HomeMy Public PortalAboutForm 460 (Feb 20 - June 30, 2005)
Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
Type or print in ink.
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from tJ;)./ ~ù ) oS-
through D(;/3öf OS-
"
1. Type of Recipient Conmittee: All Convnmees - Complete Parts 1, 2, 3, and 4.
bi[ Officeholder, Candidate Controlled Committee 0 Primarily Formed Ballot Measure
0 State Candidate Election Committee Conmittee
0 Recall 0 Controlled
(Also Complels Pert 5) 0 Sponsored
(Also complele Pelt 6)
0 General Purpose Committee
0 Sponsored
0 Sma. Contributor Committee
0 Political Party/Central Committee
0 Primarily Formed Candidate/
Officeholder Committee
(AJso CompIeIB Pert 7)
3. Committee Infonnation I ./N~3 Ii? ~ '1'
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
1);(/ j J P'K. ~ ~ (} ;' 1~1 {J tJ UI/J ð./ ¿
5l~ESS u;; B~L¡_- / é~ S' 'T~ i!.e~:r
CITY STATE ZIP CODE ~ AREA C9D:/r¿:t°NE
C" I Ct ¡( e~"1rKYT.jT r; A- q I 7 / I ~" . I:dt? '.¡ f3
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR PO. BOX ~ ~
(!. ¡ ¿), 13-.o,>< /1 R J
CIT . > STATE ZIP CODE EA CODE/PHONE
I (1;é.. e/fYl~J CIJ. '1/71 / '9!!J)i~(".jggj
OPTIONAL: FAX / E-MAIL ADDRESS l~~.
COÆR PAGE
Date Stamp
RECEIVE
Date of election if applicable:
(Month, Day, Year)
I
JUN 1 3 2005
of
7
Page
-3 ) D~ j D_.r;-
CITY Cl.f.Rk
.cITY Of' ClAnEMOI'11'
For Official Use Only
2. Type of Statement:
0 Preelection Statement
0 Semi-annual Statement
0 Termination Statement
(Also file a Fonn 410 Termination)
0 Amendment (Explain below)
0 Quarterly Statement
0 Special Odd-Year Report
0 Supplemental Preelection
Statement - Attach Fonn 495
Treasurer(s)
NAME OF JiifASURER
c.::n4/ e tv
MAILING ADDRESS
:2 5" t2ö a ¡Ve l' I ~.Ie. rJ 1,.1. €.
CITY STATE ZIP CODE ARl:. ~ODE/PHONE
C I c~ R edn 0 tv 1- C.A c¡ I ì I tP.~'~) 6~.r:5-zi I
NAME OF ASSISTANT TREASUR~R, IF ANY---.:/ b
C,a.~ ¡Q,
MAILING ADDRESS
CITY
STATE
ZIP CODE
AREA CODE/PHONE
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 ~wledge the information contained herein and in the attached schedules is true and complete. I certify
under penally of perjury under the lawe ?' the Slate °' California that the foregoi", 10 true and c . /1)
Executed on ¿;~/:3/. (;75'- BY,.. /(þ . ~~ . I /
I ~ \ ture er or . /'J: 1 reasurer
Executed on " 13 05- BY' ../ ' .' . ïJj
Date SIgnature of Cot1rollrg Ofkeho r, ndidal8, Slate M easure 'þ~ponent or ResponsI¡Ie OIIIcer of Sponsor
Executed on
By
Date
Executed on
.,
By
Date
SIgnature of CootroIk1¡ OIIiceholder, Candidate, Slate Measure Proponert
~ture of Co~ OIIIcehok*, Candidate, Slate Mea8U18 Proponert FPPC Form 460 (JanuarylO6)
FPPC ToO-Free Helpline: 86IIASK-FPPC (8&6i27&-3772)
State of California
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
L-Iewe/ fc¡vi M// /{)~
Contribution' Received
1. Monetary Contributions ........ ........... .................. ...... Schedule A. Une 3 $
2. Loans Received ...". .,.... ......" ........".. .,... ..... """""" Schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS ......................... MdLines 1 + 2
4. Nonmonetary Contributions. ................................... ScheåJle C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED ...................."..... Add Lines 3 + 4
Expenditures Made
6. Payments Made.... .... ................. ......... ....,.. ......."..... Sch6duJe E, Une 4
7. Loans Made...........................................,................. Schedule H. Line 3
8. SUBTOTAL CASH PAYMENTS .................................... Md Lines 6 + 7
9. Accrued Expenses (Unpaid Bills) ............................... SchsduJeF, Une3
10. Nonmonetary Adjustment ...".. ..... ............ ....,... .......... Schedule C, Une3
11. TOTAL EXPENDITURES MADE ................................AddL.inøs8+ 9+ 10 $
Current Cash Statement
12. Beginning Cash Balance ....................... P1eviousSummaryPage, Une16
13. Cash Receipts.... ........ ............................... ......" Column A. Line 3 abcNe
14. Miscellaneous Increases to Cash """"""""""""'" SchsduIeI, Line 4
15. Cash Payments .......................... ........................ Column A. Line 8ab<:Ne
16. ENDING CASH BAlANCE... .. .. .. . Add Lines 12 + 13 + 14, then subtract Line 15
If this is . termination statement, Una 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... SchsduIeB. Pad 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ...." .................. "'" ........... See instruåions on reverse $
19. Outstanding Debts......................... Add Line 2 t UiJe 9 in Column B above $
TYpe or print in Ink.
Amounts may be rounded
to whole dollars.
ColumnA
TOTÞt THIS PERIOD
(FROMATWHÐ SCHEDULES)
')" .........
~~J ~ ~ t:,)- $
'-17-
$ ('1 ~~.~/) - $
/ O~f -
$d /3~~- $
$ S; / ::L.3.-- $
/ .~
$ ~/ ~,~ --.
&.
I () Lf~
c-.J .., "" "7
'-}~~ 0( I' - $
$ ~9¿i3~-
~ t~~:; 1).-
~ I'~. 3-
r) --
) .-..
$ ~
SUMMARY PAGE
Statement covers period
from /1:2/ ~:> / {) :')-
through 0 b-- ðð'~ ~-
CALIFORNIA 46 0
FORM
CoIUIM B
C'\LENDAR YEAR
TOTÞt TOtWE
9' 0 G ~
/~
,
C/o h ~
/79
CJ;;;. ~J
$
91 tf') ~ ~
~
~ D~ :2.
~
/77
~w2-st1
To calculate CoIUlTV'l B, add
amounts in Colurm A to the
corresponding amounts
from CoIurm B of your last
'-. report. Some amounts in
Colurm A may be negative
figures that should be
subtracted from previous
period amounts. If this is
the first report being filed
br ttis calendar year, only
carry over the amoUl'lts
from LInes 2, 7, and 9 (if
any).
..~
Page ,.;l
of 7
I.D. NUMBER
/:L3/'t'~ J
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6130
7/1 to Date
20. Contributions
Received $
21. Expenditures
Made $
$
$
Expenditure Limit Summary for State
Cand idates
22. Cumulative Expenditures Made.
(If SUbject to \Qluntaly Expenditure LImit)
Date of Election
(mmIdd/yy)
Total to Date
I
$
$
J
I
I
*Amourilln this section may be different from amounts
reported In Colurm B.
FPPC Form 460 (JanuaryIO5)
FPPC ToIl.Free Helpline: 888/ASK.FPPC (8881275-3772)
Schedule A
Monetary Contributions Received
M; l/eJf
~TE
RECEIVED
{) () tJ S- W / III ~()Î WI ~l J!/~¿iJ l ~I
gp;;; ? C? () B .I,!n- / /' r /:V ,-
D ¿tile'{ 5'. /X 7j- ~ ~ ~
I
.'J j'.z~ !<í C)\ ~ S'e c'-lI.e_~
;J:;; P D l~'~ 7 )/2-:3 7
~)S J4-Y\jt:?Jé <j I r it c¡ 00 7 l
'.- CA.d.-/IS.~t1.> ¡lv:fiJ ~~V~ ~
\9 / !J :J.JS ;;;t. ò c¿_J J a s J- (t.f:- f- O/Ý\ \v
fl () ct.')~V\ I 7'~)( "7 7 b/ r
., / t> O/Y'f\-O.! ,~ C () n J 'Lay¡
8/.s- ÖV\. it C) r"'~ :S5-"',\ H õ L L ~ ~
A (¿Y~'.'" n 1(.-:- N Y I DC; D 1-
'Z,C - ~ Q+: f r1-o fe-tLt¡ ~s
12-2-- á-b6 ~~t ß.oNi"L-
c \ ttl~.JVyy~-r J (~A- if, '7 I J
Type or print In Ink.
Amounts may be rounded
to whole dollars.
