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HomeMy Public PortalAboutForm 490 (Feb 14 - July 30, 1999)~:~fficc:holder, Candidate, Type Dlprlntlnlnk. and Controlled Committee Campaign Statement -Long Form (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Check orle of the following boxes to Indlute the type of statement being filed: Pre-election Statement Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) Special Odd-Year Campaign Report Semi-annual Statement Termination Statement (Attach a completed Form 41 S to this statement.) is QQ er an ate, an on roe ommlttee Inclu~ed in tfils Statement NAME OF Or FFIC`EHOLDER Oil CANDR)ATE IN~LL1 ~NI ~ lL-~t e /ICt fOUGNjQR HEED QNC1UDt LOCATION Alb OKTRICT N41ttalR M AMlICllelEl. 1~1~1'-4 ILL: 1"~1 U ~ RtslotNruu oR alrsa/t}s Aooatss ~. ~ - ~ L urY ANOSrR[m ~k~vG-fl TE ~~ ~ ~ ~ ~ ~ I A ,l L COVER PAGE -LONG F Statement covers period from Z ~~ "L~ through Oate of election H applicable: (Month, Day, Year) Date Stamp ~tECEI~/E® J U L 3 0 1999 ~ ~ oflici.l use only ctrr ct.ERtc CITY OF CLAREMORtV° utner c.ommlttees Not Included in this Statement: L/stanyother commhtees not Includedln this coruolldatedstatement that are controlledby you and any committees o/which you have knowledge that a-e primarily loaned to receive contrlbutloru a to make expenditures on 6ehaNo/your candldaq. COMMn7EE NAME LD. NUMaER NAMt Oi i11EASURER CONTROIIEDCOMMITTEET - _ ^ Yes ^ No COMMITTEE ADDRtSS (NO. AND STR[[T) ~y`l -~~LUC} CRY fTATE ZI-COOE AREA CODEIDAY11Mt -MON! ~VMMII leC IIIAMC I.D. NNMtER COMMRT[ ADOr1ESS (110. ANDfTREtT) Z ~Z Z S , ~ R ~- ~T-M U ~ ~ 1-t Y~ V t CIT1I ATE ZI/COOE ARIACODI/DAYTMtt-HONE 1<v~s ~ ~~ /ERMANlMI AODatSS 0/ Ta[ASUR[a 2'Z Z S ~Ma ~}, ~e~r~~r~~r~~~~ (NO. ANO fTRtET) /~ f~~T ~'l o v ~~H ~ V t'. f Tt ZV"'C~ODt AREA [d MAME LD. NUMtfR MAMI Of TR[ASUIIEa COMROllEO COMMITItt 1 j ^ r[s ^ No COMMRTEt ADDRESS (N0. AND sTRE[n CRY STATE tl-CODE AREA CODE/DAYTIME /LION! INONpE 1 ' O C~ ~ y AttacA addltlonal In/wmadon on appropriately labekdcont/nuatlon sheets. ere ua on 1 have used ell reasonable diligence in preparing this statement. I have reviewed the statement and to the Mst of m~(r Jloow~e the Intor etl con fined h n an n the attached schedules is true and complete. I artily C eJ penalty of rjury under the laws of the Shaty~of California that the foregoing IsT u nd- orrect. Executed on =3v G At ~ ~{~'' i'~l D IJ ~ ~ . ~t By ~ •r ~ OAT CRY AN IA1E SIGNATURE Or RE ASUIUR An offlcehoWer a urtdldate who controls a commktee mutt also verify the campaign statement. I have used all reasonable diligence and to the be knowledge the treasurer has used all reasonable diligence In preparing this statement. I have reviewed the statement and to the best of my knowle the informs tained h n and in the ch ules is true snd complete. 1 carte der nalt~l of perjury und~r the laws of the State of California t at the foregoing it true a l Execugd on ~~ At ~L~~~= ~d ~~ ~ / ~ By OA CRY AND STATE SIGNAIURI Or CANDIDAI!/OIr1ClHOlDIR Executed on ol-Tt Executed on DATt At At CRT AND STATE CRY AND STATE By By fIGN41 URF OI CANDIOAIE/OIIICEHOI DER SIGNAIUR[ OI CANDIDATE/OI IItIN010I11 TOR xwOaMATKIN uOUWD 101E -ROVIDtO TO TOU -URSUAM 10TH[ INIORMAIKIN MACTKIS ACl Of It/r, SEE INI QRMATION MANUAL tkI (AMPAI 01 C Q IR P110VISIONS 01 Itg PQI111(Af ~11011r~ BSI Slala of Callfornla fall Pollllral Plartlrel fommllllorl Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF OFFICEHOLDER OR CANDIDATE AND Contributions Received Type or print In Ink. Amounb may be rounded to whokE dollars. D COMMITTEE ~1 / ~~i~~=~ ~TI C~L~t:T ~,/~-LCD(//~~~ 1. Monetary Contrf butions ............................... s~ieduk a, tine 9 2. Loans Received ......................................... ScMduk e, une 7 .SUBTOTAL CASH CONTRIBUTIONS ...................... addun•s f + 2 4. Non•monetary Contributions ......................... schedule c, un.3 5. SUBTOTAL CONTRIBUTIONS (Erclwi~e Enrornable Prombtt) 6. Enforceable Promises (Excl~dr Loan GwrarEtett, Une fe below) .................. . 7. TOTAL CONTRIBUTIONS RECEIVED ..................... Add Unet 3 + Column A IOIAI TIfS riNOD ~ 110M ATTACH! D f01EDUlE S) ~- s ~ ~.% ,a - -ter-. s .`~ ~ `~ ~- s ~ ~~ ~ - SchedbN D, Une 7 Add tlrwt S + 6 s ~~ Statement/covers perb9d from 2'~( ~ r~ I through ` ~3 ~ ~~ Column B' ions nTEVrous rEUOD (SEE NOTI a[lOW) .~' s 21~~~-- -6- s ~-l~5 ~~ ~~ s ~~.~ •~ SUMMARY PAGE Pape `7r d I.D. NUMBER ~~o9i~ Column C IOrAL TO DATE tADD COLUMNS A • ~) : Z6~O _.~-_ ti ~ ~~ .~ s ~Z~ ~ U "-'{~- s Z66O Expenditures Made ~. 8. Cash Payments (Other than Loans Made) ........... . 9. Loans Made ........................................... ,_ °~ 10. SUBTOTAL CASH PAYMENTS .................... . schedua t:, une s saiedr,le H une 7 Add Unet a + 9 11. Accrued Expenses (Unpaid Billsl ........................ sdredule F, une s 12. TOTAL EXPENDITURES MADE ......................... addUriet 10 + 1 f s /~/~~ 'ET s 1~~.~ s !~~_ l196 s l 1. ~~ -~ l1 ~ Z~ ~ °~- 7~6 s 7_66 rent Cash Statement 1 Beginning Cash Balance 14. Cash Receipts ............ .................. lrevlout Summary lope, Urse 17 .......................... Column A. Line ~ above -~ Q s ~~_~ CJ 1 S. Miscellaneous Increases to Cash ........................ Schedule ~ tine a ~~- 16. Cesh Payments .................................... column a, lkie foabore ` '~?~ ~ .5 17. ENDING CASH BALANCE ..... addtlnet f3 + 1e + fS, thentubhadUne flf s '-~"- N thlt B • tennlnadon atatemenl LLse 17 mutt be:ero. E LADING usH aAEaNtE sHOUID NOT eI A NEGATIVE AMOUNT 16. LOAN GUARANTEES RECEIVED .............. Schedule e, fart 1, column (b) s -~ • From previous Statement Summary Pape, Column C. However, it this b the first report filed for the calendar year, Column B should be blank except for LwrTS Received (Line 2), Enforceable Promises (Line 6), Lorns Made (line 9), and Aurued E>tpenses (Line 11). Summary for Candidates in Both June and November Elections 21. ~ont~ibl~tions s ecetve Cash Equivalents and Outstanding Debts _ 22. €xpenditures 19. Cash Equlvalen4 ......................."...... Se+ lnte,T,ctloru on newne s ~ e ....... s 1/1 through 6130 711 to Date 20. Outstanding Debts ................. addtllrle s + rate t f In column c above s ~T Schedule A Tvoeororlntlnlnk. SCHEDULER • Amounts maybe rounded Monetary Contributions Received to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period Irom z ~ / I ~~ through ~ ~~~ ~ ~ ape / of NAME OFOFFICEHOIDERORCANDIDATEANDCONTROILEDCOMMITTEE _ ~1~LigNM f ~•~~~-~O~JMIITCf.~ 7~0 ~GC~C'T",SI~C.~~,1/'t:J~ I.D.NUMBER ~1 r 1~C7~/•~ DATE RECEIVED full NAME AND ADDRESS OF CONTRIBUTOR (IECpMMITEEE,~IAD[Mf10N1000MMtT1E['tNAMEANOA~[111ESS,EN1I111.D NUM~E11 o1~EtNO1.D.NWaraNASaElNAfs1GNED,EMTERi11EAtU11EA'fNAMEANDADOAEfs) OCCUPATION AND EMPLOYER (~isEll-[M/IOYEO,eNrEe NAME OrausrrESS- AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE LENDARYEAR ~lAN.1-DEC. 31) CUMULATIVE TO DATE OTHER (IF APPLICABLE) SUBTOTAL s Monetary.Contributions Summary 1. Amount received this period - contributions of S 100 or more. ~ © n~ (Include all Schedule A subtotals.) ................................................................................................ .. s l 2. Amount received this period - contributions of less than S 100. (Do not itemize.) ...................................................................... ................... S 3. Total monetary contributions received this period. Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ........ ............................. ... TOTAL S X05",~~ ~~ ~~ l~0 Schedule B -Part I loans Received SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Amounts may ba rounded to whole dollars. Statement cov~,e/rt peQrioad from Z ~~ ! - L through ` ~ ~ ~ ~~ NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE ~~i~~~AM G~ ~sC -~ ~n%,rrt-~ DATE LENDER OR GUARANTOR'S FUII NAME AND ADDRESS RECEIVED Ir coMMrn[e, tNTEII full NAAEE, AODlltss ANO t.o. NuMSte. N rro ro. rM1MalII INt ~EtN ASSNiMEO,lNIEII TT1l 111tASU11t11'S NAM[ ANO ADDIItSf) ~~ ~c4vi;U~ ~ ~ivr~-Y ~/~,3 ~ z'Y6 ~ N ~~ c?n b GT . ~ ~~ ~~~,~~ ,~;, c~ Lander ^ Guartantor ~ ^ Lander Lander ^ Guart+ntor ~ Guartlntor ~ important lmtructions on revere. LENDER /GUARANTOR'S TENDER INFORMATION OCCU-ATION AND tMKOrt11 M Stlr- EM-IOYED,lNlElItUSINtfSNAME) DUEDAIEr AMOUNT INTErI[Sl Mtt Or IOAN DUE DAZE INI ~~'~[J ~ ~ EItESTMtt /~ ~ '\~.s' ' x DUE DATE rNrtusT MTt x DuE oArt INTE11[Si MT! x SU9TOTAl s G ti~/~ CUMUTA~TNI TO DATE (AItNDAII rtAtr t ~~~ OTHtII SCIiEDUIE 8 -Part I Pale ~ of I.D. NUMBER ~t~o yl ~~ GUARANTOR INFORMATION AMOUNT CUMUlA1Nl GUAMNtlED rnn~u CAItNDA11 rtA11 1 OTNtII t CAItNDA11 rtAR t O1N111 f CALINDAIIrtAA f f fAItNDAII rtAll t OINlA t uItNDAe rtArr f OTNl11 f s Loans Received -Part 1 Summary ~• 1. loans of s 100 or more received this period. (Include all loans Received - Part I (a) subtotals) .......... f - ~ ~~ 2. loans under s 100 received this period. (Do not itemize.) ........................................... f 3. Total loans received this period. (Add lines 1 and 2.) ...................................... • TOTAL S ~ ~~! loans Received - Part II Summary 4. loans of s 100 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 iteml:e the transaction on Schedule A.- .............. S 5. loans under: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 lines4 + S.) .............................................. TOTAL S ~ ~" l~ • ) 7. Net change this period. (Subtract line 6 from line 3.) Enter the net here and on the Summary Page, Column A, line 2 . .............. NET ................. s _..- O1NIA s Enter bl on Sumn~ry 1~yt. lhr It nnl. Schedule B -Part II Type.orprlntlnlnk. SCHEDULEe-Pane Amounts may De rounded Repayments Made on Loans Received, Loans tovyholedollars. Forgiven, and Loans Repaid by a Third Party SEE INSTRUCTIONS ON REVERSE Statement covers period from Z - ~ y -9 q through ~ - ~ ~ ~~ / epe ~J of NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROIIED COMMITTEE Gc~ i l~~ /f~--r Cc~1 ~ ~ ~ - ~.~ ~ ,' M ~ ~TT~~ T-u C i/~ t' r C i ~ ~= ' '~ ~~~ ~~ I.D. NUMBER gog~~ DATE OF REPAOYR ENT FORGIVENESS DATE Of ORIGINAL IOAN FULL NAME OF LENDER INTEREST RATE lir cru-r~tol AMOUNT REPAID OR FORGIVEN ON PRINCIPAIf (rMCIUDt -AYMEM Or IMltusr- OUTSTANDING PRINCIPAL INTEREST PAID ._~ Attach additional infiormation on appropriately labeled continuation sheets. SUBTOTAL Z I~ rr G TOTAL INTEREST PAID THIS PERIOD Idj S 'IMPOAT/UIIT: Nuty part of • loan is Ibnpivt:n or repaid by a third party, also itemize the transaction on Schedule A, Includirtp tM nwna crud addnu o/ tM parson lor~yiviny the loan or the third party making the payment, and the amount /or~IVtrl Orpald. Enter the amount In column (d) In the summary section o! Schedule E, ! ine 3 Do not tarry this total to the fummary section of Schedule B. SCHEDULE E Sch ed tt le E Type or print In Ink. Amounts may be rounded Statement covers period ~ Payments and Contributions to whole dollar:. z / `/ -n ~ ~ (Other Than Loans) Made from `~ SEE INSTRUCTIONS ON REVERSE through ( ~ 3 ~ ~ ` Pape ~ of c° NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER w ~ wi /~-~ ~~ .~,- ~-~ ~ - ~~~M~~ ~rTe~ T~ L ~~: r r ~, ~ ~ ~ti~r~,s- ~- °~ 90 9 ~ ~ 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' - MONETARY ANDIN-KIND(NON-MONETARY) •B' - BROADCAST ADVERTISING 'G' - GENERAL OPERATIONS ANDOVERHEAD 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 p easrrmte, m •oortroN so coMramtrs wcMt Iwo aDDass, ercrta ro. BuMet^ oa. r ra ro. IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE ~ OF THE SUMMARY SECTION BELOW. wrwute raf et[M AflrGMlD, tNilll ilWflMlta7 ru-Mt wao wpDpesS) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID ~~~2~ ~~o~~%~ /-~ ~~17~ / ~ 9 3 ~~~ i~ ~,~ ~ ~~ ~ ~ ~ i~v~ (.~* ~ J~ ~- C: c.;4re: ~-r o ~v r C' 04 ~1 7 ~ l j A C: C~ V c; 1, i ~-J ~~ G ~{ ~`~V /~ y N Gc) nv ~ C ~ y ~, ~~ ~l'N' ~~c-`~'.9~ J ~~ c,~/ T' ~ ~~ Z v 7 ; , C-L ~-~: c M,~ r ~ 17 I/ .Important: Contributions and expenditures made out of campaign funds to or on behalf of other SUBTOTAL i J ~,) 7 3 officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Part 1. l - I Payments and Contributions Made Summary - 1. Payments made this period off 100 or more. (Include all Schedule E subtotals.) ....... ......................... S ~ ~ `~ ~- ., 2. Payments made this period of under s 100. (Do not itemi:e.) ....................................................................... s 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 itemise. 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.) ......... TOTAL S ~-