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Home My WebLink AboutForm 460 - Mahmoud A. Shirazi; preelectionRecipient Committee ALIFORNIA Campaign Statement � FORM Cover 460 Page SEE INSTRUCTIONS ON REVERSE Statement covers period from through 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee O State Candidate Election Committee ❑ Primarily Formed Ballot Measure ❑ Recall Committee O Controlled (Also Complete Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored Primarily Formed Candidate/ ❑ Small Contributor Committee Officeholder Committee ❑ Political Party/Central Committee (Also Complete Pad 7) 3. Committee Information COMMITTEE NAME (OR CANDIDA - 0 19 p I F,ra a 22 q.Ve of Date of election if a (Month, Day, Ye r) For Official Use Only �CLERWS OFFICE 2. Type of Statement: Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) I.D. NU BER Treasurer(S) NAME OF 17TREASURER ,1W� a �� MAILINGADDRESS S 1 REEL ADDRESS NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE RESS (IF DIFFERENT) NO. AND Ze't - 451 " _. . NAME FASSISTANTTREASURER, IF MAI INGADDRESS OPTIONAL: FAX / E-MAIL ADDRESS STATE ZIP CODE AREACODE/PHONE 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 y Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on g Date y Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (1an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov t�'�, ,fir==��s•;€ tii'�I 6. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDE OR CANDIq�AT E, , a OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) 2fy �s RESIDE IAL/BUSINESS ADDRESS (N . AND STREET) CITY STATE (� ZIPS? 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 AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 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. 6 NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD i d6ti� LISUPPOR�'®� T ❑ 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 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded to whole dollars. Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER�� Column A ,erg Contributions Received TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 4 1. Monetary Contributions................................................... Schedule A, Linea $ 2. Loans Received... .......... .............................. ...... ...... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $-- 4. Nonmonetary Contributions ............................................ Schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ r A' Expenditures Made 6. Payments Made... ........................................................ .... Schedule E, Line 4 $_ 7. Loans Made....................................................................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ �t 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 R@C@IptS........................................................... 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 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ — 19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column B above $ Statement covers period from through Column B CALENDAR YEAR TOTAL TO DATE $ $ SUMMARY PAGE Page of I.D. NUMBER _ Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ 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) $ To calculate Column B, add amounts in Column A to the corresponding `Amounts in this section may be different from amounts amounts from Column B reported in 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). FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may/ be rounded SCHEDULE A vo WFIOae doua®s. Monetary �®��r�u��®r�s Received Statement covers period p • - A • 1 from,/ • • ' — SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER _ -I.D. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR OCCUPATION AND EMPLOYER CONTRIBUTOR RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) IND El COM ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL Schedule A Summary 1. Amount received this period — itemized monetary contributions. �— (include all Schedule A subtotals.).......................................................................................I.................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ........................... $ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ "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 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E SEE INSTRUCTIONS ON REVERSE NAME OFFILER, 47.:� _ //" -7--/ Amounts may be rounded to whole dollars. Statement covers period from through SCHEDULE E Page of,_ I.D. NUMBER 7LI CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAID radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmorI OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs VIFIL 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 LLEG legal defense PRO professional services (legal, accounting) VOT voter registration VILIT 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 CA, 7- /aiq-& kjC_,4 lne, A IL�Z �e 600 LUD that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ -3 1. Itemized payments 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 13, 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.) ....... ............................ $ L4'7 ................ .............. s 2�_! S ............................... $ .................. TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov