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HomeMy WebLinkAboutForm 460 - Greg Brockbank for Mayor 2011 (2011-10-22)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Page Of Statement covers period Date of election if applicable: nth, Day, Year) 1511,0 fN For Official Use only from (Mo through 1. Type of Recipient ConlifnifteG: All Committees - Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee F1 Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Compitte, Part 5) 0 Sponsored (Also COMPIOM Part 6) ❑ General Purpose Committee Primarily Formed Candidate/ 0 Spons 0 Small Co Committee❑ Officeholder Committee 0 Political Party/Central Committee (Also Conniisle Part 7) 3. Committee Information I.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) STREET ADDRESS (NO P.O, SOX) CITY STATE ZIP CODE AREA CODE/PHONE 5C.- eolm'o-k MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. CITY STATE ZIP CODE AREA CODE/PHONE 2. Type of Statement: Preelection Statement n Quarterly Statement ❑ Semi-annual Statement n Special Odd -Year Report ❑ Termination Statement n Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY STATE ZIP CODE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE I 4. Verification 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 the laws of the State of Califomia that the foregoing is true and correct. ty Executed on By Signature ofTreasureror Assistant Treasurer - Executed on By 4, Date ure otControking Officeholder, Candidata, state measure Proponent or Responsib officer of Sponsor Executed on Date By SqW!ure0fc7="3F7ce�Cw4�UW State Measure Pmponent Executed on Date By Solstumefconvo"Otticeholder, Candidare, State Wi4�_PmPtrftnt FPPC Form 460 (JanUafY108) FPPC Toll -Free Helpflne: 866/ASK-FPPC (9661276-3772) State of CaMmta Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 g, Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) w�tv' RES DENTIA USINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Scn ej �t Related Committees Not Included in this Statement: List any committees not Included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. I.D. NUMUMM NAME OF TREASURER COMMITTEE ADDRESS STREET ADDRESS (NO P.O. 80x) STATE ZIP CODE AREA CODEIPHONE CITY COMMITTEE NAME ILD. NUMBER NAME OF TREASURER COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) WWII 1CCi STATE ZIP CODE AREA CODEIPHONE CITY 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER ' JURISDICTION COVER PAGE - PART 2 Page of ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidates) for which this committee is primarily formed- NAME ormed 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 ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 450 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (8561275-3772) State of California Campaign Disclosure Statement SummaryPage Type or print In Ink. Amounts may be rounded to whole dollars. sUMMAKY tAUI: Statement covers parlo2iiiiiiiiii from FCALIFORNIA O RM 46 0 $ I IL, SEE INSTRUCTIONS ON REVERSE through Page — of NAME OF FILER I.D.NUMBER Contributions Received 1. Monetary Contributions ................................... 2. Loans Received ... ...... ............ .......................... 3. SUBTOTAL CASH CONTRIBUTIONS ......................... 4, Nonmonetary Contributions .................................... 5. TOTAL CONTRIBUTIONS RECEIVED .............. Schedule A. Line 3 $ Schedule 8, Line 3 Add Lines 1 + 2 Schedule C, Line 3 - .. Add Lines 3 + 4 Column TOTALTHIS PERIOD (FROMATTACHED SCHEDULES) Ii , 0 r� 'Co Expenditures Made t-3 6. Payments Made .................................. .......... ........ Schedule E, Line 4 $ 7. Loans Made ............................................................. Schedule H, Line 3 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) ................ ............. . Schedule F Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ `3.0 1 Current Cash Statement t-3 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 13. Cash Receipts ................