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HomeMy WebLinkAboutForm 460 - Greg Brockbank for Mayor 2011 (2013-12-31)COVERPAGE • s s Rei ler 01111i11ee Type or print In ink. Data Stamp Campaign Statementr , � ' Cover Pa a r (Government Cade Sections 84200-84216.5) Page of Statement covers period Date of election if applicable: {Month, Day, Year} - = �` For Official Use Only from SEE INSTRUCTIONS ON REVERSE through 1. Type of Recipient Committee: All Cofnmittees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement: Officeholder, Candidate Controlled Committee F-1 Primarily Formed Ballot Measure ❑ Preelection Statement F1 (quarterly Statement Q State Candidate Election Committee Committee r_1 Semi-annual Statement j_ j Special Codd -Year Report Q Recall 0 Controlled Termination Statement [� Supplemental Preelection (Also Comp/ate Part 5) Sponsored P Also file a Form 410 Termination � } Statement -Attach Form 495 ❑ General Purpose Committee (Also Complete Parts) ❑ Amendment (Explain below) 0 Sponsored n Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee luso Complete Part ij 3. Committee Information I.D. NUMBER N v Treasurer{s} COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER N r x a - MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY ���- ;. µv v w a MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODEIPHONE 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 California that the foregoing is true and correct. t� Executed on BY Date D; I Signature of Treasurer or Assistant Treasurer e r_K s' � g Executed on .. �m v . (*'t }B Data Signature of Controlling holder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on # Data BI Sigtura ofControlling Officeholder, Candidate, State Measure Proponent Executed on ByGate Signature of Controlling Cfftceholder, Candidate, Stag Measure Proponent FPPC Form 460 January105 FPPC Toll -Free Helpline: ne: 866/ASK—FPPC (8661275-3772) State of California rA ALIFORNI • • - FORM 4 b" `0 NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) �. :. RESI DENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION 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 candidate(s) for which this committee is primarily formed NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD Q SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE CITY 61AIE 11H U11JUL A F -R UUUt/Hf1U t Attach continuation sheets if necessary FPPC Farm 460 (January/05 FPPC Toll -Free Helpline. 866/ASK-FPPC (8661275-3772 State of California Campaign Disclosure Statement Type or print in ink. $ SUMMARY PAGE Summary Page 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 Amounts may be rounded to dollars. 15. Cash Payments .................................................. Column A, Line 8 above Statement covers period CALIFORNIA $ If this is a termination statement, Line 16 must be zero. whole 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 460 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ........ .............. _ Add Line 2 + Line 9 in Column B above $ 7/t/ 13 FORM from y �4 9/� SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER f5 tt jr, I.D.NUMBER Contributions Received Column A Column B NNOW Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTO DATE Running in Both the State Primary and I ZO of General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ - $ 2. Loans Received ...................................................... Schedule B, Line 3 4; 0 :� "It > ugh 1/1 thio 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS......................... Add Lines I + 2 $ C $ 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 r* em" pa 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ $ Made $ $ Expenditures Made 6., Payments Made ....................................................... ScheduleE, Line 4 $ 7. Loans Made .......... I ................................................... ScheduleH, Line 3 8. SUBTOTAL CASH 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 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 13. Cash Receipts ................................................... ColumnA, 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 $ 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 ........ .............. _ Add Line 2 + Line 9 in Column B above $ H, 91 To calculate Column B, add amounts in Column A to thit corresponding amounts from Column B of your last report. Some amounts in Column A may 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (if Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) *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 (866/275-3772) Schedule A Type or print in ink. SCHEDULE A Monetary Contributions Received Amounts may be rounded Statement covers period 'CALIF* OR'NIA'* to whole dollars. 7/1/13460 from FORM SEE INSTRUCTIONS ON REVERSE through 9F2+43 Page 4"' of NAME OF FILER I.D. NUMBER 4356049-, A_J F DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT OCCUPATION AND EMPLOYER RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 DEC. 31) (IF REQUIRED) OF BUSINESS) F� IND E]COM nOTH [] PTY nSCC n IND ncom F] OTH n PTY El SCC n IND ncom nOTH [:] PTY n SCC n IND ncom nOTH F-1 PTY [-I SCC E] IND EICOM [ ] OTH n PTY El SCC .... ..... ...... SUBTOTAL $ .......... Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ........................................................................................................ $ 71! L 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. (Add Lines I and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTA L $ *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 For 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 6*101: Ig g1fj fl:g ga Uk .Towffiff IyFW WI Fillilt III gilm. Schedule B — Pall I Amounts may be rounded Statement covers period CALIFORNIA 460 Loans Received to whole dollars. 7/1/13 from FORM through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER (a) OUTSTANDING (b) AMOUNTAMOUNT W PAID (d) OUTSTANDING (e) INTEREST (rt) ORIGINAL W CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE t E]"PAID CALENDAR YEAR $ ffFORGIVEN % RATE $ PER ELECTION" --2--cA I t (A '-'t c $ $ DATE DUE t$ ED( IND n COM F] OTH F� PTY 0 SCC 10 DATE INCURRED PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION DATE DUE tEl IND F] COM [:1 OTH ❑ PTY R SCC DATE INCURRED F-] PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION** DATE DUE t❑ IND F� COM Fj OTH ❑ PTY M SCC DATE INCURRED tq - - - - ------ $ 0 V SUBTOTALS 9NRMMM_WJWEa= 1. Loans received this period ....................................................................................... I ............................. $ 2 (Total Column (b) plus uniternized loans of less than $100.) O'l f x 2. Loans paid or forgiven this period ............................................................................. ............................ $ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans pa -id by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............................................................... NET (May be a negative number) Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. If required. (Enter (e) on achedule E, Line 3 tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party G#V&,utor Couai4ftee FPPC For 460 Januar /05 FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) ScheduleE SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print In Ink. Amounts may be rounded to whole dollars. j%jHE Statement covers period, I CALIFORNIA FORM 460 from 4 through CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CUP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings, and appearances RFD returned contributions CTB contribution (explain nonmonetary)* CTC office expenses SAL campaign workers' salaries CVC civic donations, PET petition circulating TEL t.v. or cable airtime and production costs FIL 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 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 PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings FRT print ads MB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) _ 02"��6_cLk L -1-k- CtLlqo� Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBMTAL$ Schedule E Summary (3 6- 1. Itemizedpayments made this period. (include all Schedule E subtotals.) ......................................................... ....... 2. Uniternized payments made this period of under $100 ......................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part I , Column (e).) ............................................................................... $ Al r, 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ FP PC Form 460 (January/06) FPPC Toll -Free Helpline: 866JASK-FPPC (8661276-3772)