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Recipient Committee A m M2r-t COVER PAGE Campaign Statement Type or print in ink. Date Stamp _ RECIERVED Cover Page (Government Code Sections 84200 - 84216.5) n Statement covers period Date of election if applicable: JUL 1 2 2011 (Month, Day, Year) Page of from July 1, 2009 VTY CL EPRgtS R'F-" ' For Official Use Only SEE INSTRUCTIONS ON REVERSE through December 31, 2009 1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. 2. Type of Statement: ® Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee 0 Primarily Formed ❑ Semi - annual Statement ❑ Special Odd -Year Report Q Recall 0 Controlled Termination Statement (Also Complete Part 5) 0 Sponsored ❑ E] Supplemental Preelection (Also Complete Part 6) ® Amendment (Explain below) Statement - Attach Form 495 ❑ General Purpose Committee Previous corrections to Summa Pa ge carried over. Q Sponsored ❑ Primarily Formed Candidate / Summ g Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER Treasurer(s) 1236008 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Committee to Elect Chuck Washington Kathy Washington MAILING ADDRESS 31205 Kahwea Rd. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 31205 Kahwea Rd Temecula CA 92591 (951) 699 -5706 CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS (951) 699 -7786 (951) 699 -7786 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 nd correct. , Executed on, ` By D to � Q Si re Trea - reasurer Executed on ' By Date Signature of Controlling Officeholder, Candid e, to Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on June /01 BY Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 ( ) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Recipient Committee Type or print in ink. COVER PAGE -PART 2 Campaign Statement m a • 1 Cover Page — Part 2 Pa of 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Chuck Washington OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT City Council, Temecula I I I ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 31205 Kahwea Rd. Temecula CA 92591 Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE /PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEE NAME I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES ❑ NO ❑ SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period CALIFORNIA Summary Page to Whole dollars Jul 1 Zoos FORM ' • from y ' SEE INSTRUCTIONS ON REVERSE through Dec. 31, 2009 page 3 of 3 NAME OF FILER I.D. NUMBER Committee to Elect Chuck Washington 1236008 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and 1. Monetary Contributions ............ ............................... schedule A, Line 3 $ 00.00 $ 00.00 General Elections 2. Loans Received ....................... ....:.......................... schedule e Line 3 00.00 10,000.00 1/1 through 6130 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add o 00.00 10,000.00 20. Contributions Lines 1 + 2 $ $ Received $ $ 4. Nonmonetary Contributions .......................... schedule C Line 3 00.00 00.00 ........... ••••••••� 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ••..• .. ....................AddLines3 +4 $ 00.00 $ 10,000.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................ ............................... schedule E, Line 4 $ 1500.00 $ 4500.00 Candidates 7. Loans Made .............................. ............................... schedule H Line 3 00.00 00.00 1500.00 4500.00 22• Cumulative Expenditures Made" 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ $ (ItSublectto Voluntary Expenditure Urnit) 9. Accrued Expenses (Unpaid Bills) ............................... schedule F, Line 3 00.00 00.00 Date of Election Total to Date 10. Nonmonetary Adjustment ........... ............................... schedule C Line 3 00.00 00.00 (mm /dd /yy) 11. TOTAL EXPENDITURES MADE .... ............................Add Lines 6+ 9+ 10 $ 1500.00 $ 4500.00 _ J J $ Current Cash Statement -O 467, a $ 12. Beginning Cash Balance ....................... Previous summary Page Line 16 $ 49,366:89 To calculate Column 8, add _ $ 13. Cash Receipts ......................................... Column A Line 3 above 00.00 amounts in Column A to the 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 250.00 corresponding amounts from Column B of your last -J__/ $ 00 report. Some amounts in 15. Cash Payments ................... ............................... Column A, Line a above 1500. Column A may be negative f9''f6 - 89 - figures that should be -� -� $ 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ , "'1 9 2� 7 If this is a termination statement, Line 76 must be zero. / 24 7fD subtracted from previous period amounts. If this is $ the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... schedule e, Part 2 $ 00.00 for this calendar year, only carry over the amounts 'Since January 1, 2001. Amounts in this section may be Cash Equivalents and Outstanding Debts a ro y )' m Lines 2, 7, and 9 (if different from amounts reported in Column B. 18. Cash Equivalents ......... ............................... See instructions on reverse $ 00.00 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ 10'000.00 FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Recipient Committee COVER PAGE Campaign Statement Type or print in