Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Size: px
Start display at page:

Download "Recipient Committee Campaign Statement Cover Page (Government Code Sections )"

Transcription

1 Recipient Committee Campaign Statement Cover Page (Government Code Sections ) E-filed on: 10/04/ :29:21 Date of election if applicable: (Month, Day, Year) Date Stamp FORM Page 1 of 9 For Official Use Only COVER PAGE /05/ Type of Recipient Committee: All Committees Complete Parts 1, 2, 3, and 4. X Officeholder, Candidate Controlled Committee State Candidate Election Committee Recall (Also Complete Part 5) General Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee COMMITTEE NAME (OR CANDIDATE S NAME IF NO COMMITTEE) 3. Committee Information Primarily Formed Ballot Measure Committee Controlled Sponsored (Also Complete Part 6) Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 2. Type of Statement: X Preelection Statement Semi-annual Statement Termination Statement (Also file a Form 410 Termination) Amendment (Explain below) Treasurer(s) NAME OF TREASURER Nancy R Haley MAILING ADDRESS Quarterly Statement Special Odd-Year Report Supplemental Preelection Statement - Attach Form 495 STREET ADDRESS (NO P.O. BOX) San Diego CA (858) MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX (760) NAME OF ASSISTANT TREASURER, IF ANY Robin Stephen MAILING ADDRESS OPTIONAL: FAX / ADDRESS OPTIONAL: FAX / ADDRESS nhaley@thinkcpa.com 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on Date By Signature of Treasurer or Assistant Treasurer Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent State of California

2 Recipient Committee Campaign Statement Cover Page Part 2 COVER PAGE - PART 2 FORM 460 Page 2 of 9 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Marti Emerald (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member City of San Diego District: 9 RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Diego CA BALLOT NO. OR LETTER JURISDICTION Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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. DISTRICT NO. IF ANY COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS CONTROLLED COMMITTEE? YES NO STREET ADDRESS (NO P.O. BOX) 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS CONTROLLED COMMITTEE? YES NO STREET ADDRESS (NO P.O. BOX) Attach continuation sheets if necessary State of California

3 Campaign Disclosure Statement Summary Page FORM SUMMARY PAGE 460 Page 3 of 9 s Received 1. Monetary s... Schedule A, Line 3 $ $ $40, Loans Received... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS... Add Lines $ $ $40, Nonmonetary s... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED... Add Lines $ $ $40, Expenditures Made 6. Payments Made... Schedule E, Line 4 $ $19, $ $84, Loans Made... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS... Add Lines $ $19, $ $84, Accrued Expenses (Unpaid Bills)... Schedule F, Line Nonmonetary Adjustment... Schedule C, Line 3 Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) Column B CALENDAR YEAR TOTAL TO DATE -$2, TOTAL EXPENDITURES MADE...Add Lines $ $17, $ $84, Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 6/30 7/1 to Date 20. s Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) / / $ Total to Date Current Cash Statement 12. Beginning Cash Balance... Previous Summary Page, Line 16 $ 13. Cash Receipts... Column A, Line 3 above 14. Miscellaneous Increases to Cash... Schedule I, Line Cash Payments... Column A, Line 8 above 16. ENDING CASH BALANCE... Add Lines , then subtract Line 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED... Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents... See instructions on reverse $ $19, $19, To calculate Column B, add amounts in Column A to the corresponding amounts Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts Lines 2, 7, and 9 (if any). / / *Amounts in this section may be different amounts reported in Column B. $ 19. Outstanding Debts... Add Line 2 + Line 9 in Column B above $

4 Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SCHEDULE D Page 4 of 9 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE San Diego County Democratic Party TYPE OF PAYMENT X Monetary DESCRIPTION (IF REQUIRED) to support San Diego County Democratic Party AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) $13, $13, $13, P-12 Nonmonetary X Support Oppose Independent Expenditure Support Support Oppose Oppose Monetary Nonmonetary Independent Expenditure Monetary Nonmonetary Independent Expenditure SUBTOTAL $ $13, 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 $ $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.)... TOTAL $ $13, $13,300.00

5 Schedule E Payments Made SCHEDULE E Page 5 of 9 NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ) CompleteCampaigns.com a div. of Aristotle Internat'l. Inc. CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID WEB $9.18 Washington DC CompleteCampaigns.com a div. of Aristotle Internat'l. Inc. OFC $ Washington DC CompleteCampaigns.com a div. of Aristotle Internat'l. Inc. OFC $ Washington DC * 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.)... $ 2. Unitemized payments made this period of under $ $ 3. Total interest paid this period on loans. (Enter amount Schedule B, Part 1, Column (e).)... $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)... TOTAL $ $19, $19,788.00

