
- Contributions Received
7. Monetary contributions received this period
8. Non -monetary contributions received this period....................................................................................................................................
9. Total contributions received from previous statement.........................................................................
Previous Summary Page, Line 10
$
(if this is,the first statement for the calendar year, enter zero.)'
e 10. TOTAL CONTRIBUTIONS RECEIVED TO DATE ........................
.................. Add Lines 7 + 8 + 9
$
Zero
F Current Cash Statement
,- -
11. Beginning cash balance .....................................................................................................................
Previous Summary Page, Line 15
$
606.00
12. Cash receipts this period....................................................................................................................................................
„F o
Line 7 above
13. Miscellaneous increases to cash............................................................................................................................................................
$
14. Cash expenditures this period......................................................:.............................................:.......................................
Line 3 above
15. ENDING CASH BALANCE THIS PERIOD ................................. ....................................................
Add Lines, + 12 + 13, then subtract Line 14
$
$606.00
-
FPPC Form 450'(January/05)
u
FPPC Toll -Free Helpline: 866/ASK-FPPC;(866/275-3772)