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Home My WebLink AboutForm 460 - Mahmoud A. Shirazi; Termination (copy)Recipient Committee D I Campaign Statement nnDDT COVER PAGE E ' Cover Page ' - SEE INSTRUCTIONS ON REVERSE Statement covers,period from ' r414 through 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ State Candidate Election Committee F Recall (Also Complele Part 5) ❑ General Purpose Committee NSponsored Small Contributor Committee I Political Party/Central Committee 3. Committee Information ❑ Primarily Formed Ballot Measure Committee n Controlled ❑ Sponsored (Also Complete Part 6) Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTE /; ,HmDub I.D. NU IBER f %Z/ / STREET ADDRESS (NO P.O. BOX) CITY TATE ZIP CODE / AREA CODE/PHONE ZI /" CODE AREA CODE/PHONE Date of election if appli (Month, Day, Year) 0 E C - 4 2024 of For Official Use Only ., , CITY CLERK'S OFFICE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ElSpecial Odd -Year Report VrTermination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below)��— /lrlb�d Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY i$TATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY �n(/ MAI ING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX /E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS 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 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) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAAMMEE OF OFFICEHOLDER OR CANDIDATE a � � ��/ 'e-'z/U /? ( X//�%Z-yq?i- l FFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF LICABLE) ESIDENTIAL/BUSINES ADDRESS (NO.ANDSTREET) 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 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO 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 Listnames of officeholder(s) or candidate(s) for which this committee is primarily formed. COMMITTEE ADDRESS &TREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary NAME OF OFFICEHOLDER fO. (CAANN�DIIDAATE`� 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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER'%;ram,L Contributions Received 1. Monetary Contributions................................................... Schedule A, Line 3 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 Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 7. Loans Made....................................................................... Schedule H, 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 Amounts may be rounded to whole dollars. Statement covers period from Column A Column B TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE $ 4— $ $ $ W $ $ .d IF- $ 100� $ Current Cash Statement 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 X - 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ A 2� — If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts ,g 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 A to 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). SUMMARY PAGE Page of I.D. NUMBER 1 I47Y10-, 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) $ "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 L1JII�-� Monetary Contributions Received to wliole Uolla�s. Statement covers period I CALIFORNIA 460 from A4 FORM SEE INSTRUCTIONS ON REVERSE through DA—C AJAA12 L !" Page of NAME OF FILERrn*/s172 r4ek ei (� o1/y .,r I.D. NUMBER �9 FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE 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.)............... �.5 TOTAL $ 7" '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 A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole collars. Statement covers period CALIFORNIA 460 from FORM 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 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 J SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ::1 OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY n SCC 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 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Amounts may be rounded SCHEDULE B - PART 1 Schedule B — Part 1 to whole dollars. Statement covers period 11111110 Loans Received CALIFORNIA from FORM SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS PERIOD THIS PERIOD. CLOSE OF THIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD PERIOD ❑ PAID CALENDAR YEAR $ $ % $ $ RATE ❑ FORGIVEN PER ELECTION DATE DUE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION** RATE $ $ $ ❑ IND ❑ COM ❑ OTH ❑PTY ❑SCC tEl $ $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION` RATE $ $ $ $ $ DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE SUBTOTALS $ $ $ $ Schedule B Summary 1. Loans received this period....................................................................................................................$ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.).............................................................. NET $ Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number) 'Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. (Enter (a) on Schedule E, Line 3) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Parry SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 2 Schedule B — Part 2 Amounts may oe rounaea Statement covers period to whole dollars. ' • Loan Guarantors � from SEE INSTRUCTIONS ON REVERSE through Page of I.D. NUMBER NAME OF FILER FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE BALANCE CONTRIBUTOR * OCCUPATION AND EMPLOYER LOAN GUARANTEED TO DATE OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) THIS PERIOD TO DATE LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH DATE PER ELECTION PTY (IF REQUIRED) ❑ SCC $ LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC $ CALENDAR YEAR LENDER ❑ IND ❑ COM $ ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC $ LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC g Enter on SUBTOTAL $ Summary Page, Line 17 only. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Statement covers period from through SCHEDULE C Page of I.D. NUMBER FULL NAME, STREET ADDRESS AND IFAN INDIVIDUAL, ENTER AMOUNT/ CUMULATIVE TO DATE CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF DATE RECEIVED ZIP CODE OF CONTRIBUTOR CODE* (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET CALENDAR YEAR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) VALUE (JAN 1 - DEC 31) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND J COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH I PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)......................................................................................................................$ 2. Amount received this period — unitemized 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 $ PER ELECTION TO DATE (IF REQUIRED) "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 D SCHEDULE D Summary of Expenditures Amounts may be rounded Statement covers period to whole dollars • Supporting/Opposing Other • Candidates, Measures and Committees from through Page of SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED) PERIOD CALENDAR YEAR TO DATE OR COMMITTEE (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent - ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.)