HomeMy WebLinkAbout1996 older, Candidate, Type or print in ink. COVER PAGE - LONG FORM
dnd Controlled Committee Statement covers period Date Stamp
= Campaign Statement — Long Form from
(Government Code Sections 84200- 84216.5) 0
SEE INSTRUCTIONS ON REVERSE through
Check one of the following boxes to Indicate the type of statement being filed: Date of election M applicable: a , of
DP DEC 5`:: 1996 For Official Use Only
Pre-election Statement (Month, Day, Year)
Supplemental Preelection Statement (Attach a completed Form 495 to this statement.)
Special Odd -Year Campaign Report _
Semi - annual Statement ^ ^----------- - - - - -- - --
Termination Statement (Attach a completed Form 41 S to this statement.)
I Off IC@ O er an I ate, an ontrO a ommittee Committees O Included in this tatemen • Littanyother
included in this Statement committee, notlncludedin this consolidatedstatementthatarecontrot tedbyyouand any
NAME OF OFFICEHOLDER OR CANDIDAT committees of which you have knowledge that are primarily formed to receive contributions
-r or to make expendltureson behalf ofyourcandidacy.
COMMITTEE NAME 1 D. XVMBER
Jrf / IU SOIN - Nr Oft HELD DXCtUOE IOUTN7N AND DISTRICT NUMBER IF AMIG[lE)
RESID[NTIAL OR BUSINESS ADDRESS DIO. STAEET) ' "ME Of LL
TREASURER CONTROEDCOMMr"EE/
4 e0_ ! 5 1` 7e.) 4PWY dYj eze /�° ❑ Y ❑ No
CRY STATE IIPCOOF AREA CODEMAYTIME PH ONE COMMITTEE ADORES% (NO.ANDSTREET)
'Fz
COMMITTEE NAME m I.D.NUMBIA C STATE INCODE AREA COOE/DAYTIMEPHONE
joc X17 , "G ��/ ZJ z G�
COMMITTEE NAME I.D. NUMBER
COMMITTEE ADDRESS (NO. AND STREET)
CRY STATE EIP CODE AREA COOUDAYTIMt PHONE NAME OF TREASURER CONTROLLEDCOMMmEEI
❑ YES ❑ No
HA OFTREASURER COMMITTEE ADDRESS (NO.ANDSTAEFT)
PERMANENT ADDRESS OF TREASURER (NO. AND STREET) CITY STATE ENCODE AREA CODEMAYTIME PHONE
STATE ZIP CODE AMA CODFx1AYTIM[PNONE '
p
/ X77 Q Attach additional Information on appropriately labeledcontinwtlonSheetr.
III Verification
I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the Information contained herein and In the attached schedules is
true and complete certify under penalty of per under the laws of the � State of California that the foregoing Is true a�E�N /rcfor-re�ct. //
Executed On U At /�/��" z� ' By
DA E CRY AND STATE �T SIGNATURF OF TREASURER
AnoHi ceholderor candidate who controls a committee must also verify the , campaign s tatemerlt. I have used all reasonable diligence and toth best of my knowledge the treasurer has used all
reasonable diligence in preparing this statement. 1 have reviewed the statement and to the best of my knowledge the info matron containedfi Bin ana In the attached schedules is true and
complete. lcert ��� ify �� ' �� ' uqq5 /// +d ,����.�� o ������ p//////e��nnna//(llty of perjury under the laws of the State of Ca l that the foregoing is true and rr
Executed on At T l- {tom''` ( q ( ` 2' �!� B j 114' 1\ ,"Nny.C>T•' -1J�'
Y
GATE CITY AND STATE SIGNATURE Of CANOIDATElOfFICIMMOIR
Executed on At By
DATE CRY AND STATE SIGNATURE OF CANDIDATEgf FNEHOLDER
Executed on At By
DATE CRY AND STATE SIGNATURE OF CANDIDATEIOFFIC[HOLD[ R
FOR INFORMATION REQUIRED TO 81 PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF I97I, SEE INFORMATION MANUAL ON CAMPAIGN DRCLOSURE PROVISIONS Or THE POLITICAL REFORM ACT
Campaign Disclosure Statement Type or print In Ink. SUMMARY PAGE
Amounts may be rounded Statement covers period
Summary Page to whole dollars.
from
SEE INSTRUCTIONS ON REVERSE thrwgh page of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
Contributions Received Co lsift A Column Be column C
tOIALTHISrt TOTAL PREVIOUS PERIOD TOTAL TO DATE
PAM ATTACHED SCHEDULES) (SEE NOTE aELOW) (ADD COLUMNS A ♦ a)
1. Monetary Contributions ............................... schedule A, Line 3 S X77/. /d s / c, /• & c s 4Z25 / o
2. Loans Received Schedule B, Une 7 $- "; /�v. 'yd
61 CJ, do
.......... ...............................
. SUBTOTAL CASH CONTRIBUTIONS ...................... Add Until 42 f /o 7/. kJ S
4. Non- monetary Contributions ......................... schedule c, Line 3 -
S. SUBTOTAL CONTRIBUTIONS (Exclude Enforceable Promises) A diunes3 4 s ;277 /e 7G/
6. Enforceable Promises �-
(Exciude Loan Guarantees, Une 18 below) ................... Schedule D, Une 7 -
7. TOTAL CONTRIBUTIONS RECEIVED ..................... AdlUnesS e 6 S �?7 7/•/U ' S -� Zu/• a °c� S J'` /o
Expenditures Made X230, cq foZ3t�, 3 �8� r
S. Cash Payments (Other than Loans Made) ............ schedule E, LMe s s s f
9. Loans Made .............. ............................... schedule H, Une 7 �.7U • J� 1/ OJ / 6�/. 79
10. SUBTOTAL CASH PAYMENTS Aatfunes8 .9 / � s X 75% ? J c� s 9` -? ,
11. Accrued Expenses (Unpaid Bills) ........................ Schedule P, Lines °1 9- -- z!D-
12. TOTAL EXPENDITURES MADE ......................... Adduneslo + II S 9
rent Cash Statement
Beginning Cash Balance .................. Previous Summary Page, Une 17 f �✓,o • --3 • From previous Statement Summary Page, Column C. However, If
14. Cash Re ce i p t s "" " " " " " " " " "" ... .. Column A, Une 3 above this Is the first report tiled for the calendar year, Column B should be
/1 blank except for Loans Received (Line 2), Enforceable Promises (Line
15. Miscellaneous Increases to Cash . ....................... schedule L Line t "� 6), Loans Made (Line 9), and Accrued Expenses (Line 11).
