Daniel Palmerlee - 1985/10/20 - 1985/12/31
CONSOLIDATED
CAMPAIGN STATEMENT
n":\), ~~13H 12
(y~., ',,'
'\,' ..' .A...
('~ ~
IC
!" Jt\N 1986
<;1.,..
()
~
OJ
CD!
em ~1S mBGf c:;.
G1t~ fA -'::::;'1
; ,
(Government Code Sections 84200-84217)
Form 490
1985
For use by candidates/officeholders and their controlled committees.
(Type or Print in Ink)
~
CANDIDATE/OFFICEHOLDER INCLUDED IN THIS CONSOLIDATED REPORT
IO~ZO-B5 through 11 ~.o1-6~
I TOTA,iGu,
A OFFICIAL USE ONLY/
Statement covers period from
DATE OF ELECTION (MO., DAY. YR.II,,' A~~~ICA....I'
CITV
OF"'CE SOUGHT OR t-tELD hNCI.UDC L.OCATION AND DIST"ICT
NUM.." '" AP"~fCA.~.'
CJ ~
NAME OF CANDIDATE:
...".... coDe
,....ON. NUM.t!R
BUS\IJE\SS AD~~!? $~1 nun ql~()'/ ~e '1~~()
1800 \A/REt-J Av.c. "'BL:D6. E. ['5<4 Cj IlR.DY CA 7J5()2()
II CONTROLLED COMMITTEES* INCLUDED IN THIS CONSOLIDATED REPORT
04613. ~'Z:" 1~h4
Alt.... co :'OM HE NUM.."
o4.DP:r PA: '7'- 21055
NAME OF CDMMITTEE:
1.0. NUMBER
ADDRESS OF COMMITTEE:
NO. AND STIIt.IIT
CITY
STATe
z.... cooc
......A coDe
"HONe NUM....
NAME OF TREASURER:
PERMANENT ADDRESS OF TREASURER:
NO. AND .TR.CT
CITY
STATE
%." COOII
AItC... COOII
"''''ONII NUM.."
NAME OF COMMITTEE.
I.D. NUMBER
ADDRESS OF COMMITTEE:
NO. AND ST'utIlT
CITY
STATE
Z." COD.
...".... coDa
,....ON. HUM.."
NAME OF TREASURER.
PERMANENT ADDRESS OF TREASURER: NO. ANO n....T
CITY
STATe
ZIP' CoDe
"'''CA coo a
.....ON. NUM.ER
AtrllCh lIdditional information on appropriattlly IlIbtlltld continuation shtltltt.
!II CANDIDATE/OFFICEHOLDER ONLY: LIST ANY OTHER COMMITTEES NOT INCLUDED IN THIS
CONSOLIDATED STATEMENT WHICH ARE CONTROLLED BY YOU OR ARE PRIMARILY FORMED
TO RECEIVE CONTRIBUTIONS OR MAKE EXPENDITURES ON BEHALF OF YOUR CANDIDACY.
COMMITTEE NAME
AND 1.0. NUMBER
A\..H.E.'R.\..E.~ t>.::?A l (j tJ c..tH
#' \
COMMITTEE ADDRESS
5400 NlCOUS WAY
c..A 960'2.0
TREASURER
Controlled Committee?
YES NO
Attach additional information on appropriataly labeled continuation shetltt.
. (A controlled committee is one which is controlled directly or indirectly by a undidllte or which ectt jointly with II undidBte or controlled committee in
connection with the making of expenditures. A cllndidate controls a committee if thtl candidate, thtl candidattl's agtlnt, or any other committee he or she
controls, has significant influtlnce on thtl actions or decisions of thtl committetl.)
VERIFICATION
I declare under penalty of perjury that to the best of my knowledge this statement and its schedules are true, correct and complete and that
I have used all reasonable diligence in their preparation.
~xecuted on~~\J.~:Rt z.. 7 at GI~()Y CA by
(OAT. (CITY AND STATE!
~xecuted on at by
\DAT&) (CITY ANO STAT_' '.'ONATU". 0'" TRIEASUJile:IIt,sJ J
i declare under penalty of perjury that to the best of my knowledge this statement and its schedules
treasurer(s) of this committee(s) has u~ed all reasonable diligence in the preparation of is state n
Executed onJfiJoJ 12T~111 q 8"b at C11 (.. ~ 9c~v AN~nl by .'ONATU"K O~ CAN".OAn 0" O~~IC""O~".R
For information reqUired to be provided to you pursuant to the Information Practices Act of 1977. see "Information Manual on Campaign Disclosure Provisions
~~VY1 In, ~~
(SIGNATUIIt 0 T".A.U......(.i)
IV ALLOCATION OF CONTRIBUTIONS AND EXPENDITURES MADE TO OR ON BEHALF OF OTHER
CANDIDATES, OFFICEHOLDERS AND MEASURES (Allocate expenditures from Schedules E & F made
to or on behalf of another candidate, officeholder or measure. AmounU may be rounded off to whole dollars.)
DATE IND. NAME OF CANDIDATE OR OFFICEHOLDER AND OFFICE CHECK ONE CUMULATIVE
EXP.... OR MEASURE AND BALLOT NUMBER OR LETTER Support Oppole AMOUNT TO DATE
N () N~_
AttllCh <<Idirional information on appropriatt1lv labt1't1d continuation shHtI.
· Check box if "independent expenditure." (See Instructions below.)
INSTRUCT'ONS FOR PREPARING COVER PAGE
CONSOLIDATED CAMPAIGN STATEMENT
FORM 490
PERIOD COVERED BY STATEMENT:
The periOd covered begins the day after the closing date of the last campaign statement filed. If no previous
statement has been filed, the period begins on January 1 of the current calendar year. The 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:
It this statement is filed in connection with an election held on a data other than June 4, or November 5, 1985,
enter the date of the election.
PART I:
Provide the candidate's or officeholder's full name, residential address, business address and telephone numbers,
and the office sought or held.
PART II:
Identify the controlled committees included in the consolidated report and the treasurers of the committees. Use
the same information that appears on the committees' Statements of Organization filed with the Secretary 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 Ill:
The candidate or office holder must list all additional committees not included in this consolidated report which
are controlled -by the candidate or officeholder or are primarily formed to receive contributions or make expen-
ditures on the candidate's behalf and whether or not they are controlled committees.
VERI FICATION:
The statement must be signed by each committee treasurer included in the consolidated report and by the
candidate or officeholder who controls the committee. The treasurer and candidate or officeholder must review
the information contained in the statement before signing the verification.
ALLOCATION OF CONTRIBUTIONS AND EXPENDITURES MADE TO OR ON BEHALF OF OTHER
CANDIDATES, OFFICEHOLDERS AND MEASURES:
List all contributions (including loans) and independent expenditures itemized on Schedules E and F to support or
oppose officeholders, candidates, and ballot measures (other than those controlling this committee or for which
this committee is, primarily formed). Also list in-kind contributions and independent expenditures which involve
goods or services provided to or on behalf of a candidate or committee when a payment is not made (e.g.,
employee services. in-house printing, etc.). A description of the goodS or services must also be provided. Indicate
the date of the expenditure; if the expenditure is an independent expenditure (an expenditure not made at the
behest of the candidate or committee on whose behalf it is made) check the box to so indicate; the office sought
or held (or the measure's number or letter and the jurisdiction); the amount of the expenditure; and the cumulative
amount to date. The "Cumulative to Date" column should include the total of expenditures for or against each
candidate or measure since January 1 of the current calendar year. (See "Information Manual on Campaign
CAMPAIGN DISCLOSURE STATEMENT SUMMARY PAGE
FORM 420, 430 OR 490
(Amounts May Be Rounded To Whole Dollarsl
STATaMIlNT COVIl". ...:".00
T"'''OU_'''
NAME 0" CANDIDATE 0" COMMITTEE
I.D. NUMBER (.~ CO....ITT..;
16CJ5
'-1..... ., . .
(eHOU\.O CQuAL. \.IH. ..
