Professional Documents
Culture Documents
RECEIVED
t
Type
or
In Ink
CITY
a
e
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Sletemen
cove
period
Date of election If
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67
Page
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through 2
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An Commldoee
Type of Statement
reelactlon Statement
annualSmtement Semi
Q Controlled Q Sponsored
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Explain below
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3 Committee Information
D I
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s Treasurer
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IAAILINO ADDRE59
CITY
STATE
ZIP CODE
AREA CODEIPHONE
CITY
STATE
ZIP CODE
AREA CODEIPHONE
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OPTIONAL FA 1NUL E ADDREb9
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4 Veriflcetion
I have used ell reasonable under
diligence
e
In
prepadng
and
reviewing
penalty
o1
perjury
under t
edge the
comptem
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Exewted
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from
nt lme State Q
eovere
period
through
O
Calendar Year
Page
of
D I NUMBER
a l
Contributions Received
1 2
rr
Column A
TOTAL1Nn
Column B
FRONATfALI
To ro
Monetary Contributions
Loans RBCeiVed
schedule
q une
D
dt7
n y
Summary for Candidates In Both the State Primary and General Electlons
Running
Schedule e une 3
Add unea l z
7
2D COntdbudona
111
thmuah
8130
7A to Date
3
4
SUBTOTALCASH CONTRIBUTIONS
Nonmonetery Contributions
TOTALCONTRIBUTIONSRECEIVED
Received 21 Expenditures
Made
Expenditures Made
8 7 8 9
Payments
Made
schedule E une4
ZD 7O ZR
ZO
P7
Zf 70 8
D
for State
Loans Made
Schedule H une 3
7 Adduneae
7
a
p
ZO
une3 sdreduleF
Date of Eladlon
Total to Date
10
Nonmonetary Adjustment
una3 saadulsc
lo a gddurreaa
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mmrddlyy
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20
S
Beginning
Cesh Balance
llnets PraWOUasummaryPe0o
cdumn q unesebove sdtedde t
0
n
To calculate Column
B add
Amounts In this section may be differentfrom amounts
13 Cash
Receipts
uiar
corresponding amounts
from Column B of your last
Payments
lneeebove cdumnAf
2d g 70 gn Z4
statement Llne
16 must be
zero
report Soma amounts m Column A may be negethre figures that should be eubtrected frem previous pedod amounts If this is the first report baing filed
for this calendar year
reported
In Column B
schedda s Pen z
onty
If
Cash
19
18 Cash
e reven
any
Outstanding Debts
unaelnCOlumneatwve Addunez
0
FPPC Toll Free
Melpllne
FPPC 8861ASK
Jenuary105 666I275J772
nee
SCHEnI 11 F R
PART i
CneQUle C
Yal 7
Loans Received
Statement
ram
covare
period
D
th roug h
Pege
l IStt I
iIYI Y1 L r
1
y
r
n l
D I NUMBER
rr 20 s
O
i y
FULL NAME STREET ADDRESS AND ZIP CODE OF LENDER ALSO DFeouuRTEE ENTER I NUUSFx o
11
pNDING
lei AMOUM
AMOUNT PAID
OR FORGIVEN THIS PERIOD
RECENED THIS
PERIOD
eU6NEae
INTEREST
PAID THIS PERIOD
ORIGINAL
AMOUM OF LOAN
CUMULATIVE
CONTRIBUTIONS TO GATE
CAlENL3ARVEAR
ir CL ZQS
3 S
5n
y
G
rl2 ru z
I mo
l I
4Cttl l
PAIb
i
FORGNEN
i
MTE
i
DATE INCURRED
i
PER
G y II uf
t
IND COM
ELECTION
171C
OTH PTY
SCC
S
TE DUE
PHD i
1
RATE
FORONEN
i i
DATE OUE PNO
f DATE INCURRED
IND
COM
OTH
PTY
SCC
CALENDAR VEAR i
i
RATE
i PER ELECTION
FORONEN
i
DATE DUE
i
GATE INCURRED
IND
COM
OTH
PTV
SCC SUBTOTALS S
S
on e enmr
6tlwEUe E LM3I
Schedule B
1
Summary
period b plus unitemized
DiJ J
loans of less than
Total
2
Column
100
tConVlbulor Codes
Loans
paid orforgiven this period Total Column c plus loans under 100 paid orforg ven Include loans paid by a third party that are also Itemized
T
on
IrWMdual IND
Schedule
A
NET
Netchange this period Subtract Line 2 from Line 1 Enterthe net here and on the Summary Page Column A Line 2
forgiven
or
U G
nbe 0einep
Recipient Committee other Man PTV or SCC OTH OMer e buslnass entlry g Political PTY Party
Small SCC ConMbutorCommlttee
COM
Amounts
paid by
enolher
party
also must be
mported
on
Schedule A
Ir required
J
FPPC Toll Free
Helpline
type
or
In Ink
sperlod tr en ve Statem o
from
1L lJ
SEE
through
Page
01
9300
CODES
CtvP CNS
of the following codes accurately describes the payment you may enter the code Otherwise describe the payment ti18R membercemmunleatlens RAD radio airtime and productlon coats Mi0 meetings and appearances RFD returned conhlbutions CTB OFC office expenses SAL campaign workers aeledes CVC dvlc donations PEr T0 v I or cable airtime end produdlon costa petition Grculafing Fb candidate fltlnglbellot fees PHO phone banks TRC candidate treval lodging end meals FPD tundreising events FrOL potlinp end survey resaereh TRS staRlspcuse travel lodging end meals ODD ture POS postage delivery end messenger services independent expend suppoNnglopposing olhere ezplefn TSF transfer between committees of the same cendldatelaponaor lEG PRO professional services legal accounting legal detenea VOT voter reglstretlon LfT campaign literature and mailings PRT WEB Information tedmology costa Print ads Internet e malp
one
If
CODE
OR
DESCRIPTION OF PAYMENT
AMOUNT PAID
T l
2 7hc72 G
a
l2 yC L
z r L ye
1
r
ILl
wt
o
hL
era
5
se I
C
or
Lis
Payments that
c
moat also be summarized on Schedule D
eontrlbutlone
Independent expenditures
SUBTOTALS
G1 z S J
7 ZD
Schedule E
Summary
period Include all Schedule E subtotals
3 Total interest
4 Total
on
loans
payments made this period Add Lines 1 2 and 3 Enter here and
the
TOTAL
T t F
Januaryl06
type
or
print In Ink
trom J CL L7
er v co t n me te St
period
INSTRUCTIONS
ON REVERSE
NAME OF FILER
through
de p
of
n
OD 9
following
codes accurate y describes th e paymen t you may enter the code
MBR
CODES
GAP
CtAS
If one of the
membercommunicetlone
CfB CVC Fg
FND PD
MiG OF C
PET
RFD
SAL
Nndrelsing
PFp
POL
events
E0 1 LfT
Independent expendtlure eupportlng othara ex p lain opposing legal defense campaign laereture and melOnpe
patltlon etrgdatlng phone banks polling and survey research pos t age d etlvary erM messenger eeMces profesefonel services legal aecountlng pdnt ads
TEL
TRC
eampelgn warkere seladea v t or csDle aMime end produetlon costa candidate Vaval lodging end meals staglspouse revel lodging end meals transfer helween commllteea of the creme raplshatlon inkrmellon technology
voter
candidateleponsor
eoele
Internet e melq
NAME AND
gDORESa OF PAYEE
CODE OR
MAeae w prcowanmxAUrosure i
DESCRIPTION OF PAYMENT
AMOUMPAID
11
L Cf ul
Ci ti
Payments
Independent expenditures
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