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HomeMy WebLinkAboutForms 460 12-31-2011 Committee to Elect Tom O'MalleyCommittee I Statement (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type. or print in ink. Statement covers period Date of election If appli from `7 /, / t (Month, Day, Year) r A through � 3' '' N R COVER JAN 18 2012 Page �- ofd For Official Use Only CITY OF ATASCADE qO CITY CLERK'S OFFI C F 1- Type of Recipient Committee: All Committee. - Complete Parte 1, 2, 3, and 4. 2. Type of Statement: Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure STATE ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Q Recall Committee Q Controlled ❑ Semi-annual StatementS E]p ecial Odd -Year Report (Also Ccrnuw.Pans) C Sponsored ❑ Termination Statement ❑ Supplemental Preelection face compressed sp. Also file a Farm 419 Termination ( ) Statement - Attach Form 495 ❑ General Purpose Committee ❑ Amendment (Explain below) Q Sponsored ❑ Primarily Formed Candidate/ Q.. Small Contributor Committee Officeholder Committee Q Political Party/Central Committee tarso compras Pan �)..: 3. 4. COyy�vf\ t_t*22. To G -ho CCN -y COuv�C.\ IID.NUMBER Treasurers) IF NO COMMITTEE) NAME 76tr1 (_C.TtTO) MAILiI C�V(�,50-Po �en1-o1 C, �2oU MAILING ADDRESS (IF DIFFERENT) NO. AND. STREET OR P.O. EC us CITm 1`^(C�CTR� STATE ZIP COC OPTIONAL: FAX /'E-MAIL ADDRESS P\ O M A ) Y-2 Y 9- G.\'\ o- 4"_�'2 r . Oluet" 4SURER \mow. 0 . f' v, ' VA o ' ESS �o�ca�a 2aa 5 TE ZI OWE AREA CODE/PHONE C �{y2 CBos)66-tea STANT TREASURER,. IF ANY MAILING ADDRESS verltncanon 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 thq laws of the State of California that the foregoing Is true aorre t. ,r /WSW Executed on �� By L9�%/� AL le \ tura oITresa Q urarw Assistant Treasurer Executed on �i � L B Date Executed on By Date Signature of CommlGng 01 Candpate, Stale Measure Pmponent Executed an gy Dela SignaturedConUdfng ORkandtler, Cardgale, Slate Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866275-3772) State of California CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX 1 E-MAIL ADDRESS verltncanon 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 thq laws of the State of California that the foregoing Is true aorre t. ,r /WSW Executed on �� By L9�%/� AL le \ tura oITresa Q urarw Assistant Treasurer Executed on �i � L B Date Executed on By Date Signature of CommlGng 01 Candpate, Stale Measure Pmponent Executed an gy Dela SignaturedConUdfng ORkandtler, Cardgale, Slate Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866275-3772) State of California Recipient Committee Campaign Statement Cover Page — Part 2 Type or print in ink. C 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE ` o`n'e O. FICE SOUGHT OR L (INCLUDELOCATION AND DISTRICT NUMBER IF APPLICABLE) cx)J C--%\ vi�a talo V- i C i+/ 0k 1 S C Cv c�k ru RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP �\a (�� vt or G- 4)3 CA omi'L. Related Committees Not Included in this Statement: List any committees not included In this statement that: are controlledby you or are primarily formed to receive contributions or make expenditureson behalf ofyour. candidacy. COMMITTEENAME .I I.D. NUMBER ❑ YES ❑ NO ADDRESS (NO P.O. CITY STATE ZIP CODE AREA CODE/PHONE NAME NUMBER ❑ YES ❑ NO P.O. BOX) Page 2— of 6 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE nnu.OT NO, OR LETTERI JURISDICTION (❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any, NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholders) or candidatets) 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 E] SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑ OPPOSE CITY STATE ZIP CODE - AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 660 (January/05) FPPC Toll -Free Helpline: 666/ASK-FPPC(8661275-3772) State of. California Campaign Disclosure Statement Summary Page