Gilroy Citizens Opposing Measure F - 460 - 2015/07/01 - 2016/01/20Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 7/1/2015
through
11-7 (Wi
12/31/2015
1. Type of Recipient Committee: All committees — complete Parts 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Committee ® Primarily Formed Ballot Measure
O State Candidate Election Committee Committee
O Recall O Controlled
(aso complete rats) O Sponsored
(aso Cw*M Pat B)
❑ General Purpose Committee
O Sponsored ❑ Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee
O Political Party /Central Committee (4- C—plete Part 7)
3. Committee Information
NAME IF NO COMMITTEE)
Gilroy Citizens Opposing Measure F
I.D. NUMBER
1372023
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE /PHONE
OPTIONAL: FAX/ E -MAIL ADDRESS
4. Verification
COVER PAGE
Stamp
Date of election if applicabl `�N2 TFor 77-7
(Month, Day, Year) 6 �%6 Official Use Only
2. Type of Statement:
❑ Preelection Statement ❑ Quarterly Statement
Semi - annual Statement ❑ Special Odd -Year Report
Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Harvey Blodgett
MAILING ADDRESS
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX/ E -MAIL ADDRESS
I have used all reasonable diligence in preparing and reviewing this statement and to
Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAL/ BUSINESSADDRESS (NO.ANDSTREET) CITY STATE ZIP
Related Committees Not Included in this Statement: List any committees
not included in this statement that are controlled by you or are primarily formed to receive
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE . ZIP CODE AREA CODE /PHONE
COVER PAGE - PART 2
Page 2- of 13
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
City of Gilroy Safety & Quality of Life Measure
OFFICE SOUGHT OR HELD
BALLOT NO. OR'LETTER
F
JURISDICTION
I Gilroy
❑ SUPPORT
I� OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
❑ OPPOSE
OFFICE SOUGHT OR HELD
DISTRICT NO. IF ANY
7. Primarily Formed Candidate /Officeholder Committee List names of
officeholder(s) or candidate(s) for which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
El OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
Amounts may be rounded
to whole dollars.
Statement covers period
from 7/1/2015
SUMMARY PAGE
SEE INSTRUCTIONS ON REVERSE
6. Payments Made ................................. ...............................
Schedule E, Line 4 $ 109.43 $ 249.43
through
12/31/2015
Page 3 of 13
NAME OF FILER
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line
10. Nonmonetary Adjustment .......................... ...............................
Schedule C, Line 3
I.D. NUMBER
11
acrtZe, -4S (J car,
�/�enS�r�
1372023
Contributions Received
olum
ColuDmn B
Calendar Year Summary for Candidates
To loo
(FROM ATTACHED SCHEDULES)
YEAR
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions .................... ...............................
Schedule A, Linea $
30.00 $
30.00
1/1 through 6130 711 to Date
2. Loans Received ................................. ...............................
Schedule s, Line 3
30.00
30.00
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines 1 +2 $
$
Received $ $
4. Nonmonetary Contributions ............. ...............................
Schedule C, Line 3
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ....................................
Add Lines 3 +4 $
30.00 $
30.00
Made $ $
Expenditures Made
6. Payments Made ................................. ...............................
Schedule E, Line 4 $ 109.43 $ 249.43
7. Loans Made ........................................ ...............................
Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS ........... ...............................
Add Lines 6+ 7 $ 109.43 $ 249.43
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line
10. Nonmonetary Adjustment .......................... ...............................
Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ......... ...............................
Add Lines 8 + 9 + 10 $ 109.43 $ 249.43
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 79.43
13. Cash Receipts ............................ ............................... Column A, Line 3 above 30.00
14. Miscellaneous Increases to Cash ... ............................... Schedule 1, Line 4 0
15. Cash Payments .......................... ............................... Column A, Line 8 above 109.43
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 0
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED . ............................... schedule 8, Part $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................. ............................... See instructions on reverse $ 0
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0
To calculate Column B,
add amounts in Column
A to the corresponding
amounts from Column B
of your last report. Some
amounts in Column A may
be negative figures that
should be subtracted from
previous period amounts. If
this is the first report being
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
any).
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(if Subject to Voluntary Expenditure Llmlt)
Date of Election Total to Date
(mm/dd/yy)
I $
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Schedule A Amounts may be rounded
Monetary Contributions Received to whole dollars.
Statement covers period
from 7/1/2015
SCHEDULE A
SUBTOTAL$
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.) ........................................................................... ..............................$
2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ......................TOTAL $
30.00
30.00
0
30.00
"Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
through 12/31/2015
Page 4 of 13
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
1372023
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF - EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
VI IND
8/11/2015
Harvey Blodgett
Co
Banker
$30.00
$30.00
El PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.) ........................................................................... ..............................$
2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ......................TOTAL $
30.00
30.00
0
30.00
"Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Amounts may be rounded SCHEDULE B - PART 1
Schedule B — Part 1
to whole dollars. Statement covers period - +
Loans Received 7/1/2015 - '0
from .
SEE INSTRUCTIONS ON REVERSE through 12/31/2015 Page 5 of 13
NAME,OF FILER
I.D. NUMBER
1372023
FULL NAME, STREETADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
AMOUNT
(N
AMOUNT PAID
OUTSTANDING
INTEREST
ORIGINAL
CUMULATIVE
OF LENDER
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF - EMPLOYED, ENTER
BALANCE
BEGINNING THIS
RECEIVED THIS
OR FORGIVEN
BALANCEAT
CLOSE OF THIS
PAID THIS
AMOUNT OF
CONTRIBUTIONS
NAME OF BUSINESS)
PERIOD
PERIOD
THIS PERIOD'
PERIOD
PERIOD
LOAN
TO DATE
-
❑ PAID
CALENDAR YEAR
El FORGIVEN FORGIVEN
PER ELECTION"
t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
S
S
S
S
DATE INCURRED
S
DATE DUE
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION"
RATE
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
S
S
S
S
DATE DUE
_
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION-
RATE
1E:1 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
S
S
S
S
S
DATE DUE
DATE INCURRED
SUBTOTALS $ $ $ $
-`
Schedule B Summary
1. Loans received this period ...................................................................................... ..............................$ In
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period ........................................................................... ..............................$ . n
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from: Line 1.) ............................... ............................... NET $
Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number)
'Amounts forgiven or paid by another party also must be reported' on Schedule A.
• If required.
(Enter (e) on
Schedule E. Line 3)
tContributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small, Contributor Committee
FPPC Form 460 (Jan /2016)
FPPC Advice: advice@fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
SCHEDULE B - PART 2
ounwou1@ 13 — rarT L M111VU11LU 1114y o@ rounuvu
to whole dollars.
Loan Guarantors
Statement covers period
from 7/1/2015
o
• '
SEE INSTRUCTIONS ON REVERSE
through 12/31/2015
page 6 of 13
NAME OF FILER
I.D. NUMBER
11372023
FULL NAME, STREETADDRESS AND
ZIP CODE OF GUARANTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CONTRIBUTOR
CODE
WAN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF - EMPLOYED, ENTER
NAME OF BUSINESS)
LOAN
AMOUNT
GUARANTEED
THIS PERIOD
CUMULATIVE
TO DATE
BALANCE
OUTSTANDING
TO DATE
El
LENDER
CALENDAR YEAR
❑ COM
s
DATE
❑ OTH
PER ELECTION
(IF REQUIRED)
❑ PTY
❑ SCC
s
CALENDAR YEAR
❑ IND
LENDER
❑ COM
s
❑ OTH
PER ELECTION
(IF REQUIRED)
DATE
❑ PTY
❑ SCC
s
❑ IND
LENDER
CALENDAR YEAR
❑ COM
$
❑ OTH
PER ELECTION
(IF REQUIRED)
DATE
❑ PTY
El SCC
❑ IND
LENDER
CALENDAR YEAR
❑ COM
$
DATE
El OTH
PER ELECTION
(IF REQUIRED)
❑'PTY
❑ SCC
$
Enter on
SUBTOTAL $ 0 Summary Page,
Line 17 only.
-
d ,
y
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Schedule C Amounts may be rounded
SCHEDULE C
Nonmonetary Contributions Received Lo W11010 u011ars.