6 Schedule E (Continuation Sheet) Payments Made SCHEDULE E (CONT.) Page 6 of 9 NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ) CompleteCampaigns.com a div. of Aristotle Internat'l. Inc. CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID OFC $ Washington DC KM Strategies CNS $ San Diego CA San Diego County Democratic Party (#741906) CTB Monetary : to support San Diego County Democratic Party $13, San Diego CA Scott & Cronin LLP PRO $1, Scott & Cronin LLP PRO $1, * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ $17,603.22

7 Schedule E (Continuation Sheet) Payments Made SCHEDULE E (CONT.) Page 7 of 9 Scott & Cronin LLP NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID PRO $ Donald J. Mullen MTG See Sch. G $ San Diego CA * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ $1,675.60

8 Schedule F Accrued Expenses (Unpaid Bills) SCHEDULE F Page 8 of 9 KM Strategies NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER ) (a) (b) (c) (d) CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD CNS $ $ San Diego CA Scott & Cronin LLP PRO $1, $1, * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS $ $2, $ $ $2, $ 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 unitemized payments on accrued expenses under $100.)...PAID TOTALS $ 3. Net change this period. (Subtract Line 2 Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.)... NET $ $2, $2, May be a negative number

9 Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) SCHEDULE G NAME OF AGENT OR INDEPENDENT CONTRACTOR Donald Mullen Page 9 of 9 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Humphrey's NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID MTG Campaign Victory Brunch wcandidate +15 Supporters $ San Diego CA Attach additional information on appropriately labeled continuation sheets. TOTAL* $ $ * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E.

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Date of election if applicable: (Month, Day, Year) Date Stamp FORM Page 1 of 12 For Official Use Only COVER PAGE

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) through of election if applicable: (Month, Day, Year) 09/22/ 11/06/ Stamp E-Filed 09/27/ 15:58:41 Filing ID: 173949065

More information

Recipient Committee Campaign Statement (Government Code Sections )

Recipient Committee Campaign Statement (Government Code Sections ) Recipient Committee Campaign Statement (Government Code Sections 84200-84216.5) Date Stamp COVER PAGE 2001/02 FORM 460 Date of election if applicable: (Month, Day, Year) Page 1 of 15 For Official Use Only

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Statement covers period

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Statement covers period Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Date of election if applicable: (Month, Day, Year) Date Stamp E-Filed 08/07/2017 11:25:58 Filing ID: 165607327

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Date of election if applicable: (Month, Day, Year) 06/07/2016 Date Stamp E-Filed 02/17/2016 16:46:26 Filing ID:

More information

Recipient Committee Campaign Statement (Government Code Sections )

Recipient Committee Campaign Statement (Government Code Sections ) Recipient Committee Campaign Statement (Government Code Sections 84200-84216.5) Date Stamp COVER PAGE 2001/02 FORM 460 Date of election if applicable: (Month, Day, Year) Page 1 of 20 For Official Use Only

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Date of election if applicable: (Month, Day, Year) 11/06/2018 Date Stamp E-Filed 09/26/2018 15:00:24 Filing ID:

More information

Use the Form 460 to file any of the following:

Use the Form 460 to file any of the following: Recipient Committee Campaign Statement FORM 460 The Form 460 is for use by ALL recipient committees, including: Candidates, Officeholders and Their Controlled Committees A candidate or ficeholder who has

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Statement covers period

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Statement covers period Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Date of election if applicable: (Month, Day, Year) Date Stamp E-Filed 07/25/2017 11:18:04 Filing ID: 165485987

More information

Use the Form 460 to file any of the following:

Use the Form 460 to file any of the following: Recipient Committee 460 Campaign Statement FORM The Form 460 is for use by ALL recipient committees, including: Candidates, Officeholders and Their Controlled Committees A candidate or ficeholder who has

More information

Type or print in ink. (Month, Day, Year) from 10/18/2015. termination 11/03/2015. Treasurer(s) I NAME OF TREASURER Diet Stroeh MAILING ADDRESS

Type or print in ink. (Month, Day, Year) from 10/18/2015. termination 11/03/2015. Treasurer(s) I NAME OF TREASURER Diet Stroeh MAILING ADDRESS Cover Attach Recipient Committee Campaign Statement (Government Code Sections 842-8421 6.5) Date Stamp RECEIVED Date election if applicable OtT 2 9 215 1/18/215 (Month, Day, Year) termination 11/3/215

More information

0 Political Party/ Central Committee

0 Political Party/ Central Committee COVER PAGE Stamp SEE INSTRUCTIONS ON REVERSE I Statement covers period 1. Type Recipient Committee: All Committees Complete Parts 1, 2, 3, and 4. April 1, 2018 d Officeholder, Candidate Controlled Committee

More information

be subject to contribution limits imposed by local ordinance. Questions concerning local limits purpose of making contributions to candidates

be subject to contribution limits imposed by local ordinance. Questions concerning local limits purpose of making contributions to candidates Recipient Committee Campaign Statement The Form 460 is for use by ALL recipient committees, including: Candidates, Officeholders and Their Controlled Committees A candidate or offi ceholder who has a controlled

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Date of election if applicable: (Month, Day, Year) 11/06/2018 Date Stamp E-Filed 10/23/2018

More information

2. 11 F) r ~;t,z:, r (t;

2. 11 F) r ~;t,z:, r (t; Recipient Committee Campaign Statement Cover Page Date Stamp COVER PAGE through 12/31/2015 Date of election if applicable: (Month, Day, Year) FIB I b 3: SS 1. Type of Recipient Committee: AU Committees

More information

Date of Election if applicable: (Month, Day, Year) 12/31/2011. Treasurer(s) NAME OF TREASURER Mary Ellen Padilla MAILING ADDRESS MAILING ADDRESS

Date of Election if applicable: (Month, Day, Year) 12/31/2011. Treasurer(s) NAME OF TREASURER Mary Ellen Padilla MAILING ADDRESS MAILING ADDRESS ..., Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) from 07/01/2011 through 12/31/2011 1. Type of Recipient Committee: li2f Officeholder, Candidate Controlled

More information

411 D. Recipient Committee Campaign Statement Cover Page. D Primarily Formed Candidate/ Officeholder Committee (Also Complete Pett 7) 17'0~M

411 D. Recipient Committee Campaign Statement Cover Page. D Primarily Formed Candidate/ Officeholder Committee (Also Complete Pett 7) 17'0~M Recipient Committee Campaign Statement Cover Page from 1/1/216 of election if applicable: (Month, Day, Year) Stamp ZS Alfililfi'!RfiJI~ 17'~M 411 D COVER PAGE BB Page : of _7 _ For Official Use Only through

More information

Use the Form 460 to file any of the following:

Use the Form 460 to file any of the following: Recipient Committee Campaign Statement FORM 460 The Form 460 is for use by ALL recipient committees, including: Candidates, Officeholders and Their Controlled Committees A candidate or ficeholder who has

More information

Note: Refer to the Statement of Organization, Form 410, for guidance to determine the type of committee.

Note: Refer to the Statement of Organization, Form 410, for guidance to determine the type of committee. Recipient Committee Campaign Statement FORM 460 The Form 460 is for use by ALL recipient committees, including: Candidates, Officeholders and Their Controlled Committees A candidate or fi ceholder who

More information

o Sponsored (Also Complete Pert 6) o Primarily Formed Candidate! Officeholder Committee (Also Complete Part 7)

o Sponsored (Also Complete Pert 6) o Primarily Formed Candidate! Officeholder Committee (Also Complete Part 7) Recipient Committee Campaign Statement Cover Page from 7/1118 of election if applicab1e: (Month, ay, Year) Stamp COVER PAGE Page of 7 For Official Use Only through 9/22/18 November 6, 2018 1. Type of Recipient

More information

Type or print in ink. Date of election if applicable: (Month, Day, Yegp.q vill. Jun 30, Treasurer(s) NAME OF TREASURER David Whittum

Type or print in ink. Date of election if applicable: (Month, Day, Yegp.q vill. Jun 30, Treasurer(s) NAME OF TREASURER David Whittum RecipiL-, it Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Statement covers period Date of election if applicable: (Month, Day, Yegp.q vill 31 P tr: 3 Ll For Official

More information

i: T r ~ 1 (~. ~ l~ () r\ ~ :~-~ ~ ;

i: T r ~ 1 (~. ~ l~ () r\ ~ :~-~ ~ ; Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) from 02/20/2011 through 0 3 / 0 2/2 0 11 1. Type of Recipient Committee: GZl Officeholder, Candidate Controlled

More information

06/05/2018. [il. Treasurer( s) Stacy Owens MAILING ADDRESS CITY AREA CODE/PHONE. Peter Sullivan MAILING ADDRESS AREA CODE/PHONE CITY

