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Home My WebLink AboutForm 460 - Mahmoud A. Shirazi; 2nd preelectionRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period 1Li _� /nJ , / from through 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure State Candidate Election Committee Committee Recall ❑ Controlled (Also Complete Part5) ❑ Sponsored ❑ General Purpose Committee L- Sponsored Small Contributor Committee ❑ Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CAN OPTIONAL: FAX / E-MAILADDRESS �{ (Also Complete Part 6) L�J Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER COVER PAGE La U SO DleStff .- i Date of election abl FPage__ of (Month, DaIN Year I I For Official Use Only U t 2. T�yppee of Statement: LvJ Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF T�RpEASURER NAME F ASSISTANT TREASURER, IF ANY ` � CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/E-MAILADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDI ATE OFFICE SOUGHT OR HELD (INCLUDE /LO',TIOONN AND DISTRICT NUMBER IF APPLICABLE) A fin .B A . P _ s fir / P 7 " _ —_ A rs _ - RESID 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 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/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. i NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT Op�R� 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 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. Statement covers period from ? SUMMARY PAGE Page ofe1�4q&_ SEE INSTRUCTIONS ON REVERSE through NAME OF FILER>�� I.D. NUMBER Ig7Ll/01 Contributions Received Column A THIS Column B Calendar Year Summary for Candidates TOTAL PERIOD (FROM ATTACHED SCHEDULES) CALENDARYEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ $ 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ $ 20, Contributions Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 W. 21. Expenditures Made $ $ 7 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ $ a Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ schedule E, Line 4 $ 1��-r $ Candidates 7. Loans Made....................................................................... Schedule H, Line 3 �s 22. Cumulative Expenditures Made" 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ $ (if Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE. ................................... Add Lines 8+9+10 $ $ $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 'r 13. Cash Receipts........................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 i?r 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 $ To calculate Column B, add amounts in Column Ato the 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). 'Amounts in this section may be different from amounts reported in Column B. 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 LO whole dolla„. Monetary Contributions Received Statement covers period p CALIFORNIA from A �_ .1 through 1;�'4L4 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER -y� I.D. NUMBER % DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF IFAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER 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 ❑ COM ❑ OTH ❑ 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.).................................................................... 2. Amount received this period — unitemized monetary contributions of less than $100 ........ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)........ .............$ � yj .............$ 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) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER jz1, e-t, Amounts may be rounded to whole dollars. Statement covers period from - through SCHEDULEE Page of 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 nonmonetary)* OFC office expenses SAL campaign workers' salaries VC 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 PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE I q -z CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) _` l be to A `) Ski -"fi/ %�T �T-�� J C/ -( q(11 J * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $� Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ................. 2. Unitemized 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 $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov