HomeMy Public PortalAboutForm 490 (Jan 1 - Jan 16, 1999)Officeholder, Candidate, Type DrpTlntlnlnk.
and Controlled Committee
Campaign Statement -Long Form
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
CMck one of the following boxes to Indlute the type of statement being flied:
Pre-election Statement
Supplemental Pre-election Ststement (Attech a completed Form 495 to this statement.)
Special Odd-Year Campaign Report
Semi-annual Statement
Termination Statement (Attach a completed Form 415 to this statement.)
uded in this Statement
c. /
LICE SOUGM Oil HELD (aN1UDt LOCATION AND OryTRICT NUMaUI / APKKAttE) /
RESIDENTLAI OR aufrNESS ADDRESS (NO. AND STREE7)
CRY STATE A- CODE AREA CODE/DAYTIME PHONE
clLrPi~/lon ~ ~G. ~(7/I ~?c~~c-~{d'~~_D~IC~
COMMITTEE NAME I.D. NUMSER
r;.r~~ l~e
ADDRESS
CRY STATE ER CODE AREA CCIDE/DAYTIME -FLONE
c ~~_,~~ v~-on -~ ~~~ ~~ ~r r ~~ro ~> ~,r~ -~~6 ~,
NAME OF TREASURER
~5~.[~~r~ ~~I.A~~i c ~
PEMEAMEM A SS Or TREASURER r INO. AMD STREET)
~Y STATE EIP CODE AREA COOEAAYTIME PFEONE
Statement covers period
from (' ( - C~ C~
through "^ ~ - ~ ~ - C~ C,
Date of election M applicable:
(Month, Day, Year)
Date Stamp
COVER PAGE -LONG FORM
Page 1 of
for Official Use Onlv
utner c.ommlttees Not Included in this Statement: L/st.ny oche.
committees not included/n this consolidated statement that are controlled by you and any
committees of which you have knowledge that a-e primarily /ormed to receive contrlbuUoru
or to make expenditures on behaHofyour cand/dacy.
COMMRTEE NAMf
I.O. NUMaEA
NAME OE TREASURER CONTROIIED COMMITTEE T
^ r[S ^ No
COMMRIEE ADDRESS
(NO. AND STREET)
CITY STATE 21-COOE AREA CODE1DAr/1ME .HONE
COMMITTEE NAME
I.D. NUMlER
NAMI01 TREASURER CONTROIIED COMMIIT[ET
^ rrs ^ ND
COMMITTEE ADDRESS (NO. AHD STREET)
CRY STATE 7:IP CODE AREA CODE/DAYTIM[ .HONE
Attach addltlonalln/ormatlon on appropriately labeled contlnuatlon sheets.
er) ice ion
I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge t Infor contained herein and in the attached schedules is
true and complete. I certify under penalty of perjury under the laws of the Statedoi California that the foregoing Is true an '
Executed on ~ <C' "_J~ At C ~C-/YGv~ 6 /1 •>L C/-7 By -~
DATE CRY AND STA ATURE OE TREASURER
An ofllceholder or uTTdldate who controls a commhtee mutt also verify the campaign statement. I have used all reasonable diligence a to the best of my knowledge the treasurer has used ell
reasonable diligence in preparing this statement. I have reviewed the 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 and Corr
Executed on ~~ Z r.~ - ~ ~~ At I lc=.~-C vvw ~+ f (C~ By Z- s ~,
OATI CRYA DSTATE SIGNAIJ/ EOfCANDIDATE/O--ICFHOIDER
Executed on At By ~,~
DATE CRY AND STATE SIGNATURE Or CANDIDATE/OIrIC[NDI OfR
Executed on At By
OAIE CRY AND STATE SIGNAL URE OE CANDIDATE /OI I ICI IIOI DF R
TOR INr011MATKIN RIQUIRED 10 aI PROVIDED i0 YOU -URSUANi i0 THE INIORMATKMI PMCTKES ACl OE 197), SEE IN/ORMATION MAHUAI ON CAMPAI H DI ClOS1111E PIIOVIS~ONS Oi I11F PQI IIICAI RF iORM ~C]
State of California Falr PollTlESI PlartlreE CDmmIELIDn
I ~r Ci t-~i CC?~lnc( I
(l10. AR
Allocation Page -Part I
Contributions and Independent Expenditures
IVlade from Campaign Funds
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND COONTROLLED COMMITTEE I.D. NUMBER
'N'l ~ Ic ~.c..i. -~ r C ~ Y- ~ ~OU n c I
list each contribution and independent expenditure of s 100 or more made from campaign /ands to other committees or
to support or oppose other candidates or ballot measures.
DATE
NAME OF OFFICEHOLDER, CANDIDATE, COMMITTEE, OR MEASURE CHECK ONE
Support O
IND~
EXP
AMOUNT
CUMULATIVE TO DATE
(LAN NU DEC. 31)
CUMULATIVE TO DATE
(IF APPLICABLE)
•See reverse regarding independent expenditures. SUBTOTAL s
Attach additional i nforrnatien nn anmm~riatn/v lahplar~ rnn-:nu~~:nn chance
..~wa.n.wn - rrn~ ~ wmmr~n~
1. Contributions and independent expenditures of 5100 or more made this period from campaign funds.
(Include all Allocation Page - Part I subtotals.) ......................................................................................... .
2. Contributions and independent expenditures under S 100 made this period from campaign funds.
(Do not itemise.) ........................... .
3. Total contributions and independent expenditures made this period from campaign funds.
(Do not carry this total to the Summary Page.) .................................. , , , , , . , , .... TOTAL
.......................................
,~
,~
,~_
Allocation Page -Part II
Contributions and Independent Expenditures
Made From Personal Funds
SEE INSTRUCTIONS ON REVERSE
Typa or print In Ink.
Amounts may be rounded
to whole dollars.
NAME Of OFFICEHOLDER OR CANDIDATE
cr k l~ a ~;
Statement covers
ALLOCATION - PART II
through ~ - ~~ ' ~(~ I Pepe ~- of ~L-
Oun t [ l
list each contribution and independent expenditure of f 100 or more made /rom the officeholder or candidate's personal funds to support or oppose
other officeholders, candidates and committees.
DATE
NAME OF OFFKEHOLDER, CANDIDATE, COMMITTEE, OR MEASURE CHECK ONE
Support O e IND.
Exp•
AMOUNT CUMULATIVE TO DATE
CALENDAR YEAR
JAN. 1 - DEC. 31 CUMULATIVE TO GATE
OTHE R
IF APPLICABLE
'See reverse rcyardiny independent expenditures. SUBTOTAL s
ALLOCATION - PART II SUMMARY
Attach additional information on appropriately labeled continuation sheets.
1. Contributions and independent expenditures of S 100 or more made this period from personal funds.
(Include all Allocation Page - Part II subtotals.) ............................................................................................ S ~'
2. Contributions and independent expenditures under S 100 made this period from personal funds.
(Do not itemi:e.) ...................................................................................................................... .... ... S
3. Total contributions and independent expenditures made this period from personal funds. l
(Do not carry this total to the Summary Page.) ................................................................. .. ...... ....... TOTAL S
Campaign Disclosure Statement Type orprlntlnlnk. SUMMARY PAGE
Summary Page Amounts may be rounded
towhokdollars. Statement covers perbd
from 1- ~ ~i ti
SEE INSTRUCTIONS ON REVERSE through 1- ~ ~ - ~y Page ~ of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
p1 i+I/ /
Contributions Re ived Column A Column B* Column C
TOTAL TMS rEIUOD TOTAL MEVIOUS -E1110D iOTAI TO DATE
FROM ATTACHED fCHEDUIES) (SEE MOT[ aElOV1~ (ADD COLUMNS A ~ !)
1. Monetary Contributions ............................... schedule A, une 3 S ~Z.sU cc~ s s
Loans Received ......................................... ScheohrM s, une ~
SUBTOTAL CASH CONTRIBUTIONS ...................... Addunes / t 2
f ._
.zS~ t~~
s t
4. Non-monetary Contributions ......................... schedule c, une 3 ~ ~U ~~~
S. SUBTOTAL CONTRIBUTIONS (Exdede Enfiorreabk PromJses) Addunes3 f ~ s S~C~O G' f S
6. Enforceable Promises
(Exclude Loan Gwrantees, Une /d below) ................... ScheduN D, Une 7 ~ ~,;
7. TOTAL CONTRIBUTIONS RECEIVED ..................... Addunets + 6 s S-K~ J f S
Expenditures Made
8. Cash Payments (Other than Loans Made) ............ ~ ScheduN E, une s s ZD ~/ ~ s s
9. Loans Made ............................................. schedule H, une ~
10. SUBTOTALCASHPAYMENTS ............................ Addunes6 + 9 S ZC~t/ 2~ s S
11. Accrued Expenses (Unpaid Bills) ........................ ScheduN F, une s ~
12. TOTAL EXPENDITURES MADE ..........
............... Addur-es 10 t 1 f
f z~
ZOO-(
S s
rent Cash Statement
13. Beyinniny Cash Balance .................. Ierevloussumm.ryPaye, tine 17
s ~?
Z- ~ Z
• From previous Statement Summary Page, Column C. However, it
......................................
14. Cash Receipts
Column A, une 3 above ~ `~~
z. ~ ~ this Ls the first report filed for the calendar year, Column B should be
...
15. Miscellaneous Increases to Cash schedule l,t~ne t blank except for Loaru Received (Line 2), Enforceable Promises (Line
~ ~~n~ Z~ Z?,~ 6), Loans Made (Line 9), and Aurued EMpenses (Line 11).
-2So"~ 37 .s
16. Cash Payments .................................... cdumn A, Une f 0 shove ZOO( Z-=L
17. ENDING CASH 9ALANCE ..... Addt-nes f3 ~ f~ ~ rs, thensubhacf Une l6 s 'ZSS , 5 ~ Summary for Candidates in Both tune and
ffthlsbaterminatlonstatement tine 17 must be:em. ENarwusHSAUNCESf1ouLD November Elections
NOT aE A NEGATIVE AMOUNT
VED
~ 1/1 through 6130 7/1 to Date
21
i
ib
.............. Schedule a, Part 1, Column (b)
18. LOAN GUARANTEES RECEI s . ~ont~
Ut
ons
ecelve .... s
Cash Equivalents and Outstsndin~ Debts
(`^~ 22. Ex enditures
~
~
19. Cash Equivalen4 ............. ... .............. see IrssVUCtbns on reverse s M
c
e ....... S
~%
20. Outstanding Debts .......... • ~ • • • • ~ Addtln.? + tine 111nColumnCabove s
Schedule A TyPeorprl"tlnlnlc. scHl:ouLE A
Monetar Contributions Received am°""tsmayber°und.d
y to whole dollars.
SEE INSTRUCTIONS ON REVERSE Statement coversperlod
from , ^' ~ _ CI 1
through i ~ ~ 6 " ~ ~
~
Pape ~ of ~ I
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
~~ ~~ ~. ~ ~ ~ ~-~ . ~ , ~ r I.D. NUMBER
DATE
RECEIVED FULL NAME ANO ADDRESS OF CONTRIBUTOR
(ircOMMmEE,p1ADpIT1pMT000MMRTEE'fNAMEANDADOREfS,ENTERI.D.NUMIER
OI~iNOI.D.NUM/ERHASaEIMAffIGNED,ENrERTR[AfUR[R'SNAMEANDADDRESf) OCCUPATION AND EMPLOYER
(IfSfEF-[MMOYED,ENTER
NAMEOi/UfN1EfS) AMOUNT
RECEIVED THIS
PERIOD CUMULATIVE TO DATE
CALENDAR YEAR
(lAN.1-DEC.31) CUMULATIVE TO DATE
OTHER
(IF APPLICABLE)
~o s -eve UV`cr k. ~Y
~~~ w. I2w`~~~-
C' 1~;.~c~...~.a ,• ~J Cam.. ~' /7 I ( ~j ~C ~, el
S~~~I
c~~~"~~ .,~ ~
1~ ~ s ~r , ~ 4-
boo
I S
o~
I ~~ -
I ~D Jch~ deer"`-/ ~ ter. G<-~eru I ~~„+,~...~~..;~ 04 I Duo
SUBTOTAL S
Monetary Contributions Summary
1. Amount received this period - contributions of S 100 or more. o ~
(Include all Schedule Asubtotals.)
.................................................................................................... s z
2. Amount received this period - contributions of less than S 100. ~ ,
(Do not itemize.) ....................................................................................................................... s ~
3. Total monetary contributions received this period. ~,c~
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ........ ................................. TOTAL S 2 SC' -
Schedule A (Continuation Sheet)
Monetary Contributions Received
Type or print In Ink.
Amounts may tN! rounded
to whole dollars.
Statement cover:
from ~-~ ' ~~
SCHEDULE A (cont.)
through ~ ~ ~ ^ r % I Page ~_ of Z ~
NAME OFnO,~FFICEHOLDER OR CANDIDATE~A`ND CONTRO/L'LED COMMITTEE I.D. NUMBER
• DATE
RECEIVED ~ FUII NAME AND ADDRESS OF CONTRIBUTOR
MCDMMmIE.INADDRIONTOCOMMITTEE'SN11MlANDADDIIESS,ENTERI.D.NUMIEII
o~pND~,D.NUM~EIIHAS~EENASfIGNED,[NT[IITAEASUIIEII'SNAMEANDADDRESS)
OCCUPATION AND EMPLOYER
(1FSNAMEOr~USINESS)TE~
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(IAN. 1 - DEC. 31)
CUMULATIVE TO DATE
OTHER
(IF APPLICABLE)
SUBTOTAL s
Schedule e - Part I Type orprlntlnlnk.
Loans Received Amounts maybe rounded
to wholt dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONIITROLLED COMMITTEE
V" \G.f' . l..C ~ ~ I t ~ aKnc l '
DATE LENDER OR GUARANTOR'S FULL NAME AND ADDRESS LENDER /GUARANTOR'S
RECEIVED EY COMMfIIEE, INTER iUll NAME, ADDRESS AND I.D. NUM(ER. M NO1.0. OCCUPATION ANO EM-IOTER (lf SEIf•
MUMalRNAftfIMAfSNirRD,ENlI8111ETRUfU11ER'fNAMEANDADDIIESS) EMKOYED,INTER~USINIfSNAME)
•
_ SCHEDULE B -Part I
naTemenTlcoversGptr Lod
from ~ - I r ~ 1
through (- ~ 6"~/~/ page ~ of Z..
I.D. NUMBER
LENDER INFORMATION GUARANTOR INFORMATION
DUf DATEi AMCRINT CUMUTATNE AMOUNT CUMULATNE
INTERESTMIE 0-IOAN TODAiE GUAMNT[[0 IODAI!
DUI DATE ULtNDAR YEAR Ul[NDAR YEAR
f f
INTEREST MTf
OTHER OTNER
^ Ltnder ^ Guarantor ~
t
x_ s
DUf DATE UIENDAR YUR
CALENDAR YEAR
INiEREfT MTE { f
OTHER OTHER
^ lender ^ Guarantor' x t f
DUE OATS UIENDAR YEAR UIENDAR YEAR
INTEREST MTE
f
s
OTHER OIHIR
^ lender ^ Guarantor ~
x
f
s
ee important imtructions on reverse. SUBTOTAL s a) s rol Enl1i ro, o~
fumm~ry -~pt.
Loans Received - Part I Summary lIM 11 OnIT.
1. Loans of S 100 or more received this period. (Include all Loans Received - Part I (a) subtotals.) .......... i
2. loans under 6100 received this period. (Do not itemize
)
.
................. .
................
......... s
3. Total loans received this period. (Add Lines 1 and 2.) ..........
........................... • • TOTAL S
Loans Received - Part II Summary
4. loans of 1100 or more repaid, forgiven, or paid by a third party this period. (Include all Part II (c)
subtotals. If forgiven or paid by a third party, also itemise the transaction on Schedule A.) ..... ......... S
5. loans under f 100 repaid, forgiven, or paid by a third party. (Do no itemize.) If forgiven or
paid by a third party, include this amount on Schedule A Summary, Line 2 . ..............
S _
.....
6. Total loans repaid, forgiven, or paid by a third party.this period. ........
(Add Lines 4 + 5.) ................................ TOTAL S ~ )
...
...................................
7. Net change this period. (Subtract Line 6 from Line 3.) .
Enter the net here and on the Summary Paye, Column A, Line 2 . ............................. .. NET s
Schedule B - Part I (Continuation Sheet) Type or printlnink.
SCHEDULE B - Part I (cont.)
Amounts maybe rounded
Loans Received Statement covers period
tOwhDledDllars.
from ~ - ~ -C! y
through ~- ~G -~/~/ 1 Z
~
page
_ 0
NAME OF OFFICEHOLDER OR CANDIDATE AND CON
TROLLED COMMITTEE I.D. NUMBER
.
/
LL ! Y-L U ~
DATE
LENDER OR GUARANTOR'S FULL NAME AND ADDRESS
LENDER /GUARANTOR'S
LENDER INFORMATION
GUARANTOR INFORMATION
RECEIVED pf COMMInEE, ENTER /Ull NAME, ADOIIESS AND 1.0. NUMBER. IF NO I.D. OCCUPATION AND EMPlOYf11(Ir SELf•
NUM,ER NAS SEEN ASSIGNED, ENTla 111E TREASURER'S NAME AND ADDRESS) EMPLOYED, ENTER BUSINESS NAME) DUE OAIE/ AMOUHi CUMULATIVE AMOUNT CUMUUIiNE
INTEREST RATE O[ LOAN 10 DATE GUARANTEED TO DATE
DUE DATE CALENDAR YCAR CALENDAR YEAR
i
INTERF Si MTE
OTH[R ~ OTHER
^ Lender ^ Guaranto~~ x s t
DUE DATE CAl[NDAR TEAR
EAIFHDAR YEAR
MrT[11EST MTE S S
OTHER OTHER
^ Under ^ Gwrantov a x s t
DUE DATE CALENDAR YEAR
CAl[NDAR rf AR
f
IMEREST MTE t
OTHER OTHER
^ Lender ^ Guarantors x s s
• DUE DATE CALENDAR YEAR CAI[NOAR r[AR
f f
INTf REST RATE
OTHER OTHER
^ lender ^ Guarantor x s t
DUE GATE CAIINDAR YEAR CAL! NDAR rF AR
S
S
INTFR[Sl RAZE
OTHER OIHfA
^ Lander ^ Guarantors x s s
•-
•See important instructions on reverse o/page 1 o/Schedule B, Part 1. SUBTOTAL S m) Inie~ rol o~
s Summ.~~ P.y~.
I Ine le unl~
Schedule B -Pelt II Type or print in ink. - SCHEDULER-Partll
Amounts may he rounded
Repayments Made on Loans Received, Loans to whole dollars.
Forgiven, and Loans Repaid by a Third Party
SEE INSTRUCTIONS ON REVERSE Statement covers perbd
from (- (- G ~(
through ~ ~ ~G -~~
age ~ of Z
NAME OF OFFICEHOLfDEROR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
DATE OF
REPAYMENT
OR
FORGIVENESS
DATE OF
ORIGINAL LOAN
fULL NAME OF LENDER
INTEREST
RATE
(ir cw-uGEOI
AMOUNT REPAID OR ~
FORGIVEN ON PRINCIPAL
(ExCIUDE ~ArMEM Or ItliEllESr1
OUTSTANDING
PRINCIPAL
INTEREST
pAlp
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL S (o ~ TOTAL INTEREST
PAID THIS PERIOD Idj
S
°IMPOIiTANT: Nanypart ofa loan K forpitren or repaid by a third party, also itemize the transaction on Schedule A,
indudinp th+ nanN and address o/ t11~ ptr'son forgiving the loan or the third party making the payment, and the amount
/Or9lven Or paid. Enter the amountln column (d) in the
summary section of Schedule E, l ine 3. Do
not carry this total to the summary section o!
Schedule B.
Schedule B -Part III Type or print intnk. SCHEDULER-Partlll
Amounts may tre rounded
Annual Report of Outstanding Loans Received ~ to wholedoltars.
SEE INSTRUCTIONS ON REVERSE Statement covert period
from I-(- ~(
through ~ ~ / ~ - 4 C~
sge (0 0{ Z--
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
~~ c~~~ ,~ I.D. NUMBER
FULL NAME OF LENDER ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL UNPAID INTEREST
•
Attach additional information on appropriately labeled continuation sheets. TOTAL S
NOTE: This total should be
the same amount as entered
on the Summary Page,
Column C, Llne ?.
Schedule C Typo orprlntlnlnk. SCHEDULE C
Amounts may be rounded
Non-Monetary Contributions Received. towhof.dD))ar/. ststement covers period
from ~ ~ ~ -~~~
SEE INSTRUCTIONS ON REVERSE through I - ~b "- 7 % PeQa ~ of
NAME OF O
FFI
CEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
n
/
/ V 1 CJ~ /~ ~- ~. [~i. r l ~l r ~.
DATE
RECEIVED FULL NAME AND ADDRESS OF CONTRIBUTOR
III COMMITTEE. IN ADDr110N TO COMMrrtEE'S NAME ANO ADDRESS,
ENTER I.D. NUM/ERCII~ U NOI.D. NUM/[R HAS •EENASSIGMED,
ENTER TRIASURlR'S NAME AND ADDRESS)
OCCUPATION AND EMPLOYER
III SEII•EMVLOYED, ENTER NAME Or
/USINESS)
DESCRIPTION OF
GOODS OR SERVICES
FAIR MARKET
VALUE
CUMULATIVE TO
DATE
CALENDAR YEAR
(JAN. 1 - DEC. 31) CUMULATIVE TO
DATE OTHER
(IF APPLICABLE)
(Zc Cl«.~a~l uti`c~r ~ ~~..~
~?oZ C.Je L les (c~
cis-ems„ ~- ~~.. ~~ ~ (~ ~~vlJi~-.e ci /
~~ ~ s~.~~,«~ ~z b Vic. e,
~ o0
33
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL S
Non•Monetary Contributions Summary
Amount received this period- non-monetary contributions of 5100 or more. °`'
(Include all Schedule C subtotals.) .................................................................................... s - 3 ~~
2. Amount received this period -non-monetary contributions of less than S 100. ~
(Do not itemize.) ......................................................................................................... s
3. Total non-monetary contributions received this period. ~ o
(Add lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ........................ TOTAL S ~ ~o
Schedule D Type orprlntlnlnk. SCHEDULE D
Enforceable Promises Received (Other than Loan Amounts may be rounded
to whole dollart.
Guarantees, Loan Endorsements, and Loan Security) Statement covers period
/'
from (-/ - ~7
I I
be reported on Sched le 0 a NOT ScheduletDas~ INSTRUCTIONSON REVERSErceable promises' that must through ~ - /~' - ~ ~ Page 12 of ~ ~
NAME Of OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
M.G~/ ~~ ~' ~ ~ r ~~ • ~~ r~ n I.D. NUMBER
• DATE
RECEIVED FULL NAME AND ADDRESS OF CONTRIBUTOR
M COMMITT[E,INADDrT10NT000MMRT!['f NAME AND ADDRESS,
ENT[RI.D.NUMtEROI~MNDI.D.NlR11tERHASaE[NASSNiNED,
ENTER TRIASUIIER'f NAME AND ADDRESS) ,
OCCUPATION AND EMPLOYER
hr sEU-EmrrtortD, ENTER NAME Of
aus~NESSI
AMOUNT PROMISED
THIS PERIOD AMOUNT PAID
THIS PERIOD
U-tSOENTERON
SCHEDULE A) CUMULATIVE TO DATE
CALENDAR YEAR
(IAN.t-DEC.31) CUMULATIVE TO
DATE OTHER
(IFAPPLICABIE)
~tach additional information on appropriately labeled continuation SUBTOTALS s
eels.
Enforceable Promises Received Summary
1. Promises received of S 100 or more this period (Column (a)) . ..................... .
2. Promises received under 5100 this period.
(Do notitemi:e.) ............................................................
3. Total promises received this period.
(Add Lines 1 and 2.) .................................................. TOTAL
S
S
~-
4. Payments received on promises of s 100 or more this period.
(Column (b)) . ................................................................................... s
5. Payments received on promises under 5100 this period.
(Do not itemise. Also Include on Schedule A Summary, Line 2.) ...................................... s
6. Total payments received.
(Add Lines 4 and 5.) ..................................................................... TOTAL s 1 _~ f
7. Net change this period. (Subtract Line 6 from line 3. Enter the difference here and on ~f
the Summary Page, Column A, Line 6.) ......................................................NET s ~"
Schedule E
Payments and Contributions
(Other Than Loans) Made
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
Type orprlntlnlnk. SCHEDULE E
Amounts maybe rounded Statement covers period
to whole dollsrs.
from ~-~-CCU
through f -" ~6 `" t1 ~~ Pege ~_ of Z' t
I.D. NUMBER
CODES FOR CLASSIFYING EXPENDITURES
If one of the following codes accurately describes the expenditure, you may enter the code and leave the "Description of Payment' column blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations of each category.
'C' - MONETARYANDIN-KIND(NON-MONETARY) 'B' _ BROADCAST ADVERTISING 'G' - GENERAL OPERATIONS AND OVERHEAD
• CONTRIBUTIONS TO OTHER CANDIDATES 'N' - NEWSPAPER AND PERIODICAL ADVERTISING 'T' - TRAVEL, ACCOMMODATIONS AND MEALS
AND COMMITTEES 'O' - OUTSIDE ADVERTISING (MUST BE DESCRIBED)
'I' - INDEPENDENT EXPENDITURES 'S' - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS ~P' - PROFESSIONAL MANAGEMENT AND CONSULTING
'L' - LITERATURE
'F' -
FUNDRAISING EVENTS SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
IM cowwrrTSe, w AoortioN To couwmt[•s NAMt ANO Aoouss, trots i.o. NuMlte or<r No ~.o. IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 Of THE SUMMARY SECTION BELOW.
MNA!!II rrAS et[N ASSrGMto, tMTl11 TIItAfUR[Q's NAMt ANO AOprltsS)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
I
tmporiant: Contributions arw exPenurtures made out of campaign funds to or on behal/o/other SUBTOTAL S
officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Part 1.
Payments and Contributions Made Summary ~~
1. Payments made this period of 5100 or more. (Include all Schedule E subtotals.) ............................:......................... S
Z~~ .~
2. Payments made this period of under S 100. (Do not itemize.) ....................................................................... s 2~ ~~
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. s ~
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ..............................•........ s
5. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8. Z9
........... TOTAL s Z O y --
Schedule E Type or printlnink. SCHEDULE E (cont.)
Amounts maybe rounded Statement covers riod
(COntlnuatlOn Sheet) towhokdollars. w
Payments and Contributions from ~ - I -~ y
(Other Than Loans) Made
(lam
SEE INSTRUCTIONS ON REVERSE through ' - I ~ r ~ Page (~ l of Z
NAME OIIFnnO,,~~FFICEHOLDERORCANDIDATEAND/CONTROLIEDCOMMITTEE I.D.NUMBER ~
U ~/ l c,.r (C fir. ~ ~ .~, _ (, ~ ~, ~ ~ ~~, , .. ,. ,'
CODES FOR CLASSIFYING EXPENDITURES
"C' - MONETARYANDIN-KIND(NON-MONETARY) •B' - BROADCAST ADVERTISING "G' - GENERAL OPERATIONS AND OVERHEAD
CONTRIBUTIONS TO OTHER CANDIDATES •N" - NEVNSPAPERANDPERIODICAL ADVERTISING "T" - TRAVEL, ACCOMMODATIONS AND MEALS
AND COMMITTEES •O" - OUTSIDE ADVERTISING (MUST BE DESCRIeEO)
I" - INDEPENDENT EXPENDITURES "S" - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS "P' - PROFESSIONAL MANAGEMENT AND CONSULTING ~
~' - LITERATURE
'F" -
FUNDRAISING EVENTS SERVICES
tI
NAME AND ADDRESS Of PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION
IM COMMnTEE, M AOOnNkI TO COMMRTE['S NAME AND ADOAESS, ENTEa I.D. MUMeEa Oa, N NO I.D.
NUMaE~NASaIENASSIG11E0,lIrTEaTaEASUREII'SMAMEANDADDAESS)
`
~ ~ ~ ~' - ~ ~
CODE OR DESCRIPTION OF PAI~MENT 1
I ~)
1
~ ~~
AMOUNT PAID WIC
•
1 ,
i~ I,
7J '.
SUBTOTAL S
„'
Schedule F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
n
Type or print In Ink. SCHEDULE F
Amounts may be rounded Statement covers period
to whole dollars.
from ~- ~-~~
through ~ - /6 "• `7 % Pape ~_ of 2- ~
I.D. NUMBER
CODES FOR CLASSIFYING EXPENDITURES
If one of the following codes accurately describes the expenditure, you may enter the code and leave the "Description of Payment' column blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations of each category.
~C" - MONETARYANDIN•KIND(NON-MONETARY) 'B" - BROADCAST ADVERTISING 'G' - GENERAL OPERATIONS AND OVERHEAD
CONTRIBUTIONS TO OTHER CANDIDATES "N" - NEWSPAPER AND PERIODICAL ADVERTISING 'T" - TRAVEL, ACCOMMODATIONS AND MEALS
AND COMMITTEES "O" - OUTSIDE ADVERTISING (MUST OE DESCRIBED)
"1" - INDEPENDENT EXPENDITURES 'S" - SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS "P - PROfESSIONAI MANAGEMENT AND CONSULTING
'L' - LITERATURE "F" - FUNDRAISING EVENTS
SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, ~ RECIPIENT OF CONTRIBUTION
Qr COMMITTIE, al ADDITION 10 COMMITTEE'S NAM[ AND ADDRESS, ENTER I.D. NUMaER OR, N NO I.O. IMrO11TAMf: DO NOT rtEMILE THE ~A1IMENT Or ACCRUED Ex-ENSES ON SCH[DUEES E OR f. RE -ORT ONIV THE lUM- fUM OI -Ar MENTs
ON SCHEDUII f, lWE ~ AND ON SCHIOUIE !, l1NE 1. DO NOT RE•REMIZE ACCRUED Ill-ENSES REPORTED IN A iRE V10US PERIOD.
NUMalRHAS1EEMASSIGNED,ENTIRTR[ASURER'SNAMEANDAODRfSf) CODE OR DESCRIPTION OF OUTSTANDING PAYMENT AMOUNT ACCRUED
I
Attach additional information on appropriately labeled continuation sheets.
SUBTOTAL S
Accrued Expenses Summary
1. Accrued expenses this period of S 100 or more. (Include all Schedule F subtotals.) ..................................................... S
2. Accrued expenses this period of under 5100. (Do not itemlze.) ..................................................................... S
3. Total accrued expenses incurred this period. (Add Lines 1 and 2.) . . . . . .... . . . . . ... . .. INCURRED TOTAL 5
.............................
4. Total accrued expenses paid this period. (Do not itemize. Enter here and on Schedule E Summary, Line 4.) ..............:.. PAID TOTAL S ~ ~ ~
S. Net change this period. (Subtract Line 4 from Line 3. Enter the difference here and on the Summary Page, Column A, Line 1 1.) ...... NET S ~~
Mir b. ~ n~q~n.• nomM.
SChedu~e ~7 Type orprlntlnlnk. SCHEDULE G
Amounts maybe rounded Statement covers rl
Payments Made by an Agent or Independent to whole dollars. ~ ~
Contractor (on Behalf of an Officeholder or ~
from (-I-G t I Ii I
Candidate
SEE INSTRUCTIONS ON REVERSE through ~ - ~ 6 -`1 ~l Paye ~ of Z
NAMEiOAFAOFFI'CEHOLDER ORCANrDIDATE AN/D C/ONTROLLE/D~COMMITTEE I.D. NUMBER
NAME OF AGENT OR INDEPENDENT
CODES FOR CLASSIFYING EXPENDITURES
If one of the following codes accurately describes the expenditure, you may enter the code and leave the "Description of Payment' column blank. Refer to the
back of Schedule E-Continuation Sheet for detailed explanations of each category.
'L' - LITERATURE 'S' - SURVEYS, SIGNATURE GATHERING,DOOR-TO-DOOR SOLICITATIONS
'B' - BROADCAST ADVERTISING 'F' - FUNDRAISING EVENTS
'N' - NEViISPAPER AND PERIODICAL ADVERTISING 'T' - TRAVEL, ACCOMMODATIONS AND MEALS
'O' - OUTSIDE ADVERTISING (MUST BE DESCRIBED)
NAME AND ADDRESS OF PAYEE OR CREDITOR
(K COMMRTEE,111 ADORIOl1 TO COMMn7E['S NAME AND ADOIIEfS, ENTEA I.D. NUM~EII OR IF
NOI.D.NUNI~EIIIIAS~EENAfS1GNE0,[NTEIITIIEASUIIEII'fNAMEANDADDIIESS) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Attach additional in/ormation on appropriately labeled continua ion sheets. TOTAL* S
~ Do not trans/er to any otMr schedule or to the Summary Pape. Thls total may not eQual the amount paid to the spent or independent contactor as reported on Schedule E by the olliceholder[c andida to
Schedule H -Part I Type orprlntlnlnk. SCHEDULE H-Partl
roans mane to utners ~~~~~°~"'~~~°r"`~°°~~°C°
to whole dollar. Ststementcoversperiod
//II
from I-~ -~`T
SEE INSTRUCTIONS ON REVERSE through ~ - ~~~" ~ ~ Page ` ( of Z
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
r 1, ~~ [ C~ ~t~ l
DATE OF LOAN fUIL NAME AND ADDRESS OF RECIPIENT
(IrCOMMITT[I,MADDIiIONTOCOMMITiEf'SNAMEANDADDAESS,ENTEIII.D.NUMSEII INTEREST RATE DUE DATE AMOUNT
011, B NOI.D. NUMaEII HAS a[EN ASSIGNED, ENi[II iREASURF0.'S NAME AHD ADDIIESS)
SUBTOTAL s
~ns Made to Others -Part t Summary
1. owns of S 100 or more made this period.
(Include all Loans Made - Part I subtotals.) ......................................
~ ~~~~~~~~~~~~~~~~~~~~
S
2. Loans underi100madethisperiod.
(Do notitemize.) ...........................................................
~ ~ ~ ~ ~ S
3. Total loans made this period.
(Add Li
l
d 2
nes
an
.) .......................................................................... TOTAL s
Loans Repayments Received - Part II Summary
4. Payments received on loans of S 100 or more. (Include all loan payments received and all loans of S 100 or more
which have been forgiven by this officeholder, candidate, or committee -Part II (a) subtotals.
If forgiven, also itemize on Schedule E.) .........................................
s
.......................
S. Payments received on loans under S 100.
(Including a forgiveness. Do not itemize.) .............................................................. 3
6. Total loan payments received this period. .
(Add Lines 4 and 5.) .. ... .... ... ........ ............................................... TOTAL ,
s ~ !
7. Net change this period. (Subtract Line 6 from Line 3.
Enter the net here and on the Summary Page, Column A, line 9.) ................................... . NET
S
Schedule H - Part I Type orprlritlnlnk. SCHEDULE H - Part I (cont.)
YII{>t 111' Yt I VYIIYtY
Loans a e to t ers to wholedollan.
(Continuation Sheet)
Statement coversperlod
from r - ~ -G
through ~ - ~ ~ '(1~~
2
Pe9e ~ of Z l
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE
/ C c (~ ~ ~ ~- t_ O V, ~ I I.D. NUMBER
DATE OF LOAN FULL NAME AND ADDRESS OF RECIPIENT
(IiCOMMnTEE.wAOOlTIOwTOCOMMn1[E'SNAMEANDADDpESS.fN1EI11.D.NUMlER
OIL Y NO I.D. MUM~EII NAS BEEN ASSIGNED, ENi[II TIIEASUIIEII'S NAME AND ADDRESS)
INTERESTRATE
DUE DATE
AMOUNT
SUBTOTAL S /~~
Schedule H -Part II Type or print in ink. SCHEDULE H - Part II
nmouncs may oe rounaaa
oan epa ments eceive on Loans Mae to whole dollar:.
to Others ~ncluding Payments Received
fromThird Parties) and Loans Forgiven
SEE INSTRUCTIONS ON REVERSE Statement covers r
~ IOd
from -
// `
through ~ -~U - ~ % Page _L1_ of Z
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE 1.0: NUMBER
~- -~~ r C~ o ~~
DATE Of
REPAYMENT OR
FORGIVENESS DATE F
ORIGINAL
LOAN
FULL NAME OF RECIPIENT OF LOAN INTEREST
RATE
pFCHANGEO) AMOUNT REPAID OR
FORGIVEN ON PRINCIPAL*
(fzClUDE11ECEIVTOfINTENEST)
OUTSTANDING
PRINCIPAL
INTEREST
RECEIVED
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL S ~ TOTAL INTEREST s ~ro-
RECEIVED THIS PERIOD
'IMPORTANT: If any part of a loan is forgiven, also itemize the forgiveness on Schedule E. If a repayment is received from a
third a
p rty, Inter the name and address of third party in the ~FULI NAME OF RECIPIENT OF LOAN' column above, along with the
nam! O/ th! rlClpllAt Of th! loan. Enter the amount In column (b) In the
summary section oI Schedule 1, Line 3. Do
not tarry this total to the summary section
o/Schedule H.
Schedule H -Part III Type orprlntinink. SCHEDULER-Partlll
~{~~~VYII{) ~IIO' uc ~ VYIIYCY
nnua eport o utstan ing Loans Made towholedollart.
SEE INSTRUCTIONS ON REVERSE Statement covers period
p
from ~ ~ ~ -t
through ~ ~ ~6J ~/ l
ape ~~ of Z
NAME OF OFFICEHOLDER-- OR CANDIDATE AND CONTROLLED COMMITTEE
l~ ~ l~i~ 1. / i ~ / I.D. NUMBER
FULL NAME OF RECIPIENT OF LOAN ORIGINAL DATE OF LOAN AMOUNT OF ORIGINAL LOAN UNPAID PRINCIPAL UNPAID INTEREST
Attach additional information on appropriately labeled continuation sheets. TOTAL S
NOTE: ThlstotalshouldHe
the same smount as entered
on the Summary Paye,
Column C, Llne 9.
Schedule I Type orprlntlnlnk. SCHEDULE I
Miscellaneous Increases to Cash Amountsmeyberounded
to whole dollars. Stattementcoversperlod
I
iron T_~'~/ ~I
SEE INSTRUCTIONS ON REVERSE through ~r ~b '~ ~ GJ Pew •Z( ~ Z
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
• DATE
RECEIVED FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE, M ADOIT1011 TOCDMMRTEE'S NAME AND ADDRESS, ENTER I.D. NUMlER
DESCRIPTION OF RECEIPT AMOUNT Of
INCREASE TO CASH
U NO I.D. NUMBER IfAS SEEN ASSIGNED ENTER TREASURER'S NAME AND ADDR[SS
5~-e~lnr~r ~ ~~-°-' ye ~
s-o ~ c
~2,s
s ~ ~ ~ cal ~ ~~.~c. ~; o..
~ s ~
l DD G~
i6 ~Y o.~
~
.
l
" {~ t~c'to ~ -{~ t ~ I ~4~
~
C
~e;ti..~~ i-, C~.. 4 l
7 L c .
~
Z~^ s ~ P S f ~D°v
~Z~~~~~~ , I
.
~(~S ~~~~~~~ +~ 1~11~~
C(~~~~~.,,1 (~ i~~~I
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL S
Miscellaneous Increases to Cash Summary
1. Increases to cash of s 100 or more this period . .................................................... s ~ ~ o0
2. Increases to cash under S 100 this period. (Do not itemize.) ................................................. s ,~D ~
3. Total of all interest received this period on loans made to others. (Schedule H, Part II (b).) .................... s
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Paye, Line 15.) .............................................................:.......... TOTAL S