ink. Date Stamp CALIFORNIA 460 Cover Page RECEIVED 0 2001/02 (Government Code Sections 84200 - 84216.5) '?.O FORM LP Statement covers period Date of election if applicable: JAN 2 6 Atil pa t of 7 from July 1 , 2009 (Month, Day, Year) CITY CLERKS DEPT For Official Use Only SEE INSTRUCTIONS ON REVERSE through December 31, 2009 1. Type of Recipient Committee: All committees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement: IXI Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee 0 Primarily Formed ® Semi - annual Statement ❑ Special Odd -Year Report Q Recall Q Controlled ermnaon me (Also Complete Part 5) ❑ Termination Statement ❑ Supplemental Preelection 0 Sponsored ❑ Amendment (Explain below) Statement - Attach Form 495 (Also Complete Pens) 111 General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Arco Compete Pert ]) 3. Committee Information I NUMBER 1236008 Treasurer(s) COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) NAME OF TREASURER Committee to Elect Chuck Washington Kathy Washington MAILING ADDRESS 31205 Kahwea Rd. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 31205 Kahwea Rd. Temecula CA 92591 (951) 699 -5706 CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 (951) 699-5706 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS (951) 699-7786 (951) 699-7786 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 on i /n / 0 ( l By sue..!.iL I �� std e Date WW0117 07 re - Fro/ Assistant Treasurer ! V Executed on / By Date Signature of Controlling Officeholder, , Slate Measure Proponent or Responsible Officer of Sponsor Executed on By Dale Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Dale Signature of Controlling Offcehdder, Candidate. State Measure Proponent FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC State of California 2 Type or print in ink. COVER PAGE -PART2 Recipient Committee CALIFORNIA Campaign Statement FORM 460 Cover Page Part 2 Page y of 7 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Chuck Washington OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION SUPPORT City Council Temecula OPPOSE RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, if any. 31205 Kahwea Rd Temecula CA 92591 NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7 Primarily Formed Committee List names of officeholder(s) orcandidate(s) for which this committee is primarily formed. YES NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE CITY STATE ZIP CODE AREA CODE /PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE COMMITTEE NAME I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD YES NO ❑SUPPORT OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period CALIFORNIA 460 Summary Page to whole dollars. from July 1, 2009 FORM SEE INSTRUCTIONS ON REVERSE through Dec. 31 2009 Page 3 of 1 NAME OF FILER I.D. NUMBER Committee to Elect Chuck Washington 1236008 ColumnA Co Calendar Year Summary for Candidates o Contributions Received PERIOD Running in Both the State Primary ATTACHED SCHEDULES) TOTALTO DATE g r V and General Elections 1. Monetary Contributions Schedule A, Line 3 00 00.00 2. Loans Received Schedule e, Line 3 00.00 10,000.00 1/1 through 6/30 7/1 to Date 00.00 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines +2 00 10,000.00 20. Contributions Received 4. Nonmonetary Contributions Schedule C. Line 3 00.00 00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 +4 00.00 10,000.00 Made Expenditures Made Expenditure Limit Summary for State 6. Payments Made Schedule E, Line 4 1500.00 4500.00 Candidates 7. Loans Made Schedule H, Line 3 00.00 00.00 1 500.00 4500.00 22 Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS Add Lines 6 +7 (x Subject to Voluntary Expenditure LimitI 9. Accrued Expenses (Unpaid Bills) Schedule F Line 3 00.00 00.00 Date of Election Total to Date 10. Nonmonetary Adjustment Schedule C, Line3 00.00 00.00 (mm/dd /yy) 11. TOTAL EXPENDITURES MADE Add Lines 8 9 10 1500.00 4500.00 Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 20,366.89 To calculate Column B, add J 13. Cash Receipts Column A, Line 3 above 00.00 amounts in Column A to the 250.00 corresponding amounts 14. Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B of your last 15. Cash Payments Column A, Line 8above 1500.00 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE Add Lines 12 13+ 14, then subtract Line 15 19,116.89 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 00.00 for this calendar year, only carry over the amounts "Since January 1, 2001. Amounts in this section may be from Lines 2, 7, and 9 (if different from amounts reported in Column B. Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents See instructions on reverse 00.00 19. Outstanding Debts Add Line 2 Line 9 in Column B above 10,000.00 FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Type or print in ink. SCHEDULE B PART 1 Schedule B Part 1 Amounts may be rounded Statement covers period CALIFORNIA 1 6 0 Loans Received to whole dollars. July 1, 2009 FORM T from SEE INSTRUCTIONS ON REVERSE through Dec. 31 Page 4 of NAME OF FILER I.D. NUMBER Committee to Elect Chuck Washington 1236008 IF AN INDIVIDUAL, ENTER 1BI Ibl lc) lal lel Irl 191 FULL NAME, STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OCCUPATION AND EMPLOYER BALANCE BALANCE AT OF LENDER (IF SELFEMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS OF COMMITTEE, ALSO ENTER LO. NUMBER) NAME Oreuswass) PFR Of) PERIOD THIS PERIOD" PERIOD PERIOD LOAN TO DATE Chuck Washington Airline Pilot 0 PAID CALENDAR YEAR 31205 Kahwea Rd. 00.00 10,000.00 0 10,000.00 Temecula, CA 92591 o FORGIVEN RATE PER ELECTION" 10,000.00 00.00 00.00 na 00.00 6/30/08 tg IND COM OTH PTY scc DATE DUE DATE INCURRED o PAID CALENDAR YEAR S o FORGIVEN RATE PER ELECTION" 5 5 To IND COM OTH PTY SCC DATE DUE DATE INCURRED o PAID CALENDAR YEAR 5 5 o FORGIVEN RATE PER ELECTION" S S S S 5 to IND COM OTH PTY SCC DATE DUE DATE INCURRED SUBTOTALS 00.00 00.00 10,000.00 00.00 (e) on Schedule B Summary Schedule (,Lin LiN e 3) 1. Loans received this period 00.00 (Total Column (b) plus unitemized loans less than $100.) 'Amounts forgiven or paid by another party also must be 2. Loans paid or forgiven this period 00.00 reported on Schedule A. (Total Column (c) plus loans under $100 paid or forgiven.) If required. (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 00.00 Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number) t Contributor Codes IND Individual COM Recipient Committee (other than PTY or SCC) OTH Other PTY Political Party SCC —Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule D SCHEDULED Summary of Expenditures Type or print in ink. Statement covers period Su ortin /O osin O ther A may be rounded CALIFORNIA 460 PP 9 pP 9 to whole dollars. f rom July 1, 2009 FORM Candidates, Measures and Committees 'f through Dec. 31 2009 Page of L SEE INSTRUCTIONS ON REVERSE 9 NAME OF FILER I.D. NUMBER Committee to Elect Chuck Washington 1236008 CUMULATIVE TO DATE PER ELECTION DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN.1 DEC. 31) (IF REQUIRED) OR COMMITTEE James Desmond for Mayor ID #1286317 II Monetary 11/18/2009 1720 Seely Ct. contribution $250.00 $250.00 San Marcos, CA 92069 El Nonmonetary Contribution Independent Support Oppose Expenditure Monetary Contribution Nonmonetary Contribution Independent Support Oppose Expenditure Monetary Contribution Nonmonetary Contribution Independent Support Oppose Expenditure SUBTOTAL 250.00 Schedule D Summary 1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) 250.00 2. Unitemized contributions and independent expenditures made this period of under $100 00.00 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL 250.00 FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule E Type or print In ink. SCHEDULEE Amounts may be rounded Statement covers period CALIFORNIA 460 Payments Made to whole dollars. from July 1, 2009 FORM SEE INSTRUCTIONS ON REVERSE through Dec. 31 2009 Page of 1 NAME OF FILER I.D. NUMBER Committee to Elect Chuck Washington 1236008 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. GP 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 fling /ballot fees PI-10 phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals IUD 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 UT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Temecula United Methodist Church Food Pantry Donation to food pantry 42690 Margarita Rd. CVC $500.00 Temecula, CA 92592 David Morgan Campaign consultant 30441 Big River Drive CNS $750.00 Canyon Lake, CA 92587 James Desmond for Mayor ID #1286317 Campaign Donation 1720 Seely Ct. CTB $250.00 San Marcos, CA 92069 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1500.00 Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) 1500.00 2. Unitemized payments made this period of under $100 00.00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) 00.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL 1500.00 FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule I Type or print in Ink. SCHEDULE Miscellaneous Increases to Cash Amounts may be rounded Statement covers period CALIFORNIA A 60 to whole dollars. �'F from July 1, 2009 FORM through Dec. 31 2009 Page 7 of 7 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Committee to Elect Chuck Washington 1236008 DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER/ DESCRIPTION OF RECEIPT INCREASE TO CASH James Desmond for Mayor ID #1286317 Refund of campaign donation 12/13/09 1720 Seely Ct. $250.00 San Marcos, CA 92069 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL 250.00 Schedule I Summary 1. Increases to cash of $100 or more this period. 250.00 2. Unitemized increases to cash under $100 this period. 00.00 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) 00.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) TOTAL 250.00 FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866/ASK-FPPC M *n � M � COVER PAGE Recipient Committee Campaign Statement Type or print in ink. Date Stamp _ I , Cover Page RECEIVED W - 1 ' (Government Code Sections 84200 - 84216.5) q 9 Statement covers period Date of election if applicable: oUL ! 