CO,-UMH. A . _I
.If this is the fim report filed for the calendar year, Column A should be blank except for unpaid/oans, bills and pledges.
STATEMENT OF CHANGES IN FINANCIAL CONDITION
10. Cash on hand at the beginning of, this period: (Line 14 of previous statement)'.. $ 947
835
COLUMN A
Cumulative
total from
.
pt'lIVioul p.riod
CONTRIBUTIONS RECEIVED
1. Monetary contributions . . . . . . . . . .
910
$
2. Loans......................
-0-
3. Subtotal....................
$ ~IO
LINK. I . I
4. Non-monetary contributions. . . . . . .
54-
5. Pledges.....................
-0-
,..
6. TOTAL CONTRIBUTIONS. . . . . . . .
$
~fcA-
LINK. J . " . .
EXPENDITURES MADE
7. Payments....................
1<4'7
$
8.
86
1.35
Accrued expenses (unpaid bills) . . . . .
9.
TOTAL EXPENDITURES. . . . . . . .
$
LINKS 1 + .
11.
COLUMN B
Total this period
from attached
IChedul..
$ fj55
.CHEDULIE A. LINe..
- 0-
aCHIlDUL& a, LINK.
$ 635
L,N.. I . Z
-0-
SCHEDULIE C,L'N& J
-0-
.CHEDULE.. D, ,LIN._7,~',
$ c5.?5
LIN.. J . " . .
$ I 4 cO A.. .
aCHKDUL&: E., LINK.
ISlA,
.CHEDULI[ IT. LIN. I
$ 1(1'){oO
LINKS 7 . .
Cash receipts this period (Line 3, Column B above) . . . . . . . . . . . . . . . .
- 0-
12. Miscellaneous adjustments to cash (Schedule G, line 7) . . . . . . . . . . . . . .
14. Cash on hand at closing date (Lines 10+11+12-13 above)*............
l4CD:;C
3z..o
2.8 Co
13. Cash payments this period (Line 7, Column 8 above). . . . . . . . . . . . . . . .
15. Outstanding debts (Line 2 + Line 8 of Column C abovel. . . . . . . . . . . . . .
16. Ending surplus (if Line 14 is greater than Line 15, subtract Line 15 from Line 14). . . . . . . . . . . .
17. EndinQ deficit (if Line 15 is greater than Line 14, subtract Line 14 from Line 151 . . . . . . . . . . . . $
· Ending cash on hand shOuld nor b4I anegarlve amount.
B
COLUMN C
Cumulative
to data
(ColumN A + BI
$
1'/-45
-0 -
$ I t(~ 5
LINK. I . 1
54
- o.
$
\'199
L......_.. ... .'1.'-
I_HOULO .QUAL L.I". _.
COL,.U...N. A . .)
$
\(000
'A-BCo
$
$
34-
18. CASH EQUIVALENTS (OTHER ASSETS HELD) (SH lnatructlona on Fie_): $
-0-
SUMMARY FOR CANDIDATES IN BOTH A JUNE AND NOVEMBER ELECTION (See Instructions on Reverse)
, /1 thru 6 /30 7/ 1 to date
19. CONTRIBUTIONS RECEIVED:
20. EXPENDITURES MADE:
['199
1'205
SCHEDULE A
MONETARY CONTRIBUTIONS RECEIVED
FORM 420,430 OR 490
(Amounts May Be Rounded To Whole pollars)
STATEMENT COVERS PERIOD
~~OM THROUGH
NAME 0,. CANDIDATE OR COMMITTEE.
8
,.ULL NAME AND ADDRESS 0"
DATil CONTRI8UTOR
".C.C c... c~'::~::..r~.:A':.N:~:~.~.;:::.~T" 0..
EMPLOYER
AMOUNT
OCCUPATION
(.... ..LP'''.M~LOV.D. <<NT."
NAM. 0... aUStN...)
...c.,v.a
CUMULATIVE
TO OAT.
"'D~N"'l S \'
K~NNE1t\ W,"8EU-;l).H,
IN e.. .