16. Cash Pay ments Column A , Une 10 above mod' G/• �
17. ENDING CASH BALANCE ..... Add Urvas 13 a 14 . Is, then subtract Une 16 S Summary for Candidates in Both June and
M this batecminatlon Statement. Une 17 must berem. ENOM CASH aALANCESHOULD November Elections
NOT it A NEWTNE AMOUNT
1l1 through 630 711 to Date
18. LOAN GUARANTEES RECEIVED .............. Schedule 6, Part 1, Column (b) S 21. Rene it b tions s �-��� w
Cash Equivalents and Outstanding Debts 22. Expenditures 1f95�z . /7
19. Cash Equivalents . ............................... See Instmcdrnaonreverse s e ....... s
20. Outstanding Debts ................. Add Urge 2 • Line I r In Column Cabove S
Schedule A Type or print In ink. SCHEDULEA
Amounts may be rounded Statement Covers period
Monetary Contributions Received to whole dollars.
from
SEE INSTRUCTIONS ON REVERSE through. � 'V �� Page of �Z
N ME OF OFFKEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
%%/ `/�`�e Lfxi v Jam" -7 &� a c >G '6/ g�')
FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND E MOL0 AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE
RE ED (e COMMITTEE, mADDn ION TOCOMMTEE 'S NAME AND AODRESS. EWER 1.0,NUMEEA IeSELr-EMKOTtD.tWER RECEIVEDTHIS CCgqLENDgqqqYEqqR OTHER
01LS NO CO. Nwa[a HAS SEEN AESwNtD.[m[a TREASURER'S ruMrf.ND AOOesssl NAME of atnrNESSI PERIOD UAN.I�DEC.31) pF APPLICABLE)
mod, 3�x 5sy6.o
e"';"
�I�L /h✓o� . Jr�-�c Cs��C•ssJaC D � � � �
/7�1r'i✓ Gc %'�"li�Ge ✓ �� ��l•�G`? vd
SUBTOTAL S
Monetary Contributions Summary
1. mount received this period — contributions of $100 or more. S
Include all Schedule A subtotals.) .................................................................... ...............................
2. Amount received this period — contributions of less than 5100.
(Do not itemize.) ...... ............................... _ ........................... ............................... __ ...........
" 3. Total monetary contributions received this period. / /
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ........... ............................... TOTAL S` D
Schedule B —Part 1 Type or print in ink. SCHEDULER - PartI
Loans Received Amounts may be rounded Statement covers period
to whole dollars. 7D:� lf from 2 �� C— � SE E INSTRUCTIONS ON REVERSE through !_ of NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE 8ER
LENDER OR GUARANTOR'S FULL NAME AND ADDRESS LENDER/ TOR'S LENDERINFORMATION - GUARANTOR INFORMATION
DATE OF COMMTEE,EWEN FULL NAME. ADDRESS AND I.D. NUMBER. IT NO I.D. OCCUPATIONANDEMPLOYERaFSELF-
RECEIVED NUMBER HAS BEEN ASSIGNED. EWEN THE TREASURER'S NAME AND ADDRESS) EMPLOYED. ENTER BUSINESS NAME) DUE DATE/ AMOUNT CUMULATIVE AMOUNT
CUMULATE
INTEREST RATE Of LOAN TO DATE GUARANTEED TO DATE
DUE DATE CALENDARYEAR CALENDARYEAR
INTEREST M7E � Of ��
OTHER
ly Lender ❑ Guarantor - % s s
///JJJ DUE DATF CALENDAR YEAR
✓� / /�� CALENDAR YEAR
OTHER
Lender ❑ Guarantor
DUE DATE CALENDAR YEAR CALENDARYEAR
S f
- -
MEREST RATE
OTHER OTHER
❑ Lender ❑ Guarantor - % f B
ee important instructions on reverse. SUBTOTAL
7 un. n aILE.
Loans Received — Part I Summary
1. Loans of $100 or more received this period. (Include all Loans Received —Part I (a) subtotals.) .......... S
2. Loans under $100 received this period. (Do not itemize.) ............ ............................... S
3. Total loans received this period. (Add Lines 1 and 2.) ......... .............................. TOTAL S
Loans Received — Part ll Summary
4. Loans of $100 or more a �, forgiven, or paid by a third party this period. (Include all Part II (C) G`
subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) ..........:... S
S. Loans under $100 repaid, forgiven, or paid by a third party. (Do no itemize. If forgiven or
paid by a third party, include this amount on Schedule A Summary, Line 2. :. . ........................ S -
6.'Total loans repaid, forgiven, or paid by a third party this period.
(Add Lines + 5:) ............ .... ............................. TOTAL
G
7. Net change this period. (Subtract Line 6 from Line 3.) NET �—
Enter the net here and on the Summary Page, Column A, tine 2. S
May LN a negative numb*,.
Schedule B — Part II Type or print In Ink. SCHEDULE B - Part II
Amounts may be rounded Statement covers period R E
Repayments Made on Loans Received, Loans to whole dollars.
Forgiven, and Loans Repaid by a Third Party from %o /lam / 7c,
SEE INSTRUCTIONS ON REVERSE through /� %� Papa � of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE 41 I.D. NUMBER
DATE OF
REPAYYRMENT DATE OF INTEREST AMOU PAID OR OUTSTANDING
ORIGINAL LOAN FULL NAME OF LENDER RATE FORGIVEN ON PRINCIPAL PRINCIPAL INTEREST
FORGIVENESS Of CHANGED) (EXCLUDE PAYMENT OF INTEREST) PAID
I
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL S (r) TOTAL INTEREST j
9 ,'7,. PAID THIS PERIOD *IMPORTANT. • If any part of loan is forgiven or repaid by a third party, also itemize the transaction on Schedule A Enter the amount In column (DO in the
including the name and address of the person forgiving the loan or the third party making the payment, and the amount summary section of Schedule E, Line 3. Do
forgiven Or paid. not carry this total to the summary section of
Schedule B.
1
Schedule E Type or print In Ink. SCHEDULE E
Amounts may be rounded Statement covers period
Payments and Contributions to whole dollars.
(other Than Loans) Made from A) ' G
SEE INSTRUCTIONS ON REVERSE through 6 Page of
N AME OF OFFICEHOLDER OR CANDIDATES AND CONTROLLED COMMITTEE I.D. NUMBER /l
CODES FOR CLASSIFYING DITURES
If one of the following codes accurately describes the expenditure, you may enter the code and leave the* Description of Payment' column blank. Refer to the
back of Schedule E- Continuation Sheet for detailed explanations of each category.
•'C' - MONETARY AND IN-KIND (NON-MONETARY) 'B' - BROADCAST ADVERTISING 'G' - GENERAL OPERATIONS AND OVERHEAD
CONTRIBUTIONS TO OTHER CANDIDATES "N' - NEWSPAPER AND PERIODICAL ADVERTISING 'T' - TRAVEL. ACCOMMODATIONS AND MEALS
AND COMMITTEES 'O'- OUTSIDE ADVERTISING (MUST BE DESCRIBED)
'I' - INDEPENDENT EXPENDITURES 'S" - SURVEYS, SIGNATURE GATHERING. DOOR-TO-DOOR SOLICITATIONS 'P' - PROFESSIONAL MANAGEMENT AND CONSULTING
'L' - LITERATURE 'F' - FUNDRAISING EVENTS SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
Or COMMmEE, ADDMONTO COMMITTEE'S NAME AND ADDRESS, ENTER I.D. NUMBER OR. a NO I.D. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW.
NUMBER HAS BEEN ASSIGNED. EWER TREASURER'S NAME AND ADDRESS)
CODE OR / DESCRIPTION OF PAYMENT AMOUNT PAID
Zi /. r� Sri,
Al
,r( 7�f.5 6 y//� Z.c�ic� Gl� J/F ��_. Gis�,E✓�iS.Fi/J�,.�- �''l/%SG/f� / ��..
2C
Important. Contributions and expenditures made out of campaign funds to or on behalf of other r
officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Part 1. SUBTOTAL S ��JD s O U
Payments and Contributions Made Summary �� � 1.9
1. Payments made this period of $100 or more. (Inilude all Schedule E subtotals.) ............. ...............:...............
2. Payments made this period of under S 100. (Do not itemize.) ......................................... ............................... S
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule 8, Part II, Column (d).) .............................. $ _
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) S—
S. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) ..... I .... • TOTAL $ 'Y .
r
Type or print In Ink. SCHEDULE E
'Schedule E Amounts may be rounded Statement covers period
Payments and Contributions to whole dollars.
(Other Than Loans) Made from
SEE INSTRUCTIONS ON REVERSE through =�`� ►sge /— ol
NAM OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D.NUMBER
CODES FOR CLASSIFYING EXPEND U S
If one of the following codes accurately describes the expenditure, you may enter the code and leave the `Description of Payment' column blank. Refer to the
back of Schedule E- Continuation Sheet for detailed explanations of each category.
'C' — MONETARY AND IN-KIND (NON-MONETARY) 'B' — BROADCAST ADVERTISING 'G' — GENERAL OPERATIONS AND OVERHEAD
CONTRIBUTIONS TO OTHER CANDIDATES 'N'— NEWSPAPER AND PERIODICAL ADVERTISING 'T' — TRAVEL, ACCOMMODATIONS AND MEALS
ANDCOMMITTEES 'O' — OUTSIDE ADVERTISING (MUST BE DESCRIBED)
'I' — INDEPENDENT EXPENDITURES 'S' — SURVEYS, SIGNATURE GATHERING, DOOR-70-DOOR SOLICITATIONS 'P' — PROFESSIONAL MANAGEMENT AND CONSULTING
'L' — LITERATURE 'F' — FUNDRAISING EVENTS SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENTOF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
OF COMMITTEE. NE AD DmON to c OASMDTtt'S NAM AND ADDRESS. ENTER I.D. NUMREA OR. N NO ID, REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW.
"01111 HAS MEN ASSIGNED, EWER TREASUIUR'S"ME AND ADDRESS) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
T /li/�i ✓O�O �.P/�E'i�i�`ic i:✓L
Impo rtant. Contributions and expenditures made out of campaign funds to or on behalf of other SUBTOTAL S
officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Part 1.
Payments and Contributions Made Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................ :.......................
..
2. Payments made this period of under $100. (Do not itemize.) ........................................ ............................... f
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. s
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ...... ............................... S
S. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) .......... TOTAL $
1
f
Schedule H —Part I Type or print In Ink. SCHEDULE R -Part I
Amounts may be rounded Statement covers period
Loans Made to Others to whole dollars.
from C�
SEE INSTRUCTIONS ON REVERSE through Pege Of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE / I.D. NUMBER
DATE OF LOAN FULL NAME AND ADDRESS OF RECIPIENT
OF COMMITTEE. BI ADOmON TO COMMMEE'S NAME AND ADDRESS, ENTER IO. NVMMR INTEREST RATE DUE DATE AMOUNT
OR, N NO I.D. NUMBER HAS BEEN ASSIGNED. ENTER TREASURER'S NAME AND ADDRESS)
SUBTOTAL $
�ns Made to Others — Part I Summary
owns of $100 or more made this period. '-x (Include all Loans Made - Part 1 subtotals.) ............................. ............................... S =i —
2. Loans under $ 100 made this period.
(Do notitemize.) ..................................................... ............................... S
3. Total loans made this period.
(Add Lines and 2.) ........................................... ............................... TOTAL f
Loans Repayments Received — Part II Summary
4. Payments received on loans of f100 or more. (Include all loan payments received and all loans of $100 or more
which have been forgiven by this officeholder, candidate, or committee - Part II (a) subtotals.
If forgiven, also itemize on Schedule E.) ................................. ............................... $
S. Payments received on loans under f 100.
(Including a forgiveness. Do not itemize.) ............................... ............................... S
6. Total loan payments received this period.
(Add Lines and 5.) ................................. ............................... TOTAL $
7. Net change this period. (Subtract Line 6 from Line 3.
Enter the net here and on the Summary Page, Column A, Line 9.) ..... ............................... NETS e X 70
1 May be a - eealbe - amber. .
7o,?- —mss
Campaign Disclosure Statement RECEIVED Ty pe or print in Ink. SUMMARY PAGE
Amounts may be rounded Statement covers period
Summary Page NOV 01 1996 towholedollars.
CITY CLEtiKS UtPT. S�� rrom W
r y r
SEE INSTRUCTIONS ON REVERSE � J throng , Page I of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE � i .. u .. NUMBER
G°G J G.�Y 7 7
Contributions Received Column A column Be Column C
TOTALTHNRNOD TOTAL PREVIOUS PERIOD TOTAL TO DATE
PROM ATTACHED SOIEDVLES) (SEE NOTE IWELOW) (ADD COLUMNS, A ♦ U
1. Monetary Contributions ............................... I Schedule A Line 3 S !���/1: on s /�� /.dd s fX�. /m
Loans Received .......... ............................... Schedule 8, Line 7 90 , 'go /�' , u C)
SUBTOTALCASH CONTRIBUTIONS ...................... Add Lines 1 s //70 �J S /Or /. od S -Z/7/ • UU
4. Non - monetary Contributions ......................... Schedule C, Line 3 / 7S Ud5 S c J
5. SUBTOTAL CONTRIBUTIONS (Exclude Enforceable Prornbes) AddUnes3 «e s X. _Z/.S: C)d S /SSG 02 S /. DD
6. Enforceable Promises t ip-. . 1 -
(Exclude Loan Guarantees, WEe 18 below) ................... Sdwduk D, Line 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... Add Lines s «6 S �✓�� OtJ i ��. ad s 7di 0�
Expenditures Made
e. Cash Payments (Other than Loans Made) ............ schedule E one s S 9 �0 ed s /Z57 . 36
9. Loans Made .............. ............................... Schedule H, Line 7 `✓/ . dJ —r5— �f1r/ , Dd
10. SUBTOTAL CASH PAYMENTS ............................. Add Lines 8 ♦ 9 S /44 � .0 e) /74
11. Accrued Expenses (Unpaid Bills) ........................ Schedule F Line s _6` _z9
12. TOTAL EXPENDITURES MADE ......................... ADHUnes10* It S 1�� Dd 1,7 ✓��
W'urrent Cash Statement
13. Beginning Cash Balance .................. Previous summary page Line 17 S • From previous Statement Summary Page, Column C. However, if
14. Cash Receipts "" " " " " " " " " " " " " "' . ... . Column A, Line 3 above // //J. O d this is the first report filed for the calendar year, Column 8 should be
blank except for Loans Received (line Z), Enforceable Promises (Line
15. Miscellaneous Increases to Cash ........................ schedule t Line 6). Loans Made (Line 9), and Accrued Expenses (Line 11).
16. Cash Payments ..... ............................... Column une to above gff
17. ENDING CASH BALANCE ..... Add Lines 13 + 14 s 1S, then subtract Line 16 S AD Lax Summary for Candidates in Both June and
ff this baterminadon statement Line 17 must be"o. ENDING CASH NLLANCESHOULD November Elections
NOT aE A NEGATIVE AMOUNT
1/1 through 6/30 711 to Date
IS. LOAN GUARANTEES RECEIVED ............... Schedule a Part I, Column (b) S 21. CC ontrib tions
Receive .... S e)(.
Cash Equivalents and Outstanding Debts
19. Cash Equivalents . ............................... See Instructions onreverse S zz. Exp4 e nditure iture s S
20. outstanding Debts ................. Addune2 a Lble ff In ColumnCabove S
Officeholder, Candidate, Type or print In ink. COVER PAGE - LONG FORM
and Controlled Committee Statement covers period Date Stamp
Campaign Statement — Long Form from /O / / /mac RECEIVED
(Government Code Sections 64200- 84216.5)
SEE INSTRUCTIONS ON REVERSE through � /� ��
OCT 2 51996 Page Df
Check one o/ the following boxes to Indicate the type of statement being filed: Date of election H applicable: � For Official Use Only
Preelection Statement (Month, Day, Year) C�-�y CLERKS DEPT.
Supplemental Preelection Statement (Attach a completed Form 495 to this statement.)
Special Odd -Year Campaign Report /�
Semi - annual Statement
Termination Statement (Attach a completed Form 415 to this statement.)
1 Off IcQ o er an 1 ate, an Controlled Committee Other Committees of nc u e m this ustanyother
inducted in this Statement committees not Included In this consol(datedstatement that are controlledbyyou and any
NAME OF OFFICEHOLDER OR CANDIDATE / committees of which you have lrnowl e% ethatarc primarily formed to receive contributions
6 6e W' s , T . orromake eacendlturesonbehallof ourcand/deg.
COMMITTEE NAME I.D. NUMBER
OFFICE SOUGHT OR HELD ONCLUDE LOCATION AM DISTRKTNUMBER =NUMBER
RESIDENTIAL OR BUSINESS ADDRESS (NO.ANNDDJSSTTREE" NAME OF TREASURER CONTROLLED COMMRTEEI
0 4 1— /V C / /� / C- �!_ ❑ YES ❑ NO
CRY STATE ZIP CODE AREA CODEUDAYTIME PHONE COMMITTEE ADDRESS (NO.ANDSTREET)
COMMITTEE NAME _ ID. NUMBER cmr STATE ZIP CODE AREA CODFAAYTIME MIONF
�� �� J � % � �- C� "y `���� COMMITTEE NAME I.D.NUMBER
COMMITTEE ADDRESS (NO.ANDSTREET)
CI /J STA ZNCODE AREA CODMAYTIME PHONE NAME O TREASURER CONTROLLEDCOMMITTEET
AC
/ 63 f ❑ YES ❑ No
NAME OF TREASURER COMMITTEE ADDRESS (NO. AND STREET)
PERMANENT ADDRESS O TREASURER (NO.ANDSTREET) CT STATE ZIP CODE AREA COD&oAYTIME PHONE
CRY STATE ZIPCODE AREA CODE/DAYTIME MORE
Attach additional Information on appropriately labeledcontlnuationsheets.
III Verification
I have used all reasonable diligence in preparing this statement. I have reviewed the 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 thatthe foregoing Is true4ril correct.
Executed on At Z/� �A. By za i .C� ✓./•C�_����
DATE CRY ANDS ATE SIGNATURE OF TREASURER
An officeholder or candidate who controls a committee must also verify the campaign statement. I have used all reasonable diligence and to the ben of my knowledge the treasurer has used all
reasonable diligence In preparing this statement. I have reviewed the 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 At By
DATE MY AND STATE SIGNATURE OF CANDIDATF /OFFICEHOLDER
Executed on At By
DATE CRY AND STATE SIGNATURE OF CANDIDATER OFFICEHOLDER
Executed on At By
DATE CRY AND STATE SIGNATURE O CANDIDATVOFFICEHOLDE R
FOR INFORMATION REO NALOTO BE MIOVIDEDTO YOU PURSUANT TOIHE INFORMATION PMCTN:ES ACT Of 1917, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS Of THE POLITICAL REFORM ALI ,
SLaN of CRIRn FRI, pnl;tl,xl P, v,Ir R• r..,,G, IeA��
Campaign Disclosure Statement Type or print inInk. SUMMARY PAGE
Amounts may be rounded Statement covers period iI
Summary Page towholedollars.
from
SEE INSTRUCTIONS ON REVERSE through page ' of
�lJ ?i Z
- NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
� cam' " ,
Contributions Received eQluITT column a• column C
TOTALTMKWOO TOTAL PREVIOUS PERIOD Tool TO DATE
PROM ATTACHED SCHEDULES) (SEt Not[ BELOW) ODD COLUMNS A . q
1. Monetary Contributions ............................... Schedule A, Line 3 S S _. 00•!lJ S
2. Loans Received .................. ....................... Schedule 6, Line 7 d . Jd
•. SUBTOTAL CASH CONTRIBUTIONS ...................... Addunes 1 .2 S f %/ 7D. Ud S
4. Non - monetary Contributions ......................... Schedule C, Una 3
S. SUBTOTAL CONTRIBUTIONS (Exclude Enforceable Promises) AddUnes3ee S
6. Enforceable Promises --
(Exclude loan Guarantees, Line 18 below) ................... Schedule D, Line 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... Add Lines s e 6
Expenditures Made
8. Cash Payments (Other than Loans Made) ............ schedule E, Line s s s
9. Loans Made .............. ............................... Schedule H Line 7 4 • i
10. SUBTOTALCASH PAYMENTS Add Lines 8 +9 S s
11. Accrued Expenses (Unpaid Bills) ........................ schedule F Line s
12. TOTAL EXPENDITURES MADE ......................... Addunes10 + r1 S 60 S
� urrent Cash Statement
3. Beginning Cash Balance .................. Previous Summary Page, Une 17 S • From previous Statement Summary Page, Column C. However. It
14. Cash Receipts """"" "" " "" " " " " "" ...... Column A , Linea above this is the first report filed for the calendar year, Column B should be
blank except for Loans Received (Line 2), Enforceable Promises (Line
15. Miscellaneous Increases to Cash ............ schedule I Li 4 6), Loans Made (Line 9), and Accrued Expenses (Line 11).
16. Cash Payments ..... ............................... Column A, Line 10 above
17. ENDING CASH BALANCE ..... Add Lines 13 a u, ►S, then subtract Line 16 S Summary for Candidates in Both June and
M this is a termination statement, Une /7 must be zero. ENDDHG CASH BALANCE SHOULD November Elections
NOT BE A NE"TWE AMOUR
1/1 through 6130 711 to Date
18. LOAN GUARANTEES RECEIVED .............. Schedule 0, Put I, Column (b) S 21. Reteveytions S
C ....
Cash Equivalents and Outstanding Debts
22. expenditures
i9. Cash Equivalents . ............................... See lrotrocNOryonnvem s e ....... s
20. Outstanding Debts ................. Addlhle2AUne►f1nColumnCabove S
Schedule A Type or print In Ink. SCHEDULE A
Amounts may be rounded Statement covers period
Monetary Contributions Received to whole dollars. /
from 1� / � �
SEE INSTRUCTIONS ON REVERSE through �� Page =: of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
FULL NAME AND ADDRESS OF CONTRIBUTOR 6CCdPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE
DATE (IF COMMITTEE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, ENTER I.D. NUMBER (If SELF {MMOYED, EWER RECEIVED THIS C YEAR OTHER
RECEIVED Oft. IF NOID.NUMBER HAS BEEN ASSNiN[D.EWER TII[ASURER'S NAME AND ADDRESS)
NAME OF BUSINESS) PERIOD ( JAN. I -DEC. 31) (IF APPLICABLE)
,3i�eGl
�•�dU aU ,�OU. oo
s
SUBTOTAL S
Monetary Contributions Summary
1. Amount received this period — contributions of $100 or more. o�
(Include all Schedule A subtotals.) ..................................................................... ............................... s 11 6)0, O o
2. Amount received this period — contributions of less than $100. r
(Do not itemize.) ............................................................................................ ...........................
3. Total monetary contributions received this period.
(Add Lines i and 2. Enter here and on the Summary Page, Column A, Line 1.) ..........: ............................... TOTAL S OD
Schedule B —Part I Type or print In Ink. SCHEDULE B - Part I
Amounts may be rounded Statement covers period
Loans Received to whole dollars.
from
SEE INSTRUCTIONS ON REVERSE through Al Z Page of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
LENDER OR GUARANTOR'S FULL NAME AND ADDRESS LENDER /GUARANI 'S LENDERINFORMATION GUARANTOR INFORMATION
DATE (N COMMITTEE, ENTER FULL NAME. ADDRESS AND I.D. NUMBER. IFNOLD, OCCUPATIONANDEMPLOYEROFSELF-
RECEIVED NUMBER HAS BEEN ASSIGNED. EMIR THE TREASURER'S NAME AND ADDRESS) EM PLOYED, ENTER BUSINESS NAME) DUE DATE/ AMOUNT CUMULATIVE AMOUNT
CUMULATIVE
INTEREST RATE OF LOAN TO DATE GUARANTEED TO DATE
DUE DATE CALENDAAYEAR CALENDAR YEAR
Zft
INTEAESTMTE
OTHER �y(/r
orll[A
Lender ❑ Guarantor" % S f
n DUE DATE CALENDAR YEAR CALENDAR YEAR
INTEREST MT[ f f
orllER OTHER
Lender ❑ Guarantor" T+ S
DUE DATE CALENDAR YEAR CALENDARYEAR
S f
INTEREST RATE
OTHER OTHER
❑ Lender ❑ Guarantor" N ! f
lal
ee important instructions on reverse. SUBTOTAL � � S a+) Enter(a)on St r
na M; Page,
Loans Received — Part I Summary
1. Loans of $100 or more received this period. (Include all Loans Received —Part I (a) subtotals.) .......... $ f
2. Loans under $100 received this period. (Do not itemize.) ............ ............................... S
3. Total loans received this period. (Add Lines 1 and 2.) ........ ............................... TOTAL 5
Loans Received — Part II Summary
4. Loans of $100 or more a ai orgiven, or paid by a third party this period. (Include all Part II (c)
subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) .......:...... S U'
5. Loans under $100 repaid, forgiven, or paid by a third party. (Do no itemize.) If forgiven or
paid by a third party, include this amount on Schedule A Summary, Line 2 . ........................... S
6. Total loans repaid, forgiven, or paid by a third party this period.
(Add Lines + 5.) ........... ..... TOTAL S U 5
............:.................. .........................
7. Net change this period. (Subtract Line 6 from Line 3.)
Enter the net here and on the Summary Page, Column A, Line 2. NET
• . • ....... • .......... • ....... May M 0 negative nundNT.
Sc C Type or print In ink. SCHEDULE C
Amounts may be rounded statement coven period I �• -
Non - Monetary Contributions Received towholedonars.
from ��Z
SEE INSTRUCTIONS ON REVERSE through �' 2 Io Page � of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE (/ I.D. NUMBER
Vie
FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMP R CUMULATIVE TO CUMU TO
DATE 1N COMMITTEE. IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, DESCRIPTION OF FAIRMARKET
RECEIVED 11f SELF EMYLOYE EWER OF GOODSORSERVICES -VALUE DATE DATE E OTHER
ENTER ID.NUMBER OR, IF NO I.D. NUMBER HAS BEEN ASSIGNED, BUSINESS) NESS) CALENDAR YEAR (IF APPLICABLE)
ENTER PLEASURE WS NAME AND ADDRESS) (JAN. 1 -DEC. 31)
P �C ry,44 I*. Zs L tL nE' ifs
f f� j� ;J��Gr�✓�✓�.t`� —�,e �� �� sue, elegy
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Non - Monetary Contributions Summary
1. Amount received this period— non - monetary contributions of $100 or more.
(Include all Schedule C subtotals.) ........................................... ............................... I......... S
2. Amount received this period— non - monetary contributions of less than $ 100.
(Do not itemize.) ......................................................................... ............................... S
3. Total non - monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ....................... TOTAL S ��� • ud
Schedule E T ype or pr in roun SCHEDULE E
Amounts untsma be rounded Statement rovers period
Payments and Contributions to whole dollars.
(Other Than Loans) Made from
SEE INSTRUCTIONS ON REVERSE through �C 1 �' Page of 7
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED CO,MMMMIITTE E / I.D. NUMBER
CODES FOR CLAtSWYING EXPENDITURES
If one of the following codes accurately describes the expenditure, you may enter the code and leave the 'Description of Payment' column blank. Refer to the
back of Schedule E- Continuation Sheet for detailed explanations of each category.
'C' — MONETARYANDIN- KIND(NON- MONETARY) 'B' — BROADCAST ADVERTISING 'G' GENERAL OPERATIONS AND OVERHEAD
CONTRIBUTIONS TO OTHERCANDIDATES 'N'— NEWSPAPER AND PERIODICAL ADVERTISING 'T' — TRAVEL, ACCOMMODATIONS AND MEALS
ANDCOMMITTEES 'O'— OUTSIDE ADVERTISING (MUST BE DESCRIBED)
'I' — INDEPENDENT EXPENDITURES 'S' — SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS 'P' — PROFESSIONAL MANAGEMENT AND CONSULTING
'L' — LITERATURE 'F' — FUNDRAISING EVENTS SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
(IF COMMITTEE, m ADDITION TO COMMm113 NAME AND ACIDNESS, ENTER I.U. NUMBER On. IF NO I.U. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ONLINE 4 OF THE SUMMARY SECTION BELOW.
NUMBER 1/AS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS)
/ CODE OR DESCRIPTION OF PAYMENT A MOUNT PAID
v..i3o � v `T`i.�Gs Cq.
v
�yis �� NCi✓s1ri7Ei�
Important: Contributions and expenditures made out ofcampai gn funds tooron behalf ofother SUBTOTAL f
officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Part I.
Payments and Contributions Made Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ....................... ............................... f 4
2. Payments made this period of under $100. (Do not itemize.) ........................................ ............................... S 7739
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. $ —8
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ...... ............................... $ "
S. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line B.) ........... TOTAL $
Y
Schedule H —Part I Type or print In ink. SCHEDULE H -Part I
Loans Made to Others Amounts may be rounded Statement covers per
lod
to whole dollars. /
from ZU� �L��
i
SEE INSTRUCTIONS ON REVERSE through 4L� Pape of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE �? I.D.NUMBER
DATE OF LOAN FULL NAME AND ADDRESS OF RECIPIENT
OF COMMITTEE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, EWER I.D. NUMBER INTEREST RATE DUE DATE AMOUNT
OR IF NO I.D. NUMBER HAS BEEN ASSIGNED. ENTER TREASURER'S NAME AND ADDRESS)
X1116 ' �'
T��zcc�C 9yS
SUBTOTAL $
T ans Made to Others —Part I Summary
Loans of $100 or more made this period. ' --
(Include all Loans Made – Part 1 subtotals.) - °
2. Loans under 5100 made this period.
(Do not itemize.) ..................................................... ............................... S
3.s made this period.
(Add Lines 1 and 2.)
..................................... ............................... TOTAL S
(Add
Loans Repayments Received – Part II Summary
4. Payments received on loans of $100 or more. (Include all loan payments received and all loans of $100 or more
which have been forgiven by this officeholder, candidate, or committee – Part II (a) subtotals.
If forgiven, also itemize on Schedule E.) ................................. ............................... $
S. Payments received on loans under $100.
(Including aforgiveness. Do not itemize.) ............................... ............................... S
6. Total loan payments received this period.
(Add Lines and S.) ................................. ............................... TOTAL S t �'
7. Net change this period. (Subtract Line 6 from Line 3.
Enter the net here and on the Summary Page, Column A, Line 9.) ..... ............................... NET S ' 7�;
May be a npetive nwnber.
Officeholder, Candidate, Type or print In Ink. COVER PAGE - LONG FORM
and Controlled Committee Statement covers period Date Stamp
Campaign Statement — Long Form from
(Government Code Sections 84200- 84216.5)
SEE INSTRUCTIONS ON REVERSE through I [I _
qa of ly
Chock one of the following bones to indicate the type of statement being filed: Date of election M applicable:. For Official Use Only
Pre - election Statement (Month, Day, Year) OCT '7 . 1996
Supplemental Preelection Statement (Attach a completed Form 495 to this statement.)
Special Odd -Year Campaign Report
Semi-annual Statement Q
Termination Statement (Attach a completed Form 415 to this statement.)
u QQ er an i ate, an Cont Comm ittee Oth er ommittees o cue n t is tatement: Listan
�nclU�eOlhtfllSStatement commltteetnotlncludedlnthisconso /idat emensthetareconsrolledbyyousndsny
NAME OF OFFICEHOLDER OR CANDIDAT committees o /which you have knowledge that are primarily formed to receive contributions
�. ortomake experdMuresonbehallo/ ourcendlda .
liJ YY��//���, COMMITTEE "ME I.D. NUMBER
EKE HTORHELD (INCLUDE LOCATIO AND D ISTRICT NUMBER IF APPLICABLE)
RESI , T ) IAL �l OI1 B AD{DrR�E�SS y_ ( /N�-CLANDDSTREET) 7 NAME OF TREASURER CONTROLLEDCOMMTEE7
1 y / / O ✓A�tTh ❑ YES ❑ No
CRY STATE ZIP CODE AREA CODE/DAYTIME PHONE COMMITTEE ADDRESS (NO. AND STREM
/ COMMITTEE NAME I.D. NUMBER CT STATE ZIP CODE AREA CODE/DAYTIME PNONF
COMMITTEE NAME I.D. NUMBER
COMM ITT [E ADDRESS (NO. AND STREET)
CRY STATE ZIP CODE AREA CODEMAYTIME PHONE NAME OF TREASURER CONTROLLEDCOMMTEET
TmP� /,,-, Cam . �' z�� y ���¢ [1 YES ❑ No
� N EOF TREASURER COMMITTEE ADDRESS (NO. AND STREET)
�Gii�J
PERMANENT ADDRESS OE TREASURER � tN0.4ND STREET) CT STATE ZIP CODE AREA CODEMAYTIME PHONE
•CITY S /J ZIP CODE AREA CODIMAYTIME PHONE
AftachadallItlonali n/ ormallonon appropriately lebeledcaMlnuationsheeb.
III V erification
I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my know) dge the Informoti contained herein and in the attached schedules is
true and complete. I certify under penalty of perju y underthe laws of the State of California thatthe foregoing istrue a or act.
Executed on ZD s r /� At _ / WAV 117 • 8y
ATE CITY DSTATE SIGNATURE OF TREASURER
An officeholder or candidate who controls a committee must also verify the campaign statement. 1 have used all re Ulee nce a to the knowledge the treasurer has used ell
reasonable diligence In preparing this statement. I have reviewed the statement and to the best of my knowledge t t ed h i and i he a ache schedules is true and
complete.Icertify nder naltyofperjury "the laws of the tateof�C r
Executed on At �� � - l By
A [ITV ANDS ATE SIGNATURE OF UNOIDAIF/OrFIC DG
Executed on At By
DATE CITYANDSTATE SIGNATURE OF CANDIDAT11OFFNEIIOLDER
Executed on At By
DATE CRY AND STATE SIGNATURE Of tANDIDATE10TfKtHOLOSR
FOR INFORMATION RE WIRED TO aE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAL ON CAMPAIGN DKCLOSUM PROVISIONS OF THE POLITICAL REFORM ACT
State of CAllfnrnin FRI Pnllflral Pr A011.1 fnmmtrdnn
1 "
Campaign Disclosure Statement Type or print In Ink. SUMMARYPAGE
Amounts may be rounded statement covers period
Summary Page to whole dollars. 7
}rom GO
SEE INSTRUCTIONS ON REVERSE through 3 0 page — 2 — :-- of S
NAMED OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
Contributions Received olumn A column B Column C
TOTALTHrSRNOD TOTAL PREVIOUS PERIOD TOTAL TO DATE
aROM ATTACHED SCHEDULES) (SEE NOTE BELO" (ADD COLUMNS B)
1. Monetary Contributions ............................... Schedule A Line 3
Loans Received .......... ............................... schedule e, Line 7 �—
SUBTOTAL CASH CONTRIBUTIONS ...................... Add Lines I +2 f ,L/; /. ad s f
4. Non- monetary Contributions ......................... schedule c, Line 3
S. SUBTOTAL CONTRIBUTIONS (Exclude Enforceable Promises) Add S �3s�.o� s f 1
6. Enforceable Promises �j-
(Exclude Loan Guarantees, Line 18 below) ................... Schedule D, Line 7
7. TOTAL CONTRIBUTIONS RECEIVED ..................... Add Lines 5 +6 S /352-, o,) S s
Expenditures Made
�aa..
S. Cash Payments (Other than Loans Made) ............ schedule E Line s f c_ 3 s s
9. Loans Made .............. ............................... schedule H, Line 7 —-
10. SUBTOTALCASH PAYMENTS AddLines8 +9
11. Accrued Expenses (Unpaid Bills) ........................ schedule F Lines "�-
12. TOTAL EXPENDITURES MADE ......................... Addunes fa + 1 1 s
went Cash Statement
13. Beginning Cash Balance .................. Previous Summary Page, Line 17 S • From previous Statement Summary Page, Column C. However, if
14. Cash Receipts """" " " " " " " " " "' c o/umnA Line 3 above this is the first report filed for the cale ndar year, Column B should be
blank except for Loans Received (Line 2), Enforceable Promises (Line
i S. Miscellaneous Increases to Cash ........................ schedule 1 une 4 6), Loans Made (Line 9), and Accrued Expenses (Line 11).
16. Cash Payments ..... ............................... column A, Line 10 above
17. ENDING CASH BALANCE ..... AddLlnes 13 + 14 + 15 then subtractune 16 S Summary for Candidates in Both June and
M this Is a termination statement, une17 must bezero. ENDING CASH BALANCE sHOUtD November Elections
NOT Of A NEGATIVE AMOUNT
1/i through 650 711 to Date
18. LOAN GUARANTEES RECEIVED .............. Schedule B, Part t, column (b) S �� 21. 5ontribt tions f
ecelve ....
Cash Equivalents and Outstanding Debts EEx
19. Cash Equivalents . ............................... See instructions onreverse f zz. Drie nditure iture s S
20. Outstanding Debts ................. AddLIME2 4 Lk* 11 In Column Cabove f —
Schedule A Type or print in Ink. SCHEDULE A
Amounts maybe rounded statement covers period i P
Monetary Contributions Received to whole dollars. li
from
SEE INSTRUCTIONS ON REVERSE through Page ot
NA
,V E OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATIO MPLOYER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE
RECEIVED (9 COMMITTEE IN ADDITION TO COMMITTEE'S NAME AND ADDRESS. ENTER I.O. NUMBER (O SELVEMROYEDAMER RECEIVEDTHIS CCAALENDAR YEAR OTHER
OR,MNOI.D. NVMBER Nl1f BEENASSIGNEO .lMfRTR[ASVRER'S IWME AND ADDRESS) NAME Or BUSINESS) PERIOD (JAN.I -DEC. 31) (IF APPLICABLE)
xv ao
I �c%�xc///Jr%' ✓��Caw�/ �/�,��— /ate. o�
o.lA G'n . Z �—
SUBTOTAL S
Monetary Contributions Summary
1. Amount received this period — contributions of $100 or more. —�
(Include all Schedule A subtotals.) .............................................................:....... ............................... S �DQEAci
2. Amount received this period —contributions of less than $100.
(Do not itemize.) ........................................................................................ ............................... $
'3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ........... ............................... TOTAL S ,AW 60
Schedule C Type or print in ink. SCHEDULE C
Amounts may be rounded Statement covers riod
Non- Monetary Contributions Received towhofedollars. �9�
}rom
SEE INSTRUCTIONS ON REVERSE through o Psge� of S
N / A A�MM E E� OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION A PLOYER CUMULATIVE TO CUMULATIVE TO
DATE OE COMMITTEE. M T ND ADDITION TO COMMEE'S NAME A ADDRESS. DESCRIPTION OF FAIR MARKET
RECEIVED IIr SFIi- EMROYED,FWER NI1ME Or GOODS OR SERVICESVAIUE CALENDAR YEAR DATE OTHER
EWER I.D. NUMBER OIL N NO I.D. NUMBER HAS BEEN ASSIGNED. BUSINESS) CALEN RYEA) (IF APPLICABLE)
EWER TREASURERY NAME AND ADDRESS)
A 7S'
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Non - Monetary Contributions Summary
1. Amount received this period— non - monetary contributions of $100 or more.
(Include all Schedule C subtotals.) ..................................................... ............................... $
2. Amount received this period— non - monetary contributions of less than $100.
(Do not itemize.) ......................................................................... ............................... S
3. Total non - monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ....................... TOTAL
i ,
Type or print In ink. SCHEDULE E
Schedule E Amounts may be rounded State " !covers period
Payments and Contributions to whole dollars. Q �
(Other Than Loans) Made from
SEE INSTRUCTIONS ON REVERSE through �J Page Of
NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER
CODES FOR CLASSIFYING 6tPE9DITURES
If one of the following codes accurately describes the expenditure, you may enter the code and leave the 'Description of Payment column blank. Refer to the
back of Schedule E- Continuation Sheet for detailed explanations of each category.
'C' — MONETARY AND IN-KIND (NON-MONETARY) •B' — BROADCAST ADVERTISING 'G' — GENERAL OPERATIONS AND OVERHEAD
CONTRIBUTIONS TO OTHER CANDIDATES 'N' — NEWSPAPER AND PERIODICAL ADVERTISING 'T' — TRAVEL, ACCOMMODATIONS AND MEALS
ANDCOMMITTEES 'O' — OUTSIDE ADVERTISING (MUST BE DESCRIBED)
'I' — INDEPENDENT EXPENDITURES 'S' — SURVEYS, SIGNATURE GATHERING, DOOR-TO-DOOR SOLICITATIONS 'P' — PROFESSIONAL MANAGEMENT AND CONSULTING
'L' — LITERATURE 'F' — FUNDRAISING EVENTS SERVICES
NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION IMPORTANT: DO NOT ITEMIZE THE PAYMENT OF ACCRUED EXPENSES ON SCHEDULE E.
Of COMMITTEE, IN ADDITION TO COMMmEE• S NAME AND ADDRESS, ENTER I.D. NUMBER OR. NNOI.D. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW.
NUMBER HAS BEEN ASSIGNED, EWER TREASUREMS NAME AND ADDRESS)
CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Important: Contributions and expenditures made out of campaign funds to or on behalf of other SUBTOTAL f
officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Part I.
Payments and Contributions Made Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............. .......... .....:......................... S
2. Payments made this period of under $100. (Do not itemize.) ........................................ ............................... $
3. Total interest paid this period on outstanding loans. (Enter amount from Schedule 8, Part II, Column (d).) .............................. S
4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ...... ............................... S �_
S. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) ........... TOTALS 3 /JCS _ ,3 ✓�,