ME OF C Type or print in Ink. Amounts may be rounded to whole dollars.. SUMMARYPA State—/ mentt covers period J , 7 ' from ` ' Z I FORM L® through-� I / I' Page of I.D. NUM ER Contributions Received ColumnA Column B Calendar Year Summa for Candidates Summary ............................. Schedule e, one 4 $ TOTALTISPERIOO (FROM ATTACHED SCHEDULES) CALENOARYEAR TOTALTOOATE Running in Both the State Primary and 1. Monetary Contributions ............... ���•�•���................... Schedule A, Line i 'soo l 51 Sc)` General Elections 8. SUBTOTAL CASH PAYMENTS ....... ..., ..... Add Lines $ $ $ 22. Cumulative Expenditures Made" 2. Loans Received ................ .. .......,. Schedule a Line 3 . _ 600 -- 3 5 V 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS .. ........... Add Lines I.2 $ —IOQ 20. Contributions 4. Nonmoneta Contributions ry Schedule c, Line 3 $ Received $ $ ....:. Schedule C. Line 3 j 1 5. TOTAL CONTRIBUTIONS RECEIVED .— "-' Wo - �� 21. Expenditures ...........':....Add Lines 3+4 $ $ Made. Ex end't M d V tures a e 6. Payments Made - Expenditure Limit Summary for State ............................. Schedule e, one 4 $ Y� $ -- Candidates 7. Loans Made .......: ..` Schedule H Line 3 8. SUBTOTAL CASH PAYMENTS ....... ..., ..... Add Lines $ $ � 22. Cumulative Expenditures Made" 9. Accrued. Expenses (Unpaid Bilis).. .... ......... Schedule F, ones. --per (If8ubleettovalunt gEzpontlitura Llmitl 10. Nonmonetary Adjustment Date of Election Total to Date ............................ Schedule c, Line 3 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE Add Lines +8+10 $ 1 Current Cash Statement 12. Beglnning Cash Balance Previous Summary Page, Line 16 13. Cash Receipts .................................................•. Column A, Line 3ebove 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15. Cash Payments .......... 1,.......0 .............................. Column A. Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 ' If th/s Is a lamination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule A Pan 2 Cash Equivalents and Outstanding Debts 16. Cash Equivalents........................................ See instructlonson reverse 19. Outstanding Debts ...... ........ Add Line 2+ Line 9 I Column 8 above too To calculate Column B, add amounts In Column A to the corresponding amounts from Column 8 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 firstreport being filed for this calendar year, only carry over the amounts from Lines 2, 7,, and 9 (If any). `Amounts In this section may be different from amounts reported in Column B. $ $ FPPC Form 460 (January/05) I FPPC Toll -Free Helpline: 866/ASK•FPPC (6661275-3772) MW — ScheduleA SCHEDULE A gmoums may ;)a rounpoa Monetary Contributions Received to whole dollars. St atomont eavorn 'ROD -7 , �p ,. .. from -� • I �) , SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER LD.. NUMBER 12.` 57 7 4 - DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE,N-SO ENTER; 0. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION. TO DATE RECEIVED CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN t - DEC. 31) (IF :REQUIRED) OFBUSINESS) IND []coM _ 7!�`1201� (xC)SCi SaPrGfvJCn�` SO CA l't�SCCr O.,DS2� CI\' 0.PSL'I LrL-_ DPTY ❑SCC. 7�Z�wii M Pl IND LJCOM DOTH I_o a�u^� I i�CCI ) t,000 I�?3o �.3� �v�• Pam '1va'r- C ❑SCC 7f3�Z0�� KIND COM DOTH OWYVt`r ko I,Cv i,cc) 3�5Gt1$�hh�.i�S o��yna,I�S ee..kxv- QPTY 3y4% cs c MIND D COM MOTH D PTY. ❑SCC [-]IND (]COM DOTH ❑ PTY ❑SCC SUBTOTAL$ Soo alai Ii r( x 7 Schedule A Summary 1. Amount received this period - itemized monetary contributions. (include all Schedule A subtotals)............................................................................... 2. Amount received this period — unitemized monetary contributions of less than $100 ....... 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1) .................. *Contributor Codes IND -Individual $ 2i O(] COM- Recipient. Committee (other than PTY or SCC) DTH - Other (e.g., business entity) $ PTY - Political Party Soo SCC- Small Contributor Committee TOTAL $ 2--) FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/2753772) C.. h,. Sl..i.. ® 1711_ a A TYPe or print in ink. SCHEDUI F R-PART1 �... .............. _- . u.. . s may be Loans Received Amo totwholedollarsnded FO �. 60 fromatem7c;v/;;eriod FORm SEE INSTRUCTIONS ON REVERSE through 17411 ! 4 \ Page S of NAME OF FILER I.D. �N(7UMBERt, FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING IbI AMOUNT tc) Itl) OUTSTANDING (e) t 91 OF LENDER 11FcoramlrrEE,ALsoErvieRl D NUMBER) OCCUPATION AND EMPLOYER p $ELF. MPLOYED ENTER .BALANCE BEGINNING THIS RECEIVED THIS AMOUNTPAID OR FORGIVEN SALP.NCEAT CLOSE OF THIS .INTEREST PAID THIS ORIGINAL AMOUNTOF CUMULATIVE CONTRIBUTIONS 1 `� 1�nC 13� NAME OF BUSINEssI .PERIOD THIS PERIOD` PERIOD LOAN DATE O` Q� l PAID x EN CALENDAR YEAR $ Z, oo $ 151011 N � % g r+c�nn�T I` D FORGIVEN' RATE $ PER ELECTION" ^7 7 ... $ g $ t IND [I COM ❑ OTH D PTY D SCC DATE DUE DATE INCURRED CALENOARYEAR _% S It TPAM PER ELECTION" RATE tD IND D COM D OTH D PTY D SCC 8 S E DATE INCURRED8 CALENDAR YEAR FORGIVEN PER ELECTION" Rare tQ' .IND .COM El D OTH D PTY. D SCC $ $ $ 8 DATE DUE DATE INCURRED $ SUBTOTALS $ $ $ ii Schedule B Summar (E.leE,UR 'J Schedule E, LirIe 3) 1. Loans received this period...... ......... ..................................................................... $ (Total Column (b)plus uniternized loans of less than $100) tcontdbDtor codes ` 1�o( IND—Individual 2. Loans paid or forgiven this period ......... ....... ...................................................... $ �) COM - ReDlpient Committee (Total Column (c) plus loans under $100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third parry that are also itemized on Schedule A) OTH - other (e.g., business entity) 6C)o PTY -Political Party 3. Net change this period. (Subtract Line 2 from Line 1.) ....... ,NET $ �) SCC—Small Contributor Committee Enter the net here and on the Summary Page, Column A, Line 2. (AAay --g— Amounts no bell 'Amounts forgiven or paid by another party also must be reported on Schedule A " If required. .� r ' a `I" "': VnlIULtIlt'N$/.0/J-t W) - vx14'^ s ' SCHEDULEE `�".Schedule E ' Type or print In ink, _ Statement covers period Payments Made Amounts may of rounded t / IN !NU7M6ER_,! y to whole dollars. fromSEE INSTRUCT70NS ON REVERSEthrough ) '..PagNAME OF FILER LD. TO 152 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment CNP campaign paraphernalialmisc. MBR member communications RAD radio airtime and. production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)" OFC office expenses SAL campaign workers' salaries CVC civic.: donations PET. petition circulating TEL t.v, or cable airtime and production costs FIL candidate filing/ballot fees PHO .phone. banks TRC candidate travel, lodging, and meals FND fundraising events POL-:pollingand survey research TRS staff/spouse travel, lodging, and meals INC independent expenditure supporting/opposing others (explain)" POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG. legal defense-. - PRO professional services (legal, accounting) VOT voter. registration LT campaign literatureand mailings -, PRT print ads WEB Information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE. pr COMMITTEE, ASC ENTER I.Q. NUMBER) CODE =. OR DESCRIPTION OF PAYMENT. AMOUNT PAID . Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ t" 2. Unitemized payments made this period of under $100 ............... ......... ....... .........,.............,............................................. $ 1 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 $ - FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)