HomeMy WebLinkAbout2013 Recipient Committee COVER PAGE ALIFORN Campaign Statement Type or print in ink. Date Stamp IA
Cover Page "2001/02' 61
(Government Code Sections 84200-84216.5) Q y .
Statement covers period Date of election if applicable: JAN 28 2014
July 1, 2013 (Month, Day,Year) Page�_ of
from CLERKS DEPT. For Official Use Only
SEE INSTRUCTIONS ON REVERSE through December 31, 2013
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 Pan 5) 0 Sponsored ❑ E] Supplemental Preelection
(Also Complete Part 6) ❑ Amendment(Explain below) Statement-Attach Form 495
❑ 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 City Council 2012 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 951699-5706
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 istrue and correct.
Executed on
/ Date- Il gnatureofT surerorAssis urer
Executed on t/ L rz ' By /
Date Signature ofContro' Off -older.Candidate, Measure t or Responsible Officer of Sponsor
Executed on By /
Date Signature of Controlling Officdhekrer,Candidate,State Measure Proponent
Executed on June/01 BY
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460( )
FPPC Toll-Free Helpline:866/ASK-FPPC
State of California
Recipient Committee Type or print in ink. COVER PAGE-PART2
Campaign Statement • 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 ❑ 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
Summary Page Amounts may dollars.rounded Statement covers period
from
July 1, 2013 • - •
r
SEE INSTRUCTIONS ON REVERSE through December 31, 2013 Page - of
NAME OF FILER I.D. NUMBER
Committee to Elect Chuck Washington City Council 2012 1236008
Column Column B Calendar Year Summary for Candidates
Contributions Received TOTAL THIS PERIOD CALENDAR YEAR
(FROMATTACHED SCHEDULES) TOTALTODATE Running in Both the State Primary and
0000 500.00 General Elections
.
1. Monetary Contributions ........................................... Schedule A,Line 3 $ $
00.00 00.00 1/1 through 6/30 7/1 to Date
2. Loans Received ...................................................... Schedule e,Line 3
00.00 500.00 20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1+2 $ $ Received $ $
4. Nonmonetary Contributions.................................... Schedule C,Line 3 00.00 00.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED .•••....•..................AddLines3+4 $ 00.00 $ 500.00 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made....................................................... Schedule E,Line 4 $ 1050.00 $ 3750.00 Candidates
7. Loans Made............................................................. Schedule H,Line 3 00.00 00.00
1050.00 3750.00 22• Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ $ (If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ...............................schedule F Line 3 00.00 00.00 Date of Election Total to Date
10. Nonmonetary Adjustment .......................................... schedule C,Line 00.00 00.00 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE................................Add Lines 6+9+10 $ 1050.00 $ 3750.00 $
Current Cash Statement $
12. Beginning Cash Balance....................... Previous Summary Page,Line 16 $ 7587.38
To calculate Column B,add $
13. Cash Receipts ................................................... Column A,Line 3 above 00.00 amounts in Column A to the
00.00 corresponding amounts
14. Miscellaneous Increases to Cash........................... Schedule/,Line 4 from Column B of your last / $
15. Cash Payments.................. ..... 1050.00 report. Some amounts in
Column A,Line&above Column A may be negative
6537.38 figures 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 e,Part 2 $ 00.00 for this calendar year, only
carry over the amounts *Since January 1, 2001. Amounts in this section may be
Cash Equivalents and Outstanding Debts from Lines 2,7, and 9(if different from amounts reported in Column B.
18. Cash Equivalents........................................ See instructions on reverse $
00.00 any).
19. Outstanding Debts......................... Add Line 2+Line 9 in Column B above $ 5000.00 FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Type or print in ink. SCHEDULEB-PART1
Schedule B— Part 1 Amounts may be rounded Statement covers period
Loans Received to whole dollars. from July 1 2013 • - • 1
SEE INSTRUCTIONS ON REVERSE through December 31, 2013 page A__ of
NAME OF FILER I.D. NUMBER
Committee to Elect Chuck Washington City Council 2012 1236008
IF AN INDIVIDUAL, ENTER a (b) (c) (d) (e) (f) (g)
FULL NAME,STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT OUTSTANDING INTEREST ORIGINAL CUMULATIVE
OCCUPATION AND EMPLOYER BALANCE AMOUNT PAID BALANCEAT
OF LENDER (IF SELF-EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE
Chuck Washington Airline Pilot ❑PAID CALENDAR YEAR
31205 Kahwea Rd. $ 00.00 $ 5000.00 0.00 % $ 5000.00 $ 00.00
Temecula, CA 92591 ❑FORGIVEN RATE PER ELECTION**
$ 5000.00 $ 00.00 $ 00.00 NA $ 00.0 10/15/12 $
t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED
❑PAID CALENDAR YEAR
❑FORGIVEN RATE PER ELECTION**
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED
PAID CALENDAR YEAR
$ $ % $ $
❑FORGIVEN RATE PER ELECTION**
tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED
SUBTOTALS $ 00.00 $ 00.00 $ 5000.00 $ 00.00
(Enter(e)on
Schedule B Summary Schedule E,Line 3)
00
1. Loans received this period.................................................................................................................... $ 00. *Amounts forgiven or paid by
(Total Column(b)plus unitemized loans less than$100.) another party also must be
2. Loans paid or forgiven this period ......................................................................................................... $
00.00 reported on Schedule A.
(Total Column(c)plus loans under$100 paid or forgiven.) **If required.
(Include loans paid by a third parry that are also itemized on Schedule A.)
3. Net change this period. Subtract Line 2 from Line 1. NET $ 00.00
g p (Subtract ...............................................................
Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number)
t Contributor Codes
IND—Individual COM—Recipient Committee(other than PTY or SCC) OTH—Other PTY—Political Party SCC—Small Contributor Committee FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Schedule E Type or print in ink. SCHEDULEE
Amounts may be rounded Statement covers period ,
Payments Made to Whole dollars. • - • ,
from July 1, 2013
through December 31, 206 Page� of �
SEE INSTRUCTIONS ON REVERSE 9 9
NAME OF FILER I.D. NUMBER
Committee to Elect Chuck Washington City Council 2012 1236008
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP 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
FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals
IND independent expenditure supporting/opposing others (explain)" POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE,ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
RCPFBF c/o FF Chris Douglas Trust Donation to trust set up for fallen firefighter
21160 Box Springs Road Ste. 105 CVC 1000.00
Moreno Valley, CA 92559
Secretary of State
Political Reform Division FIL Annual campaign committee fee 50.00
PO Box 1467
Sacramento, CA 95812 p
' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1050.00
Schedule E Summary
1. Payments made this period of$100 or more. Include all Schedule E subtotals. 1050.00
2. Unitemized payments made this period of under$100 .......................................................................................................................................... $ 00.00
3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e).) 00.00
4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 1050.00
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
Recipient Committee Type or print in ink. Date Stamp COVER PAGE
Campaign Statement • - , A a 1
Cover Page EECEI ® 0 '
(Government Code Sections 84200 - 84216.5)
Statement covers period Date of election if applicable: JUL 3 0 2O y l3 Page—/-- of
January JUL 1, 2013 (Month, Day, Year) 7.
from For Official Use Only
SEE INSTRUCTIONS ON REVERSE through June 30, 2013 CITY CURKS ®E".
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
(Also Complete Part 5) E] Termination Statement E] Supplemental Preelection
0 Sponsored ❑ Amendment (Explain below) Statement - Attach Form 495
❑ General Purpose Committee (Also Complete Part 6)
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 City Council 2012 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 7 Date By / VMA Date Sign r f easurerorAssistantTreasurer
Executed on 7/25/13 By
Date Signature of Controlling Officeholder a idate, StateMeasureProponentorResponsible0fficeroiSponsor
Executed on g
Date y Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on June /01 By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 ( )
FPPC Toll -Free Helpline: 866 /ASK -FPPC
State of California
Recipient Committee Type or print in ink. COVERPAGE -PART2
Campaign Statement 460
1 FORM ;
Cover Page — Part 2
Page Z of
5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE
Chuck Washington
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT
City Council, Temecula I 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 CALIFORNIA '
from January 1, 2013 FORM
SEE INSTRUCTIONS ON REVERSE through June 30, 2013 Page of 7
NAME OF FILER I.D. NUMBER
Committee to Elect Chuck Washington City Council 2012 1236008
Contributions Received
To Column oD CALENDAR Calendar Year Summary for Candidates
(FROMATTACHED SCHEDULES) TOTALTO DATE Running in Both the State Primary and
1. Monetary Contributions ............ ............................... Schedule A, Line 3 $ 500.00 $ 500.00
General Elections
2. Loans Received ....................... ............................... Schedule s, tine s 00.00 00.00 1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add tines 1 + 2 $ 500.00 $ 500.00 20. Contributions
Received $ $
4. Nonmonetary Contributions ..... ............................... Schedule C, Lines 00.00 00.00 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED •.••..• ......• .............AddLines3 +4 $ 500.00 $ 500.00 Made $ $
Expenditures Made Expenditure Limit Summary for State
6. Payments Made ........................ ............................... schedule E, Line 4 $ 2700.00 $ 2700.00 Candidates
7. Loans Made .............................. ............................... Schedule H, Line 3 00.00 00.00
2700.00 2700.00 22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 + 7 $ $ ( if Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills Schedule F Line 3 00.00 00.00 Date of Election Total to Date
10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 00.00 00.00 (mm /dd /yy)
11. TOTAL EXPENDITURES MADE . ............................... Add Lines 6 + 9 + 10 $ 2700.00 $ 2700.00 $
Current Cash Statement $
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 9128.25
To calculate Column B, add
13. Cash Receipts .................... ............................... Column A, Line 3 above 500.00 amounts in Column A to the
13 corresponding amounts *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 659. from Column B of your last reported in Column B.
15. Cash Payments ................... ............................... Column A, Line 8 above 2700.00 report. Some amounts in
Column A may be negative
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 7587.38 figures that should be
subtracted from previous
ff 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 e, Part 2 $ 00.00 for this calendar year, only
carry over the amounts
Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if
q 9
18. Cash Equivalents ......... ............................... See instructions on reverse $ 00.00 any).
19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 5000.00 FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Schedule A Type or print in ink. SCHEDULE A
Monetary Contributions Received Amounts may be rounded p
to whole dollars. Statement covers period CALIFORNIA
from
January 1, 2013 FORM •
SEE INSTRUCTIONS ON REVERSE through June 30, 2013 Page 4 : of 7
NAME OF FILER
I.D. NUMBER
Committee to Elect Chuck Washington City Council 2012 1236008
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION
RECEIVED (IF COMMITTEE ,ALSO ENTER I.D.NUMBER) CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE
(IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED)
OF BUSINESS)
2/1/13 EMS Management LLC ❑❑IoM 500.00 500.00
6200 S.Syracuse Way Ste. 200 k] OTH
Greenwood Village, CO 80111 ❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL $ 500.00
Schedule A Summary `Contributor Codes
1. Amount received this period - contributions of $100 or more. IND - Individual
(Include all Schedule A subtotals.) ......................................................................... ............................... $ 500.00 COM - RecipientCommittee
(other than PTY or SCC)
2. Amount received this period - unitemized contributions of less than $100 .............. ............................... $ 00.00 OTH -Other
PTY — Political Party
3. Total monetary contributions received this period. SCC -Small contributor committee
(Add Lines 1 and 2. Enter here and on the Summa e TOTAL $ 500.00
Summary Page, Column A, Line 1. ) FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
Type or print in ink.
SCHEDULE B - PART 1
Schedule B — Part 1 Amounts may be rounded Statement covers period _ NIA
Loans Received to whole dollars. � 1
from January 1, 2013 FORM
SEE INSTRUCTIONS ON REVERSE through June 30, 2013 Page of 7
NAME OF FILER I.D. NUMBER
Committee to Elect Chuck Washington City Council 2012 1236008
IF AN INDIVIDUAL ENTER a (b) (c) (d) (e) (f) (g)
,
FULL NAME, STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE
OCCUPATION AND EMPLOYER BALANCE BALANCE THIS
OF LENDER (IF SELF - EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE C THIS PAID THIS AMOUNTOF CONTRIBUTIONS
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAMEOFBUSI EN PERIOD * PERIOD LOAN TO DATE
PERIOD THIS PERIOD PER OD
Chuck Washington Airline Pilot E] PAID CALENDARYEAR
31205 Kahwea Rd. $ 00.00 $ 5000.00 0.00 % $ 5000.00 $ 00.00
Temecula, CA 92591 ❑ FORGIVEN RATE PER ELECTION
$ 5000.00 $ 00.00 $ 00.00 NA $ 00.00 10/1 $
t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED
❑ PAID CALENDAR YEAR
❑ FORGIVEN RATE PER ELECTION **
t $ $ $ S S
❑ IND ❑ COM ❑ OTH ❑PTY ❑SCC DATE DUE DATE INCURRED
❑ PAID CALENDAR YEAR
❑ FORGIVEN RATE PER ELECTION **
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED
SUBTOTALS $ 00.00 $ 00.00 $ 5000.00 $ 00.00
( Enter
edule
Schedule B Summary ,Lin
Schedule E, Line 3
0 0
1. Loans received this period ..................................................................................... ............................... $ 00. *Amounts forgiven or paid by
(Total Column (b) plus unitemized loans less than $100.) another party also must be
2. Loans paid or forgiven this period .......................................................................... ............................... $
00.00 reported on Schedule A.
(Total Column (c) plus loans under $100 paid or forgiven.) ** If required.
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. Subtract Line 2 from Line 1. 00.00
g p ( ) ................................ ............................... NET $
Enter the net here and on the Summary Page, Column A, Line 2. (Ma be a ne number)
t Contributor Codes
IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC —Small Contributor Committee FPPC Form 460 (June /01)
FPPC Toll -Free Helpline: 866 /ASK -FPPC
.SCHEDULEE
Schedule E Type or print in ink. Statement covers period
Amounts may be rounded CALIFORNIA A '
Payments Made to whole dollars. from January 1, 2013 FORM ,
SEE INSTRUCTIONS ON REVERSE through June 30, 2013 Page of 7
NAME OF FILER I.D. NUMBER
Committee to Elect Chuck Washington City Council 2012 1236008
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP 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 AMOUNT PAID
Rotary Club of Temecula sponsorship of fund raising event
PO Box 64 CVC 550.00
Temecula, CA 92593
Premiere Marketing Campaign management and assistance
31915 Rancho California Rd. #200 -215 CNS 1250.00
Temecula, CA 92590
Western Riverside Council of Governments Purchase of tickets for General Assembly
4080 Lemon St, Riverside, CA 92501 FND 800.00
' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2600.00
Schedule E Summary
1. Payments made this period of $100 or more. Include all Schedule E subtotals. 2600.00
2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... $ 100.00
3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e).) $ 00.00
4. Total a ments made this period. Add Lines 1, 2, and 3. Enter here and on the Summa Page, Column A, Line 6. 2700.00
P Y P � Summary 9 ) ............................. TOTAL $
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 � � '
from January 1, 2013 •
SEE INSTRUCTIONS ON REVERSE through June 30, 2013 Page –2 — of
NAME OF FILER
I.D. NUMBER
Committee to Elect Chuck Washington City Council 2012 1236008
DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF
RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH
City of Temecula Reimbursement of candidate statement fee
2/1/13 41000 Main Street 181.16
Temecula, CA 92590
City of Temecula Additional reimbursement of candidate
5/31/13 41000 Main Street statement fee 477.97
Temecula, CA 92590
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 659.13
Schedule I Summary
1. Itemized increases to cash this period ......................................................................................... ............................... $ 659.13
2. Unitemized increases to cash of under $100 this period .............................................................. ............................... $ 00.00
3. Total of all interest received this period on loans made to others. Schedule H, Column (e). 00.00
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Page, Line 14. 659.13
Summary 9 ) ............................................................................................ ............................... TOTAL $
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)