06/05/2018. [il. Treasurer( s) Stacy Owens MAILING ADDRESS CITY AREA CODE/PHONE. Peter Sullivan MAILING ADDRESS AREA CODE/PHONE CITY COVER PAGE Recipient Committee Campaign Statement Cover Page Date Stamp (Government Code Sections 84200-84216.5) Statement overs period / -~ - - - from --+--+-through 1. Type of Recipient Committee: 1K]

More information

Recipient Committee Campaign Statement (Government Code Sections )

Recipient Committee Campaign Statement (Government Code Sections ) Recipient Committee Campaign Statement (Government Code Sections 84200-84216.5) Date Stamp COVER PAGE 2001/02 FORM 460 Date of election if applicable: (Month, Day, Year) Page 1 of 31 For Official Use Only

More information

o Sponsored Small Contributor Committee

o Sponsored Small Contributor Committee Recipient Committee Campaign Statement Cover Page Statement covers period from 07/01/2017 Date of Election if dpphcd 01 (Month, Day, Year) E g cio Datamp CL) CO w CO Page 1 of7 COVER PAGE tu1mn21 A I 03

More information

Recipient Committee Campaign Statement (Government Code Sections )

Recipient Committee Campaign Statement (Government Code Sections ) Recipient Committee Campaign Statement (Government Code Sections 84200-84216.5) Date Stamp COVER PAGE 2001/02 FORM 460 Date of election if applicable: (Month, Day, Year) Page 1 of 63 For Official Use Only

More information

Type or print In Ink. I.D.NUMBER Treasurer(s) NAME OF TREASURER Kelly Lawler MAILING ADDRESS MAILING ADDRESS

Type or print In Ink. I.D.NUMBER Treasurer(s) NAME OF TREASURER Kelly Lawler MAILING ADDRESS MAILING ADDRESS Recipient Committee Campaign Statement (Government Code Sections 84200-84216.5) COpy from 10/30/2008 Type or print In Ink. Date of election If applicable: (Month, Day, Year) Date Stamp RECEIVED FEB 0 r;

More information

LOS ANGElES CITy ETHICS COMMISSION MAY Date Stamp.OS ANGELES Cl ~~~:::;---,--:::-:---:-:-----_2THICSC0NMISSI01\ 1 Statement r;overs period

LOS ANGElES CITy ETHICS COMMISSION MAY Date Stamp.OS ANGELES Cl ~~~:::;---,--:::-:---:-:-----_2THICSC0NMISSI01\ 1 Statement r;overs period Recipient Committee Campaign Statement Cover Page LOS ANGElES CITy ETHICS COMMISSION MAY 0 3 2013 RECEIVED Date Stamp OS ANGELES Cl ~~~:::;---,--:::-:---:-:-----_2THICSC0NMISSI01\ 1 Statement r;overs period

More information

o Amendment (Explain below)

o Amendment (Explain below) Recipient Committee Campaign Statement Cover Page (Govemment Code Sections 84200-84216.5) Type or print in ink. Statement covers period of election if applicable: (Month, Day, Year) Stamp COVER PAGE CALFORNA

More information

Type or print In Ink. (Month, Day, Year) from 07/01/2014. Treasurer(s) NAME OF TREASURER Felipe Fuentes MAILING ADDRESS AREA CODE/PHONE

Type or print In Ink. (Month, Day, Year) from 07/01/2014. Treasurer(s) NAME OF TREASURER Felipe Fuentes MAILING ADDRESS AREA CODE/PHONE . '.,. Recipient Committee Campaign Statement (Government Code Sections 84200-84216.5) Type or print In Ink. Date of election If applicable: (Month, Day, Year) from 07/01/2014 Date Stamp... COVER PAGE

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Date of election if applicable: (Month, Day, Year) 11/06/2018 Date Stamp E-Filed 09/25/2018

More information

Cover Page Government Code Sections

Cover Page Government Code Sections y w e ptit Recipient om ee Campa Statement Cover Page Government Code Sections 84200 84216 5 l or print Statement corers period in ink o election ifs Month DaY p Icable far Stamp W Page o For Officia Use

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 842-64216.5) Date Stamp COVER PAGE ( \I II ()J{'\1 \ 46 I'OIUI l ot 11 Dale of Election "applicable: A For Official Use Only

More information

!.03 1.HGELES COUNT' Page 1e (_ t'o'' I (Month, Day, Year) Lu I u Y - P i~ ~ : Q2 For Official Use Only

!.03 1.HGELES COUNT' Page 1e (_ t'o'' I (Month, Day, Year) Lu I u Y - P i~ ~ : Q2 For Official Use Only '. i Recipient Committee Campaign Statement Cover Page January 1, 2016 from October 22, 2016 through--------- 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. D Officeholder,

More information

Type or print in ink. Date of election if applicable: 151('Semi-annual Statement. tj Termination Slatement (Also file a Form 4 10 Termination)

Type or print in ink. Date of election if applicable: 151('Semi-annual Statement. tj Termination Slatement (Also file a Form 4 10 Termination) .' tiecipientcommiuee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE lejcopy Statement covers peri7 0d from /-1..- L!.._ throu 3D" /1 Date of election

More information

Date of election if applicable: Month, Day, Year) 2. Type of Statement: Preelection Statement. P Semi - annual Statement.

Date of election if applicable: Month, Day, Year) 2. Type of Statement: Preelection Statement. P Semi - annual Statement. Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period Date of election if applicable: Month, Day, Year) 11/ 6/ 18 Date Stamp keec- r V JAN 3120171 CITY CLERK

More information

C CE V ED Statement covets pet-iou Date of election if applicalle yf i (Month, Day, Year) Treasurer(s) MAILING ADDRESS

C CE V ED Statement covets pet-iou Date of election if applicalle yf i (Month, Day, Year) Treasurer(s) MAILING ADDRESS Recipient Committee Date Stamp Campaign Statement Cover Page (Government Code Sections 84200-84216.5) C CE V ED Statement covets pet-iou Date of election if applicalle yf i (Month, Day, Year) (pr* Page

More information

1121 Preelection Statement D. Treasurer(s) Ryan Luther CITY. San Francisco AREA CODE/PHONE MAILING ADDRESS AREA CODE/PHONE CITY

1121 Preelection Statement D. Treasurer(s) Ryan Luther CITY. San Francisco AREA CODE/PHONE MAILING ADDRESS AREA CODE/PHONE CITY Recipient Committee Campaign Statement Cover Page )lt:f~o from 7/1/216. 9/24/216 1. Type of Recipient Committee: All Committees- Complete Parts 1, 2, 3, and 4. State Candidate Election Committee Recall

More information

Date of election if applicable ~ (Month, Day, Year) 711/17 12/31/17. Treasurer(s) NAME OF TREASURER CITY MAILING ADDRESS

Date of election if applicable ~ (Month, Day, Year) 711/17 12/31/17. Treasurer(s) NAME OF TREASURER CITY MAILING ADDRESS ~ecip,ient Cmmittee Campaign Statement Cver Page Date f electin if applicable ~ (Mnth, Day, Year) frm thrugh 1. Type f Recipient Cmmittee: I!lI 12/31/17 2. Type f Statement: All Cmmittees - Cmplete Parts

More information

Type or print in ink. Date of election if applicable: (Month. Dav. Year) Statement covers period 11/4/2014. Treasurer(s)

Type or print in ink. Date of election if applicable: (Month. Dav. Year) Statement covers period 11/4/2014. Treasurer(s) Recipient Committee Campaign Statement Cover Page (Goverment Code Sections 84200-84216.5) Type or print in ink from 711/2 014 Date of election if applicable: (Month. Dav. Year) Date Stamp CALIFORNIA 2001/02

More information

Recipient Committee Campaign Statement (Government Code Sections )

Recipient Committee Campaign Statement (Government Code Sections ) Recipient Committee Campaign Statement (Government Code Sections 84200-84216.5) Date Stamp COVER PAGE CALIFORNIA 2001/02 460 Date of election if applicable: (Month, Day, Year) Page 1 of 24 For Official

More information

Recipient Committee Campaign Statement Cover Page (Government Code Sections )

Recipient Committee Campaign Statement Cover Page (Government Code Sections ) Recipient Committee Campaign Statement Cover Page (Government Code Sections 8420084216.5) Type or print in ink Date Stamp 2001/02 FORM COVER PAGE 460 d Through Date of election if applicable: (Month, Day,

More information

Recipient Committee Campaign Statement Cover Page

Recipient Committee Campaign Statement Cover Page Recipient Committee Campaign Statement Cover Page through Date of election if applicable: (Month, Day, Year) Date Stamp COVER PAGE Page 1 of For Official Use Only 30 1. Type of Recipient Committee: All

More information

Type or print in ink. o Amendment (Explain below) Treasurer(s) NAME OF TREASURER. Jim King MAILING ADDRESS CITY AREA CODE/PHONE MAILING ADDRESS