2 201E from January 1 , 2009 (Month, Day, Year) age / of 3 1 5 L - For Official Use Only SEE INSTRUCTIONS ON REVERSE through June 30, 2009 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 2. Type of Statement: ® Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee ❑ Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Q Primarily Formed ❑ Semi - annual Statement ❑ Special Odd -Year Report 0 Recall Q Controlled ❑ Termination Statement Su lemental Preelection (Also Complete Part S) 0 Sponsored ❑ pp (Also Complete Part 6) ® Amendment (Explain below) Statement - Attach Form 495 ❑ General Purpose Committee Previous corrections to Sch A. E. I reflected in Summa Pa Q Sponsored F Primarily Formed Candidate / Summ e g Q Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER Treasurer(s) 1236008 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Committee to Elect Chuck Washington Kathy Washington MAILING ADDRESS 31205 Kahwea Rd. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 31205 Kahwea Rd. Temecula CA 92591 (951) 699 -5706 CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 (951) 699 -5706 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS OPTIONAL: FAX / E -MAIL ADDRESS (951) - 699 -7786 (951) 699 -7786 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 t ue and correct. Executed on I By to Si eo rea �rerdr$ssistant T reasurer Executed on ! �( By re Date Signature of Controlling Officeholder,Can te, StateMeasureProponentorResponsibleOfficerofSponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on ( June/01 ) 460 BY FPPC F Date Signature of Controlling Officeholder, Candidate, State Measure Proponent ( ) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Recipient Committee Type or print in ink. COVER PAGE -PART2 Campaign Statement - • 1 Cover Page — Part 2 Page Z of 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Chuck Washington OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT City Council, Temecula I ❑ OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 31205 Kahwea Rd. Temecula CA 92591 Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODE /PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE COMMITTEE NAME I.D. NUMBER NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ YES ❑ NO ❑ SUPPORT ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Attach continuation sheets if necessary FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Campaign Disclosure Statement Type or print In ink. SUMMARY PAGE Amounts may be rounded Statement covers period - Summary Page to whole dollars. ' from January 1, 2009 F OR M SEE INSTRUCTIONS ON REVERSE through June 30, 2009 Page of s- NAME OF FILER I.D. NUMBER Committee to Elect Chuck Washington 1236008 Column Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDARYEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and 1. Monetary Contributions $ 00.00 $ 00.00 General Elections ........... ............................... Schedule A, Line 3 00 1p000 1/1 through 8130 7/1 to Date 2. Loans Received ....................... ............................... Schedule e Line 3 000.00 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 00. $ 10,000.00 4. Nonmonetary Contributions ..... ............................... 00.00 00.00 Received $ $ Schedule C , Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3+ 4 $ 00.00 $ 10,000.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................ ............................... Schedule E Line 4 $ 3000.00 $ 3000.00 Candidates 7. Loans Made .............................. ............................... Schedule H Line 3 00.00 00.00 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines s+ 3000.00 $ $ 3000.00 22. Cumulative Expenditures Made* (if Subject to Voluntary Expenditure Limit) 9. Accrued Exp enses ( Unpaid Bills Schedule F, Line 3 00.00 00.00 Date of Election Total to Date 10. Nonmonetery Adjustment Schedule C Line 00.00 00.00 (mm /dd /yy) 11. TOTAL EXPENDITURES MADE .Add Lines 8 +9+ fo $ 3000.00 $ 3000.00 $ Current Cash Statement � 45z � 9 -J-/ $ 12. Beginning Cash Balance ....................... Previous summary Page, Line is $ *2 To calculate Column B, add _ J_ J $ 13. Cash Receip Column A, Line 3 above 00.00 amounts in Column A to the 08 corresponding amounts 14. Miscellaneous Increases to Cash ........................... schedule /, Line 4 1014. from Column B of your last $ 15. Cash Payments " " " " " " " " " " " " " " " "" .. Column A , Line 8 above 3000.00 report. Some amounts in ' Column A may be negative 66"89 - • fi gures that should be -� -J $ n^ 16. ENDING CASH BALANCE .......... Add Lines 12 + 1 3 + 14, then subtract Line 15 $ - 2G7 3 66 - .89 - Z J ©� subtracted from previous If this is a termination statement, Line 16 must be zero. J period amounts. If this is J $ the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... Schedule B Part 2 $ 00.00 for this calendar year, only carry over the amounts "Since January 1, 2001. Amounts in this section may be from Lines 2, 7, and 9 (if different from amounts reported in Column B. Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents .............. See instructions on reverse $ 00.00 19. Outstanding Debts ......................... Add Line 2+ Line 9 in Column 8 above $ 10,000.00 FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC w Qa o to z Ea E K i O 0 y cad U t0 w n 2m (j > c ` O w ° O O ° m 'o U m m v 00 m 00 0 ~m.m. m o o€ ¢ a c J € i 9 _ d Vli x ¢ m LLN E a: to 0 N N G ¢ O ¢ 2 6 d • • E v ° • o` an d o- _m N LL y LL m m m m< w W U V C j a m c a U E w w w m m w E o o o 'a 0 0 0) o m a M 0} m v LL a m °g w y y a 04 N O) N o C.. 1:1 El 9 ^.j W Q m $ n F U F o m ::e ".i y w c _ o c $ ` > Z ° a n 1. 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