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Home My WebLink About460 09/25/2012 Recipient Committee Campaign Statement Cover Page 07/01/2012 - 08/31/2012Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 84216.5) Type or print in ink. Statement covers period / from —/— /1' 'l SEE INSTRUCTIONS ON REVERSE I through a 3 / 0— 1. �,,s Type m pe of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. / Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee 0 Recall Q Controlled (Also Cd oea Pad5) O Sponsored (AISd Complete Par6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also Complete Part 7) ff 7S_0 3. Committee Information D. N/ " COVER PAGE Date Stamp RECEIVED MMUM _ Date of election if applicable: Page of (Month, Day, Year) SEP 2 5 2012 For Official Use 1 CITY CLERK CITY of SEAL BEACH 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ❑ Semi - annual Statement ❑ Special Odd -Year Report [Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER RIB 1Sk t SIci}N 1XI or'I �.,L c;�7 cc,,Vcy -L �t/� /� 5Lvrtr STREET ADDRESS (NO PO. BOX) STATE ZIP CODE AREA CODE /PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET CITY STATE ZIP CODE AREA CODE /PHONE / E -MAIL ADDRESS /'/' ,- ^/ NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained under penalty of perjury under the Iam of the State of California that the foregoing is true and Date ^ cehdder Candidate, Stale Measun and in the attached schedules is true and complete. I certify Executed on By Oate Signature of Contrdlinq Officeholder, Candidate, Slate Measure Proponent Executed on By Data Signature ofCOntrdlinq Officehddeq Candidate, Slate Measure Proponem FPPC Farm 460 (January106) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661276 -3772) State of California Campaign Disclosure Statement Summary Page f a1,l l n Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 6Y 41 u I u 1: r_ > . A '7_R Tom' SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER C 3 tl ga ColumnA Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOO CALENDARYEAa Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TDTALTODATE 9 Primary General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line 3 2. Loans Received ...... ........... ................ ........ Schedule e, Line 3 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines l +2 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 Expenditures Made 6. Payments Made . ................... ...................... ........... Schedule E, Line 7. Loans Made /2.f.`.:.if A-1 Schedule N, Line 3 .......... ............................... 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 +7 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ............... ................. Add Lines e +9 +10 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 13. Cash Receipts .................... ............................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule L Line 4 15. Cash Payments .................. ..._ .......................... Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. $ rim $ X06 $ 006 $ .'3'000 $ S-000 $ $ $ &0o 0 „�Qt9fib $ 17. LOAN GUARANTEES RECEIVED ........................... Schedule e, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ............................. See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2+ Line 9 in Column B above $ $ 451 y I f'6� $ 5a 000 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) $ '�-gpo $ To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being fled for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). —J $ 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) SCHEDULEB -PART1 Schedule B — Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. 7!f/ ._0- ME= from �r -%/ -/1 SEE INSTRUCTIONS ON REVERSE through 7 Page of NAME OF FILER I.D. NUMBER A v i s uu/ A-i FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER a OUTSTANDING (b) AMOUNT Icl AMOUNT PAID Itl) OUTSTANDING (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN ggtpNCEAT CLOSE CEAT PAID THIS AMOUNTOF CONTRIBUTIONS (IFCOMMITTEE,ALSOENTER LD./NyUMBER) NAME OF BUSINESS) P R PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE /��y J3 r t v 1 b 6/ �`1 -I w C �, y' fc PAID CALENDAR YEAR 2� 9 coil el I- nff "� aK $ I' f-z V f /war` c- 7 RATE 0 FORGIVEN PER ELECTION" E 5 vGp S p E 1 T IND ❑ COM ❑ OTH ❑ PTY ❑ SCC S DATE DUE DATE INCURRED 0 PAID CALENDARYEAR 8 S % S 5 ❑ FORGIVEN PER ELECTION" RATE $ E 8 5 S DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH El PTV [—j $CC E] PAID CALENDARYEAR S 8 % $ $ FORGIVEN PER ELECTION *" RATE $ S S $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ Q $ $ $ (Enter (e)on Schedule B Summary Schedule E, Lire3) 1. Loans received this period ..................................................................................... ............................... $ J !9 6 0 (Total Column (b) plus unitemized loans of less than $100.) O B„rI y e y,11� 9.5, 2. Loans paid orforgiven this period .......................................................................... ............................... $ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ................................ ............................... NET $ y Enter the net here and on the Summary Page, Column A, Line 2. (Maybe a negative number) 'Amounts forgiven or paid by another party also must be reported on Schedule A. If required. TContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January105) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772)