8ND
DOOM
OaTH
OPTY
osee
lStIND
DOOM
OaTH
OPTY
osee
tf2fU:.lD
DOOM
OaTH
OPTY
osee
~D
DOOM
OaTH
OPTY
Osee
~D
DOOM
OaTH
OPTY
osee
IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF selF-EMPLOYED, ENTER NAME
OF BUSINESS)
ß et., ~ ~C£
oJi.a¡¡¿J Hydr:'-
COh\f~ 'j
M AA-"-OL Ö .e(L#
I-J LId r; r:. ~o t
Fi ;,~'V\ C ~ TeG It
~ \ GL c:{z. f2-~;> c- K
SòJtÄ't ~S
L' Ð'r"-' t -+ '
1 'lurit..:. ~"" J""Y)
SCHEDULE A
Statement covers period
from ¿,~ / ~Ò ) 0 .c~-
through ¿J 61 ~ / t:>"s-
CALIFORNIA 46 0
FORM
AMOUNT
RECEIVED THIS
PERIOD
~ bLJ ~-
~OD.--
~') ~\...
(~'O,""_.
Mò"-
J F3,,()'~
SUBTOTAL $ L ~ 0 i)
(
Schedule A Summary
1. Amount received this period - itemized monetary contributions.
(Include all Schedule A subtotals.) ................................... ..................... ................... ............. ................ $ I ~ 0 ()
2. Amount received this period -unitemized monetary contributions of less than $100............................. $ I t) ~ /)
3. Total ~onetary contributions received this period. . ;;¡ :J.d).. Ò
(Add Unes 1 and 2. Enter here and on the SYl11mary Page, Column A, Line 1.) ....................... TOTAL $ .
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
L / £/..{.ve / /:/n
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
(IF COMMITTEE, AlSO ENTER I.D. NUMBER) CODE *
Page 3
of 7
I,D. NUMBER
/d-.3 / SJ~ /f
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 - DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
.Contributor Codes
IND-Indivldual
COM - Reclplert Conmlttee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
see - SrnaH Col'1trmutor Cormittee
FPPC Form 460 (JanuarylO5)
FPPC ToU-Free Helpline: 8661ASK-FPPC (8681275-3772)
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
/ leCi()ellvjJ1 M, /1e6
DATE FULL NA~TREET ADDRESS AND CONTRIBUTOR --- IF AN INDIVIDUAL, ENTER
RECEIVED ZIP CODE OF CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER
(IF COMMITTEE, ALSO ENTER I.D, NUMBER) (IF SELF-EMPlOYED, ENTER
NAME OF BUSINESS)
81ND
0 COM
OaTH
oPTY
osce
OIND
oeOM
OaTH
oPTY
osee
olND
oeOM
OaTH
OPTY
osce
olND
oeOM
OaTH
oPTY
osee
Attach additional information on appropriately labeled continuation sheets.
Schedule C
Nonmonetary Contributions Received
.;? 0 Ô S-TjI A-!:-[ Y ';;/D L¿
3/ ~ ~ s / /V(a ~ /f1~h -¡
72)3 C I C\ 1!þ(Y1 <::Tr1J; q 7 I )
Type or print in ink.
Amounts may be rounded
to whole dollars.
Stat~:t ¡v;rs:,el: .
from ¿) ~ / tJ.-'j /) s
through () hi S-tò/ oS' Page "f of 7
DESCRIPTION OF
GOOOS OR SERVICES
AMOUNT!
FAIR MARKET
VALUE
1.0. NUMBER
/¿J~5/'! c:<C?
CUMULATIVE TO /
DATE
CALENDAR YEAR
(JAN 1 - DEC 31)
ÆR ELECTION
TO DATE
(IF REQUIRED)
MDCt t<k€1¡ t1 c:\ ,iA-l Ð ,(4~ L
I fle .-17t~ -;-0 ~ \<.. \ L-\(.~
M. ¡r S-ÂÑ Ar.ifblJlr> fûfI.LJ-v.¡!>e~ AT
GA(J..DE1\J S 1 fbJVOt" \-~+tt P\törA
I Dtf-- I 7 9-
SUBTOTAL S I 0 If---i
Schedule C Summary
1. Amount received this period - itemized nonmonetary contributions.
(Include all Schedule C subtotals.) ..................................................................................................................... $
/ oLj .-
., *Contributor Codes
IND -Individual
eOM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
see - Small Contributor Committee
2. Amount received this period - unitemized nonmonetary contributions of less than $100 .................................... $
3. Total nonmonetary contributions received this period. / J 1-' '-
(Add lines 1 and 2. Enter here and on the Summary Page, Column A, lines 4 and 10.) ...................... TOTAL $ (
FPPC Form 460 (January/OS)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)
SCHEDlLE E
Statement covers period
CALIFORNIA 46 0
FORM
Schedule E Type or print in Ink.