Statement covers period
CALIFORNIA
from 7/1/2015
FORM
SEE INSTRUCTIONS ON REVERSE
through 12/31/2015
Page 7 of 13
NAME OF FILER
I.D. NUMBER
1372023
DATE
FULL NAME, STREET ADDRESS AND
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
DESCRIPTION OF
AMOUNT/
CUMULATIVE TO
DATE
PER ELECTION
RECEIVED
ZIP CODE OF CONTRIBUTOR
CODE *
OCCUPATION AND EMPLOYER
(IF SELF - EMPLOYED, ENTER
GOODS OR SERVICES
FAIR MARKET
VALUE
CALENDAR YEAR
TO DATE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
NAME.OF BUSINESS)
(JAN 1 - DEC 31)
(IF REQUIRED)
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
--
- - --
❑ COM
❑ OTH
❑ PTY
❑ SCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Schedule C Summary
Amount received this period — itemized nonmonetary contributions.
(Include all Schedule C subtotals.) ........................................................................................ ..............................$
2. Amount received this period — unitemized nonmonetary contributions of less than $100 .... ..............................$
3. Total nonmonetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) .....................TOTAL $
"Contributor Codes
IND — Individual
0 COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
0
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Schedule D
SCHEDULE D
QU11111101 y UI GAPV1IUI LU1 tP5 ♦amounts may oe rounaea
Statement covers period
Supporting /Opposing Other to whole dollars.
_
'
Candidates, Measures and Committees
from 7/1/2015
I
••
SEE INSTRUCTIONS ON REVERSE
through 12/31/2015
page 8 of 13
NAME OF FILER
I.D. NUMBER
1372023
DATE
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION,
TYPE OF PAYMENT
DESCRIPTION
AMOUNT THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
OR COMMITTEE
(IF REQUIRED)
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
SUBTOTAL $
Schedule D Summary
1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ........................ ............................... $
2. Unitemized contributions and independent expenditures made this period of under $ 100 ..................................................... ............................... $
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL.. $
FPPC Form 460 Elan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Amounts may be rounded
to whole dollars.
Statement covers period
from 7/1/2015
through 12/31/2015
6Yy7I�1�Jg��
Page 9 of 13
NAME OF FILER }
1I.D. NUMBER
U (ts Dr c tt;z -0-4s y— 372023
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalia /misc.
MBR
member communications
RAID
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)"
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing /ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff /spouse travel, lodging, and meals
IND
independent expenditure supporting /opposing others (explain)'
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate /sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
GILPAC
7471 Monterey Street
Gilroy, CA 95020
CTB
Donation
$94.43
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) . ............................... 94.43
2. Unitemized payments made this period of under $ 100 ........................................................................................................... ............................... $ 15.00
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column ( e).) .............................................. ............................... $ 0
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ 109.43
FPPC Form 460 (Jan /2016)
FPPC Advice: advice@fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Schedule F Amounts may be rounded
Accrued Expenses (Unpaid Bills) to whole dollars.
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 7/1/2015
through 12/3112015
SCHEDULE F
Page 10 Of 13
I.D. NUMBER
1372023
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalia/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)*
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
Lv. or cable airtime and production costs
FIL
candidate filing /ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff /spouse travel; lodging, and meals
IND
independent expenditure supporting/opposing others (explain)*
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate /sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (intemet, e-mail)
NAME AND ADDRESS OF CREDITOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR
DESCRIPTION OF PAYMENT
(a)
OUTSTANDING
BALANCE BEGINNING
OF THIS PERIOD
(b)
AMOUNT INCURRED
THIS PERIOD
(c)
AMOUNT PAID
THIS PERIOD
(ALSO REPORT ON E)
(d)
OUTSTANDING
BALANCEAT CLOSE
OF THIS PERIOD
* Payments that are contributions or independent expenditures must also be SUBTOTALS $
summarized on Schedule D. $ 0 $ 0 $ 0
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ....................... .......................INCURRED TOTALS $
2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on
accrued expenses of $100 or more, plus total Lin itemized payments on accrued expenses under $ 100.) .... ............................... PAID TOTALS $
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
onthe Summary Page, Column A, Line 9.) ......... ....................... ......................................................................................................... ............................... NET $ 0
May be a negative number
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Schedule G
SCHEDULE G
Payments Made by an Agent or Independent
Amounts may be rounded
Statement covers period I CALIFORNIA
Contractor (on Behalf of This Committee)
to whole dollars.
from 7/1/2015 .. • .1
through 12/31/2015 Page 11 Of 13
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
1372023
NAME OF AGENT OR INDEPENDENT CONTRACTOR
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia /misc.
