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HomeMy WebLinkAbout1996 J' Officeholder, Candidate, Type or print in Ink. COVER PAGE - LONG FORM and Controlled Committee Statement covers period Date Stamp Campaign Statement — Long Form from 10 -20 -96 rF o r (Government Code Sec tions 84200- 84216.5) SEE INSTRUCTIONS ON REVERSE through 12 -31 -96 D n 70nly J Check one of the following boxes to Indicate the type of statement being filed: Date of election If applicable: - AN 2 7 199 Pre - election Statement (Month, Day, Year) Supplemental Pre - election Statement (Attach a completed Form 495 to this statement.) Special Odd -Year Campaign Report Semi - annual Statement 11 -05 - ---- • - - - - -- Termination Statement (Attach a completed Form 41$ to this statement.) Officehold Candidate, andControlled Committee 11 Ot ommlttees Ot Indu e In t IS tatement: Llstanyother Included in & s Statement committees not Included in this consolidated statement that are controlled by you and any N E OF OFFICEHOLDER OR CANDIDATE committees of which you have knowledge that are primarily formed to receive contributions TEVEN J.FORD or to make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER OFFICE SOUGHT OR NEW ONCLUDE LOCATxIN AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL, TEMECULA, CA RESIDENTIAL OR BUSINESS ADDRESS (NO.ANDSTREET) NAMEOTREASURER CONTROLLED COMMITEEI 29900 VILLA ALTURAS . ❑ YES ❑ NO CRY STATE ZIPCODE AREA CODEMAYTIME PHONE COMMITTEE ADDRESS (NO. AND STAEET) TEMECULA CA 92592 (909)676 -3756 COMMITTEE NAME I.D. NUMBER CRY STATE ZIP CODE AREA CODMAYTIME PHONE COMMITTEE TO ELECT STEVEN FORD 962340 COMMTEE NAME I.D. NUMBER COMMITTEE ADDRESS (NO.ANDSTREET) 43500 RIDGE PARK DR., STE. 104 CITY STATE ZIPCODE AREA CODEFDAYTIME PHONE NAME Of TREASURER CONTROLLED COMMITTEE? TEMECULA, CA 92590 (909)676 -3013 ❑ .YES ❑ NO NAME OF TREASURER COMMITTEE ADDRESS (NO. AND STREET) DEREK D. THOMAS PEAMINEW ADDRESS OF TREASURER (NO. AND STREET) CRY STATE ZIP CODE AREA CODMAYTIME PHONE IW820 VIA LEVANTAR CRY STATE ZIPCODE AMA CODEMAYTIME PHONE TEMECULA, CA 92592 (909)676 -3013 Attach additional information on appropriately labeled continuation sheets. III V erification I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge t n or or ti d 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 7 - 7- ` 2 '7 At TEMECULA, CA By 777 MET CITY AND STALE SIGNATURE Of TREASURER D J �L7 MET An officeholder orcandidate who controls a committee must also verify the campaign statement. I have used all reasonable diggence and to the best 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 infor on contained herein and in the attached schedules is true and complete. I certify u der natty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on ✓ I Z At TEMECULA, CA eY� L CTi D F CRY AND STATE SIGNATURCOKAN If ICEHOLDCR STEVEN FORD Executed on At BY J DATE CITY AND STAR SIGNAL UP[ Of (ANDIDAIUOI IIC[HOI D[R Executed on At BY DALE CITY AND STATE SIGNATURE Of CANDIDATEIOFFICEHOLDER FOR INIORMATION REQUIRED TO SE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT Of 1977. SEE INFORMATION MANUAL O N CAMPA DISCLOSURE PROVISIONS Of 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 10 -20 -96 SEE INSTRUCTIONS ON REVERSE - through 12 -31 -96 P age 2 O f 7 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMMITTEE TO ELECT STEVEN FOP.D 962340 Contributions Received Column A Column B• Column C TOTALTHISKRIOD TOTAL PREVIOUS PERIOD TOTAL TO DATE (FROM ATTACHED SCHEDULES) (SEE NOTE BELOW) (ADD COLUMNS A e) 1. Monetary Contributions ............................... Schedule A, Line 3 S $4,212.00 S 7,328.00 S 11,540.00 2. loans Received .......... ............................... Schedule e, Line 7 ( 375.00) 375.00 .00 3. SUBTOTAL CASH CONTRIBUTIONS ...................... Add Lines I +2 S 3,837.00 S 7,703.00 S 11,540.00 4. Non-monetary Contributions ......................... Schedule c, Line 3 .00 161.63 161.63 5. SUBTOTAL CONTRIBUTIONS (Exdude Enforceable Promises) Add Lines 3 +4 S 3,897.00 S 7 864.63 f 11.701.63 6. Enforceable Promises 00 .00 .00 (Exclude Loan Guarantees, Line /9 below) ................... Schedule D, Line 7 7. TOTAL CONTRIBUTIONS RECEIVED AddLinesS + 6 $ 3,837.00 S 7,864.63 S 11, 701.63 Expenditures Made B. Cash Payments (Other than Loans Made) ............ Schedule E, Line S S 2,674.76 S 5,101.67 S 7,776.43 9. Loans Made .............. ............................... Schedule H, Line 7 .00 .00 .00 10. SUBTOTAL CASH PAYMENTS ............................ AddLlnes8 + 9 S 7,674.76 S 5-101.67 S 7,776.43 11. Accrued Expenses (Unpaid Bills) ........................ Schedule r Line 5 .00 .00 .00 12. TAL EXPENDITURES MADE ......................... Add Lines 10 + 11 S 2,674.76 S 5,101.67 S 7,776.43 Current Cash Statement 13. Beginning Cash Balance .................. Previous Summary Page, Line 17 S 2,601.33 • From previous Statement Summary Page, Column C. However, if 14. Cash Receipts ................................. above Column A, Linea ab 3,837.00 this is the first report filed for the calendar year, Column R should be blank except for Loans Received (Line 2), Enforceable Promises (Line 15. Miscellaneous Increases to Cash . ....................... Schedule L Lira 4 .00 6), Loans Made (Line 9), and Accrued Expenses (Line 11). 16. Cash Payments Column A, Line 10 above 2,674.76 17. ENDING CASH BALANCE ..... Add Lines 13 + 14 + 15, then subtract Line 16 s 3.765.57 Summary for Candidates in Both June and If this Ba termination statement, Line l7mustbezero. ENDING CASH BALANCE SHOULD November Elections NOT Of A NEGATNE AMOUNT 1/1 through 6130 711 to Date 18. LOAN GUARANTEES RECEIVED .............. Schedule e, Part 1, Column (b) S • 21. Ontribltions (ecelve/1 .... S Cash Equivalents and Outstanding Debts 22. Ex nditures 19. Cash Equivalents . ............................... See instructions on reverse s 00 Mace ....... S 20. Outstanding Debts ................. Add Line 2 + Line II in Column Cabove S .00 Schedule A Type or print In Ink. g SCHEDULE A Monetary Contributions Received Amounts may Statement covers period whole ,)9 y to whole dollars. from 10 -20 -96 SEE INSTRUCTIONS ON REVERSE through 12 -31 -96 pave 3 of NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.O. NUMBER COMMITTEE TO ELECT STEVEN FORD 962340 FULL NAME ANDADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE - DATE (IF COMMITTEE, IN ADDITION TO COMMRTEE'S NAME AND ADDRESS, ENTER LO. NUMBER (if SELF-EMPLOYED, ENTER RECEIVEDTHIS CALENDAR YEAR OTHER RECEIVED OR, If NO I.D. NUMBER LAS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS) NAME Of BUSINESS) PERIOD (JAN.1 -DEC. 31) (IF APPLICABLE) • SUBTOTAL S Monetary Contributions Summary 1. Amount received this period —contributions of $100 or more. (Include all Schedule A subtotals.) ..................................................................... ............................... $ . 2. Amount received this period — contributions of less than $100. (Do not itemize.) ........................................................................................ ............................... $ 4,212.00 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 4,212.00 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 10 -20 -96 SEE INSTRUCTIONS ON REVERSE through 12 -31 -96 71.D.NUMBER of 7 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE COMMITTEE TO ELECT STEVEN FORD LENDER OR GUARANTOR'S FULL NAME AND ADDRESS LENDER /GUARANTOR'S LENDER INFORMATION GUARANTOR INFORMATION DATE RECEIVED NU(IF COMMITTEE, ENTER FULL NAME, ADDRESS AND I.D. NUMBER. IFNOLD. OCCUPATIONANDEMPLOYER(IFSELE- MBER HAS BEEN ASSIGNED, EWER THE TREASURER'SNAME AND ADDRESS) EMPLOYED.ENTEA BUSINESSNAME I DUE DATE/ AMOUNT CUMULATIVE AMOUNT CUMULATIVE INTEREST RATE OFLOAN TO DATE GUARANTEED TO DATE DUE DATE CALENDAR YEAR CALENDAR YEAR • f t INTEREST RATE OTHER OTHER ❑ Lender ❑ Guarantor" % t f DUE DATE CALENDAR YEAR CALENDARYEAR S S INTEREST RATE OTHER OTHER ❑ Lender Guarantor % t s DUE DATE CALENDAR YEAR CALENDAR YEAR 4 S INTEREST RATE OTHER OTHER ❑ Lender ❑ Guarantor w t t lU S W Summary P •SorFportant instructions on reverse. SUBTOTAL $ NNW Lim LB only. Loans Received — Part I Summary 1. Loans of $ 100 or more received this period. (Include all Loans Received -Part I (a) subtotals.) .......... S • 00 2. Loans under $100 received this period. (Do not itemize.) ............ ............................... S .00 3. Total loans received this period. (Add Lines 1 and 2.) ....... ............................... • TOTAL $ 00 Loans Received - Part II Summary 4. Loans of $100 or more repaid, forgiven, or paid by a third party this period. (Include all Part II (c) 375.00 subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) .............. $ 5. Loans under $100 repaid, forgiven, or paid by a third party. (Do no itemize.) If forgiven or .00 paid by a third party, include this amount on Schedule A Summary, Line 2 . ........................... $ 6. Total loans repaid, forgiven, or paid by a third party this period. 375.00 (Add Lines + 5.) ............................... ......... ............................... TOTAL $ 7. Net change this period. (Subtract Line 6 from Line 3.) ( 375.00) Enter the net here and on the Summary Page, Column A, Line 2 . ............................... NET $ May be • negrUve number. i Schedule B —Part II Type or print in Ink. SCHEDULE B - Part II Amounts may be rounded Statement covers period I Forgiven, nd Loans Repaid d b Received, a Third Party to whole dollars. from 10 -20 -96 9 Y Y I SEE INSTRUCTIONS ON REVERSE through 12 -31 -96 Page 5 of 7 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMMITTEE TO ELECT STEVEN FORD 962340 DATE OF INTEREST AMOUNT REPAIDOR REPAYMENT DATE OF RATE FORGIVEN ON PRINCIPAL OUTSTANDING INTEREST OR ORIGINALLOAN FULL NAME OF LENDER PRINCIPAL FORGIVENESS (IE CraNGED) tE%CLUDE PAYMENT OE INTEREST) PAID 110/96 8/8/96 STEVEN FORD -0— $375.00 —0— —0- 29900 VILLA ALURkS, TEMECULA, CA 92592 • Attach additional information on appropriately labeled continuation sheets. SUBTOTAL S 375.00 I I TOTAL INTEREST "I PAID THIS PERIOD S *IMPORTANT: If any part of a loan is forgiven or repaid by a third party, also itemize the transaction on Schedule A, Enter the amount in column (d) 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 not carry this total to the summary section of forgiven or paid. schedule B. i Schedule E Type or print In ink. SCHEDULE E Amounts may be rounded Statement covers period Payments and Contributions to whole dollars. s (Other Than Loans) Made from 10 -20 -96 SEE INSTRUCTIONS ON REVERSE through 12 -31 -96 Page 6 of 7 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMMITTEE TO ELECT STEVEN FORD 962340 CODES FOR CLASSIFYING 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. 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 '0 "— 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 coMMrrrEE•S NAME AND ADDRESS, ENTER I.D. NUMBEROR. IF NO I.D. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW. NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID STEVEN FORD REIMBURSEMENT FOR SIGN MATERIAL 133.74 29900 VILLA ALTURAS, TEMECULA, CA 92592 ELECTION NIGHT REFRESHMENTS 180.06 KEVIN WILLIAMS & CO. SIGN INSTALLATION /REMOVAL 375.00 P 0 BOX 1321, TEMECULA, CA 92590 • KUEBLER, THOMAS & CO. 43500 RIDGE PARK DR., STE. 104, TEMECULA, CA 92590 ACCOUNTING /CAMPAIGN STATEMENT FILINGS 305.50 52.00 Imp ortant: Contributions and expenditures made out of campaign funds to or on behalf of other SUBTOTAL $1,046.30 officeholders, candidates, committees, or ballot measures must also be entered on the Allocation Page, Pa 1. Payments and Contributions Made Summary I. Payments made this period of $100 or more. (Include all Schedule E subtotals.) . . . . .. . .. . ..... . • , . , ..... $ 2, 625.68 2. Payments made this period of under $100. (Do not itemize.) ........................................ ............................... $ 49.08 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. S .00 4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ...... ............................... $ 00 5. Total payments made this period. (Add Lines 1, 2, 3, and 4. Enter here and on the Summary Page, Column A, Line 8.) .......... • TOTAL $ 2,674.76 Schedule E Type or print in ink. SCHEDULE E (cont.) Amounts maybe rounded (Continuation Sheet) to whole dollars. Statement covers period p 8 Payments and Contributions f rom 10 -20 -96 x�a, (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE through 12 - 3 1 -96 Page 7 of 7 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMMITTEE TO ELECT STEVEN FORD 962340 CODES FOR CLASSIFYING EXPENDITURES 'C' — MONETARY AND IN- KIND(NON- MONETARY) •B" — BROADCAST ADVERTISING 'G" — GENERAL OPERATIONS AND OVERHEAD • CONTRIBUTIONS TO OTHER CANDIDATES 'N'— NEWSPAPER AND PERIODICAL ADVERTI SING '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 (IF COMMEREE. IN ADDITION TO COMMOEEEY NAME AND ADDRESS, ENTER I.D. NUMBER OR, IF NO I.D. NUMBER HAS BEEN ASSIGNED. ENTER TREASURER'S NAME AND ADDRESS) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID BARGAIN BULLETIN P 0 BOX 9608, VISTA, CA 92083 FLYERS' 677.80 CONNIE SMITH REFRESHMENTS FOR VICTORY PARTY. 225.26 38981 PASEO DE ORO MURRIETA CA 92563 C & A SANDWICH REFRESHGIENTTS FOR VICTORY PARTY 401.69 41790 WINCHESTER RD.,UNIT F TEMECULA, CA 92590 CALLAWAY VINEYARD & WINERY REFRESHMENTS FOR VICTORY PARTY 161.63 32720 RANCHO CALIFORNIA ROAD TEMECULA, CA 92590 FORTNER TRUE VALUE HARDWARE SIGN MATERIAL 113.00 28115 DEL RIO RD. TEMECULA, CA 92590 SUBTOTAL S 1,579.38 Officeholder, Candidate, Type or print In Ink. COVER PAGE - LONG FORM and Controlled Committee Statement covers period Date Stamp Campaign Statement — Long Form from 10 -01-96 (Government Code Sections 84200- 84216.5) r7 L'li'Cy V'C� SEE INSTRUCTIONS ON REVERSE through 10 -19 -96 MO � Ps e 1 of Check one of the following bosses to Indicate the type of statement being filed: Date Of election If applicable: 'MOT 4 � g For Official Use Only Pre - election Statement (Month, Day, Year) uukk $ Supplemental Pre - election Statement (Attach a completed Form 495 to this statement.) CITY CUE108' b0 1. Special Odd -Year Campaign Report Semi - annual Statement 11 -05 -96 Termination Statement (Attach A completed Form 415 to this statement.) Off iceholder F- ancl iclate, and C ontroll ed C ommittee 11 O th er Committees Rot Includ In th is Statement: Listanyother Included in tftis Statement committees not Included In this consDlldatecistatement that are controlled by you and any N E OF OFFICEHOLDER ORCANDDATE committees of which you have knowledge that are primarily formed to receive contribut ions EVEN J. FORD or to make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL — TEHECULA, CALIFORNIA RESIDENTIAL OR BUSINESS ADDRESS (NO. AND STREET) NAME OF TREASURER CONTROLLED COMMITTEE? 29900 VILLA ALTURAS . ❑ YES ❑ NO CRY STATE ZIP CODE AMA CODEMAYTIME PHONE COMMITTEE ADDRESS (NO.ANDSTREEI) TE1-1ECULA CA 92592 (909)676 -3756 COMMITTEE NAME I.D. NUMBER CRY STATE ZIPCODE AREA COOEIDAYTIME PHONE MZ1ITTEE TO ELECT STEVEN FORD APPLIED FOR COMMITTEE NAME I.D. NUMBER COMMITTEE ADDRESS (NO.ANDSTREET) 43500 RIDGE PARK DR., STE. 104 CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE NAME OF TREASURER CONTROLLED COMMITTEE? TENECULA CA 92590 (909)676 -3013 ❑ YES ❑ No NAME OF TREASURER COMMITTEE ADDRESS (NO.ANDSTAEET) DEREK D. THOMAS PE ANENT ADDRESS OF TREASURER (NO.ANDSTMET) CRY STATE ZIP CODE AREA CODE/DAYTIME PHONE 820 VIA LEVANTAR CRY STATE IIP CODE AREA COOMAYTIME PHONE TEPiECULA CA 92592 (909)676 -3013 Attach a Information on appropriately labeled continuation sheets. III Verification I have used all reasonable diligence in preparing this statement. 1 have reviewed the statement and to the best of my knowled In or aGaa2a(ned herein and in the attached schedules is true and complete. I certif under penalty of perjury under the laws of the State of California that the foregoing is true and c e Executed on 10 -23 -96 At TDIECULA, CA By e DATE CITY AND STATE DEREK D. OMAS SIGNATURE OF TREASURER T An officeholder orarsdidate who controls a committee must also verify the campaign statement. ?have used all reasona a ligence and to the best 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 i or tion 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 Corr Executedon 10 -23 -96 At TETIECULA, CA By / Z� DATE CITY AND STATE S I RD SKINATURE OF CAND /OrFICEHOLDER Executed on At By DATE CITY AND SLATE SIGNATURE Of CANDIDATE/OFFICEHOLDER Executed on At By DATE CITY AND STATE SIGNALURE Of CANDIDAIE /OAICEHOLDER FOR INFORMATION REWIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS OF THE POLITICAL REFORM ACT Campaign Disclosure Statement Type or print In ink. SUMMARY PAGE Summary Page AmDt iao =nded Statement covers period from 10 -01 -96 SEE INSTRUCTIONS ON REVERSE through 10 -19 -96 7APPLIED 6 NAME OF OFFICEHOLDER ORC ANDIDATE AND CONTROLLED COMMITTEE COIZIITTEE TO ELECT STEVEN FORD Contributions Received column A column B* column C TOTAL THIS PE MOD TOTAL PREVIOUS PERIOD TOTAL TO DATE (FROM ATTACHED SCHEDULES) (SEE NOTE BELOW) (ADD COLUMNS A♦ B) 1. Monetary Contributions ............................... Schedule A,Une3 S 4,877.00 $ 2,451.00 s 7,328.00 2. .nsReceived .......... ............................... Schedule 8, Line? .00 375.00 375.00 3. SUBTOTAL CASH CONTRIBUTIONS ...................... Add Lines I +2 S 4,877.00 s 2,826.00 s 7,703.00 4. Non - monetary Contributions ......................... Schedule C, Line 3 161 63 n0 161.63 S. SUBTOTAL CONTRI 8 UTIONS:(Exdu* Enforceable Prom ises) Add Unes3 + a S 5,038.63 S 2,826.00 s 7,864.63 6. Enforceable Promises 00 00 .00 (Exclude Loan Guarantees, Line 18 below) ................... Schedule D, Line 7 - 7. TOTAL CONTRIBUTIONS RECEIVED ..................... AddunesS +6 S 5,038.63 s 2,826.00 s 7,864.63 Expenditures Made 8. Cash Payments (Other than Loans Made) ............ Schedule E, Line S S 1 4,726.67 s 375.00 S 5,101.67 9. Loans Made .............. ............................... Schedule H, Line 7 .00 .00 .00 10. SUBTOTAL CASH PAYMENTS ............................ Add Lines 8+9 S 4,726 -67 s 375.00 S 5,1.01.67 11. Accrued Expenses (Unpaid Bills) ........................ Schedule r Une S .00 .00 .00 12.I&TAL EXPENDITURES MADE ......................... Add Lines 10 + II S 4,726.67 S 375.00 S 5.101.67 Cu nt Cash Statement 13. Beginning Cash Balance .................. Previous summary Page, Line 17 S 2.451.00 • From previous Statement Summary Page, Column C. However, if 14. Cash Receipts " " " " " " " " " "' ..... Column A, Line 3 above LI , 877.00 this is the first report tiled for the calendar year, Column IS should be blank except for Loam Received (Line 2), Enforceable Promises (Line 15. Miscellaneous Increases to Cash ........................ Schedule 1, Line 4 .00 6), Loans Made (Line 9), and Accrued Expenses (Line 11). 16. Cash Payments ..... ............................... Column A, Line 10 above 4,726.67 17. ENDING CASH BALANCE ..... Addtrnes 13 114 + 15, then subtract Line 16 S 2,601.33 Summary for Candidates in Both June and H this isa termination statement, Une17 must bezero. ,. ENDING CASH BALANCE SHOULD November Elections NOT BE A NEGATIVE AMOUNT 1/1 through WD 711 to Date 18. LOAN GUARANTEES RECEIVED .............. Schedule 8, Part 1, Column (b) S .00 21. Contributions eceive .... S Cash Equivalents and Outstanding Debts pPenditures 19. Cash Equivalents . ............................... See instructions onreverse S 00 M 22. Ex ane ....... S 20. Outstanding Debts ................. Add Line 2+ Line I I in Column C above S 375.00 Schedule A Type or print In Ink. SCHEDULE A Contributions Received Amounts may be rounded statement covers period Monetary to whole dollars. I j� from 10 -01 -96 SEE INSTRUCTIONS ON REVERSE through 10 -19 -96 Pape 3 of 6 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMhIITTEE TO ELECT STEVEN FORD APPLIED FOR FULL NAME ANDADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE DATE (IF COMMITTEE. IN ADDITION TO CommrrT 's NAME AND ADDRESS. ENTERLD. NUMBER (IF SELFAMRLOYED. ENTER RECEIVEDTHIS CALENDARYEAR OTHER RECEIVED OR, IF NO I.D. NUMBER NITS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS) NAME OF BUSINESS) PERIOD (JAN.I -DEC. 31) (IFAPPLICABLE) • SUBTOTAL S Monetary Contributions Summary 1. Amount received this period —contributions of $100 or more. (Include all Schedule A subtotals.) ..................................................................... ............................... $ 00 2. Amount received this period — contributions of less than $100. 4 G77.00 (Do not itemize.) ........................................................................................ ............................... S 3. Total monetary contributions received this period. 4 , 877.0 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ........... ............................... TOTAL S Schedule C Type or print In Ink. SCHEDULE C Amounts may be rounded Statement covers period 7 FO R Non - Monetary Contributions Received to whole dollars. from 10 -01 -96 SEE INSTRUCTIONS ON REVERSE through 10 -19 -96 Page 4 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMf9ITTEE TO ELECT STEVEN FORD APPLIED FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER CUMULATIVE TO CUMULATIVE TO DATE (I{ COMMITTEE, IN ADDRION TO COMMFRE['f NAME AND ADDRESS, DESCRIPTION OF FAIR MARKET DATE RECEIVED (I{ SELF - EMPLOYED, ENTER NAME OF GOODS OR SERVICES VALUE CALENDARYEAR DATE OTHER ENTER I.D. NUMBEROk IF NO I.D. NUMBER HAS BEEN ASSIGNED, BUSINESS) (IF APPLICABLE) ENTER TREASURER'S NAME AND ADDRESS) (IAN. 1 - DEC. 31) 1W8/96 COUNTRY SIGNS AND DESIGNS 27620 COMERCE CENTER DR., #101 3 -4' X 4' 161.63 161.63 TEMECULA, CA 92590 SIGNS Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 161.63 Non - Monetary Contributions Summary 1. Amount received this period— non - monetary contributions of $ 100 or more. 161.63 (Include all Schedule C subtotals.) ..................................................... ............................... S 2. Amount received this period— non - monetary contributions of less than $ 100. (Do not itemize.) ......................................................................... ............................... S nn 3. Total non - monetary contributions received this period. 161.63 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 4.) ....................... TOTAL S 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 10 -01 -96 SEE INSTRUCTIONS ON REVERSE through 10 -19 -96 Page 5 of 6 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COIII-IITTEE TO ELECT STEVEN FORD APPLIED FOR CODES FOR CLASSIFYING 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. 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) '1' — 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, IN ADDITION TO COMMITTEE'S IiAME AND ADDRESS, ENTER I.D. NUMDEROR. N NO I.D. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW. MUMMER 14AS DEEM ASSIGNED. ENTER TREASURER'S NAME AND ADDRESS) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID COUNTRY SIGNS & DESIGNS 27620 COMMERCE CENTER DRIVE, #101 TEMECULA, CA 92590 SIGNS 646.50 COUNTRY SIGNS AND DESIGNS 27620 C011MERCE CENTER. DRIVE, #101 WCULA, CA 92590 BANNERS 659.52 EDWARD HORN CO. BUMPER STICKERS, POSTERS, FIVE SO. EASTERN ROAD DOORKNOB 1;ANGERS 3,7.39.90 GLENSIDE, PA 19038 Imp ortant. 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 L 4,545.92 Payments and Contributions Made Summary I. Payments made this period of $100 or more. (Include all Schedule E'subtotals.) ......................... $ 4.726.67 2. Payments made this period of under $100. (Do not itemize.) ........................................ ............................... f .00 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. $ .00 4. Total accrued expenses paid this period. (Do not itemize. Enter amount from Schedule F, Line 4.) ...... ............................... $ .00 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 $ 4,726.67 f Schedule E Type or print in ink. SCHEDULE E (cost.) Amounts may be rounded (Continuation Sheet) to whole dollars. Statement covers period Payments and Contributions from 10 -01 -96 (Other Than Loans) Made SEE INSTRUCTIONS ON REVERSE through 10— ].9 -9 Pape 6 of 6 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMITTEE TO ELECT STEVEN FORD APPLIED FOR CODES FOR CLASSIFYING EXPENDITURES '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 SERVICES 'L' — LITERATURE 'F' — FUNDRAISING EVENTS NAME AND ADDRESS OF PAYEE, CREDITOR, OR RECIPIENT OF CONTRIBUTION SIE COMMITTEE. IN ADDIT ION TO COMMIT NAME AND ADDRESS, ENTER I.D. NUMBER OR, IT NO I.D. NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS) - CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID EDWARD HORN CO. FIVE SO. EASTERN ROAD CLENSIDE, PA 19038 BUTTONS 180.75 SUBTOTAL $ 180.75 office holder, Candidate, Type or print In Ink. COVER PAGE - LONG FORM and Controlled Committee statement covers period Date Stamp Campaign Statement — Long Form from 7 -1 -96 (Government Code Sections 84200- 84216.5) �. SEE INSTRUCTIONS ON REVERSE through — 30 — 6 ` 3 19% Page 1 of 5 Check one of the following boxes to indicate the type of statement being flied: Date of election H applicable: OCT 1T�V For Official Use Only ® Pre - election Statement (Month, Day, Year) ; ❑ Supplemental Pre - election Statement (Attach a completed Form 495 to this statement.) Special Odd -Year Campaign Report 11-5-96 Semi - annual Statement ��p tl)ry)�_ Termination Statement (Attach a completed Form 415 to this statement.) r I Off ice o er an i ate, an Controlled Committee ter Committees of Included in is Statement: Llstanyother Included in this Statement committees not Included in this consolidated statement that are contro tiedbyyouandany NAME OF OFFICEHOLDER OR CANDIDATE committees of which you have knowledge that are primarily formed to receive contributions . STEVEN J. FORD or to make expenditures on beha of your candidacy. COMMITTEE NAME I.p. NUMBER OFFICE SOUGHT OR HELD UNCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL — TEMECULA, CALIFORNIA RESIDENTIAL OR BUSINESS ADDRESS (NO. AND STREET) NAME OF TREASURER CONTROLLED COMMITTEE? 2 VILLA ALTURAS ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODIUDAYTIME PHONE COMMITTEE ADDRESS (NO. AND STREET) TEMECULA CA 92592 (909)676 -3756 COMMITTEE NAME LD. NUMBER CRY STATE Ee CODE AREA CODMAYTIME PHONE COMMITTEE TO ELECT STEVEN FORD APPLIED FOR COMMITTEE NAME I.D. NUMBER COMMITTEE ADDRESS (NO. AND STREET) 43500 RIDGE PARK DR., STE. 104 CITY - STATE ZIP CODE AREA CODEIDAYTIME PHONE NAME OF TREASURER CONTROLLED COMMITTEE? TEMECULA CA 92590 (909)676 -30 ❑ "ES ❑ No NAME OF TREASURER COMMIT TEE (NO. AND STREET) DE D. THOMAS PERMANENT ADDRESS OF TREASURER IND. AND STREET) CRY STATE ZIPCODE AREA CODUDAYTIME PHONE 31820 VIA LEVANTAR �RY STATE ZIP CODE AMA COOMAYTIME PHONE TEMECULA CA 9 2 59 2 ( - 3013 Attach additional Information on appropriately labeled continuation sheets. III V erification I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my k et e 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' rue and Corr Executed on 10 -2 -96 At TEMECULA CA B ti DATE CITY AND STATE y D PIWMAS SIGNATURE Of TREASURER An officeholder or candidate who controls a committee must also verify the campaign statement. I have used all reasonabl ence and to the best 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 into tor contain e erein an the attached schedules is true and complete. I certify under penalty of perjury underthe laws of the State of California that the foregoing is true and corre Executed on 10 -2 -96 At TEMECULA, CA B DATE CITY AND STATE N FORY fIGNATURE Of CANDID /OFFICEHOLDER Executed on At By DATE CITY AND STATE SIGNATURE OF CANDIDATEIOFI ICEHOLDER Executed on At By DATE CITY AND STATE SIGNATURE Of CANDIDATE /OFFICEHOLDER FOR INFORMATION MOUIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS OF THE POLITICAL REFORM ACT a. / •r Campaign Disclosure Statement Type or print In ink. SUMMARY PAGE Amounts may be rounded '" Statement covers period i� Summary Page tD whole dOuarE. � I from 7-1-96 SEE INSTRUCTIONS ON REVERSE through 9 -30 -96 Pam 2 of 5 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMMITTEE TO ELECT STEVEN FORD APPLIED FOR Contributions Received Column A Column B• Column C TOTAL THIS PENOD TOTAL PREVIOUS PERIOD TOTAL TO DATE O ROM ATTACHED SCHIDU LES) (SEE NOTE aELOVV) (ADD COLUMNS A 0) 1. Monetary Contributions ............................... Schedule A,Line3 s 2451.00 S S 2451.00 *oansReceived ............................. Schedule 8, Line? 375.00 375.00 3. SUBTOTAL CASH CONTRIBUTIONS Addunesl+2 $ 2826.00 s S 2826.00 4. Non - monetary Contributions ......................... schedule C, Line 3 .00 .00 5. SUBTOTAL CONTRIBUTIONS . (Exdude Enforceable Promises) Addunes3+4 $ 2826.00 S S 2826.00 6. Enforceable Promises .00 .00 (Exclude Loan Guarantees, Line 18 below) ................... Schedule D, Line 7 7. TOTAL CONTRIBUTIONS RECEIVED Add Lines 5+6 S 2826.00 S s 2826.00 Expenditures Made 8. Cash Payments (Other than Loans Made) Schedule E, Line S $ 375.00 s S 375.00 9. Loans Made .............. ............................... Schedule H, Line 7 .00 .00 10. SUBTOTAL CASH PAYMENTS ............................ AddLlms8 +9 S 375.00 s S 375.00 11. Accrued Expenses (Unpaid Bills) . ....................... Schedule F Lines .00 .00 1�TOTAL EXPENDITURES MADE ......................... AddLlnes 10 + 11 S 375.00 $ S 375.00 urrent Cash Statement 13. Beginning Cash Balance .................. Previous Summary Page, Line 17 S • 00 • From previous Statement Summary Page, Column C. However, it 14. Cash Receipts """ " " " "' ..... column A , Linea above 2826.00 this is the first report filed for the calendar year, Column R should be blank except for Loans Received (Line 2), Enforceable Promises (Line 15. Miscellaneous Increases to Cash ........................ Schedule 1, Line 4 .00 6), Loans Made (Line 9), and Accrued Expenses (Line 11). 16. Cash Payments Column A, Lim 10 above 375.00 17. ENDING CASH BALANCE ..... AddLlnes 13 + 14 + 15, thensubtract Line 16 S 2451.00 Summary for Candidates in Both June and If thlsls a term /natlonstatement, Line l7mustbezero. ENDING CASHA SHOULD November Elections NOT aE A NEGATIVE AMOUNT 1/1 through 6/30 711 to Date 18. LOAN GUARANTEES RECEIVED .............. Schedule 6, Part 1, Column (b) S .00 21. Reeeveytions S tl .... Cash Equivalents and Outstanding Debts zz. Expenditures 19. Cash Equivalents . ............................... See instructions on reverse S OO Made ....... S 20. Outstanding Debts ................. AddLlnez + Line 11in Column eabove S 375.00 Schedule E Type or print in ink. SCHEDULE E Amounts may be rounded Statement covers period t Payments and Contributions to whole dollars. !iy (Other Than Loans) Made }rOm 7 -1 -96 I. SEE INSTRUCTIONS ON REVERSE through 9 -30 -96 Page 5 of 5 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMMITTEE TO ELECT STEVEN FORD APPLIED FOR CODES FOR CLASSIFYING EXPENDITURES If one of the following codes accurately describes the expenditure, ou 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. 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. (IF COMMmEE, IN ADDITION TO COMMITTEE'S NAME AND ADDRESS, ENTERLD. NUMSEROR. N NO I.D. REPORT ONLY THE LUMP SUM OF SUCH PAYMENTS ON LINE 4 OF THE SUMMARY SECTION BELOW. NUMBER HAS BEEN ASSIGNED, ENTER TREASURER'S NAME AND ADDRESS) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID CITY OF TEMECULA CANDIDATE STATEMENT FEE 350.00 43174 BUSINESS PARK DRIVE CANDIDATE FILING FEE 25.00 TEMECULA CA 92590 Important: Contributions and expenditures made out of campaign funds to or on behalf of other SUBTOTAL $ 375.00 officeholders candidates committees or ballot measures must also be entered on the Allocation Page, Pa rt L Payments and Contributions Made Summary 1. Payments mode this period of $100 or more. (Include all Schedule E subtotals.) ....................... ............................... f 375.00 2. Payments made this period of under $100. (Do not itemize.) $ .00 3. Total interest paid this period on outstanding loans. (Enter amount from Schedule B, Part II, Column (d).) .............................. $ . 00 4. Total accrued expenses paid this period,. (Do not itemize. Enter amount from Schedule F, Line 4.) ...... ............................... $ . 00 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 $ 375.00 ._, R . Schedule A Type or print In ink. SCHEDULE A Monetary Contributions Received Amo to whol rounded Statement covers period 'I j to whole do llars. u = I� from 7 -1 -96 SEE INSTRUCTIONS ON REVERSE through 9 -30 -96 7APPL 3 of 5 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE BER COMMITTEE TO ELECT STEVEN FORD FOR FULL NAME AND ADDRESS OF CONTRIBUTOR OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE CUMULATIVE TO DATE DATE (IF COMMMEE.IN ADDnINE TO COMMRTEE's NAME AND ADDRESS, ENTER I.D. NUMBER (IF SELF - EMPLOYED, ENTER RECEIVEDTHIS CALENDARYEAR OTHER RECEIVED OR, IF NO I.D. NUMBER HAS BEENASSIGNED. ENTERTREASURER'S NAME AND ADDRESS) NAME OF BUSINESS) PERIOD (JAN.1 -DEC. 31) (IF APPLICABLE) • SUBTOTAL $ Monetary Contributions Summary 1. Amount received this period — contributions of $100 or more. (Include all Schedule A subtotals.) ............................ S • 00 2. Amount received this period — contributions of less than $100. 2451.00 (Do not itemize.) ............................................... — .............................................. ....................... $ 3. Total monetary contributions received this period. 2451.00 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ........... ............................... TOTAL $ Schedule B —Part I Type or print in Ink. SCHEDULE 8 - Part I Amounts may be rounded Statement covers period Loans Received to whole dollars. from 7-1 -96 4, SEE INSTRUCTIONS ON REVERSE through 9 -30 -96 Page 4 of 5 NAME OF OFFICEHOLDER OR CANDIDATE AND CONTROLLED COMMITTEE I.D. NUMBER COMMITTEE TO ELECT STEVEN FORD APPLIED FOR LENDEROR GUARANTOR'S FULL NAME ANDADDRESS LENDER /GUARANTOR'S LENDER INFORMATION GUARANTOR INFORMATION DATE (IF COMMITTEE, ENTER FULL NAME. ADDRESS AND I.D. NUMBER. IFHOI.D. OCCUPATION AND EMPLOYER (IF SELF RECEIVED NUMBER HAS BEEN ASSIGNED. ENT ER THE TREASURER'S NAME AND ADDRESS) EMPLOYED, ENTER BUSINESS NAME) DUE DATEI AMOUNT CUMULATIVE AMOUNT CUMUTATIVE INTEREST RATE OFLOAN TO DATE GUARANTEED TO DATE DUE DATE CALENDAR YEAR CLENDARYEAR QP/96 STEVEN FORD BUSINESS CONSULTA 29900 VILLA ALTURAS REDHAWK COMM. & 37�.G0 s 375.00 s TEMECULA CA 92592 PAUL GARRETT ENT. "' OTHER OTHER ® Lender ❑ Guarantor % f f DUE DATE ULENDARYEAR CLENDARYEAR f i INTEREST MT[ OTHER OTHER ❑ Lender Guarantor % s s DUE DATE CLENDARYEAR ULENDARYEAR 4 4 INTEREST RATE OTHER OTHER ❑ Lender ❑ Guarantor' % t s (a) (b) Enur(b)on •� important instructions on reverse. SUBTOTAL S NM $ S..mary PAee. Lim 11 only. Loans Received — Part I Summary 1. Loans of $100 or more received this period. (Include all Loans Received —Part I (a) subtotals.) .......... $ 375.00 2. Loans under $100 received this period. (Do not itemize.) ............ ............................... $ 3. Total loans received this period. (Add Lines 1 and 2.) ....... ............................... • TOTAL S 375.00 Loans Received — Part II Summary 4. Loans of $100 or more repaid, forgiven, or paid by a third party this period. (Include all Part II (c) 00 subtotals. If forgiven or paid by a third party, also itemize the transaction on Schedule A.) .............. $ 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 . ........................... $ .00 6. Total loans repaid, forgiven, or paid by a third party this period. 00 (Add Lines + 5:) ............... ............................... ..........................TOTAL $ 7. Net change this period. (Subtract Line 6 from Line 3.) NET $ 375.00 Enter the net here and on the Summary Page, Column A, Line 2 . ............................... May be • negMlve number.