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........... .......... .... Schedule 1, Line 4 15. Cash Payments ......... ...... — ........................... .... Column A, Line 8 above -" 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ —3-T If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ...... See instructions on reverse $ 19. Outstanding Debts ............. ........ ... AddLine2 +Line gin Column above $ Column B CALENDAR YEAR TOTALTO DATE $ -7.0 9 tr(11{1, 110 q 0 � Q o $ 7'rjq To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column i, , A may tay be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 W1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* IN Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/ddtyy) *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) A Type or print In Ink. SCHEDULE A Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period I CALIFORNIA A60;� from FORM through 1 Page of SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED tIF COMMITTEE, ALSO ENTER lo. NUMBER) CODE (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 1 IND COM E]OTH Gt v7u4 '�o '_"l too, El PTY El SCC; o. emy 1--Ixr 0w;1 ooPE jjIND EICOM DOTH El PTY rgsCC FIIND EICOM DOTH F1 PTY RSCC _0IND nCOMVS,Q DOTH Q C'y C� ❑ PTY SCC t""'Aa IND [IND (0/ qM DOTH E] PTY 1 G, 6 El SCC SUBTOTALS 13 570 0 o Schedule A Summary •Contributor Codes 1. Amount received this period - itemized monetary contributions. IND -Individual COM - Recipient Committee (Include all Schedule A subtotals.) ...... ............... ................... .................... .......................... ............. $ (other than PTY or SCC) $ OTH - Other (e.g., business entity) 2. Amount received this period - uniternized monetary contributions of less than $100 ......... __ ................ PTY - Political Party SCC - Small Contributor Committee 3. Total monetary contributions received this period. TOTAL $ (Add Lines I and 2. Enter here and on the Summary Page, Column A, Line 1.) ......... FPPC Form 4660 (January/06) FPPC Toll -Free Helpline: 8661ASK-FPFC (8661276-3772) Schedule A (Continuation Sheet) Type or print In Ink.SCHEDULE A (CONT) --f --- Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA A to whole dollars.q1- 5 / FR4 /"I OM oo from i through t Page of -TD--N-UMBER NAME OF FILER 13 rrpp DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF REQUIRED) RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. I - DEC. 31) OF BUSINESS) BIND [:]COM F-JOTH f-I PTY El SCC DIND EICOM E]OTH sQ El PTY N SCC C]COM W4 1� 50, 0 nOTH "kcl L 53A El PTY El SCC nIND EICOM t (jQ F6- CID Ej OTH F1 PTY MSCC _®IND FICOM E]OTH n PTY EISCC SUBTOTAL$.' .Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/06) FPPC Tolt-Free Helpline: 866/ASK-FPPC (8661275-3772) 0-6. Avvlm A (1'nntiniinfinn Sheet) Tvas or orint In Ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded statement cover period to whole dollars. qCALIFORNIA from FORM 460 through Page of I.D. NUMBER qAME OF FILER C, r, 13 3 q 12 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF coMM(TTEE, ALSO ENTER lo. NUMBER) CONTRIBUTOR CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (W SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. I - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) IND COM FJOTH 7,[:] 77 07, 707 7�, 1 �T 4 � PTY F1 SCC E] [NO EICOM f -I OTH tCp) El PTY USCC rcm), PK- WE DIND 000M rJOTH r -1 PTY SCC q -,j C rZIND EICOM [] OTH El PTY [-] SCC ec "00,0 Ito lu;o 'Aww _ffIND RCOM E]OTH El PTY E]SCC 0 C' P77777 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity: PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January,106) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (COI, Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA - to whole dollars. from FORM 464 through Page of OF FILER FN INDIVIDUAL, ENTER DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR I OCCUPATION AND EMPLOYER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME RECEIVED I OF BUSINESS) .Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH —Other (,,.g,, business entity) jty) It PTY — Political Party SCC — Small Contributor Committee N I 1 1-33,123,( AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD I (JAN. 1 - DEC. I (IF REQUIRED) M SUBTOTALS 4(7T,40 FPPC Form 460 (January106) FIPPC Toll -Free Helpline: 86$/ASK-FPPC (8661276-3772) toc o,s W IND EICOM to N nOTH El PTY 0SCC DIND FICOM E]OTH corT, tA0APN' Ot i El PTY El SCC [j61ND ncom El PTY E1SCC [1 ] IND EICOM nOTH El PTY 0SCC jjIND EICOM l i" E]OTH r0iei q4903 [] PTY nscC .Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH —Other (,,.g,, business entity) jty) It PTY — Political Party SCC — Small Contributor Committee N I 1 1-33,123,( AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD I (JAN. 1 - DEC. I (IF REQUIRED) M SUBTOTALS 4(7T,40 FPPC Form 460 (January106) FIPPC Toll -Free Helpline: 86$/ASK-FPPC (8661276-3772) Schedule A (Continuation Sheet) Type or print In Intof _� - SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period CALIFORNIA to whole dollars. from Y,-X<�fj FORM 460 117/ through— ( C, � / Il .__ I Page Of NAME OF FILEK q, L - Sq� I f3F DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER IA NUMBER) CONTRIBUTOR CODE 5dIND r1com []OTH [] PTY E]SCC [KIND E]COM FJOTH El PTY El ScC pIND [JCOM [] OTH W C, �tu El PTY El SCC W IND E]COM E]OTH moon*) El PTY El SCC FJIND EICOM NOTH F1 PTY &SCC .Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC -Small Contributor Committee IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 1 ,33g31 � AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR TO DATE PERIOD I (JAN. I (IF REQUIRED) ra joo,OQ t'd,tA I t 00, 00 5-6 L), . 1 6100 , 00 SUBTOTALS �­ 0 `1 FPPC Form 460 (January/06) FPPC Toll -Free Helptine: 866/ASK-FPPC (8661276-3772) Schedule A (Continuation Sheet) Type or print In Ink- --I -_. - SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. from FORm j!0 through Page of ,ME OF FILER DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (W COMMMEE. ALSO ENTER 4.0. NLMSER) CODE t),,O QIND EICOM E]OTH El PTY EISCC Lk MIND [:]COM E]OTH WWI El PTY nSCC o' 6(1 Scom FJOTH C(jc' , t, 5,77 C4 - &tjj,, UN( W.3 PA,c-1 El PTY FI SCC F-Im ncom f -I OTH CA f -I PTY fg SCC —kIND [:]Com V(W� C*"jw-�-r wo opoPMW, n OTH ,, P A � tr S�m q k qyto El PTY n SCC .Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - other (e.g.. business entity) PTY - Political Party SCC - Small Contributor Committee .7,011 IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (tF sELF.FMPLOYED, ENTER NAME OF BUSINESS) '4rk-cf VCIIC-11"r ""-Iqy - �01 Ilk-r- I ly3q�-'31 C AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. I - DEC. 31) (IF REQUIRED) 100,00 ,2 5-C). 01 1 ? 5,0, 0c) SUBTOTALS C050 ") FPPC Form 460 (January(06) FPIPC Toll-Frae Helpline: 866/ASK-FPPC (886(276-3772) Schedule A (Continuation Sheet) Type or print In Ink. Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period from - q/1 through SCHEDULE A (CONT) Page to Of NAME OF FILER G9RQ FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE DATE RECEIVED OF COL"TTEE, ALSO ENTER U). KUMBER) CODE (W SEU�F�ED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINE") 0;,Fk vo MIND E]COM o 000,0V (q�t EJOTH EIPTY EISCC [:]Com E]OTH E) PTY EISCC `Contributor Codes IND - lndWual COM - Recipient Committee (other than PTY or SCC) OTH - other (e.g., business entity) PTY - political Party SCC -Small Contributor Committee SUBTOTALS (, N 0, 0 C) FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) aim f' Type or print In Ink. SCHEDULE Amounts may DO rounaeo Statement covers period Nonmonetary Contributions Received to whole dollars. CALIFORNIA 4 6 -0 from FORM through 1 t ILI Page ---- !1— Of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER ORPP` CR, 113 12 '35 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) (IF REQUIRED) ®IND FICOM 4tq Ox rtr-ff t 0,00 EJOTH ntow_ CIA E] PTY FISCIC F-JIND EICOM F]OTH EIPTY EISCC []IND ©COM FJOTH E]PTY nsec FJIND []COM LJOTH EIPTY EISCC F"Z"2 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ j3qOM Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.) ..................... .............. ..................................... ......................................... $ 2. Amount received this period — uniternized nonmonetary contributions of less than $100 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) ............................ $ ................. TOTAL $ I- - 3qc, v, — 11 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/06) FPPC Toll -Free Helptine: 8681ASK-FPPC (8661276-3772) Schedule E Payments Made Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period from . OlL2_!E(t I through age PJ-L-L— of t" SEE INSTRUCTIONS ON REVERSE -L-4— NAME OF FILER I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MR 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 FI. candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals W 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 LIT campaign literature and mailings PRT print ads WEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID o 0 e) pl, q_ LJ,y * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1 -, 0 15- 1 G 3, Schedule E Summary O� 1. Itemized payments made this period. (include all Schedule E subtotals.) ................................................................. .............................. ............. $ tp 2. Uniternized 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, Column A, Line 6.) ...................... ... TOTAL $ i � 0 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: fIMASK-FPPC (8681276-3712) SCHEDULE E (CONT.) Schedule E Type or print In Ink. Amounts may be rounded AMOUNT PAID Statementcovers period CALIFORNIA 460 (Continuation Sheet) to whole dolls rs. --j from FORM Payments Made through Pap-0— of -L4— SEE INSTRUCTIONS ON REVERSE NAME OF FILER S��. / 5C�(`UN4'fh- PICK '�AA�Vrl x-011 I.D. NUMBER 1-3:3 q 2 3 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MR member communications MTG meetings and appearances RAD radio airtime and production costs RFD returned contributions CNS campaign consultants CTB contribution (explain nonmonetary)* OFC office expenses PET petition circulating SAL campaign workers' salaries TEL t.v. or cable airtime and production costs CVC civic donations FIL candidate filing/ballot fees PHO phone banks POL polling and survey research TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals FND fundraising events IND independent expenditure supporting/opposing others (explain) POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense I rr �mm-alnnfiterature and mailings PRO professional services (legal, accounting) PRT print ads VOT voter registration WEB Information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. WIVISER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID ID C"? FNID Ll Payments that are contributions or Independent expenditures must also be summarind on Schedule D. SUBTOTAL$ FPPC Form 460 (January/05) FPPC Tolt-Free Helpflne: 86WASK-FPPC (8661276-3772) Schedule G CODE OR DESCRIPTION OF PAYMENT Type or print In Ink. Statement co7vm d bUHtUI1ULt U Payments Made by an Agent or Independent Amounts may be rounded I 11 CALIFORNIA 460 Contractor (on Behalf of This Committee) coo, N to whole dollars. from V - -5 Id 21 ILI ilt4 `LfA through- pegs of SEE INSTRUCTIONS ON REVERSE NUMBER NAME OFFILERI.D. _1 6 6 N� / ? 4,,ZT PXk NAME OF AGENT OR INDEPENDENT CONTRACTOR PC J_rtcs IDNI4 (-No'n- CODES: If one of the following codes accurately describes the payment, you may enter the code. OthervAse, describe the payment. CW campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG OFC meetings and appearances office expenses RFD SAL returned contributions campaign workers' salaries CTB contribution (explain nonmonetary)* CVC civic donations PEr petition circulating TEL t.v. or cable airtime and production costs FIL candidate fiting/baliot fees PHO POL phone banks polling and survey research TRC TRS candidate travel, lodging, and meals staff/spouse travel, lodging, and meals FND fundraising events W 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 PRT professional services (legal, accounting) print ads VOT WEB voter registration information technology costs (Internet, e-mail) LIT campaign literature and mailings * Pavmente that are contributions or Independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID rtc_ CA Vi -t Pit NA,� coo, N -5 ilt4 `LfA ? 4,,ZT PXk q45341/ Attach additional information on appropriately labeled continuation sheets. . TOTAL* $ 3-75'1 G , �z 0 * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FIPPC Form 460 (January/05) independent contractor as reported on Schedule E. FPPC Toll -Free Helpline: 8661ASK-FPPC (86W276-3772)