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HomeMy WebLinkAboutForm 460 - Greg Brockbank for Mayor 2011 (2013-06-30)SEE INSTRUCTIONS ON REVERSE Im 1. Type of Recipient Committee: All Committees - Complete Parts 1,, 2, 3, and 4. Officeholder, Candidate Controlled Committee EJ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Comnlete Part 61 General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee E] Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) Gate S�m ted4 c I Page - I . of For Official Use Only 2. Type of Statement: M Preelection Statement M Quarterly Statement Semi-annual Statement M Special Odd -Year Report ❑ Termination Statement r-1 Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 F1 Amendment (Explain below) 3. Committee Information I.D. NUMBER Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE] NAME OF TREASURER J V CITY STATE ZIP CODE 0,A ('44`14X -J' CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY ate. _ MAILING ADDRESS IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE 'CITY STATE ZIP CODE 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. Executed onBy "Data Signature of Treasurer or Assistant Treasurer 1J, Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Ofter ofSponsor Executed on By Date Signature of Controllrig Officeholder, Carddate, State Measure Proponent Executed on Date By Signature of Contro$ng Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toff -Free Helpline.* 8661ASK-FPPC (8661276-3772) State of California 0 Type or print In Ink. 5. Officeholder or candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE 0x, N' t� ( I OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) v o f 0 Q �) 11,P �� (' RESIDENTIAL/BUSINESS 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? Q 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 CONTROLLED COMMIT'T'EE? Q YES NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE-PART2 Page of 6. Primarily Formed Ballot Measure committee ME 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 offlceholder(s) or candidate(s) for which this committee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHTOR HELD OPPOSE •ri NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHTOR HELD SUPPORT . OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT ■ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHTOR HELD ■ SUPPORT ri« OPPOSE ##! Attach continuation sheets if necessary FPPC Form 460 (.lanuary105) FPPC Toll -Free Helpline 8661ASK•F (8661276-3772) State of California FP'PC Tall -Free Helpline: 866/ASK-FPPC (8661275-3772) Campaign Disclosure Statement Type or print In Ink. SUMMARYPAGE Summary Page Amounts may be rounded to whole dollars. Statement covers period • 4 from SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER 4 ,4 s Contributions Received Column A TOTALTHIS PERIOD Column B Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TODATE Running in Both the State Primary and General Elections 1, Monetary ContrlbUtlons...,,.....,a..,,,,.,...,a.....a....,a....,. schedule A, Linea $ $ ` 1!1 through 6130 7/1 to Date 2. Loans Received ................ • ............ . . ................. 0 ..... Schedule Q , Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2- $ $ 20. Contributions Received $ $ 4. Nonmonetary Contributions .,,..,..a,,,.,,,,..,a,.,....,..a.,.. Schedule C, Lane 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ $ Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ....................................................... Schedule E, Line 4 $ $ Candidates 7. Loans Made............................................................. Schedule N, Line 3 a ` 22. Cumulative Expenditures Made* 8. S U BTOTAL CASH PAYM E NTS .................................... Add Lines 6 + ? $ $ pt Subject to Voluntary Expenditure Limit) ...............................Schedule FLine 3 9. Accrued Expenses {Unpaid Bilis} , Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3. a (mm/dd/yy) 11. TOTAL. EXPENDITURES MADE ................................ Add Lines s + s + 10 $ $ �/ .� $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 gg 4g $ To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above amounts In Column A to the 14, Miscellaneous Increases to Cash ♦...............•.......... Schedule /, Line 4 correspondi Statement covers period ]lmt- 0 CALIFORNIA 460 from FORM through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMB ER7 cc-!, P:� P, DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, EWER NAME PERIOD (JAN. I - DEC. 31) (IF REQUIRED) OF BUSINESS) nIND El Com nOTH PTY -EISCC - OIND FlCOM FJOTH 0 PTY nscc [-]IND FICOM nOTH [:] PTY rlSCC RIND [I COM E]OTH El PTY [1SCC []IND EICOM FJOTH F1 PTY E] SCC SUBTOTAL$ 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ............................................. 2. Amount received this period — unitemized monetary contributions of less than $100 .......................... 3. Total monetary contributions received this period. (Add Lines I and 2. Enter here and on *Contributor Codes Individual Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business enti PTY — Political Party RrS �utiibutorCottinjl'j FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8 6612764772) SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Amounts may be rounded to whole dollars. NAME OF FILER c� rj R Statement covers period from through Page of I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphernalia/misc. NSR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions MB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET` petition circulating TEL U. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/Opposing others (explain)* POS. postage, delivery and messenger services TSF transfer between committees Of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads \AEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ 2. Uniternized payments made this period of under $100 ........ ...... ...... ............ * ........... 0_00 ........... 0..* ........... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part I Column (e).) ............................................................................... $ _� 01 ' 4. Total payments made this period. (Add Lines I t 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ Z FPPC Forrn 460 (Januar lob FPPC Toll -Free Helpline: 866JASK-FPPC (866/2764772)