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HomeMy WebLinkAboutForm 460 - Greg Brockbank for Mayor 2011 (2012-06-30)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print In ink. Statement covers period from through 1. Type of Recipient Committee: AN ContmNMes – complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also COMPWOPert6) O Sponsored ElGeneral Purpose Committee WWCompielePWQ Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (AJW CMWI&b PW 7) 3. Committee Information COMMITTEE NAME (OR CANDIDA 4. STREET ADDRESS (NO P.O. BOX) COVER�PAGGt Date of election if applicable: f '� pap — of (Month, Day, Year) — For Otfxial Use Only 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi-armuat Statement ❑ Spm Odd -Year Report ❑ Temtkration Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement -Attach Form 495 ❑ Amendment (Explain below) I.D. NUMBER Tmasurer(s) NAME OF TREASURER MAILING ADDRESS CITY STATE ZIP CODE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX Cin STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE'_s AREA CODE/PHONE vermcauon 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. 1 certify under penalty of perjury under the lows of the State of California that the foregoing is true c�rrt. Executed on ¢ r fBy f £u D r4 i g n Executed on 1' Date Executed on Dab Executed on Date X By SWwbure of S Maaftft Riopww t M Sw ahxe of St�o- Measles proponent FPPC Form 460 (January/06) FPPC Toll -Free Helpi)ne: 86WASK-FPPC (ti66/2754772) State of Confomis Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee Type or print in ink. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) -UbINLSS ADDRESS (NO.AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: ust 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. NAME OF TREASURER P.O. CITY STATE ZIP CODE AREA CODE/PHONE ULAW1 I I EE NAME I.D.---NUMBER NAME OF TREASURER -- •c MWLJM=aJ STREETADDRESS (NO P.O. BOX) CITY �5TE ZIP �CODEAREA •s •i 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE tALLUT NO. OR LETTER N COVERPAGE-PART2 IIIIIIaaaaa w 4 Page — I- Of ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, N any. -"'%,cnVLL=K, L;ANUILJAIF- OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT No. IF ANY 7. Primarily Formed Candidate/Officeholder Committee LJW tomes of officeholder(s) or Cand1daWs) for which dds committee Is prime* formed NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD❑ SUPPORT El OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT Oq HELD 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE Attach continuation sheets if necessary FPPC Form 460 (January/06) FPPC Ton -Free Helplim. $WASK-FPPC (8661276-3772) State of Caftfornia C2mpaign Disclosure Statement Summary Page Type or print In Ink. Amounts may be rounded to whole dollars. Contributions Received ColumnA 6. Payments Made SdXKk" a Lkw 4 $ TOULTMPEFUM ............................................................. Ft0MMTACHW8CHEMXM 1. Monetary ContributionsSd 14 .................................... Add Ums a+7 $ xxk" 3 A LkW %9 6 $ 3m. 2. Loans Received ...................................................... SdRKW A Line 3 Sctmd" 3. SUBTOTAL CASH CONTRIBUTIONS C. Line 3 Addlhwa+9+10 ......................... Add Unes 1 +2 $ 4. Nonmonetary Contributions ............... ............. . .. .. Sc hadde C Une 3 5. TOTAL CONTRIBUTIONS RECEIVED........................... Add LkWS 3 +4 $ Expenditures Made 6. Payments Made SdXKk" a Lkw 4 $ 7. Loans Made ............................................................. SChOdde H, Une 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Ums a+7 $ 9. Accrued Expenses lUnpaid Bills) ............................... s&,Ocw , F Line 3 10. Nonmonetary Adjustment .......................................... Sctmd" 11. TOTAL EXPENDITURES MADE ................................ C. Line 3 Addlhwa+9+10 $ Current Cash Statement 12. Beginning Cash Balance ....................... p.W., S .... a, y Fam Un. 16 $ tic 13. Cash Receipts ................................................... CoOm A Lift 3 above I 14. Miscellaneous Increases to Cash ........................... Schecua 1 Une 4 15. Cash Payments Cofurm A Line a above 16. ENDING CASH BALANCE .......... Add tines 12 + 13 + 14, then vjb&idLjn& 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Sdxl*d- A PWt 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See ins&ucffm an reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Cofwm B above $ Statement covers period CALIFORNIA from sFORM 461 through pap Of I.D.NUMBER Column a CAUMM YEm TOT&,rowE TO Q*Xdate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Cohznn A may be negative figures that should be subtracted from previous period amounts. if this is the W report being filed for this Calendar year, orgy 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 ftwough 6130 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made Expenditure Limit Summary for State Candidates 27- Cumulative Expenditures Made* I 0rSUhI8dt0V0kWAWyEq—ft" Lin" Data of Election Total to Date (mmlddlyy) J $ tl *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 886/AsK.FppC (t;6t V54772) I Schedule Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Type or print In ink. Amounts may be rounded to whole 'dollars. -P� -0! F y DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDMOUAI, ENTER RECEIVED IF COWATTEF- ALSO 8M U). WS034) OCCUPATIONAND EMPLOYER CODE (FSELFeMKVfM.8MNAUE 0F9J6**MM MIND �0 ocom []0TH OPTY 11scc -'r. FlIND ocom GOTH n PTY 0scc 4 ocom K, GOTH 0P [Iscc EIIND �(V !kOW-f fr Lt fps 1 '11 L@Com +rl - UOTH F1 PTY EISCC ffIND EICOM GOTH 0 PTY 0scc SUBTOTALS SCHEDULE A Statement covers period OA CALIFRNI from 4 6 O' FORM through page —�— Of 1J? 'NLUBM AMOUNT cUMtAATrvr=To DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TODATE PERIOD (JW I - DEC. 31) (IF REQUIRED) q Schedule A Summary *C4nfflb" Cod" 1. Amount received this period - itemized monetary contributions. IN I D–Indk*lual (include all Schedule A subtotals.) ...................................................... 1 .................................................. V COM–RedpleniCommilise �T— (other ihan PTY or SCC) 2. Amount received this period - uniternized monetary contributions of less than $100 ............................. ZQ rj T,3, OTH – Oftw (e.g., business entity) 3. Total monetary contributions received this period. $ PTY – Political Party - (Add Lines I and 2. Enter here and on the Summary Page, Column A Line I I TOTAL t SCC-SmanConbibutorConafte �iU . ....................... FPPC Form 46o (januarym) FPPC Toll -Free Helpline: 866/ASK.FppC (&66127&4772) Schedule A (Continuation Sheet) Type or print in Ink. SCHEDULER (CONT) IVIU I It: Ldt y Cutuributions Received Amounm may De rounaeo Statement covers period to whole dollars. 'I CALIFORNIA 460 from 1z FORM through __�!/ 'l" Z Page of NAME OF FILER I.D. NUMBER DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE OF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC, 31) (IF REQUIRED) _bIND OF BUSINESS) RCOM nOTH �. J [] PTY El SCC Fx-1 IND EICOM- F JOTH IN n PTY nSCC nIND [:]COM Ej OTH n PTY nSCC nlND ncom ❑ OTH ❑ PTY EISCC nIND OCOM [:] OTH El PTY EISCr-- 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/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 'Brno n� nrint In Ino SCHEDULE B - PART I Okol 1WUU1W I;J — F-01 L I - - Amounts may be rounded I Statement covers Per?o=� L*ans Remilved to, whole dollars. / t f/ 1-7 from CALIFORNIA FORM 46G� SEE INSTRUCTIONS ON REVERSE through Ll�f pap Of NAL41E OF FILER (3 Ro LD NUMBER FULL NAME v STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER ours-r"ING 1b) AMOUNT OUTS�)"• 19) OFLENDER (IF COMWTTEF-AL50 ENTER LD.NUMBER) OCCUPATION AND EMPLOYER (FSW4WIPL0YED.ENTER •OR BALANCE BEGINNING THIS RECEIVED THIS AMOUNT FORGIVEN BALANCEAT CLOSE OF THIS INTEREST PAID TKS ORIGINAL CUMULATIVE AMOUNTOF CONTRIBUTIONS P IOD PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE PAID CALENDARYEAR < ., q,1qqc 0 FORGIVEN RATE PER ELECTION' $ 7t t6j IND o COM o OTH 0 PTY 0 SCC $ DATE INCURRED DATE DUE o PAID CALENDARYEAR 0 FORGIVEN RATE, PER ELECTION to IND o COM o OTH 0 PTY o SCC DATE INCURRED DATE DUE o PAID CALENDARYEAR o FORGIVEN RATE PEREI.EcnONw to IND o COM 0 OTH 0 PTY 0 SOC i DATE INCURRED DATE DUE SUBTOTALS $ $ $ Schedule B Summary 1. Loans received this period .................................................................................................................... $ Of (Total Column (b) plus uniternized 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. *Amounts forgiven or paid by another party also must be reported on Sdhedt� A- " ff —I cnnC C- A&A(Jan.—Ina) FPPC ToIll-Free Helpline: 8661ASt4FPPC (86612754772) Sdoduis I- Urm 3) tContri1xitor Codes IND–Individual COM–ReciplentCommidee (other than PTY or SCC) OTH – Other (e.g., business entity) PTY – Political Party SCC–SmaHContrWWCommItIee Schedule E Payments Made Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 from i t 4A FORM through iLOf P age rvrunc yr riLx,^ G(� �' 13 4 V "' Nir" (F COWATTEXAM 9M LEL NUMBEM LD. NUMBER I- 3 31 1 4 CODES: If one of the IbIllowing codes accurately describes the payment, you may enter the code. Otherwise, describe the payment CW CNS campaign paraphernallaftnisc. campaign consultants MBR member communications RAD radio airtime and production costs CTB contribution (explain nonmorietary)* MTG OFC meetings and appearances office expenses RFD SAL returned contributions CVC civic donations PET petition circulating TEL campaign workers, salaries Lv. or cable airtime and production costs FL FAD candidate liting/ballot fees fUndraising events R-10 phone banks TRC candidate travel, lodging, and mask IND Independent expenditure supporting/opposing others (explain)* PCL POS, polling and survey research postage, delivery and messenger services TRS TSF staftpouse travel, lodging, and meals transfer between committees Of the LEG legal defense PRO professional services (legal, accounting) VOT same candidale/sponsor voter registration LIT I campaign literature and mailings PRT print ads WEB information technology costs (Intemet, e-mail) NAME AND ADDRESS OF PAYEE (F COWATTEXAM 9M LEL NUMBEM CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID 41 r r4V014-111"i-f- r, J Payrrients that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2,513. i7C) Schedule E Summary 1. Itemized payments made this period. (include all Schedule E subtotals.) ..............................................................................................................$ 2 F c'! 0 0 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 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 86WASK-FPPC (SUWS3772)