HomeMy Public PortalAboutForm 490 (Jan 17 - Feb 13, 1999)Offic~l-lolder, Candidate, Type orprlntlnlnk.
a:td Controlled Committee
Campaign Statement -Long Form
(Government Code Sections 84200-64216,5)
SEE INSTRUCTIONS ON REVERSE
Cfleck orle of the folbwing boxes to Indluta the type of statement being filed:
Pre-election Statement
Supplemental Pre-election Statement (Ariach a completed form 495 to this statement )
Special Odd-Year Campaign Report
Semi-annual Statement
Termination Statement (Attach • completed Form 415 to this statement.)
Nl~ C[.TL11~ i~
uTTIC nofaer f,.analaate, and controlled committee
Inclu ed in t~iis Statement
NAME OF OFFICEHOLDER OR CANODATE
G(1 ~ ~~ I rf M E%U' ` C S C
IQ SOITGNT 011IIELD pMt1UDE lOtJ1TKM1 AND DISTRNI MUMaER / AP-LNJ1elE)
C~~2t=Nto~yr C~ ry C'~E}y~JCic.
asaxlNruu oR wsrNESS ADDRESS Mo No sTREtT)
~ ~~3 L . ~~,rz Ir rl: o /~I.~
dTr STATE El- CODE AREA CODE/DAYTIME PHONE
C z~~t ~ c>~~ >- x'.11 ~~ 7 i l _ ~O~i/.,~ y y -c~ z~~~~
IVMMII 1!t NAME I I.D. NUMBER
~CIy1ly; 1^r'~~ ru L' ~c=Cr 11,'t~ Gl,~i'~ sue- ~c .~.D~~~
~~rn r[l PDDR)) ITID. AND STRJ;ET)
GTr sTAfE /~ EI-COO[ AREACODE/DAYTIMEMION!
L L,4i~ c M C.~tl T [~ /7 ~~l ~ ~7 ~I __ ~®~I ~G `L l - 3 4~ ~c"..
NAME Of TREASURER C
~cRYANdNT'AOITRESS a TRUwRER
`LZZ S. ~
r
~L/}~r /+? anJ
Statemtntfcovers period
Irom ~ - I ~ - ~~ ~~
~~ 7
through Z -~ .,3 -~ L~ 1.1
Date of election M applicable:
(Month, Day, Year)
Date Stamp
RECEIVE®
FEB 1 8 1999
CITY CLERK
CITY OF CLAREMONT
~ ~, y
For Official Use Onlv
Other Committees Not Included in this Statement: List.nyothe-
committees not Included !n this consolldetedstatement that are controlled Dy you and any
committees o/which you have knowledge that an primarily formed to receive contributlont
a to make expe-Tditures on 6ehaN of your candidacy.
COMMrrT[E NAME
I.O. NUMaER
MAME Oi TREASURER CONTROLL[D COMMITTEE 1
^ rEi ^ NO
COMMITTEE ADDRESS (NO. AND STRE[T)
dTr STATE ZIP CODE AREA CODElDAY11M[ -HOM[
COMYRIEE NAME
I.D. NUMBER
wwre yr T REAwlle R C ONi ROl l E D C OM MITT E E 1
^ rES ^ NO
COYYRTEE ADDRESS (NO. AND fTREET)
(I10. ANO STREET) CITr STATE II-CODE AREA COO[/DAr11ME -IIONF
i~Tl~oc~ rN fI i-
sTAfE EIPCODE AREAC ArTIMEPHONE
C' ~ ~ ~ 7 / ~ 1:~ (~ I~ / ~ L ~ ' ~c~ `~ ~~ Attach addlUonal in/Ormatlon on appropriately labeled contlnuatlon shlreb. _
erg fca ion
I have used all reasonable diligence in preparing this statement. 1 have reviewed the statement and to the best of my~caevated,Qe the Informal co ~ Tined h ~in a in the attached schedules is
true and complete. certi under penalty of perjury under the laws of the~tate of California that the foregoing rue i)rrect~'
Executed on At l~ ~ - , By %Y
D E ~ CnrA DSIATE SIGNATUR[ RF ASURFR
An oHlceholder or undldata who controls • commktee must also verify the campaign statement. I have used all ressonable diligence and to the best ~ wledge the treasu-er has used all
reasonable diligence In preparing this statement. I have reviewed the statement and to the best of my a the inf ont In nd atta sche is true and
complete. 1 certify under enalry of perjury un/Qer the laws of the St_te of fali/jornia that the foregoing i •
Executed on ~ At t~ L~~i ~ ~"lca•'U' r ~ r,'f By
0 TE CrTr AN STAII SIGNAIUR( OI CANDIDAI[/OIIICE HOI DER
Executed on At
OATI
CRT AND STAif
By
Executed on At ey
DATE CRY AND STALE
SIGNATUR( OI CANDIDAIf/OIII((IIOID[R
SIGNAL VR[ O! (ANOIDAIE~OIIIC(1101 DIR
/OR INIORMAixxV REODULLD 10 aE PROVIDED TO YOU PURSUANT TO THE INTORMATNkI MACTKtl ACT Of IS)T, SEE INPORMA110N MANURE ON CAMPAI N OI Cl ~( PIIOVISIONS OI IIIE PQI IIICAI 11110NM !'iT
COVERPAGE-LONGFORN
Stall of CaI1lDlnla FaL PDlhlral PiarllreT CDmmllTlnn
Campaign Disclosure Statement Type orprlntlnlnk. SUMMARY PAGE
Summary Page Am towhokdolla~s~ded StatementcJovie7rsperiod
from ~ _ ` / ~ `l C~
l
through ~ ~ / ~ ~ ~ ~
Pale G" d
SEE INSTRUCTIONS ON REVERSE ~
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D~NUM BER
Contributions Received Column A Column B• Column C
. Monetary Contributions ...............................
chedule a, tine 3 TOIAI TMS rEIUOD
f; 110M ATIACN[D fOHEDUI[S)
. -, .
S ~ ~ 1- -- TOtAI MEVN)US -EAIOD
(SEE NOT[ a[IOYV)
- 7
s ~~ ~ U IOTAI TO OATE
(ADD tOIUMNS A . !)
„' -- ~
s c._ I .7 ~
~oans Received .....................................:...
3. SUBTOTAL CASH CONTRIBUTIONS ...................... schedule a, une ~
addunet t . 2 ~~{~
S f ~ L ~ ~
s ~ ~ U ~
" ~~
i ~. ~ ~~ S
4. Non-monetary Contributions .........................
S. SUBTOTAL CONTRIBUTIONS (ExcfudM Enflor~tabk Promises)
schedule c, une 3
Addunet3 + ~
~-~_-
f ~ ~ z ~
~'`
s 3 3 C% .,.
~_ _
S Z ~ '~~ ~
6. Enforceable Promises
(EXChrdaloan Gwranteet, Une IAbeiow) ...................
7. TOTAL CONTRIBUTIONS RECEIVED .....................
SchedYiN D, floe 7
adduness . 6 ~-
s 1~ Z~ ~-
s 3 3 ~' ~-
_
s Z ~ 7
Expenditures Made ~
~ ~
~-
,.
y
~ j
8. Cash Payments (Other than loans Made) ............ schedule E, ur» s ~ s
s s
.
Loans Made
9 une ~
schediuk N ~- ~'
...................
..............
. ............
,
~ ~ ~ --
~- s
~ ~
10. SUBTOTAL CASH PAYMENTS .............. .............. Addunesa . 9 s
s ~
11. Accrued Expenses (Unpaid Bills) .......... .............. ScheduN F, une s ~ ~ "~`-
12. TOTAL EXPENDITURES MADE .............
.........
.
Adldune: to . rt .
s l ~ ~ s
~ i
~ ~ ~~ ~-
.
.
ent Cash Statement
_
~ ~~ O
13. Be~inniny Cash Balance .................. Pnrvrou, summary Page, Une 17 S ~ • From previous Statement Summary Pale, Column C. However, i1
14. Ceth Retlipts ...................................... Cdumn A, Une 3 above ~ ~ ~ 5
1 S. Miscellaneous Increases to Cash ........................ xhediure r, lirTe ~ ~`~
C
16. Cash Payments .................................... cdumnA, UrTe toaeorne
17. ENDING CASH 9ALANCE ..... Addlirres t~ . to . ts, then subbed Une t6 S t
N this Is a Mrminatlon statement Wse I7 must i4e rero. [NaNG usN aAUNa s-+ou[o
NOT ~[ A NEGATIVE AMOUNT
this is the first report flied for the calendar year, Column B should be
blank except for Loam Received (Line 2), Enforceable Promises (Line
6), loam Made (line 91, and Accrued Expenses (Line 11).
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/1 to Date
18. LOAN GUARANTEES RECEIVED .............. Schedule e, Part i, Column (b) S ~ 21. ~ontEibl~tions S
ecetve ....
Cash Equivaientf and Outstandln~ Debts
19. Cash Equit-alentt .... ............. ............. see insvuctiont on nwne s
20. Outstanding Debts ................. add lirTe ~ . Une r r in column c above s
.~_
_~-
22. ~x~4nditures
de .. s
Schedule A type orprlntlnlnk. SCHEDULE A
Amounts may ba rounded
Monetary Contributions Received to wholedoll~rs. Statement covers period
7 ~ f
from ~ ~ ~ ~! ~~ C/
SEE INSTRUCTIONS ON REVERSE through ~ ~ ~~ ~' y/ Pape "" of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
', .. /1 Y
(N; L ~-1./~M ~~(,~~ ~ ~S c -CUM, M.-'~c= c= T~ C'. ~ c.=t r ~~ c ~d~~ ~"-s ~
,/~~-~,' D i,~ c~'
DATE
RECEIVED FULL NAME AND ADDRESS OF CONTRIBUTOR
(rr(OMMIT7EE.111ADDIT10NioCOMMrtTE['SNAMIANDADDII[SS,ENtE111.D NUMEtEl1
' OCCUPATION AND EMPLOYER
(IfSEl1-tMPIOtED.[Nr[~ AMOUNT
RECEIVED THIS CUMULATIVE TO DATE
(ALENDARYEAR CUMULATIVE TO DATE
OTHER
OR,~NOI.O.MUM~IIINASt[tNASSrGN[D.ENTEIITIItASUII[II
sNAMfANDADDII[Sf) NAMFOi~USg1[SS) PERIOD l1AN.1-DEC. 31) (IFAPPLICABIE)
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SUBTOTAL s ~ ,~ (j , ~~ ~I
Monetary Contributions Summary
1. Amount received this period - contributions of s 100 or more.
(Include all Schedule A subtotals.) .............................................................................. .
....................
2. Amount received this period - contributions of less than S 100.
(Do not itemize.) ................................................................... . .
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................................... TOTAL
~ G , (?C'
1~ Z~~~~~
s
S~iledule E Type orprlntlnlnk. SCHEDULE E
Amounts maybe rounded Statement covers period
Payments and Contributions to whole dollars.
(Other Than Loans) Made From 1 - I `7 -c~ o ~' ''
SEE INSTRUCTIONS ON REVERSE through Z ~ j ~ ~~ `~~ Pape ~ of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE ~ ~ I.D.NUMBER
r /~ _ ~
~ ~L ~U ;~.~i/
W1 LLr/~~? (~(,,/(: S -C,oMMl~L ~ Tc~ L L~ C T ~j ~L~ L~(,~i`~-5 ~-_
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.
MONETARY AND IN-KIND (NON-MONETARY) •B' - BROADCAST ADVERTISING ~G' - GENERAL OPERATIONS AND OVERHEAD
CONTRIBUTK)NS TO OTHER CANDIDATES •N' - NEWSPAPER AND PERIODICAL ADVERTISING 'T' - TRAVEL. ACCOMMODATIONS AND MEALS
AND COMMITTEES 'O' - OUTSIDE ADVERTISING (MUST BE DESCRIlED)
'1' - 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
Gr coMwmrel, w ~oortaw 1ocoMMrrr!!'s ruw! ~rro ~oouss. errrla ro. euMa!^ oR a ra ro. IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 1 OF THE SUMMARY SECTION BELOW.
rrussalaw-sallM.sswMlo.llfrlrrialASURIa'sN11MlANOADOIIISS) CODE OR DESCRIPTION OFPAI'MENT AMOUNT PAID
~C~ ~~TLJ ~lGilJa
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~~ O
ly orv rC ~~ i ~~ C~4
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~~~~~ ~. «~sr ~ Z ~
U. S . ~~ ~N ~•/ c
important: contributions ana expenarturcs made out o/campaign /ands to or on behal/o/other SUBTOTAL S
o -ceholdeR, 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 ri
2. Payments made this period of under f 100. (Do not itemize.) .......................................................................E ~ 7
-~--
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. E
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ......................................E --~-
S. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) ......... ~ ~ TOTAL S I . 1 y ~'