. ' Amounts may be rounded
Payments Made to whole dollars. from ~/ ~ / 0':';-
SEE INSTRUCTIONS ON REVERSE through ~ / .~ 0 / b- ç-
NAME OF FilER
L/eu/C!//Y/l- )11, 'j /~t?
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
avP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
cm contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries
CVC civic donations PET petition circulating TEL tv. or cable airtime and production costs
FIL candidate filing/ballot fees Pt-O phone banks TRC candidate travel, lodging, and meals
FI\O fundraising events POl. polling and survey research TRS staff/spouse travel, lodging, and meals
N) 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) VaT voter registration
UT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
Page 6' of 7
1.0. NUMBER
/~ ~ /cfrÄ;1
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D, NUMBER)
CODE
OR
DESCRIPTION OF PAYMENT
1/ J /f . .
1\ /11 tj S' L t9 þ) /" t-þ~
g-¿: J-/t). ~M/£L
C//¿£'¿'l71 ð /1. T 7 / '7 / I
.LæÞeIs st.//5-f:s,J Z;c
,;25 ¡ì LJ -- / /10 ~ ~ e41t/ ~/ /f/. b-:
JiI~-/ / ey ¿;¿ ~) jA/ A q ¿? ~ 0 i:
C¡llk()t~"f JI;'J 1a-,.7. e. &¿ 1l/J\f.¡f)-11¡ L£~
1~/ 1- So ,r¡ P-Weß #-.5 'ð-l)
þc; ¡}1Y,/esj cA '7007/
* Payments that are contributions or Independent expenditures must also be summarized on Schedule D.
. Co ¡ués O~' ¿¡;ec~~. dRjl tY S"', 'I-ç
{/VI P ~(lIlIl/Je~;~/df~,
't) /) / JtZz 4 J?? edJi PJ ~ }1/ $ 7ê / ~
rt-,~ ø'ft~~ .r//e,P~ I
Wçß ~;/I.d" /c-?h t'<15e'- F j /e-f b
'Dr: Ï) R eJ.u~. c ~/j; a7; ðn
^ J::y ch::> [q"'jJ ~.n :;-
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, ColumnA, Line 6.) ............................. TOTAL $
.,
AMOUNT PAID
q I, 2 /
/ ßlJ.f- /
~ t){~ -
¥ 2- Z -'0'0----,
a,'¿) i I ~
"¥- ~-
6; / ,;L,"~~
,
FPPC Form 460 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule .E
(Continuation Sheet)
Payments Made
Type or print in ink.
Amounts may be rounded
to whole dollars.
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE. ALSO ENTER 10. NUMBER)
~2 /f /}) S;; j) A~~ 1-
;2 M <t ,Y;{/e SkQ.ß hi; I L /4 Ant H17
(Þ f a ¡.? .(WýL ð-'Yi T Co "o( i! ¡' e (!
~ 0 r Ii? ~J ~- tw ~,'Y\.AA E-
C \ C\ eè"' ('r\~-n~ q ) 7 II
Po st-,y\ (A ~rfe. ~
CJCÆ e {;mO nl, (~'A- q I -J I )
~tejr}-~ fies;:Co
A1 j/H2/ltt æ / #t b kw k(j
r ifyJ;"> /} tt, J [ì If
¿~5. 'Y9J? ,£s; l4~:.'/alhfi~
1/ ., ~þ.( ~f Q,J(.;
l-~ð ilf/ ft (J ~)!-I-l>¡¿-,e4"'{, it, ~2--
CODE
OR
DESCRIPTION OF PAYMENT
SCHEDULE E (CONT.)
CALIFORNIA 460
FORM
Page ~'
of 7
Statement covers period
from '0/ ~ Ò / ð ç
through [)I;')~:~-ðj C.s-
SEE INSTRUCTIONS ON REVERSE
NAME 7 FILER " /' fA A' ' / I:
1-/f?we//&/rJ /1// /1 Ie/I!