MBR
member communications
RAD radio airtime and production costs
CNS campaign consultants
MTG
meetings and appearances
RFD returned contributions
CTB contribution (explain nonmonetary)•
OFC
office expenses
SAL campaign workers' salaries
CVC civic donations
PET
petition circulating
TEL Lv. or cable airtime and production costs
FIL candidate filing /ballot fees
PHO
phone banks
TRC candidate travel, lodging, and meals
FND fundraising events
POL
polling and survey research
TRS staff /spouse travel, lodging, and meals
IND independent expenditure supporting /opposing others (explain)'
POS
postage, delivery and messenger services
TSF transfer between committees of the same candidate /sponsor
LEG legal defense
PRO
professional services (legal, accounting)
VOT voter registration
LIT campaign literature and mailings
PRT
print ads
WEB information technology costs (internal, e-maiq
" Payments that are contributions or independent expenditures must also be summarized on Schedule D.
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
I CODE OR
DESCRIPTION OF PAYMENT
AMOUNT PAID
D
Attach additional information on appropriately labeled continuation sheets. TOTAL" $ 0
Do not transfer to any other schedule or to the Summary Page. This total may not• equal the amount paid to the agent or FPPC Form 460 (Jan /2016)
independent contractor as reported on Schedule E. FPPC Advice: advice@fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
SCHEDULE H
Schedule H Amounts may be rounded
Statement covers period
Loans Made to Others* to whole dollars.
7/1/2015
. OF
from
12/31/2015
12
SEE INSTRUCTIONS ON REVERSE
through --
Page - of
NAME OF FILER
I.D. NUMBER
1372023
FULL NAME, STREETADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
(b)
AMOUNT
(c)
REPAYMENT OR
(d)
OUTSTANDING
(e)
INTEREST
(t)
ORIGINAL
(g)
CUMULATIVE
OF RECIPIENT
(1F COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF- EMPLOYED, ENTER
BALANCE
BEGINNING THIS
LOANED THIS
FORGIVENESS
BALANCE AT
CLOSE OF THIS
RECEIVED
AMOUNTOF
LOANS
NAME OF BUSINESS)
OD
PERIOD
THIS PERIOD
PERIOD
LOAN
TO DATE
❑ PAID
CALENDAR YEAR
s
s
x
s
s
PER ELECTION'
❑ FORGIVEN
RATE
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
--
PER ELECTION"
❑ FORGIVEN
RATE
S
$
$
$
S
-_- -
DATE DUE
DATE INCURRED
"Loans that are contributions to another candidate or committee must
-
"jam
also be summarized on Schedule D. Loans forgiven must also be
33
reported on Schedule E. SUBTOTALS
$
-t
(Enter (a) on
Schedule I, Line 3)
Schedule H Summary
Loansmade this period ...................................................................................................................... ..............................$ n
(Total Column (b) plus unitemized loans of less than $100.) —If Required
2. Payments received on loans .............................................................................................................. ..............................$ n
(Total Column (c) plus unitemized payments of less than $100.)
3. Net change this period. (Subtract Line 2 from Line 1.) ............................................................. ............................... NET $ - n
(Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number)
FPPC Form 460 (Jan /2016)
FPPC Advice: advice@fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Schedule I
SCHEDULEI
Miscellaneous Increases to Cash to whole dollars.
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 7/1/2015
through 12/31/2015
,
. 1
• '
page 13 of 13
NAME OF FILER
I.D. NUMBER
1372023
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE. ALSO ENTER I.D. NUMBER)
DESCRIPTION OF RECEIPT
AMOUNT OF
INCREASE TO CASH
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
1. Itemized increases to cash this period .............................................................................................. ..............................$
2. Unitemized increases to cash of under $100 this period ................................................................... ..............................$
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ......... ..............................$
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
SummaryPage, Line 14.) .............................................................................................. ............................... TOTAL $
SUBTOTAL$
ON
I
FPPC Form 460 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov