Daniel Palmerlee - 1990/01/01 - 1990/06/30 - Termination
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 1-1-90 through 6-30-90
CHECK ONE OF THE FOLLOWING BOXES TO INDICATE THE TYPE OF STATEMENT BEING FILED:
FORM 450
1990
o PRE-ELECTION STATEMENT
o SEMI-ANNUAL STATEMENT
o SUPPLEMENTAL PRE-ELECTION
STATEMENT (II IIl1ng a Supplemelllal
Pre-EleclJon Statement. attach a
complelBd Form 495,)
o BALLOT MEASURE QUALIfiCATION
STATEMENT
o SPECIAL 000- YEAR CAMPAIGN
REPORT
TERMINA nON STATEMENT
(Attach a completed form 415)
NAME OF COMMITTE~
f/,4LI1€f.LS3-
ADDRESS OF COMMITTEE: NO ANO SrREEl
1/1 . Se~d Sf. ~JI!:Ef
NAME OF TREASURER: f ~
Te--~ II j<..ailJ;I'}
PERMANENT ADDRESS OF TREASURER: 1C'0 ANO SlRm
5<Jo s- )tj I Cf!) Ie. ~
f1
CITY
STAlE
liP COOl
CA
tt.rOdO
DATE OF ELECTION (MO.OAY, YR,) (If APPlICA8U):
SIAI~
'"'<:"',rl\n 23-'4;J~
~,'):,:.'- .......'.J?0'....)
1-:':;:'" ,... "';'')
I~',:> JUt 1990 ,;
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A
fOR OfFICIAL USE ONL Y
1.0 NUMBER
JS6b9
AR~A COOl/PHON~ NUM8tR
Lfotf Na. 7~,/
95Lt)-o
liP COOL AKlA COOtlOA Y lIM~ PHONl NUM~~R
IS THIS A CONTROLLED COMMITTEE?
YES 0 NO
IS THIS A SPONSORED COMMITTEE?
DYES 0 NO
IS THIS A BROAD BASED COMMITTEE?
DYES 0 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 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.
BY ~~~. ~;,
/ (SlG/llATlJIE Of TR AS IEII
EXECUTED ON 1/1:1 J '10 AT
. (DAre)
c; / J~y (CI~OSTAfE)
A CANDIDATE. OFFICEHOLDER OR STATE MEASURE PROPONENT WHO CONTROLS A COMMITTEE ALSO MUST VERIFY
THE CAMPAIGN STATEMENT.
I HAVE USED AU REASDNABLE 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.
EXECUTED ON
7 //~1o
(DATe)
c,)~'YAN~E)
I CERTifY UNDER PENAL TV OF PERJURY UNDER THE LAWS OFTHE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT.
~
/ j/~ .'
BY
(SIGNATURE Of CANDIDA rElOfflCEHOl.OERlPROPONENTIRESPONSl8Lf OfflCERI
AT
EXECUTED ON
AT
BY
(DATe)
(CITY AND STATE)
(SIGNATURE Of CANOIOATe/OfflCEHOl.OERiPllOPONENfj
EXECUTED ON
AT
BY
(DATe)
(CITY AND STATe)
(SIGNATURE Of CANOIDAfEIOffIC~HOLOERiPROPONENT)
For information required to be provided to you pursuant 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
STATEMENT COVERS PERIOD
FROM THROUGH
NAME OF COMMITTEE:
La. NUMBER
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-
$ ~
$ ~1,94
$ 47.9y
$ -e-
$ LJ 7, 9 'I
$ .()-
$ e-
$ e
$ -8-
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