CODES: If 9ne of tA£ following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
0vP campaign paraphernalia/mise, 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
evc civic donations ÆT petition circulating lEL 1. v, or cable airtime and production costs
FIL candidate filing/ballot fees rHO phone banks TRC candidate travel, lodging, and meals
FND fundraising events POL polling and survey research lRS staff/spouse travel, lodging, and meals
ItÐ 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) VaT voter registration
LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
1d'3/ g ;;;{"j
0 JD Ç/ectÖA/M5At <J1l.ilt.eJ!/~5
,.. IV 0 {- (Þ tI-fl) /() ~ ik ~ <::t- S ¿.'í/ /' ~ I/s:;
- B-cl/afflC'e ¿< e -I-'J~
PI<. J þI5!¡4å;1 ~/ ß r A-/J S
(3)
'TI; st:t<-:S ~_. -fo R.. f'f\~ s s
ffia I \, n J
PD5
f/Ìí
LIT
Ph-
* Payments that are contributions or independent ~xpènditures must also be summarized on Schedule D.
AMOUNT PAID
!:3C3.7Ò
~ 6/ Y, rz)
/-'" '2 d ~./ q
1/-6~Y;J /
Îkl/J:kfj'. pP ß~cA.~e-
.fi; ~ /!ld J/¿ d tl / (rML/Ht ce )
t~- / A>vt~- ~,
(7"\ "'!.LIY rA /'/1 .
.I..JA-. vr'- ~ "fçr~e /cr:h .5 / ;;
SUBTOTAL $ 4jLf (:)-:F, ¿ I
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK.FPPC
115:--
L//, 4ô
SCHEDULE E (COOT.)
CALIFORNIA 460
FORM
Schedule E' Type or print in ink. .
(C anti" u ation Sheet) AmoUnIII may be rounded 5_1 covers penod
P t M d to whole dollars. c9-./.;;1-,/}! D ¿-
aymen s a e from 7' '1 '->
through D ,~ /~ i DID (- P 7 f '7
SEE INSTRt£TIONS ON REVERSE I 7 age 0
~M7Jëa)e f 14 A) U j I [¿ ¡« /13 I gJ d, r
CODES: If one of the foll~ng codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
OIP campaign paraphernalia/misc. t.eR member communications RAe radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
eTB contribution (explain nonmonetary). a:c office expenses SAL campaign workera' Alaries
cve civic donations ÆT petition circulating TEL t.v. or cable airtime and production costs
RL candidate filing/ballot fees PH) phone banks "fR: candidate travel, lodging, and meals
FND fundralsing events POL polling and survey research TRS staff/spouse travel, lodging, and meals
N) independent expenditure supporting/opposing others (explain). Fœ po8tage, delivery and messenger services TSF transfer between corrvnittees of the same candldate/sponsor
LEG legal defense PR) profe8&lonai services (legal, accounting) VaT voter registration
LIT campaign literature and mailings FRT print ads VVEB Information technology costs (lntemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE. ALSO ENTER 1.0, NUMBER)
CODE
ylcdte¡( ~ I!e Sh«¡!M"W
~'~ '-' /c
~ D~ J ¿¿ e.. c;' I,
C--I tLt'P P./I'YÎ,,6ì-~/ C-" /::¡ 1 / 7 /
./
f -<I h fI ;, .Ctff ~ ~t. ,J/
3 6. ~ I>i) -(-Ob!?) I é4- , f
(-:/ tl jZ£¥v> try¡ -r; (~/I-' 1 / 7 I
Q l\ I ; ~ C- Ctwoe..; <^ iïO", 0+
)~ (>{<-ð+:-bS 6~'~ ð S-.oitfK ~¡ynd (.k~
/..t?S }Ì/1JI" Ie <;, ¡ C.4 q(?()17/
'T{¿S
IMP
""-'
c'J6
* Payments that are contributions or independent e~ditures must also be summarized on Schedule D.
" '
, '
OR
DESCRIPTION OF PAYMENT
~~ r (? ck Þ ¡¿ i .~,p Lt'(';~11 cA.
¿n e,e'-t; r7 0'
(!() PJ ~t?- t/ /C €-5' ")
s 6. !L,;r1 /) r /1 5 ~ éI / O/}"lC ¿(lei
tV p;-n ø-f; ð /u '+0
!II ¡f /II ~ ~ ¿Þ,P.'-I C /ð $ e o<-i7-
AMOUNT PAID
) [)2-'
b!) &~
g ),-
SUBTOTAL $ c;( ,:=i ~ ~--
FPPC Form 460 (J...uarylO5)
FPPC Toll-Free Helpline: 8661ASK-FPPC (888127~772)