....................................................... $ 2. Unitemized contributions and independent expenditures made this period of under$100.................................................................................... $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL.. $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D (Continuation Sheet) Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees NA%1L OF FILLR Amounts may be rounded to whole dollars. NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT OR COMMITTEE ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure Statement covers period from through SCHEDULE D (CONT, Page of I.D. NUMBER DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE PER ELECTION (IF REQUIRED) PERIOD I CALENDAR YEAR TO DATE (JAN. 1 - DEC. 31) (IF REQUIRED) SUBTOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILE 1 Amounts may be rounded to whole dollars. CODES: If one of the following codes accurately describes the payment, you may enter the code CMP campaign paraphernalia/misc. MBR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)* OFC office expenses /CVC civic donations PET petition circulating V FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) q/ LIT campaign literature and mailings PRT print ads NAME AND ADDRESS OF PAYEE CODE OR SCHEDULE E Statement covers period • . from � ' • RM through Page of V `/;� Otherwise, describe the payment. RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (Internet, e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Ile 77 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ /2 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).)............................................................................. $ �f 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ j��• 3 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E (CONT.) Amounts may be rounded Statement covers period (Continuation Sheet) to whole dollars. pCALIFORNIA FORM 460 •' Payments Made from SEE INSTRUCTIONS ON REVERSE through - Page of NAME OF FILERI.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. MBR 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 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) itr Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule F Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER CODES: If one of the following codes accurately describes the payment, you may enter the code CMP campaign paraphernalia/misc. MBR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)* OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads Statement covers period from through SCHEDULE F Page of I.D. NUMBER Otherwise, describe the payment. RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) (a) (b)CURRED (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT IN AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD I. * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule F Summary SUBTOTALS $ Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under$100.).................................. PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)................................................................................................................................................................................... NET $ May be a negative number FPPC Form 460 (Jan/2016)) advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov FP PC Advice Schedule F (Continuation Sheet) Accrued Expenses (Unpaid Bills) Amounts may be rounded to whole dollars. f Statement covers period from SCHEDULE F (CONT.) NAME OF FILER through Page of 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. MBR 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 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD SUBTOTALS $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period CALIFORNIA Contractor (on Behalf of This Committee) to whole dollars. from FORM • SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER NAME OF AGENT OR INDEPENDENT CONTRACTOR 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 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 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Attach additional information on appropriately labeled continuation sheets. Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. TOTAL* $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule H Loans Made to Others* SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Statement covers period from through SCHEDULE H Page of I.D. NUMBER FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER la) to) l�l la) OUTSTANDING AMOUNT iREPAYMENT OR OUTSTANDING le) (T) ORIGINAL to) CUMULATIVE OF RECIPIENT (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BALANCE AT LOANED THIS FORGIVENESS BEGINNING THIS CLOSE OF THIS INTEREST AMOUNT OF RECEIVED LOANS NAME OF BUSINESS PERIOD THIS PERIOD` DFRI(lrl DGD tl LOAN TO DATE ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTION" DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ $ % $ $ RATE ❑ FORGIVEN PER ELECTIONI* DATE DUE DATE INCURRED `Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. Schedule H Summary SUBTOTALS $ $ �$ 1. Loans made this period....................................................................................................................................................$ (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans............................................................................................................................................$ (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.)............................................................................................NET $ (Enter the net here and on the Summary Page, Column A, Line 7.) (Enter (a) on Schedule I, Line 3) ..If Required (May be a negative number) FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (966/275-3772) www.fppc.ca.gov Schedule I Amounts may be rounded SCHEDULE 1 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule 11 Summary 1. Itemized increases to cash this period . ........................................................................................................................... $ — 2. Unitemized increases to cash of under $100 this period . ................................................................................................ $ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).)......... ..............................$ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.)............................................................................................................................. TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov