HomeMy WebLinkAbout2011 Recipient Committee COVER PAGE
Campaign Statement Type or print in ink. Date Stamp A • 1
Cover Page RECEIVED '
(Government Code Sections 84200 - 84216.5) �
Statement covers period Date of election if applicable: Q.
from
July 1, 2011 (Month, Day, Year) JAN 25 2012 IF.r of
Official Use Only
SEE INSTRUCTIONS ON REVERSE through December 31, 2011 TY CLERKS DEPT.
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 0 Primarily Formed ® Semi - annual Statement ❑ Special Odd -Year Report
0 Recall 0 Controlled Termination Statement
(Also Complete Part S) 0 Sponsored E] E] Supplemental Preelection
❑ Amendment (Explain below) Statement - Attach Form 495
(Also Complete Part 6)
❑ General Purpose Committee
0 Sponsored ❑ Primarily Formed Candidate/
0 Small Contributor Committee Officeholder Committee
0 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 true and correct.
Executed on 0 `-2, By
I glu( ate Sign , rea orAssi Treasurer
Executed on ` ` By
Date Signature ofControT6mgjOfficeholdeF, Candidate, kzj a PoponentorResponsibleOffcerofSponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 866 /ASK -FPPC
State of California
Type or print in ink. COVER PAGE -PART2
Recipient Committee CALI I
_
Campaign Statement FORM R 4 • 1
Cover Page — Part 2
Page 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 ❑ 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.
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 -
Summary Page to whole dollars. I
from
July 1, 2011 • - Q
SEE INSTRUCTIONS ON REVERSE through December 31, 2011 page 3 of
NAME OF FILER I.D. NUMBER
Committee to Elect Chuck Washington 1236008
Column Column B Calendar Year Summary for Candidates
Contributions Received TOTALTHISPERIOD CALENDARYEAR R in Both the State Prim and
(FROM ATTACHED SCHEDULES) TOTALTODATE g ma ry
1. Monetary Contributions ............ ............................... Schedule A Line 3 $ 0.00 $ 0.00
General Elections
2. Loans Received ....................... ............................... schedule e, Line 3 0 0.00 1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS ................. 0.00 0.00 20. Contributions
........ Add Lines 1 + 2 $ $ Received $ $
4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 0.00 0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 0.00 $ 0.00 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made ........................ ............................... Schedule E Line 4 $ 2.00 $ 2.00 Candidates
7. Loans Made .............................. ............................... Schedule H Line 3 0.00 0.00
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 2.00 $ 2.00 (ifSubjectto Voluntary Expenditure Limit)
9. Accrued Exp enses ( Bills s 0.00 0.00 Date of Election Total to Date
p ( p ) ............................... S F, Line 3
10. Nonmonetary Adjustment ........... ............................... schedule C Line 0.00 0.00 (mm /dd /yy)
11. TOTAL EXPENDITURES MADE . .............. ................. Add Lines 6 + 9 + 10 $ 2.00 $ 2.00 $
Current Cash Statement $
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 3653.57
To calculate Column B, add y -� $
13. Cash Receipts .................... ............................... Column A, Line 3 above 0 amounts in Column A to the
0.00 corresponding amounts
14. Miscellaneous Increases to Cash ........................... schedule /, Line 4 from Column B of your last $
15. Cash Payments ............. 2,00 report. Some amounts in
Column A, Line 8 above Column A may be negative
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 3651.57 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 $ 0.00 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 $ 0
19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ 0.00 FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 866 /ASK -FPPC
SCHEDULEE
Schedule E Type or print in ink. Statement covers period
Payments Made Amounts may be rounded from • ' '
y to whole dollars. July 1, 2011 •'
SEE INSTRUCTIONS ON REVERSE through December 31, 206 page A of
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.
CUP campaign paraphernalia /misc. MBR member communications RAID 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 filing /ballot fees PHO phone banks TRC candidate travel, lodging, and meals
FIND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals
IND independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID
Pacific Western Bank Dormancy fee from bank
27541 Ynez Rd. 2.00
Temecula, CA 92591
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2.00
Schedule E Summary
1. Payments made this period of $100 or more. Include all Schedule E subtotals. 0
2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 2.00
3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e). 0
4. Total a ments made this period. Add Lines 1, 2, and 3. Enter here and on the Summa Page, Column A, Line 6. 2.00
P Y P � Summary 9 ) ............................. TOTAL $
FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 866 /ASK -FPPC
Recipient Committee T COVER PAGE
Campaign Statement Ype or print in ink. RECIk- te.,SJ� or
19@9 � . 1
Cover Page y
(Government Code Sections 84200 - 84216.5) JUL E 2 201
Statement covers period Date of election if applicable:
from January 1, 2011 (Month, Day, Year) q ITY CLERKS DEPT 1!!! of
F Official Use Only
SEE INSTRUCTIONS ON REVERSE through June 30, 2011
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 0 Primarily Formed ® Semi - annual Statement ❑ Special Odd -Year Report
0 Recall 0 Controlled Termination Statement
(Also Complete Part S) 0 Sponsored ❑ E] Supplemental Preelection
Pa rt ❑ Amendment (Explain below) Statement - Attach Form 495
(Also Compl sore
❑ General Purpose Committee
0 Sponsored ❑ Primarily Formed Candidate/
0 Small Contributor Committee Officeholder Committee
0 Political Party /Central Committee (Also Complete Pail 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 u the laws of the State of California that the foregoing is true and correct.
Executed on 7 / 1 By
D IB natur f uLer orAssi stantTreasurer
Executed on By
Date Signature of Controlling Officeholder, a idate, StateMeasureProponentorResponsibleOtficerofSponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on June /01 460 BY FPPC Form
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent ( )
FPPC Toll -Free Helpline: 666 /ASK -FPPC
State of California
Type or print in ink. COVER PAGE - PART 2
Recipient Committee ,
Campaign Statement , ® e I o 1
Cover Page -- Part 2
Page 7 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 ❑ 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.O. 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 CODEIPHONE Attach continuation sheets if necessary
FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
State of Californla
Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE
Amounts may be rounded Statement covers period CALIFOR
Summary Page to Whole dollars. / •
from January 1, 2011 • -
SEE INSTRUCTIONS ON REVERSE through June 30, 2011 Page 3 of
NAME OF FILER I.D. NUMBER
Committee to Elect Chuck Washington 1236008
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTALTHISPERIOD CALENDARYEAR Running In Both the State Prima and
(FROM ATTACHED SCHEDULES) TOTALTODATE g Primar
1. Monetary Contributions ............ ............................... Schedule A Line 3 $ 0.00 $ 0.00
General Elections
2. Loans Received ....................... ............................... Schedule B, Line 3
0.00 0.00 1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 0.00 $ 0.00 20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ............................... Schedule C Line 3 0.00 0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 0.00 $ 0.00 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made ........................ ............................... Schedule E Line 4 $ 0.00 $ 0.00 Candidates
7. Loans Made .............................. ............................... Schedule H. Line 3 0.00 0.00
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ 0.00 $ 0.00 (If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses ( Unpaid Bills Schedule F, Line 3 0.00 0.00
P ( P ) •�•������•••••••••••••••••••••• Date of Election Total to Date
10. Nonmonetary Adjustment ........... ............................... Schedule C Linea 0.00 0.00 (mm /dd /yy)
11. TOTAL EXPENDITURES MADE ............... ................. Add Lines 8 +9 +10 $ 0.00 $ 0.00 $
Current Cash Statement $
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 3623.57
To calculate Column B, add $
13. Cash Receipts ................ ................................... Column A, Line 3 above 0.00 amounts in Column A to the
30.00 corresponding amounts
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 from Column B of your last $
15. Cash Payments ............. 0.00 report. Some amounts in
Column A, line 8 above Column A may be negative
3653.57 f i g ures that should be $
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 9
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 $ 0.00 for this calendar year, only
carry over the amounts *Since January 1, 2001. Amounts in this section may be
Cash Equivalents and Outstanding Debts
from Lines 2, 7, and 9 (if different from amounts reported in Column B.
18. Cash Equivalents ......... ............................... See instructions on reverse $
0.00 y) '
19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 0.00 FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866 /ASK -FPPC
Schedule I Type or print in ink. SCHEDULE I
Miscellaneous Increases to Cash Amounts may be rounded Statement covers period
to whole dollars. CALIF � � t
from January 1, 2011 FORM
SEE INSTRUCTIONS ON REVERSE
through June 30, 2011 Page + of A_
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
Pacific Western Bank Rebate Bank Fees
1/31/2011 27541 Ynez Rd. 30.00
Temecula, CA 92591
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 30.00
Schedule I Summary
1. Increases to cash of $100 or more this period ............................................................................ ............................... $ 0.00
2. Unitemized increases to cash under $100 this period ................................................................ ............................... $ 30.00
3. Total of all interest received this period on loans made to others. Schedule H, Column (e). 0.00
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14. TOTAL $ 30.00
FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 866 /ASK -FPPC