1990/07/01 - 1990/12/31 - Gilroy Fire Fighters PAC - Form 450
'.
RECIPIENT COMMITTEE CAMPAIGN
STATEMENT -- SHORT fORM
For use by recipient committees which have not received a contribution or
a miscellaneous receipt from any single source totaling $100 or more
during the calendar year A committee may NOT use this form if during
the calendar year it received a contribution of $100 or more, received or
made loans, has accrued expenses or outstanding enforceable promises
received
(Type or Print in Ink)
Statement covers period 7-1- 90 through 12 - 31- 90
CHECK ONE OF THE FOLLOWING BOXES TO INDICATE THE TYPE OF STATEMENT BEING FILED:
FORM 450
1990
lJ PRE-ElECTION STATEMENT
mJ SEMI-ANNUAL STATEMENT
o SUPPLEMENTAL PRE-ELECTION
STATEMENT (If IIl1ng a Supplemefltal
Pre-Election Statement. altach a
completed Form 495.)
o BALLOT MEASURE QUAl/FICA TlON
STATEMENT
o SPECIAL ODD-YEAR CAMPAIGN
REPORT
o TERMINATIONSTATEMENT
(Attach cl completed Form 415)
NAME OF COMMITTEE:
ADDRESS OF COMMITTEE:
7070 Chestnut St.
NO AND SlKHT
CIIY
G i 1 roy
lIP COOl
STATE
CA
95020
A
FOR OFFICIAL USE ONLY
I.D NUMBER
AREA COOllPHONE NUMUlR
408-842-5656
NAME OF TREASURER:
Clay Bentson
PERMANENT ADDRESS OF TREASURER:
7070 Chestnut St.
DA TE OF ELECTiON (MO. DAY, YR.j (It APPllCAUU);
NO. AND STRH r
CIlY
SIAl<
CA
liP COOl AKlA COOl/DAY lIMl PHONl NUM6lR
95020 408-842- 6 6
TOIA', PAGlS
IS THIS A CONTROLLED COMMITTEE?
DYES rn NO
IS THIS A SPONSORED COMMITTEE?
IX! YES 0 NO
is THIS A BROAD BASED COMMITTEE?
DYES [] NO
VERIFICATION
THIS COMMITTEE HAS NOT RECEIVED ANY CONTRIBUTIONS, CUMULATIVE CONTRIBUTIONS OR MISCELLANEOUS RECEIPTS FROM A SINGLE
SOURCE TOTALING $100 OR MORE WHICH MUST BE ITEMIZED, AND THIS COMMITTEE HAS NOT MADE OR RECEIVED LOANS.
I HAVE USED All REASONABLE DIUGENCE IN PREPARING THIS STATEMENT. I HAVE REVIEWED THE STATEMENT AND TO THE BEST OF MY
KNOWLEDGE THE INFORMATION CONTAINED HEREIN IS TRUE AND COMPLETE.
I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF C
AT G i 1 roy, CA
tClIY ANOSTATE)
EXECUTED ON 1-4-90
(DAlE)
BY
A CANDIDATE, OffiCEHOLDER OR STATE MEASURE PROPONENT HO CONTROLS A COMMITTEE ALSO MUST VERifY
THE CAMPAIGN STATEMENT.
I HAVE USED AU REASONABLE DILIGENCE 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 INFORMATION CONTAINED HEREIN 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 AT BY
(DATE) (CITY AND STATE) (SlGNATURf Of CANDIDA TEiOfflCEHOlOERlPROPONENTIRESPONSlllLE OffiCER)
EXECUTED ON AT BY
(OATE) (CITY AND STATE) (SIGNA TURf Of CANOtOA TEiOfflCEHOlOERlPIIOPONEN r)
EXECUTED ON AT BY
(DATE) (CITY AND STATE) (SIGNATURE Of CANOtOATE/OffICEHOLOERlPIIOPONENT)
For information required to be provided to you pursu.tnt to the Information Practices Act of 1977, see Information Manual on CamDaion Disclosure
Provisions of the Political Re form Act.
-1-
..
RECIPIENT COMMITTEE CAMPAIGN STATEMENT -- SHORT FORM
FORM 450
NAME OF COMMITTEE:
Gilroy Fire Fighters, Pol itical Action Committee
SUMMARY
(Amounts May Be Rounded To Whole Dollars)
EXPENDITURES MADE
1. Expenditures of $100 or more this period .....................................................................
2, Expenditures under $100 (not itemized) ................................................................
3. Total expenditures this period (Line 1 + 2) ......................................................................_
4. Cumulative expenditures from prior statement (Line 5 of the last statement filed.
If this is the first statement for the calendar year, enter Zero.) ...................... ................
5. Cumulative expenditures to date (Line 3 + 4)
CONTRIBUTIONS RECEIVED
6. Monetary contributions received this period .. ..-......... ..... ..... ..... .................................... ........
7. Non-monetary contributions received this period ................................................... ...............
8. Cumulative total from previous period (monetary and non-monetary) (Line 9 of last
statement filed. If this is the first statement for the calendar year, enter Zero.) ..................
9. Cumulative contributions received to date (Line 6 + 7 + 8)
CASH FLOW STATEMENT
10. Cash on hand at beginning of period (Must be the same as
"Cash on Hand at End of Period," Line 14, from the last statement filed.) .............................
11. Cash receipts this period (Line 6) ..................................................................................... -.....
12. Miscellaneous increases to cash -............. -............................... -.. ........ ... -.................... ............
13. Cash expenditures this period (Line 3) .... .......... ............ ........ ._........ .............. ...... ......... .........-
14. Cash on hand at end of period (Line 10 + 11 + 12 - 13).........................................................
-2-
STATEMENT COVERS PERIOD
FROM THROUGH
I.D NUMBER
900434
$ 100.00
$ 0
$ 100.00
$ 96.00
$ 196.00
$ 0
$ 0
$ 500.00
$ 500.00
$403.00
$ 0
$ 0
$ 100.00
$303.00
.
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