</e60 W'REN A.VE
G Il..R..OY, C-A. ~ 5 Ol.f:)
'SAH.~
,
~IOo.
\r~/e5
HR,eM~. IDME1\-\ \N.~
'OJ. lOCo E>~"THt-\DRE. t'LAC:f.,
71'Yes ~G.A"'O~, c..A ~603D
GroRBC, \1, '1E).J...\(,\-\j1),1).<S.,
r"f660 WREN A.\JE.. MS,INC.. .
;1-e... e:. - \ 5:<"
-VENll SoT
I
fj 100.00
\ ){91
'85
C-rR.E.'P.A,C. O'B.O;R..P.A.C'
rD. NO. 14:t~'Uo 'REAL (s\'ATE:..
51.5 SC>. YrRC::sIL A\JE-.
LOsAt-..lC:1c.~ CA ~007.D
C. . '"R. Ac..KJ:.R.
'1 rt 5\ 'REA <c\'.
G \ l...T-<..J::)'Y) c..A.. '15020
SAHE.
I
~ICO,OO
1/f~5
"REFus.~
"D \ 5~sA\..-
0..D.
fu UT~\ V A\.J..E"/''REFOSe:.
'"D\~-PDSA L "INC-.
'Ill 0 A k.f..)( A, t-fDER..
D CA.
I
~ ICo.OO
o
If more space is needed, check box at left
and attach additional Schedules A.
SUBTOTAL
SUMMARY
1. AMOUNT RECEIVED - CONTRIBUTIONS OF $100 OR MORE
(Include all Schedule A subtotals). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
3. TOTAL MONETARY CONTRIBUTIONS THIS PERIOD
(Line 1 + Line 2) Enter here and on Line 1 Column B of Summary Page . . . . . . . . . . . . . . . . . . . . . .
2. AMOUNT RECEIVED - CONTRIBUTIONS OF LESS THAN $100 (Not itemized) . . . . . . . . . . . . . .
-3-
NAME OF CANDIDATE OR COMMITTEE:
SCHEDULE B
LOANS
FORM 420, 430 OR 490
(Amounts May Be Rounded To Whole Dollars)
STATEMENT COVERS PERIOD
~ROM TM~OUGM
"'P A\.. H ffi LEE ('-
PART 1 - LOANS RECEIVED
DATE
REC'D
FULL NAME AND ADDRESS OF
LENDER AND ANY GUARANTORS OR
COSIGNERS h.. COMMITT.., A....O .HTaR
I.D. NUM.... 0.. TR.A.U".....
HAMS AND ADO"...)
EMPLOYER
INT.
RATE
AMOUNT
OF LOAN
CUMULA-
TIVE
TO DATE
OCCUPATION
h~ ....."'-K",PLOYCO. aNT""
HAMil! 0... BUSIH...)
E
D
If more space is needed, check box at left
and attach additional Schedules B, Part 1.
SUBTOTAL
PART 2 - LOANS REPAID, FORGIVEN OR PAID BY A THIRD PARTY:
(a)
ENTER THIS DATA ON SCHEDULE A ALSO
( )
AMOUNT "'ORG_V.N
OR PAlO .Y
TH 111'0 ..... RTV
THIRa PARTV NAMIE AND ADDR...
UNPAID
BALANCE
DATE
FULL NAME AND ADDRESS
OF THE LENDER
AMOUNT
REPAID
o
If more space is needed, check box at
left and attach additional Schedules B,
Part 2. SUBTOTAL
(a)
(b)
SUMMARY
1. LOANS OF $100 OR MORE THIS PERIOD (Part 1)
. . . . . . . $
2. LOANS UNDER $100 THIS PERIOD (Not itemized) ,
3. TOTAL LOANS RECEIVED THIS PERIOD (Line 1 + 2). . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,
4. LOANS OF $100 OR MORE REPAID THIS PERIOD (Part 2, Column (a) ) . . . . . . . . . . . . . . . . . . , . '" :
5. LOANS OF $100 OR MORE THIS PERIOD FORGIVEN OR PAID BY A THIRD PARTY (Part 2, Column (b)) .
6, LOANS UNDER $100 REPAID, FORGIVEN OR PAID BY A THIRD PARTY THIS PERIOD (Not itemized)
(Also enter this amount on Line 2 of Summary section of Schedule A) , . . . . . . . . . . . .'. . . . . . . . . . . . . . . . .
7. TOTAL LOANS REPAID, FORGIVEN OR PAID BY A THIRD PARTY THIS PERIOD (Line 4 + 5 + 6) .
8. NET CHANGE THIS PERIOD
(Subtract Line 7 from Line 3) Enter the difference here and on Line 2, Column B of Summary Page.
SCHEDULE C
NON-MONETARY CONTRIBUTIONS RECEIVED
FORM 420, 430 OR 490
(Amounts May Be Rounded To Whole Dollars)
STATEMENT COVERS PERIOD
1/
L
OCCUPATION
h.. ..L.....MPLOV.C. .NT."
NAMK 0'" aU.'N...)
DESCRIPTION OF
GOODS OR SERVICES
FAIR
MARKET
VALUE
RECEIVED
CUMU-
LATIVE
AMOUNT
DATE
REC'D
FULL NAME AND ADDRESS OF
CDNTRIBUTDR
(I... COMMITT....AJ.,IJiL..NT... I.D. HUM.....
.0"" T".A.U....... NAM. .HO ADD"...)
EMPL.OYER .
o
If more space is needed, check box at left
and attach additional Schedules C.
SUBTOTALS
SUMMARY
3. TOTAL NON-MONETARY CONTRIBUTIONS THIS PERIOD
(Line 1 + 2) Enter here and on Line 4, Column B of Summary Page
. .. . . . I . . ., . "' . . . ., .'O .. . . ..
1. NON-MONETARY CONTRIBUTIONS OF $100 OR MORE THIS PERIOD. . . . . . . . . . . . .. ',' . . . . . $
- 0-
2. NON-MONETARY CONTRIBUTIONS UNDER $100 THIS PERIOD (Not itemized). . . . . . . . . . . . . . . . .
-5-
" , .
SCHEDULE D
PLEDGES
FORM 420,430 OR 490
(Amounts May Be Rounded To Whole'Dollars)
FULL NAME AND ADDRESS OF
CONTRIBUTOR
OCCUPATION
EMPLOYER
(.~ ..L~-.M"L.OY.D. .NT."
NAM. O~ _U.'H...)
DATE
RI!C'D (u" C~'::~~::~:~.~A~H:~:'~.~.;:~:.~'f" 0"
o
If more space is needed, check box at left
and attach additional Schedules D.
SUBTOTALS
SUMMARY
STATEMENT COVERS PERIOD
~"OM THROUGH
AMOUNT
PLEDGED
THIS
PERIOD
(a)
1.0. NUMBER ('0' COM."TTRRI
AMOUNT
PAID
IA~.O
aHTa.. ON
.c...aaUL.a A)
CUMU-
LATIVE
PLEDGE
UNPAID
(b)
1.
2.
3.
4.
5.
6.
7.
PLEDGES OF $1000R MORE THIS PERIOD (Column (a) ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
PLEDGES UNDER $100 THIS PERIOD (Not itemized). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .
TOTAL PLEDGES RECEIVED (Line 1 + 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLEDGES OF $100 OR MORE PAID THIS PERIOD (Column (b) ). . . . . . . . . . . . . . . . . . . . .'. . . . . . . .
PLEDGi:S UNDER $100 PAID THIS PERIOD (Not itemized)
(Also enter on Line 2 of the summary section of Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
TOTAL PLEDGES PAID (Line 4 + 5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NET CHANGE THIS PERIOD
(Subtract Line 6 from Line 3) Enter the difference here and on Line 5, Column B of Summary Page. . . . . . .
_t::_
(May be
negative figure)
-,
SCHEOULE E
PAYMENTS AND CONTRIBUTIONS MADE
FORM 420, 430 OR 490
TATEMENT COVERS PERIOD
~"OM T""OUGM
(Amounts May Be Rounded To Whole Dollars)
"'lAME 0'" CANDIDATE OR COMMITTEE:
If one of the following codes is used to describe the expenditure, no written description is needed. (Note exceptions on
the back of this schedule for codes "C", "1" and "T".) Refer to the back of this schedule and the Information Manual
on Campaign Disclosure for detailed explanations and examples of each category.
"e"
"s"
SURVEYS, SIGNATURE GATHERING,
DOOR.TO.DOOR SOLICITATIONS
FUNDRAISING EVENTS
GENERAL OPERATIONS AND OVERHEAD
TRAVEL, ACCOMMODATIONS AND MEALS
PROFESSIONAL MANAGEMENT AND
CONSULTING SERVICES
CONTRIBUTIONS TO OTHER
CANDIDATES OR COMMITTEES
"1" - INDEPENDENT EXPENDITURES
LITERATURE
BROADCAST ADVERTISING
NEWSPAPER AND PERIODICAL
ADVERTISING
"0" OUTSIDE ADVERTISING
If one of the above codes does not accurately or fully describe the expenditure, leave the "Code" colurr r1 blank and
provide a written description in the "Description of Payment" column.
IMPORTANT: Do not itemize the payme,nt of accrued expenses on Schedule E. Report only the lump sum of these
payments on Line 3 of the Summary section, below.
JIL"
"8 "
"N"
"F"
"G"
liT"
"'P"
NAME AND ADDRESS 0'" PAYEE. CREDITOR OR
RECIPIENT 0,.. CONTRIBUTION h~ CO....,TT... AUO .NT." AMOUNT
I.D. NU...." 0.. HAM. AND ADD"... O~ T".ASU".'" CODE OR DESCRIPTION OF PAYMENT PAID
11-\ E 1,) \ S"PA \" C.J-\
Co <>4 0 0 HONiE..:RE..Y CjGjo. DO
G IL'ROY, CA. 9~Oz.o N
THE 'PR\~,ING S'"POT
0479 1ST ST. L 313.00
G 11..'R.OY, C.A . 9502.D
o If more space is needed, check box and SUBTOTAL I "3 () ?-,f'\t\
attach additional Schedules E.
IMPORTANT: Contributions and expenditures on behalf of other candidates or committees must also be entered in the
allocation section at the front of the campaign statement.
SUMMARY
1. Payments of $1JO or more made this period (Include all Schedule E Subtotals) . . . . . . . . . . . . . . . . . . . . . . .S
I 3n~, on
150.00
2. Payments under $100 this period (not itemized) . . . . . . . . . , . . . . , . . . , . . . . . . . . . . . . . . . . . . . . . . . . .$
3. Total Accrued Expenses paid this period (Schedule F, Line 4) , . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . .$
-0-
4. Total Payments this period (Line 1 + 2 + 3) Enter here and on Line 7, Column B of Summary Page. . . . . . . . . .$
\4~2,OO
).
SCHEDULE F
ACCRUED EXPENSES
(UNPAID BILLS)
FORM 420,430 OR 490
STATEMENT COVERS PERIOD
I
(Amounts May Be Rounded To Whole Dollars)
""OM
TH"OUGH
NAM!: OF CANDIDATE OR COMMITTEE:
1.0. NUMBER (." COMMITT..)
CODES FOR CLASSIFYING ACCRUED EXPENSES
'f one of the following codes is used to describe the accrued expense, no written description is needed. (Note exceptions
)n the back of this schedule for codes "C", "I" and "T".) Refer to the back of this schedule and the Information
~1fanual on Campaign Disclosure for detailed explanations and examples of each category.
"C" CONTRIBUTIONS TO OTHER "S" SURVEYS, SIGNATURE GATHERING,
CANDIDATES OR COMMITTEES DOOR-TO-DOOR SOLICITATIONS
"I" INDEPENDENT EXPENDITURES "F" FUND RAISING EVENTS
"L" LITERATURE "G" GENERAL OPERATIONS AND OVERHEAD
"B" BROADCAST ADVERTISING "T" TRAVEL, ACCOMMODATIONS AND MEALS
"N" NEWSPAPER AND PERIODICAL "P" PROFESSIONAL MANAGEMENT AND
ADVERTISING CONSULTING SERVICES
"0" OUTSIDE ADVERTISING
f one of the above codes does not accurately or fully describe the accrued expense, leave the "Code" column blank and
xovide a written description in the "Description of Payment" column.
NAME AND ADDRESS OF PAYEE, CREDITOR OR AMOUNT
RECIPIENT OF CDNTRI8UTIDN h~ COMM,TT.., ALao .NT."
I~D. HUM.IU, 0" HAME ANI) ADD"... a.. T".A.~) CODE OR DESCRIPTION OF PA YMENT ACCRUED
THE- '1)\ SF'ATCr\ La '""DORADO Tl 11.6
(0400 HOtJlE.RE.Y/ t--J 198.00
. GILKOY, C-A . 9502.0
~ If more space is needed, SUBTOTAL
check box, and attach additional Schedules F
JlPORTANT: Do not itemize the payment of accrued expenses on Schedules E or F. Report the lump sum of these
3yments on Schedule E, Line 3, and on Schedule F, line 4. Do not re-itemize accrued expenses which have been re-
.Jrted in a previous period.
SUMMARY
Accrued Expenses of $100 or More This Period. , . . , . . . . . . . . . . . . . . . . , . . . . . . , . . . . .$
Accrued Expenses of Under $100 This Period (Not Itemized) . . . . . . . . . . . . . . . . . . . . . . . .
Total Accrued Expenses Incurred This Period (Line 1 + 2) ,... . . , , . . . , . . . . . . , . . . . , , .
Accrued Expenses Paid This Period (Not Itemized) Enter here and
on Schedule E, Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Change This Period (Subtract Line 4 from Line 3), Enter difference here and
on Line 8, Column B of Summary Page, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- 6-
198.00
(May be
flegative figure)
SCHEDULE G
MISCELLANEOUS ADJUSTMENTS TO CASH POSITION
FORM 420, 430 OR 490
moun s ay ou e e a
, STATEMENT COVERS PERIOD
~ROM TMROUGH
Inh()/~~llz.../.::s J /PrS
NAME OF CANDIDATE OR COMMITTEE: 1.0. NUMBER (o~ COMMNT&&T
80069 I
AMOUNT OF
NAME AND ADDRESS OF SOURCE (IF RECEIPT) OR PAYEE (IF EXPENDITURE), (IF
DATE COMMITTEE, AlSO ENTER 1,0. NUMBER OR NAME AND ADDRESS OF TREASURER.) DESCRIPTION OF ADJUSTMENT IHe".A.. Dlle".A..
TO CASH TO CASH
.,
-
0 (a) (b)
If more space is needed, check box at left
and attach additional Schedules G SUBTOTAL
(A t M Be R nd d To Who I Doll rs)
SUMMARY
1. INCREASES TO CASH OF $100 OR MORE THIS PERIOD (Column (a)) . . . . . . . . . . . . . . . ., . $
2. INCREASES TO CASH OF LESS THAN $100 THIS PERIOD (Not itemized) . . . . . . . . . . . . . . . . .
3. TOTAL INCREASES TO CASH THIS PERIOD (Line 1 + Line 2) . . . . . . . . . . . . . . . . . . . . . . . . .
4. DECREASES TO CASH OF $100 OR MORE THIS PERIOD (Column (b) ). . . . . . . . . . . . . . . ... . .
5. DECREASES TO CASH OF LESS THAN $100 THIS PERIOD (Not itemized). . . . . . . . . . . . . . . . .
6. TOTAL DECRE'ASESTOCASH THISPERIOD (Line4+Line5).........................
7. TOTAL MISCELLANEOUS ADJUSTMENTS TO CASH THIS PERIOD
(Line 3 minus Line 6) Enter here and on Line 12 of Summary Page . . . . . . . . . . . . . . . . . . . . . . . .
- 0-
(May be
negative figure)
-9-