Sharon Albert - 1983/07/01 - 1983/12/31
CONSOLI 0,:\ TED
CAMPAIGN STATEMENT
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(Government Coce SecTions 34200.g..t217)
Fcrm ,190
1983
For use by candidates/officeholaers and :nelr conuolled committees.
Statement covers oer:od 'rem
10-23-83
throuc;h
12-31-83
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(Type or Print in Ink)
OATE,:tF t:L.ECTION \~o.. OA.Y. YR.) (I" .""'-lCAlIl..-=l:
November 8, 1983
! TQTAL PAGES, I
, '
CANDIDATE/OFFICEHOLDER INCLUDED IN THIS CONSOLIDATED REPORT
NAME OF C,.\.MOtCATE;
_ 1 S- 0 ~ S+e. wc\Y'-t
aUS1NESS AOORESS,
~Cied S:~. 11oto3 Chl-lrch' G;lr~y
II CONTROLLED COMMITTEES* INCLUDED IN THIS CONSOLIDATED REPORT
Gdro
CA.
I' OFFICE SOUGHT OR Hl!:LO I'MC~~"C C"CAnCM ANC ";n""~7
'U(;Ci~I'~~-.'-'C"c',' t Co L{nc.; I
'TA,TC Y':I,. ~:::IC.#. Y ""'etA ..::;.nll: """O:'<llll 'lUMall::"^~-'"
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9 S-Ou)
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Sharon A. Alhert
RESIDENTIAL ADORESS,
Nl.J. A,..O ST"'....1i:l"
CITY
CA
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,it e.;,., .: ~:'I!:
(y. og)
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.....O"'lE: "'V"'8C_'I:
'?47-17D9
i, ,::q~;:~;:T
NAMf! OF COMMITTEE:
ShC\yon
AOC?ESS OF COMMITT::E:
P . o. 'Bo X
A I be It
"'0. "'NO sT"'tI!!:T
9jif
ter-
C;+y COLH1Ci
~ITV
G; \ref
: O. '<UMBER
lCf 1/39
5"l"".. 1"1(
:1" coo.
..."..... ~:)o.
..loCc....e; 'tv... B~l'l!
CF\
QS-020
(408) <6lf"L -10 'I S" i.t
:-~;"o".ME OF TREASUREM.:
A", n c.o\ VI. n qC\.
PERMANENT AOORESS OF TREAsunER:
"010. """'0 ~T~C<<T
CITY
'STAT'll
;::1," ::00<<
( 4~~~ro~
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13 \ I
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Cl~07..0
5?Lf'l. -0 if r? 7
-.,.-~"""""......".--
~AME OF COMM;TTE:.E;:
I.D. NUMBER
AOQR~OF COMMI-rTE:E:
'::ITY
51""\' is:
z," -::::C&
-
':0;:;11'.:
"0. "NO 'T~IIiIl:T
;>t10"'S:
MAMl! OF TRE,>SURER:
pt!r:fMANti,'"4T ..\OORESS OF TREASURER: ,,",0. "'HQ S'rRC&T
';::ITY
'TATI(
Zll"'';:;:)OC
"''''c.... '::10&
..""'IiO..... "'"'-M. t:...t
Att3Ct) JcJditional t-nr1Jrmar:'on on a[)Drooriat~/v !3oeie-d canrinuat:on sneers.
III CANDIDATE/OFFiCEHOLDER ONLY: LIST ANY OTHER COMMITTEES NOT INCLUDED IN THiS
CONSOLIDATED STATEMENT WHICH ARE PRIMARILY FORMED TO RECEIVE CONTRIBUTIONS OR
MAKE EXPENDITURES ON BEHALF OF YOUR CANDIDACY.
COI\I:'viITT:::: ;\JA~'E
AND 1.0. NUM8ER
Contiollea C..)m""'lt~:?e?
COMMITTE:E ADDRESS
TRE,4SU RER
YES\iO
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AuJCIJ oJdairIonalmformarion on aooroorrarely laoeled conrInuarlon shet.cr.
. (A CO:ltrolled commir~ is' one whiCh is controlled directly or indirectly by a candidare or which oJ<:ts jOlnrly Him a candiaare or controlled. comml=e in
connection wirh [he making of expenditures. .4 c::mdidare conrrols a commirreff if [ne candidare. me candidate's agenr. or 3ny orner c:;mmatefJ he ;;r ;ne
controls, ,~as signdic.Jnt :nfluence on me oJ<:tlons or decisions of rhs committee.)
VERIFICATION
1 declare under per.altv of perjury that ~o :he cest of my knowledge ~hjs statement and ::5 ,jc,'1ect..!e:; .m; ~r\1e. correct Jr:d '::Jmp!ete Jnc: ::-:at
I have used all reasonaole diligenCl! in their preoaration.
Executed on(r;ft{/!!-?/ /9Jlat /g~tTI, '~~l
Executed on ' at. b'f
- lO,AT':) l":ITY AHO 'T~-~
by
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L.,~,
\SICo,..ATU"... ::J" T....A1IU"'~~t1f.1 I
I dedam uncer penaltY of :::erjury that cC t71e best of my k:lO'....ledqe this staternenr 2nd 'ts schedules ,Jre true, correCT ana ccmcie:e rd :he
treasureri51 of thiS commlttee(sl has usea ail fe3sonaDle diligence In tt1e prepaatlon Qr mls statement 3nd Its scnecuies.
Exeo.aed on ~/".J.:tl Iliift ~-k ' by ~"(A1n.~ d/&.A:;;!::;:
"O"TC~ -,' \' j';-, ..,,..g '2iTA.T"1 ~I" \:lj'."'lAr.....""tI: .J" -....A'~OI~A..ll ;.Jill ~ ll;:.,..~...~c.:;:ili
For information r&qUlflllO ('J bl> pro~ldlk1 (0 yo~ pur.;ull t tc :ha Informaflon i'nr.ticaa Act at 1977. .- '''Inform.non M.1l1U.... 00 C..mpa,'f!l Oisoo:s,u& i'ro..".ions
01 the ~l;tla.j n..,'orM Act," ?'lrt X,
_ 1 _.
IV ALLOCATION OF CONTRIBUTIONS AND EXPENDITURES MADE TO OR ON BEHALF-OF CANDIDATES,
OFF'ICEHOLDERS AND MEASURES (Allocate exr(~nditures from Schedules E & F made to or on behalf of a
candidate, officeholder or me2"ure. Amounts may be rounded off to whole dollars.)
OFFICIAL ;'.JA,\1E OF CANDIDATe: OR OFFiC2::-iOL:::E'1 ..,\,0 OF:;iCE I C:.-;ECK ONE I I C'ML. . _..-
Vi' L,,,,,,,,'J =.
USE ONL Y OATE OR ',IEASURE AND BALLOT NL;,'/BER OR l~TT=_~ SL.iDCOn: 000058 I AMOU~H i TO --- ,-::
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Artacn additJonal informatIon on aooroorrarell! ..'abeled conr:nuarion sneers.
INSTRUCTIONS FOR ?REPAR!NG.COVER PAGE
CONSOLlDATEDCAJ'I.1PAiGN STATEMENT
FORM 490
PERIOD COVERED BY STATEMENT:
The' period covered begins the day after the closing date of the last campaign statement fiied. I f a previous
statement has not been filed, the period begins on January 1 of the current calendar '1ear. Tre period ends on
the closing date for the current statement. The closing date is specified in the "Information Manual on Campaign-
Disclosure."
DATE OF ELECTION:
If this sta,tement is fiied in connection with an election, enter the date of the election.
PART I:
Provide the candidate's or officeholder's full name, residential address, business address and te!ephone nurnb2rs.
and the office sought or held.
P.~RT II:
Identify the controlled committees included in the consolidated report and the treasurers of the committ:::es. Use
the same information that apcears on the committees' Statements of Organization filed with the SeCre!3r( of
State. Do not use abbreviations. A permanent business or residential address must be provided for the treasurers.
The identification numbers must be included. (If not yet received from the Secretary of State's office, that fact
must be noted.)
PART III:
The candidate or officeholder must list all additional committees not included in this consolidated report which
are primarily formed to receive contributions or make expenditures on the candidate's behalf and wne!her or
not they are controlled committees.
VERI FICA TJON:
The statement must be signed by each committee treasurer included in the consol idated report and by the
candidate or officeholder who santrols the committee. The treasurer and candidate or officeholder must revie'.v
the information contained in the statement before signing the verification.
ALLOCATION OF CONTRIBUTIONS AND EXPENDITURES MADE TO OR ON BEHALF OF CANDIDATES,
OFFICEHOLDERS AND MEASURES:
List all contributions (including loans) and independent expenditures itemized on Schedules E and r- ~o ",u;:pcr,
or opoose officeholders, candidates and bailot measures (other than those controlling this committee or Tor
which this committee is primarily formed). !ndic3te the date of the expenditure, the office sought or held (or
the measure's number or letter), the amount of the expenditure and the cumulative 3mount :0 date. Ire
"Cumulat;ve ta Date" column 'should include the sum total of expenditures for or against each candidate or
measure since January 1 of the current calendar year. (See "I nformation Manual on Campaign Disc!osure" ror
discussion and examples of "cumuiation".)
CAMPAIGN DISCLOSURE STATEMENT SUMMARY PAGE
FORM 420,430 OR 490
(Amounts May3e Rounded To '<Vhole Dollars)
NAME OF <:AN010AT~ OR COMMIT7EE
S hcty-c:o A I ber+ +oy-
Ci+-~
C Ol{v\CI I
COLUMN A
Cumulatlvl!I
taul from
prll'tious p81"iod .
CONTRIBUTIONS RECEIVED
1.
Mor.e!3r{ contributi ons
s
J..it- 2 ~ . cro
2. loans..,.............,
- O.
3. Sub1:Otai....................
s ~Lf-;)...<i?O-C
i..Hi KS 1 ... l
q~I.'7o-
4. Non-monetary contributions. . . . . . .
5. Pledges.....................
6. TOTAL CONTRIBUT10NS. . . . . . . .
s
ja+oq.70
UNtiS J . " .. ,
EXPENDITURES MADE
7. Payments....................
s
I s 4-. " ~
.;z5".3\
11f"J9,Q9
S. Accrued expenses (unpaid ~illsl . . . . .
9. TOT~L EXPENOtnJRES . . . . . . . .
s
COLUMN B
Tool this pef'iod
from attached
scheduies
s 305,00
:iCHt:l:DUr..it A.. :....~Ht J
SCHc.::;U1..& 3, t...jN~ :t
s_ ~05. crD
l..lNi:..5 1 . .:
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SCH~::'I.H.a: :::I.. :.....Nit .;
s
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STATEMENT COVERS P~,~I
,o~ {~O_;31, J._~31~.o~3~
1'19IBr~~~ =~~~"H
COLU~'<'1N C
CUmUld!lVQ
to date
(Columns A ,. 3)
s
6(13'3.0-0
L.1NrtS 3 ... ... - ,.
s 1'55"'7. '13
SCi1S;~UL.A. E.. ~;N" J,
~ .~&
SCHlt::tut,.2; ~. ~.:"Ur. 5
sl ~ (., ~. s '1
s :J.. 7 3 '3 . 0-0
~J.....a;s l_~ ~
q9b,~:L
s 3W.8t2-
~J N ItS 3 ... " - )
(SHaUl.':> ~'~UAL..,
-=Ol..t,lMNS A .. 31
s ~'7 1J..4-L
;;4.11 _
s ~ 7Y-JJ~~
UNM:37.1 t..IN~S7...' l...JNF.:57-3
lSHOUl..:l E:'~U""t..
~::l'-:.JMNS ... . 3)
.If this is the first ro.aort filoo far rhe calendar 'lear, Column A should be blank 'Jxceor for unoaid loans, jills and:J;edqes.
STATEMENT OF CHANGES IN FINANC1AL CONDIT10N
10. Cash on hand at ,he beginning of this penod. (Line 14 of previous statement) . S I 2> () 3, ~ g
11.
Cash recaipts ,his period (Une 3. Column 8 abovel . . . . . . . . . . . . .
12.
Miscellaneous adjustment; to cash (Schedule G, Line 7) . . . . . . . . . .
13.
Cash payments this period (Line 7, Column B above} . . . . . . . . . . . .
14.
Cash on hand at cJosing date (Lines 10+11+12-13 above).........
oUlnding debts (Line 2 + line 8 of Column C abOV~) . . . . . . . . .
15.
105.a-v
(q, 30)
-
IS~'l.73
If l. ~~
3Y-./1
16.
E:1ding surplus (if L:ne 14 is greater man Line 15, subtr3ct Line 15 from Une 14).
S
'7. e:,?
. E::ding c.,sh en hand should not be a 11e-gariv8 amount.
t 7. Ending deficit (if Line 15 is grea ter than Line 14, sU,btracr Line 14 fr'em line 15/ . . . . . . . . . . . . S
~~~"I.:-'~:,-~ ."..._
SUMMARY FOR CANDIDA TES IN BOTH ,.\ JUNE AND NOVEMBER ELECTION (Se9In:rructions en ,=feverse)
18. CONTRIBUTIONS RECEIVED:
1/1 rnru S ,:;0
I
[~-
19. EXPENDITURES \-IACE:
7/ 1 to cat!!
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-1
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INSTRUCTIONS FOR PREPARING THE SUMMARY PAGE
After Schedules A through G have been completed .the information is carried 70rNard :0 the SUIT1r.lary P3<;;e.
. Column A: Enter cumulative totals from the prior campaign disclosure statement
'(Column Cl. If this is the first report filed for the calendar year, Column A
should be blank except for unpaid loans, bills and pledg.es.
~.
. "
. Column B: Enter the amount from the appropriate Schecules A through :=. Tilis column
summarizes L.,e filer's activity during the current reporting period.
. Column C: Enter the total of Columns A and B for each line.
. Line 10: Cash on hand at beginning of this period. Enter the total of all checking
accounts, saving acccunts, certificates of deposits, and steck (valued at cost).
This amount shouid be the same amount entered on Line 14 of the previous
campaign disclosure statement. If no previous statement has been filed
enter O.
. Line 14: Cash on hand at closing date. Enter the total of cash on r.and 3t :~e
beginning of me period (Line 10) plus cash receipts this period (Line 11)
plus or minus miSCellaneous Jdjusunents to cas;' (Une 12', less cash
payments this period (Line 13).
. Une 15: Outstanding debts. Enter the total of loans (Une 2, Column C) Jnd :::ccrl1ed
expenses (line 8, Column Cl.
. Line 16; Ending surplus. If line 14 is greater than line 15, subtract line 15 from
line 14.
. Line 17: Ending deficit. I f line 15 is greater man Line 14, subtract line 14 from
Une 15.
. Lines 18 & 19: lines 18 and 19 are to be completed if this S-..<3tement is being filed by a
candidate, a candidate's controlled commit:ee, or a committee formed
primarily to support or oppose a candidate, AN 0 the candidate is in born an
election held on u.,e fim: Tuesday after the fim: Moncay in June and an
elec1:ion held on me first Tuesday after the fim: Monday in November, AND
this statement covers a period during the last six months of the year:
Enter in the" first column on line 18 the total amount of contributions r.8-
ceived for the period January 1 through June 30 (Line 6, COlumn C oT the
statement ending 6/30), and enter in the first column on Line 19 the total
amount of expenditures made during the period Januar{ 1 through June 30
(Line 9, Column C of the stat~ment ending 6/30),
Enter ir.the second column of line 18 the total amount of contributions
received for the period July 1 through the closing date of the current state-
ment (Line 6, Column C of the current statement minus the first column of
line 18), and enter in the second column of Line 19 the totai amount of
expenditures made (Line 9, Column C of the current statement, minus the
fim: column of Line 19).
(S~ "Information :\1;mual on Campaign Oisc!osure" far exa~;:les'
SCHEDULE A
MONETARY CONTR1BUT10NS RECEIVED
FORM 420,430 OR 490
(Amoums Iv1ay 8e Rounaed To Whole Dollars) .
--"....--
NAMe: 01'" CANDIDATe: OR COM, MITiE!:; f'
~ [111 rCh A I be (+ lOr
I I'"UL.1.. NAMe: AND "'CORESS OF
OATe: CONTRIBUTOR
;::lEe'o It" CC"1lfIlf~.". ALJlO IlHTll.... I.D. "'4I,J.M.."
:ItC.....U".".s /'fA.... AHO A.co"....l
I
c;; ht--
I OCCUPATION
0"
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C Ol.{ V\~
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I STAT=..'.1 EN , :::;'<'~"'S ~s,c;,
,..~o.. ."""'OiPo-,;~~
110.2.:3 - ~"3 : \"2.-3j - ~ i
I ~t(tt~~;,.. ~ O~....-~
e:MPL.OYER
AMOUNT
(I" SCI.I"".CJl,ffll'-OYIEO, CHT't!,.
"'CiA"''' 0'" .US'Nc:..t
..a:CZlvrc
=._....U'-A ;"':'.' >II
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0 If mor~ spaca is n~ed. ched< box at left SUBTOTAL I
and attach additional Sche<luj~ A.
SUMMARY
1. AMOUNT RECEIVED, $100 OR MORE (Indude all Sciledule A subtotalsl . . . . . . . . . . . . . . . . . . . $
r
:
2.
AMOUNT RECEIVED LESS THAN $100 (Not itemizea)
3. TOT,.\L ,\1CNE7AnY CONTRIBUT.iONS THIS ?::n:OD
(Lin~ 1" line 2l Enter here and on Line 1 Column 9 of Summary Page. . . . . . . . . . . . . . . . . . . . . .
:5306.00
INSTRUCTIONS FOR PREP,c.,RING SCHEDULE A
l'viONETARY CONTRIBUTIONS
Schedule A is used to report all monetar/ contribuTions received. Loans forgiven or paid by a third ;::31-'( must
also be reported on this schedule as monetary contributions, with corresponoing entries on Schedule 3, Part 2. if
the contribution amounts to a cumulative total of S100 or more from a single source, the following informaTion
must be reported:
· The date received.
· 'F=uil name, streB! address, cit'/, state, zip code of ;::cntributcr. If the contributor is a Recioient
Committee also enter that commircee's name and identification number. I f the comminee's identifi-
cation number :s unknown enter the full name, Sjfeet address. city, state and Zip code or that
committee's treasurer.
. 9ccupation of contribUtor.
· Employer of the contributor. I f ::he contributor is self-employed, enter the name of the contributOr's
business.
· If the contribution is received mrough an intermediary, the same identifying information must be
provided for both the intermediary and the actual contr;butar.
· The amount of each monetary contribution recel'/ed.
· The cumulative amount of contributions received fram the contributor since January 1 of the current
calendar year.
Summarize all contributions received at the bottom of Schedule A. Contributions under 5100 need only be
reported as a lump sum amount.
(See "lnfom1ation Manual on Campaign Disclosure" for examples)
SCHEDULE A
MONETARY CONTRIBUTIONS RECEIVED
(CONTINUATION SHEET)
FORM 420,430 OR .190
STATE~ENT COVERS ?~r:ll'")O
THJtOU~~
(Amounts ~/1ay de Rounded ""'0 'Nhole Dollars)
NAMe:: OF CA......OIOATE OR CO.-..4MITTEE:
, ...... NUMBER {I!"'" ::::~""Ir-,!,;C:j
OCCUP"'T10N
I-
I
EMPLOYER
AMOUNT
REC'O
i
DATE I
I
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FULl.. NAME AND ADDRESS OF
CO:'<TRI8UTOR
(If" COWMIT"TI!:_. ALSO <<NT':" 1.0. :o.lUllootal!!:R 01'11
,.~'ltA5UI'II!!"" ~..,..e; A""O ",OORII:S3J
\ I'" Slll.-":-€~"L~ye;o. l!!:""T1U'
....04""'. 0'" ~u"INass)
I'fl!:CCIVCO
-= .........U'-A"r'.~ e:
~~ :JA.T!l:
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0 If more soace is needed, check box at left SUBTOT~L
,md artacJ, additional Schedules A.
-,
--r-'" ...~........:..:>~y~~.--;-==-==-=
SCH EDL'LE 8
LOANS
FORM 420,430 OR 490
(Amounts ,""1ay Be Rounded To Whole Ooilarsl
I'STA TE;'Tt ENT .,:ov ERS ~ s: ~ \;
.~OM ~~_OYGW
1 :
1.0. NU."v1:BER ~I'" -:~""""'I1'-.1
I
I
"'A"'E OF C....NDID....TE OR COMMITTEE:
PART 1 - LOA;\JS RECEIVED
OAT!!
FULl.. :'<AME ANO ADDRESS OF
LENCE~ AND ANY GUARA....TORS OR
COSIGNERS (I" CO,.....IT'"T'..C. ALSO CNT'l:JIIt
I.:;). N1UW.." 0" T"'C.....I,J,..,.~
....AM. "",0 AOO,....t
EMPLOYE!'!
I INT. 1 AMOUNT
I RA7l!: OF 1..0........
: I
C'...)MUL.A.
T!VE
OCCUPAT10N
{If' '.1.'-C.M~\"~V.O. CHTC'"
~.......c 0" SU.,NCSS}
TO DA--:-~
REC'O
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I f more space is neeced, c..,eci< :)Ox at left
and att:;cn adci tional Scheduies a, Part 1.
SUBTOTAL
PART 2 -- lOANS REPAID, FORGIVEN
=::;;'~-'~
I
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CA,!!: I
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OR PAID BY ~ THI RD PARTY:
\ a ~
I e:~T~R THIS DATA uN SCH!:OUl...E: A A'-..50
I ,::>)
",...au"'''' "~"'aIV<<H
';JfIII ."'0 4V ~"I"'O ~""TV "AWe ANg AOCftC".
. 1"1-41"'0 .""TV
'..)NP4..iO
3Al..ANC:
F'JL.l.. NAME ANO ADORESS
0... THI!: L.S:NCE~
AMOUNT
REPAIO
o
If more soace is needed, c..,eci< ~ox 3t
left and anach additional Sd"leCuies a,
Part 2.
\al
(bl
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SUBTOTAL
SUMMARY
1. LOANS OF S100 OR MORE THIS PERIOD (Part 1)
.. . S
2. LOANS UNDEr! $100 THIS PERIOD (Not itemized) .
J. TOTAL LOANS FlECEIVED (Line 1 + 2'. . . . . . . .
6. LOANS UNCER 5-100 REPAID, FORGIV:~ OR PAID BY A ~IRD PARTY 'T"l-!IS PERIOD I.Not ;temi:edl.
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4, LOANS OF Sioo OR ~IORE RE?AID THIS ?!;i1\OD (Part 2. C.:llumn \al ) .
5. lC;.\NS OF $100 OR MORE THIS PERIOD FORGIVEN OR PAID 3Y A THIRD PARTY (Pm 2. Column Ibl )
7. TOTAL LeANS i'E?AIO. i=QRGIVEN OR PAID BY A THIRD PARTY T:-iIS PERIGO lLine 4.5.. 51.
8. ~ET CHA,\;GE I1-iIS PERIOD
iSubU'lX:t L,"" 7 from Linl1 Jl EntllW' tnl1 aiffantrlca ~ and on Lnll 2. C.:lIumn 8 at Summa", P3<l8 .
..... '::-
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INSTRUCTIONS FOR PREPARING SCHEDULE B
LOANS
Schedule a is divided into !'No parts to allow 'Iou to report two types or loan transactions.
PCirt 1: Loans Received
If you have received loans this perfod (since the closing date of the last statement fiied), report ::-:e
receipt of these loans on Part 1.
Part 2:
Repayment or Forgiveness of Loans
,
f
If you have reduced loans this periOd (repaid by you, r,epaidby 3 third party or forgiven by the lender)
report the reduction on Part 2.
PART 1
If the loan amounts to a cumulative total of S1 00 or more from a single source, the following information must
be n;ported:
· The date received.
· Full name, street address, city, state, zip code of lender. I f the lender is a Recipient Committee aiso
enter that committee's name and identification number. If the comminee identification numt:er is
unknown O!nter the full name, street address, city, state and zip code of that commit:ee's treasurer.
· Occt;pation of lender.
· Er"ployer of the lender. If the lencer is self-employed enter the name of the lencer's business.
· ~f the loan is received mrough an intermediar(, the same identifying :nforr;.ation must 8e proviced ~cr
both the intermediarl and the ac:ual cCni:ributor.
· The interest rate of the loan received, if any.
· The amount of aach loan received.
~ The cumulative amount of loans received from the contributor since January 1 of the current calendar
year.
Summari;z~ the total of all loans received of $100 or more, and all loans under S100, which need not be i!emized.
PART 2
I f a loan of $100 or more is repaid, the following information must be reported:
· The date of me repayment or forgiveness or payment by a third party.
,0 The name and other identifying information of the lender.
· The amount repaid or the amount forgiven or the amount paid by a third party.
· The name and address of the third party if applic3ole.
Amounts of loans under $100 that are repaid, forgiven or paid by a third party need not be itemized and may be
listed in lump sum amount.
IF ;\ LOAN WAS FORGIVEN IN WHOLE OR IN P.A.RT BY THE LENDER, THE LENDER AND T~::
AtvlOUNT FORGIVEN MUST 3E LJSTEO ON SCHEDULE A. IF A LOAN WAS REPAID BY A T1-1lflO
PARTY, THE THIRD PARTY AND THE AMOUNT REPAID MUST BE LISTED ON SCHEDULE A.
(See "I nformation Manual on C.Jmoaicn m$c!ost.1r~" for eX3rT'c!esl
SCHEDULE C
NON'i'Vl0NETARY CONTRIBUTIONS RECElVED
FORM 420, 430 OR 490
(Amounts May 3e Rounced To 'Nhole Doilars)
S7ATE.ME~T =::'./~RS .;:)S~I
'.OM -~~~~~~
10-1..3 -f{3 : 1Z.-3/-\>~
NAMe: OF CANDIDATE OR COMMIT?E:
Share n f\ I be rt-:tDy
I FULl.. NAMe: ....t~O ....OORl!SS OF
CONTRIBUTOR
OATI!:
REC'O dll- <:'::"'''1''''''1['&. .4&.'0 .NT." 1.0. ,..u....C...
I 0'" ~".....u,.c,. . ............ .4HO A.OOlitll[S.'
i. C). ."i U ~ B E R 1.=::::......... I ,- '!'. ~
Ci ~Cou~c;1
I
OCCUPAT10N I (,... "CL,I"".C""""'O"'CO. CNT.JIIt
t ~A"'C 0" .uSII"'I&ssl
EMPI..OYER
i="AdR
c....;~u
L...~li'../
..l..MOl...,;N
OESCRIPTION OF
I
G0005 OR SERVICES:
,
"'ARKET !
..,....1...; E
~EC::!VE:;:) j
r
I
I
I
I
I
I
I
I
I
I
I
I
I
I
l
---I
SUBTOTALS 'I
I
o
If more space is needed, check box at lerr.
and attach additional ScMedules C.
SUMMARY
1. NON-MONETARY CONTRIBUT1GNS OF SlOG OR MORE THIS PERIOD. . . . . . . . . . . . . . . . . . . . . S
I
1
!
I
IS./~ I
2. NOl'-I.,\10NETA,RY CONTRIBUT10NS UNDEM 5100 Trll$ PEMIOD.(Not itemized). . . . . . . . . . . . . . . . .
3.
TOTAL :,-/ON-,\10NETARY CONTrllBUT1GNS THIS ?\::iIOD
(Linll 1 + 2) enter here and on Line 4, C.Jlumn 3 cf Summary P3ge
:; 15'AJ..
INSTRUCTIONS FOR PREPARING SCHEDULE C
NON-MONETARY CONTRIBUTIONS RECE1VED
Schedule C is used to report the receipt of goods and 3er:ic2s :non-rr.cnetar; contrioutlonsl.
T11e schedule also is used to report the oayrrent of bills by :nird ;::;ar::es, the receiot of discoL.;r.:s not available :0
the public generally, and the utilization or;ocds or 3enic2s paid for by others. In aGdition, :;--.9 re.o::e!ot .Jf
property, such as stocks, art objects, furniture and similar items 'Nhich may ,:Je auctioned or sold 3t;arar;e saies,
are reported on this schedule.
T11e compensation or reimbursed expenses or an employee who scenes 10 percent or :-nore of l is or her time in
anyone month providing services for DOlitical OUrDoses is r2oort3oie 3S a contribution from tr.e sma/over,
Volunteer personal services and payments '/oiunt3rily mace i:Jy 3 ::::erson for his or "er own c3IT'caign-reiated
trav.el expenses are not reportabie.
If the non-monetary contribution amounts to a cumuiative totai of S1 CO or more Trom a singie source, the
. following information must be reported:
. Tne date received.
. Full name, street address, city, state, ZiD coce oT c:Jmr~butor. If the contributor is a ?ecicient Com-
mittee aiso enter that committee's name and identification number. I f me committee :aentifiC3t~on
number is unknown enter the full name, street address, cit'{, state and zip coce oT t:-:at ~OIT'mi:t2e's
. .
treasurer.
. OCC'.Jpation of contributor.
. Employer of the contributor. if the contributor is self-empioyed enter the name of the contr~butorJs
business.
& If the contribution is received through an intermediar/, the same icentifying information :i":ust t::e
provided for both the intermediary and the ac~al contributor.
. The fair market value of each non-monetary contributi.on received.
o The cumulative amount of contributions' received from rhe contribUTOr since Januar{ or the current
calendar year.
(Note: The donor must provide you with a written statement incicating the value of the goods or SErvices prc-
'1idedif you so request.)
Summarize all non-monetary contributions received at the bottom of Schedu Ie A. Non-mone'.:ary contributions
under 5100 need only be reported as a lump sum amount.
. (See "Inrormation Manual on Campaign Disclosure" for examples)
.
SCHEDULE. 0
PLEDGES
FORM 420,430 OR 490
(Amounts May 3e Rcunc:ed To Whoie Dollars)
: ST ~ TEM e:NT COY ERS ?c.::~ I
! '~~Ou~~
I
~AMe: OF C....NDIOATE: OR COMMIT,E!!:;
1.0. NUMBER {iI"" :~",..t""rr'Jlll;
OCCUPATION
EMPLOVER
(,,., '.L."'~CM"''''OY.D. K.HT."
. ......lioii. 0" .u.,,,,,cs'J.
AMOUNT! AMOUNT I
PLEDGED i ,PAID I
THIS I \e;NTC~;JN !
~!:RIOO ;Sc)otCOUf...I: All
C_",11..
OATe:
R!!:C'O
I F'JL..L.. ~AME,ANO AOORESS OF I'
CONTRIBUTOR
1(1" COIlollWI"T""!'..w AI...JO CHTCIlt I,':). ...u....~" CJltl
T~.ASU"'C" 'S ......,..c Al"tO AOO"'CIISI I
I
!
I
t....."\ "il \"
?t..~:?C
1..l~PAI
I
i
I
i
,
I.
I
i
I
I
I
o
j I
I I i
i
i I
I
I i
,
I I
I i
(al I (01 :
I'f more space is ne~ed. check box at left i
and at1:zd, additional Sdledules D. SUBTOTALS I'-
I
:.:i(___ .~,._,,~~-~
SUMMARY
1.
2.
3.
4.
5.
6.
7.
PL~DGES OF S100 OR MORE THIS PERIOD (Column (al ) . . . . . . .
PLEDGES UNDER SlOO THIS PERIOD (Not itemized). . . . . . . . . . .
s
TOTAL PLEDGES RECEIVED (Line 1 +- 21. . . . . . . . . . . . . . . . . . . . . . .
PLEDGES OF SWO OR .'ilORE PAID THIS PERIOD iC.J!umn (b) ). . .
PLEDGeS Ui'JDER 5100 PAID THIS PERIOD (Not itemized). . . . . . .
I
I
ts
rOT AL Pl~DGcS PAID (Line 4 + 5).
'JET CHANGE nilS P~RIOD
- .
(Subr.ract Lna 6 from Line 3l ~:1ter ~he difference here and en Lne 5. CQlumn a of Summary Page. .
r...1ay :-ii
... ~-:J~:.'6 .:-
INSTRUCTIONS FOR PREPARING SCHEDULE D
PLEDGES
Schedule D is used to report pledges (enforceable promises of contributions). vVhen the person makinc; ~;-,e
pledge fulfills it, the actual payments received are also reported. If the pledge amounts to a ct.:mulative tonl of
S100 or more, the following information must be provided for the contributor:
.
Date the pledge was made.
.
Full name, street address, cirv, state, zip code of contrit:umr. If the concriburor is a Recioient C.Jm-
IT!inee also ::nter that :ommit:ee's name ,md identification numcer. If the ccmmit:::e icentific3t;on
number is unknown enter the full name, street address, c:7'(, st3te and zip code of that commit:ee's
treasurer.
.
Occuoation of contributor.
.
Employer of the contributor. I f the contributor is self-employed enter the name of the contributor's
business.
.
If me pledge is received through an intermediar(, the same icentifying information must ~e prc'Jiced
for both the intermediary and me act'..Jal contributor.
.
The amount of each pledge recaived.
.
The amount paid during this period on a pledge.
.
The cumulative amount of unpaid pledges since January 1 of the current calendar year.
Summarize pledge activity at the bonom of Schedule C. Pledges under S100 need only be reported as a lump
sum amount.
(See "Information Manual on Campaign Disclosure" for examples)
SCHEDULE E
PAYMENTS AND CONTRfsUT10NS MADE
FORM 420,430 OR ~90
ISTATE,MENT C:). VEF>S ~E'"
~.OW .~.OU~"
JD-1.3-SS ,'2-31-&3
: I.'::>. '4U:'ASER :~"=:;',,","",~-,!:
I ~q 1131
(Amounu ~l1ay Be Rounded To ....'hole Dollars)
;"I(AM':: 0': CANOIOATE OR COMMITjEZ:
S hctyon 11\ berf- fc~ Cibt- ~L-lhC.; I
CODES FOR CLASSIFY1NG EX?=NDITURES
If one of the following codes is used to describe the. expenditure, ::<0 ',Vrirten cr::scription is needed. (Note exc2o::crs
the back of this schedule for codes "C", "I" and "T",) Refer to the back of this scheGule and the Information .','ar.
on Campaign Disclosure for detailed explanations and examples of eac:, c3tegor{,
"C"
CONTrllBUT10NS TO OTH::R
CANDIDAT=S OR COMMITI=::S
INCE?ENDENT :::XPENDITUi1eS
.LJ7:::=IA TU RE
aROADCAST ADV::RT1SING
NEWSPAPER AND PE:=lIODICAL
ADVE:=lTISING
OUTSIDE ADVERT;SING
US"
SuRVEYS, SIGNA 7:"; iiE GATH::RING,
DCOR.TO.QOPR SC!...:C:TA71C~jS
ruND R;' iSii-.jG c'-j:::'JTS
GeNERAL OPERA i:CNS A~JC OVERHE;.O
iRAVEL. ~CCC:W,lCD~i!Oi'JS AND ',lEALS
;lROF=:SSiONAL "'.;.~~~G=:,lE:'-JT A,'JO
CO~iSU L T1 ~4G S=::iV 10=5
"1"
, I r-"
,
"G" -
",g" -
"T"'
I'N"
"?"
"0" -
I f one of the above codes does not accurately or fully describe the expenditure, leave the "Code" column jlanK .
Jrovide a wrinen description in the "Oescription of Payment" column.
---"-
I
I
1,~,q.r"]S
1
~ "'0
1.0. "'UN.":" C" ......... .....,..0 ....oo...s'S ~,. ~.A&\J..c.1
I coo~
A....OUNT
,,"AMI!: ANO AO.OR!!:SS Opr ",",Y1!:I!:. C~l!:OITOfll OR
Rtr:CJP1~NT 0". C:ONTRtBUTlON (11'" c:,:)......~... ",,-so liNT""
;lR
C)ESCF>'P"TION OF ""'Y"'l!:NT
Gri \ ("'0 'j 1); S pAtch
<04-00 (Y\cHI-te.re'i st.
G;\r-o ) CA c-f5lYl..O
E I fY) 0 h 'r-+o r , '
'7 '1 &>0 '1)' (Y) C 11 teY'ej S'{.
Gdr--OL~ i CA. C1SD 2.0
f.J
N
\3b.01J
SUBTOTAJ 13 5"t.f. '15
[.'j0 more spac:s is n~ded, check cox and
JC't3ch adcitional Sch~cu!es =.
~'.
~
SUMMARY
1. PJymenTs of $100 or more made thiS period (Include 311 Scneduie i.: SUDtot3isl . . . , , . . . . . . . . . . , . . . . . ..S 135Lf, '7CS
2. P3ymer\U under S100 this period (not itemizedl . . . . . . . . , . . . . . . . . . . . , , . . . . . . . . . , . . . . , . , . . . . .S I 1 <g. b^-
3. Total Accf\Jed Expenses oaid this !=eriod (Schedule F, Une.1) , . . , . . . . . . . . . . . . , . . . . . . , . . . . , . . . . . .S ,,1 't ,3 (,.
4.
Tool ?3Y!'l'!en~ tnis :::eriact (Line 1 - 2.;. 31 Enter ~er!! and on LiM 7, Column 3 of Summary P~<;e .....,...s 1551.1-1
INSTRUCTIONS FOR PREPARING SCHEDULE E
PAYMENTS AND CONTRIBUTIONS MADE
Schedule E is used to repo~t all payments for goods and services such as priming, postage, advercising, office supplies. I
also is used to report contributions made to candidates and cnro:mittees:
The following information must be provided for expenUltures of S100 or more:
. Full name and street address of the payee, creditor or recipient of contribution. I f the paYeB is 3 commi~tee. Inc:uc~
the committee's name, full street address and the identification number. I f the committee's identification num:::e!
is unknown, enter the name and address of the treasurer. If the conuibuti9n is a direct payment to a candic3te 01
committee (i.e., monetary contribution), enter "C" in the "Code" coiumn. If the expenditure is a conmoution or
behaif of a candidate or committee (i.e., non-monetary contribution), enter "C" in the "Code" column and fui!'!
describe the expenditure in the "Description of Payment" column. If the eXDenditure is an independer.t expenai
ture on behalf of a candidate or committee, enter :m "I" in the "Code" column and fully describe the ex:::enditur~
in the "Descriotion of Payment" column. I f the oayment is a loan to a candidate or commit:ee, inaica:e ::--::
interest rate. (I f a person providing the consideration is different from the payee listed, ~oth must be fully identified.
. Coded or written description of expenditure. I f one of :he following codes is entered in the "Code"-column, t~::
"Description of Payment:' column may be left blank unless other/vise noted below.
SCHEDULE E CODING CATEGORIES
"C" CONTClISUTIONS TO OTHER CANDIDATES OR COM-
.\1ITTE~S. l...!sa "C" fer ~xpend.ltures.....nIC:1 .UfI ::or'\trlbutlons
~o other :3ncidates Of :or;-;;"71.t~~e!. if In ~xcenditure is an ;n.
kind {non.monetary) contTlOution. enter a "C" In ::1e "C:Jde"
COlumn 3nd :Jro......ide oil fuJl uesctlPtion in ~j"e "DescrlPtion af
Payment" ;:lfumn.
"1" INDE?SNOENT EXPENDITURES (must De aescrioea). 8lter
.".. in t~e "C.:de":clu;71n and ;:Hovlce a ~uJ' jeScflot:cn in ::"le
"CescTlctlon of P3yment" COlumn for dxpencltures tnat are In-
aeoendent eXDenditu(~'S on cenalf 01 a canOjcate or committee.
OIL" LITEHA i"U R E. Us. ltL" for exoenOitures .35soc!ated with tne
;)reoaraticn, ;roOuc:ion ana CI5tfloutlcn :Jf :aMCalgn ti~~rature
and printed sOlicitat:ons. including exo.enaitures for :l'I311jng
lists. postaqe. ;jesign, copy and l.ayout. ~rintinq .and rl!oroQuction.
"a" SROADCAST AOVERTiSING. Use "S" ~or exoenaitures
assoctate-c1 '<Yitn tne ~roauction Jnd OlJrC:"lasa of raCl.io and
tetevtsion ao.....ertl.sing.
"N" NEWS;lAPER AND ?ERIODICAL ADVERTISING. Use "N"
for exoenaitufes, aSSOClate<t Wltn tne ::roduction and ourc~asa
of advertising in newsoapen, ;:Ierl0dlcalS and otner Publications.
"0" OUTSIDE ADVERTISING. Usa "0" far exoanaltures associ-
ated wltn aroaucllon ana ourcnase of aavertlslng an OlllOoara,
or caner c.amoai9n 'signs, ana camoalgn oaraonerna'ia sue.., a.s
outtons, ~umoer stickl'1, ootnolC1~rs, etc.
"5" SURV!;;YS. SIGNATURE GATHER!"IG. OOOR.TO.DOOR
SOLiC:TATJONS. use "5" for ~xoenQltt...;re5 JS~OCI.a:e<l Nten
ceSl<;nlng or :'..:lr,O:.JC:lng ;:'Olls, reDor:S.:In ~leC~lcn ~r~ncs. "Gter
sl...lr'''eys, ~tc., inc:uaing ;::ayments ::0 $1~r:3t'...:re :;a't."1ererS ~:::;r
~ualific4tion C1ri...~s, d.nO uoor.t.:J-joor SollCJtors.
"'F" FU!'lORAISI:".JG ~VE7'J:TS. Use "F'" f::r ~:'(:::~ncjt'-'r~s 3SS0Cj.
Jtea; ....'tn the nOlainq of a fundr.31S!ng ~vent, :r~C!:';c:lulg :.:av.
>1:ent.s to r~stau(antS, ,"ot!~jS ~r ;JiiS. Q;:erers 3nc. '.::""<tr . _"Cd
and rafre~nrnent ...encors. enter'!alnerS ana soe.a",ers. itJse ..:.....
for ~)(cen'oltures fOf orln~eC1 n;a(!er in c~nnec:~on 'NI~:1 .t'Jnj.
raising dvertS.;
"S" GENE~AL CPE~ATION AND \:JVE.~f-lEA~. Usa ..::;" for
c;enerat:.Jmoalgn ooeratin1 -!x:;.anses J.nC '.Jt~:ce o~er"eQCI.
incJuoing of1'lca rent,Jtil1!ies. ;)urcnase or rentJl .:)f Jftjc~
eqUIpment and ~urniture and staff salarle5 ana ~er.ef;~s. (Usa
"P" fer ~xOdndltures ~o :Jrofesslona' firms for ccnsultJng ana
.:amoa,gn management services.)
lOT" TRAVSL.. ':"'C:;C~..~MOCAT;CNS. :y'E~L...S. '....:ia "-;"" for ex-
;JenCltures JS50cldted. wltn t.rayet wltn,n Wllfornla. (E..xcenai-
t:.Hes a~socjatecj 'NltM travel outsl.je of CJlltornl~ must =:.e tuJly
cesCrtOed In tne "Cescription of Oayment" column.)
"P" PROF=::5SIONAL MANAGE~"'ENT AND .CONSUL i1NG SER-
VICES. use "P" for ~ees and commis~lons oalo to orI')1~!isional
camD319n management or consultin9 firms.
I f one of the above codes does not accurately or fully describe the expenditure, leave the- "Code" column blank and
provide a written description in the "Description of Payment" column.
. Amount of the expenditure or contribution.
Summarize in the Summary section at the bottom of the schedule itemized expenditures of S 1 CO or more, and non-
itemized expenditures of under S 1 00 which are reported as a lump sum. Also report accrued expenses paid this ;Jeriod.
I f a candidate or committee employs an agent or independent contractor, such as an acver::sing agency Qr a campai;n
rnanagerr,ent firm, and the agent or indepencent contractor makes any exoenditures of S 100 or more on ::enal f of
thf~ candidate or committee, such expenditures may be repor-:ed on an Attachment Schedule E-l in lieu of rsoon:ng
such ex:;enditures on Schedule E. (See the Informai.l0n ~i1anuaj on Camcaign Disclosure for J disc'.Jssion of A~-:2chme'1:
SdlllduL1 r:-I.)
(See the I nformation Manual on Campaign Disclosure for examples.)
.
SCHEDULE .E
PAYMENTS AND CONTRIBUTIONS MADE
(CONTINUATION SHEET)
FORM 420,430 OR 490)
I
.STATEMENT COVERS ?ERIOD
I
!
"'''0'-4
":'HROV::''"I
(AmounTs 'V1ay 8e Rounded To \Vhoie Dollars)
NAMe: OF CANDIDATE. OR CO~MITTEE:
1.0. NUM8E~ I''''' =':)........!--:";':=:.:;J
CODES FOR CU\SSI FY1NG EXPENDITURES
If one of the following codes is used to describe the expenditure, .no '/Jritten description is needed. (Note exceo::cns
on the back of this schedule for codes "C", "I" and "T".) Refer to .:he back of Schedule E and the Information .'/!(3f71-,af
on Campaign Disclosure for detailed explanations and examples of each caTegory.
"'e" CONTRIBUTiONS TO OTHER CA,'WIDA,::S "S" SURV:;YS. SiGNA,'.;?E GATHE,",ING.
OR COMMITT::::S DOOR-TO.OCOR S:JL;CiT",TICi'JS
INDE?ENC:::H ::XPE"iOITU?ES "F" r=UNCRAISING ::'fE'-i-:-S
L1T=~ATURE "G" C;c~~E~AL ::P=~A7 C"\S .':"I'JD GV::?iH:=AO
3ROADC.~ST ADVERT'SING "T" TRA'I::L. ACCOM."'GD,),TIO,,<S,),,'.O \I:ALS
.'JE'NSPAP~R ..\,'40 PE'1100ICAL ADVERTISING "P"' PROF:::SSIC,'JAL \1A,'J':'G<o:\~E:JT ",,:'J'J
OL;TSiC<: AD'I:::RT!Si,'JG CO~JSL.:L Tl:'.JG S::M'I:C:::S
"'\"
"'3"
":-J"
".0" -
If or.e of the above codes does not accurately or fully describe the expenditure, leave :he "Code" colurr..n blani< ana
provide a written description in the "Description of Payment" column.
NAMe: ....ND ADDR!OSS OF ,.AYEE. CREDITOR OR
RECIPIE~T OF CONTRt9UT10N {n... C~"'''''IT'T.II:. A\.50 'CNTII:'"
I D. 'CU......'" Q" ............. A,....O "'00_.." ~... .,...c:.....u..."'l
I CODE
OR
a ESC~1 P'TlON O"F P A. v 'VI E~T
~MOUNT
PAlO
I
I
I
I
I
. I
~"
-.....-....~~~-~"_...I: - ' -
[] ~f :nore, spa:e IS nee?:d. c~eCk box and SUBTOT.';L
~_ .,t,3cn ~dOl donal SC:Ldul_s E.
SCHEDULE F
ACCRU ED EXPENSES
(UNPAID BILLS)
FORM 420, 430 OR 490
STATE~ENT COVERS .::I;::~l
.q~M .W~CU~~
(.A.mounts May 3e Rounded To Whole Dollars)
,o.~~ -~.3 12.-31~~ 3
I.u. .'1lJt-At3e:R ,. -:::'.ol!~.l":"""!.~
19 /I 3 q
N~E\~~ CrAoN~ICA{\ \ol:;,.:"'j"'ITTEr. ,r
-0 rJ "" U n VA. 1 1" ::tQ-L G bt _Co u. n ~;\
CODES FOR CLASSl FYING ACCRUED EXPENSES
I f one of the following codes is'used to describe me accrued expensa, no written desc~iption is needed. iil-Jote exceO:;Ci
on the back of this schedule for codes "C", ''I'' and "T",) Rerer to the back of ttb.is schedule and :he infor,Tarle
.Manua/ 0/7 Campaign Disc/osure ror detailed explanations and examples or each.category.
"C" CONTnl8UT10l'JS TO On,ER "S" SURVEYS, SIG0JATURE GAT:-iER1NG,
CAi'JOIDATES OR CO(,1~,i'11I==S DOOR.iO.DOCR SGL:C:T.';i;C~~S
"I" INDE?ENDENT EXPENDITURES ";-" FUI'JQRA!SING EVENTS
"l" LITERATURE "G" GENERAL OPEF\AT10i'JS AND OVERHEAD
"g" 3ROAOCAST ADVERTISiNG "T" Ti1AVEL. ACCGMMCDAT:Oi\JS Ai'W W::-:,.l.LS
"N" NEWSP.L'...PE:R ,:l.,\JD PE::110DIC~.L "P" P~OF=.sSIOI'JAL \'lA,\lAG=~,lENT A,\JO
ADVE~T1SING CONSULTING SERV!C:S
"0" OUTSIDE ADVERTISING
If one of the above codes does not accurately or fully describe the accrued expense, leave the "Code" c~lur:in :iank 3::
provide a written description in the "Description of Payment" coiumn.
NAMe ANa ACCR1!:SS 01' lOA....!!:!!:, CR!!:CITOR OR
Re:CJP,e:.NT O~ CONTR1BUT10M {j" COWfIII'T"TCA:. AL.sO IINTC","
1.0. "fu...."'''' O. ......,... ,,!'Co 400.....11. c" "!'........S"u"c~i
COOE OR
Oe:SCR'P1"'CN OF .... "'...e:NT
AMOUNT
~C::RUEO
~........ML
--
I
I
I
~
-
I I
D If morl! SpClaJ is needed,
cneck box, and anach additional Sd1edules F
SUBTOTAL
SUMMARY
1. AccruedE.xpenses of S100 or More This Period. ...............................,.S
2.
3.
4.
AC"..:rued Expenses of Under S100 This Period (Not Itemized) . . . . . . . . . . . . . . .. . . . . . . . . .
Total A~;"'Ued Expenses Incurred This Period (Line 1 + 2) ...... . '.' . . . . . . . . . , . . . . . . , . '
Ao:nwd ::xpen~es ?3id This Period (Not Itemized) enter here and
on ScneoUle =, Lne 3 ....... ... .... " . ... . . .. ..... . .. .. .. ... .. . . .. . . . . . , .
3 -=), ~;Lt -
I ~:.':~
I
j
;
~,~"
5.
Net CliJ(iCJ'~ i.his P~riod (Subtract Lir.e 4 from Lna 3), Er.ter difference here ~d
on Lins 3, C0iumn a of Summary Page. . . . . . . . . , . . . . . . . . . . . . . . . . , . . . . . . . . . . . .
(.l'.1aY:'0:
INSTRUCTIONS FOR PREPARING SCHEDULE F
ACCRUED EXPENSES (UNPAI D SI LLSl
Schedule F is used to report unpaid bjlls and goods and sen/ices for which payment has no~ been made.
The following in.formation must be provided Tor accrued expenses or S 100 or more:
.
Full name and street address of the payee, creditor or recipient of contribution. I f the accrued eXDense is a n:
monetary contribution on behalf of a candidate or comminee, aiso enter me candidate's name, or the committe
name, address, and 1.0. i\Jumber or treasurer's name and address. For accrued expenses which are non-moner:
contributions, enter "c" in the "Cede" column and describe the accrwed expense in the "Description of ?av~e!
colurr.n. If the accrued expense is an inde:Jendent exoenditlJre on behalf of a candidate or commit:ee, en:er "I"
the "Cede" column and describe me accrued expense in the "Descriotion .of Paymein" column. (If the pers
;:;roviding the ~onsideration is different from the payee, both must be fuily identif:ed.)
.
Coded or wrinen description of accrued expense. If one of the following codes is entered In the "Code" caiun
the "Description of Payment" column may be left blank un!e~ ot;,en.vise noted below.
SCHEDULE F CODING CATEGORIES
"C" CONT?18UT10r;lS TO OTt..!ER CANDIDATES OR COM-
MIT::::::S. Use "C" for exoenditur~ ,,'mlC:'1 are conUlbutlOr.S
to otner C3('ldiaat~ or commlrr~. If an exoenditure ;5 an in-
kind lr.an-<T1()netary) contributIOn, enter a "C" in tne "Code"
column Jnd orO\l'oe a full:l~otion 'n :ne "O~criptlon at
Payment" column.
"S"
SURVEYS. SIGNAT1JRE GAT,.,E~ING, SeeR.Tv-CeOR"
SOL!ClTAT1CNS. Use- "5" for excendlwres assoc:atea with
designing or conducting :xJlls. reoom ..::>n ~!~c:;on ~r~ncs. -'/a:er
sur-Jeys. etc.. ;ncluaimJ ::aymencs to Signature gatrerers tor
'Qualification drl\le$. and ;jOor.lO-JOOr SOHCllors.
"L" LITERATURE. Use "L" for expenaitures associated with tn8
preoaratlon. prccu~ion and oistnbution of ':3mcalgn literature
ana pt"1nted SOliCitations, ,"cluding exoe!'1citures tor cnaliing
iisn. pcstage. design. coPV and layout, pnntlng and reoroductlon.
FUNDRAISING EVE:-JTS. Use ";:" 'or dxcenoi~ures 1SSOC:'
ated Nlth me haloing of a funaralsing event. Inc!uclnq ::ay-
ments :0 reSTaurants, '-,otels .;lr ~alis. caterers ana,)t:".er ;oca
3nd ~etreshr;"~!'\t "~cor,. ~~~~rT'3iner! ana ;ceaKer~. It..:se "L"
for ~xcanditwres for ;::rTnted :1'1an~r :n c~nnec:Jcn Wit" funa.
raising eveno.J
"I" INDE?ENDENT :::XPENDITURES (must be aesenbed!. Enter
",.. :n :!1e "C.:Jce" :Olumn ano ::;rO\lloe a full ceSc:"IPtlon in the
"Oescriotion of Payment" COlumn for exoendltur'!~ tnat art! in-
depenaent expena.tu;es on oenalf of a canoiOat!! or commlrree.
"G"
Gc:NERAL CPE::lAT10N A,"'D QVE::lHEAD. US!! ":;" for
generaJ camoalgn operating ~xoenses and "ffice :Jllernead,
Inc:ucing offic~ rl!nt. wtJiitj~. ourct1ase or r'!f10i of ~ff:~
od<JUlOment and fumlturt! and \taft ,alar'es ana banai"s. '(jse
"P" for exoenditures to Droresslonaj firms for consulting ano
campaign manaqement serv.ces.)
"3" SROADCAST ADVE RTISl NG. Usa "9" far expanditures
associated With thll croduction and purctlua of radio and
telllYls;on acI\1en:islnq.
"T"
TRAVEL. ACCOMMODATIONS, ,\olEALS. Use "r' for ex-
pencit'.Jrl?'! 3SS0c:at~ 'Nit" ':nv~f 'Nitr!ln California. (:;'(cer'dt.
tures assoc;at~ With lr3Vel outslce or Cali/omia must ::e f'<.Jlly
aescr:be<:l In me "Descr:ptlon of Payment" cOlumn.)
UN" NEYVSPAPER AND PEF'lICDICAL ADVERT1SING. Use "N"
for eXPe1'lditur~ as30ciated with the :lroduction and purenase
of advertising in newo;paoen, ;lertocicals and otner puolicatlons.
:'0" OUTSiDE ADVE::lT1SING. ~~ "0" for 3xcenaitures a=ci.
ated With oroduc'non ana purcnase of a<l\IertlSlng on blilboards
or omer campaign signs, and' camo.algn caracnemalia such as
buttons, bumper sticken. pomO/den. lite-
"?"
?ROi':SSiCNAL MMI~GcME:'H A,'<O CCNSULTING Sc:::l-
VICES. Use" PO' fOl' ~s and commi5slons paid to profe5slcnat
camo.aign manaqement or consulting firms.
If one of the above codes does not accurately or fully describe the accrued expense, leave the "Code" colun
blank and provide a wrinen description in the "Description of Payment" column.
.
'. Amount of the accrued expense or contribution. Summarize in the Summary section at the bottom (;Jf the schedu
itemized accrued expenses or S100 or more, and non-itemized accrJed expenses of under S100 which are report!
3S a !urnp sum. Also report ,he payment of expenses accrued in a prior period.
(See me Information Manual on Campaign Disclosure for examples.)
SCHEDULE G
MISCELLANEOUS ADJUSTMENTS TO CASH POSITION
FORM 420,430 OR 490
(Amounts Mav 3e Rcunced To 'Nhaie Ooilarsl
A
j STA.TEMENT cov~.~s ?E;RH
i ""'0" ~"''''OVGjo(
11O-'-3.q~ ! \2-31-<(3
,. l,~. .~U.'viaER "'.:,:).......t~-~!!:
, <]q 113
A./Yl'QU:'iT ':JF"
OAT!:
,
{I'" T'M. AO..lU.ti'T""C!'lIT I"'fVO\.VClI .... C::l....I1"",.".... OT""&" THAN ,...... 11"11..&l1li, !t1'fTll''' "!'...... =::a"....'T""'!".Il', """....
A....O ...001lt.... AL.JO lENT"'''' T'lo4. CO.......IT"":'lllt'S 1..:J4"",a...e.1It 0'" """C ,.wt.ASU....~''I "t....,",. AND .4co".ssl
,"'C~CAS.
1"0 CAS"
Oll: C" II: A. 'I &
TO C.... 5H
i ,
I I
-I
I
I
I
I
I
, I
I
I I
I I
_a_- I
I
I !
i I
!
I i
l' !
I
l
(.}
(b}
o
If more space is needed, check box at left
ilnd amch additional Schedules G
SUBTOTAL
SUMMARY
1. It'lCRE,.\SES TO CASH OF S100 OR ~110RE (Column (al ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2. INCREASES TO CASH OF LESS THAN S100 (Not it~mized). . . . . . . . . . . . . . . . . . . . . . . . . . . . .
-3. TOT~\L INCREASES TO CASH (line 1 + line 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4, DECHE),SES TO CASH QF $100 OR :Vl0RE (Coiumn (b) ) . . . . . . . . . . . , . . . . . . . . . . . . . . . . .
5.
m:CRf::'.,\SES TO CASH OF LESS THAN $100 (~~ot itemized) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
rOf,\L OECRE.~SES TO CASH (Line 4 + Line 5) . . . . . . . . . .
q.~o
I
!
I '1,3D
I
I s (q , ?>.Q)__
G.
7.
TOTAL ,'w1ISCELLANEOUS AOJUST:\1ENTS TO CASH
(L:n.1} 3 minus Line 6) Enter here and on Line 12 of SUmmilr{ P1ge
.
\'t1.]y ~.
::&Q4ClVC ~l~Ufel
INSTRUCT10NS FOR PREPARING SCHEDULE G
MISCELLANEOUS ADJUSTMENTS TO CASH POSITION
Schedule G is used to report any transaction which aff,:c:s the cash position of the candidate or comr:;ir:ee, sur
is not a contribution (monetary or non-monetary), loan, pledge, loan repayment or expenditure.
'Each miscellaneous adjustment to cash totaling S100 or more must be itemized on Schedule G, including:
· Date of the transaction.
-. A description of the adjuS+L1T1ent.
· The amount of the adjustment, in the 3oprooriate coiumn.
Examples of reportable miscellaneous increases to cash:
· Interest r~eived or cre<lited to checking or saving accounts or other time deposits.
· Proceeds from the sale of donated property, such as stocks, bonds, art objects, items sold at ";~arage
sales," etc. (Such donated items should be reported as non.monetary comributions on Schedule C.)
· Proceeds from the sale of property purchased previously and used in the campaign, such as or.;ce
. furnishings or e<:1uipment.
· Refunds received on deposits, such as telephone deposits.
· .Refunds received from over-payment of bills.
· Repayments received of loans made to mhers.
Examples of report9ble miscellaneous decreases to cash:
It Checks received from contributors and previously reported as contributions that are returned from the
bank for insufficient funds.
Summarize the transactions, induding non-itemized transactions under S1 CO,at the bottom of the schedule.
(See "Information Manual on Campaign Disclosure" for examples)