Type or print in ink. o Amendment (Explain below) Treasurer(s) NAME OF TREASURER. Jim King MAILING ADDRESS CITY AREA CODE/PHONE MAILING ADDRESS '. Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. from O_c_t_o_be_r_1..;.,_2_0_1_2_ through October 20,2012

More information

Date of election if applicable, (Month, Day, v f, July Dec Iii1! o. Treasurer(s) NAMt=OF-ffiEASURER MAILING ADDRESS CITY

Date of election if applicable, (Month, Day, v f, July Dec Iii1! o. Treasurer(s) NAMt=OF-ffiEASURER MAILING ADDRESS CITY Recipient Cmmittee Campaign Statement Cver Page I 1. Type f Recipient Cmmittee: frm July 1 2017 thrugh Dec 31 2017 Date f electin if applicable, (Mnth, Day, v f, '-11-- - - - - - - - - - ' 2. Type f Statement:

More information

BY---~~=-::~)~,.,;;:.

BY---~~=-::~)~,.,;;:. Recipient Committee Campaign Statement Cover Page (Government Code Sections 842-84216.5) from 1_/ 1 /_2_1_4 through 1_1_1_8/_2 14 Date of election if applicable: (Month, Day, Year) Nov.4,214 Date Stamp

More information

Type or print in ink. Jan 1, March 17,2008. IZI Preelection Statement. Treasurer(s) OF TREASURER (831)

Type or print in ink. Jan 1, March 17,2008. IZI Preelection Statement. Treasurer(s) OF TREASURER (831) Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE NSTRUCTONS ON REVERSE from Type or print in ink. Jan 1, 2008 March 17,2008 1. Type of Recipient Committee:

More information

CAMPAIGN FINANCE REPORT LOCAL COMMITTEES OF WISCONSIN

CAMPAIGN FINANCE REPORT LOCAL COMMITTEES OF WISCONSIN CAMPAIGN FINANCE REPORT LOCAL COMMITTEES OF WISCONSIN Is This Report an Amendment: Yes No Instructions for completing schedules are on the back of each schedule. COMMITTEE IDENTIFICATION Name of Committee

More information

Finance Checklist and GAB - Campaign Finance Overview Local Candidates

Finance Checklist and GAB - Campaign Finance Overview Local Candidates TOWN OF VERNON WAUKESHA COUNTY WISCONSIN 2018 Finance Checklist and GAB - Campaign Finance Overview Local Candidates (For additional resources and information please visit the Wisconsin Elections and Ethics

More information

Contents. Completing the CFA-4 Form Contributions Expenditures Debts Disband Important Items

Contents. Completing the CFA-4 Form Contributions Expenditures Debts Disband Important Items Disclosure The information in this presentation is designed to serve as a resource for completing campaign finance reports. It is not to be used for legal reference pertaining to Indiana campaign finance

More information

Date of Election if applicable 11/06/2012. (Month, Day, Year) Treasurer(s) NAME OF TREASURER C. April Boling, C.P.A. STREET ADDRESS CITY.

Date of Election if applicable 11/06/2012. (Month, Day, Year) Treasurer(s) NAME OF TREASURER C. April Boling, C.P.A. STREET ADDRESS CITY. Recipient Committee Campaign Statement Cover Page Date of Election if applicable 11/06/2012 (Month, Day, Year) DateStartik, 1 CLE'eS 12 OCT Jo C COVER PAGE CALIFORNIA FORM ff-t A 60 Page 1 of 17 y e For

More information

COUNTY EXECUTIVE COMMITTEE CAMPAIGN FINANCE REPORT

COUNTY EXECUTIVE COMMITTEE CAMPAIGN FINANCE REPORT COUNTY EXECUTIVE COMMITTEE CAMPAIGN FINANCE REPORT FORM CEC COVER SHEET PG 1 The CEC Instruction Guide explains how to complete this form. 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: 3 COMMITTEE

More information

Type or print in ink. Statement covers period. Treasurer(s) NAME OF TREASURER SARIT JUDGE MAILING ADDRESS CITY AREA CODE/PHONE MAILING ADDRESS

Type or print in ink. Statement covers period. Treasurer(s) NAME OF TREASURER SARIT JUDGE MAILING ADDRESS CITY AREA CODE/PHONE MAILING ADDRESS Recipient Cmmittee Campaign Statement Cver Page (Gvernment Cde Sectins 84200-84216.5) rm 7/1/13 f thrugh 12/31/13 f electin if applicable: (Mnth, ay, Year) Nv 2,2010 Stamp COVER PAGE I?[CE/VE. C!1r F Silli

More information

RECEIPTS AND EXPENDITURES QUARTERLY REPORT

RECEIPTS AND EXPENDITURES QUARTERLY REPORT RECEIPTS AND EXPENDITURES QUARTERLY REPORT NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION P.O. Box 185, Trenton, NJ 08625-0185 (609) 292-8700 or Toll Free Within NJ 1-888-313-ELEC (3532) www.elec.nj.gov

More information

STATE / COUNTY CHAIR SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT

STATE / COUNTY CHAIR SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT STATE / COUNTY CHAIR SPECIFIC- COMMITTEE CAMPAIGN FINANCE REPORT FORM SC SPAC COVER SHEET PG 1 The SC SPAC Instruction Guide explains how to complete this form. 1 Filer ID (Ethics Commission Filers) 2

More information

I from January 22, 2017

I from January 22, 2017 Recipient Committee Campaign Statement Cover Page Date of election if applicable:7 (Month, Day, Year) I from January 22, 2017 February 18, 2017 March 7,2017 through COVER PAGE Date Stamp ( ( EL/L I Page

More information

Instructions - Form R-1

Instructions - Form R-1 Instructions - Form R-1 Do not complete the front cover of the Form R-1 until all schedules are completed. Submit every schedule of the Form R-1 when filing the report. If there is no activity to report,

More information

CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For County, Municipal and School Board Candidates

CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For County, Municipal and School Board Candidates CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For County, Municipal and School Board Candidates Check if this report is an amendment This report should be filed with the County Clerk of the county in which

More information

CAMPAIGN FINANCIAL DISCLOSURE REPORT SUMMARY PAGE (Please Print or Type) City and Zip. City and Zip

CAMPAIGN FINANCIAL DISCLOSURE REPORT SUMMARY PAGE (Please Print or Type) City and Zip. City and Zip CAMPAIGN FINANCIAL DISCLOSURE REPORT SUMMARY PAGE (Please Print or Type) C-2 Rev. 10/07 Section I Name Candidate or Political Committee and Chairperson Offi ce Sought (if candidate) Seat (if any) Mailing

More information

Texas Ethics Commission P.O. Box Austin, Texas (512) (TDD )

Texas Ethics Commission P.O. Box Austin, Texas (512) (TDD ) MONTHLY FILING COUNTY EXECUTIVE COMMITTEE CAMPAIGN FINANCE REPORT FORM MCEC COVER SHEET PG 1 The MCEC Instruction Guide explains how to complete this form. 1 ACCOUNT # (Ethics Commission Filers) 2 Total

More information

Statement covers period Date of election if applicable: (Month 6/30/ /8/ Type of Statement: \i2l Preelection Statement.

Statement covers period Date of election if applicable: (Month 6/30/ /8/ Type of Statement: \i2l Preelection Statement. Recipient Cmmittee Campaign Statement Cver Page INSTRUCTIONS ON CLERK SEP 29 Statement cvers perid Date f electin if applicable: (Mnth 6/3/216 frm 1.4 9/ee,/216 11/8/216 thrugh 1. Type f Recipient Cmmittee:

More information

SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT

SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT FORM SPAC COVER SHEET PG 1 The SPAC Instruction Guide explains how to complete this form. 3 COMMITTEE NAME 1 Filer ID 2 Total pages filed: 8 FICE USE

More information

Type or print in ink. r r Type of Statement: D Preelection Statement. o Amendment (Explain below) Treasurer(s)

Type or print in ink. r r Type of Statement: D Preelection Statement. o Amendment (Explain below) Treasurer(s) Reci pient Comm ittee Campaign Statement Cover (Government Code Sections 84200-84216.5) r---------------r------------4 from JA_N_1-,-, -,2_0_16 Date of election if appllcab;lep (Month, Day, Year),, ' i'~

More information

Type or print in ink. (Month, Day, Year) For Official Use Only 07/01/ /19/ Treasurer(s) NAME OF TREASURER Trish Boorstein

Type or print in ink. (Month, Day, Year) For Official Use Only 07/01/ /19/ Treasurer(s) NAME OF TREASURER Trish Boorstein Recipient Committee Campaign Statement Covet Page RECEiVED (Government Code Sections 842-84216.5) SEP 2 4 3 Statement covets period Date of election if applicabic from 7/1/215 (Month, Day, Year) For Official

More information

Statement covers period. Date of election if applicable: (Month. Day, Year) 1/1/2017 4I 1I Preelection Statement Committee.

Statement covers period. Date of election if applicable: (Month. Day, Year) 1/1/2017 4I 1I Preelection Statement Committee. Recipient Campaign Statement Cover Paae COVER PAGE Date Stamp Date of election if applicable: LOS ANGELES CITY ETHICS COMMISSIO i'! (Month. Day, Year) from through 1. Type of Recipient : 1/1/2017 4I 1I

More information

2: tnhar23 aurr (Month, Day, Year) J u liff '+ For Official Use Only

2: tnhar23 aurr (Month, Day, Year) J u liff '+ For Official Use Only ... Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Date Stamp COVER PAGE :. f~! -ti: r,, 1,.,,, ~ (._, l')~~o-~rvq '~ (~ ~ " ~ 1 11 L...;,. ;\,, ~----------~~~--fio~a;te~o;f~el~ec~ti~on~i;f~ap;p~uc~abibj;.je

More information

o Recall 0 Controlled C Termination Statement ~ Supplemental Preelection

o Recall 0 Controlled C Termination Statement ~ Supplemental Preelection Recipient Committee ~ ~ print in mit C T~( ULrtiK~mp Campaign Statement CoverPage 29J N28 PH tpq3 (Government Code SectIons 842-842165) Statement coven period from Dte of election If applicabl: through

More information

Type or print in ink. Ii2l Semi-annual Statement. o Termination Statement. (Also file a Form 410 Termination) (A/so Complete Part 5) Treasurer(s)

Type or print in ink. Ii2l Semi-annual Statement. o Termination Statement. (Also file a Form 410 Termination) (A/so Complete Part 5) Treasurer(s) Recipient Cmmittee Campaign Statement Cver Page (Gvernment Cde Sectins 842-84216.5) Type r print in ink. Statement cvers perid frm 1/1115 f electin if applicable: (Mnth, Day, Year) C~TY Stamp \.( D7:'Cr'!"Ir::O

More information

JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT

JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JUDICIAL CANDIDATE / FICEHOLDER CAMPAIGN FINANCE REPORT FORM JC/OH COVER SHEET PG 1 The JC/OH Instruction Guide explains how to complete this form. CANDIDATE / FICEHOLDER NAME MS / MRS / MR Ms. NICKNAME

More information

11/08/16. Treasurer(s) MAILING ADDRESS

11/08/16. Treasurer(s) MAILING ADDRESS Recipient Committee Campaign Statement Cover Page ate Stamp COVER PAGE 4ma @~1111FB RJSH~ F RM 1111 from 09/25/16 Page_. of_l2 For Official Use Only through 10/22/16 11/08/16 1. Type of Recipient Committee:

More information

CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE

CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE Is this report an Amendment? YES NO NO COMMITTEE IDENTIFICATION Name of Committee Amos Roe for School Board Address PO Box City, State, ZIP Madison WI

More information

INSTRUCTIONS FOR COMPLETING THE CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT COUNTY, MUNICIPAL AND SCHOOL BOARD CANDIDATES

INSTRUCTIONS FOR COMPLETING THE CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT COUNTY, MUNICIPAL AND SCHOOL BOARD CANDIDATES INSTRUCTIONS FOR COMPLETING THE CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT COUNTY, MUNICIPAL AND SCHOOL BOARD CANDIDATES SECTION 1 - Indicate general candidate information and title of office sought.

More information

2016 Instructions for Campaign Financial Disclosure Reporting. Metro Township and Millcreek City Candidates

2016 Instructions for Campaign Financial Disclosure Reporting. Metro Township and Millcreek City Candidates 2016 Instructions for Campaign Financial Disclosure Reporting Metro Township and Millcreek City Candidates These instructions are intended to help Metro Township and Millcreek City candidates correctly

More information

STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES

STATEMENT OF NO CONTRIBUTIONS OR EXPENDITURES C-2 CAMPAIGN FINANCIAL DISCLOSURE REPORT Rev. 11/17 SUMMARY PAGE (Please Print or Type) Section I Name of candidate or Political Committee and Chairperson Office Sought (if candidate) District (if any)

More information

990-T PUBLIC DISCLOSURE

990-T PUBLIC DISCLOSURE 015 0-T PUBLIC DISCLOSURE Form OMB No. 1545-0687 (and proxy tax under section 60(e)) For calendar year 015 or other tax year beginning JUL 1, 015, and ending JUN 0, 016. 015 Information about Form 0-T

More information

COMMITTEE OR FUND INFORMATION REPORT OPTIONS

COMMITTEE OR FUND INFORMATION REPORT OPTIONS Minnesota Campaign Finance and Public Disclosure Board Suite 190. Centennial Office Building. 658 Cedar Street. St. Paul MN 55155-1603. www.cfboard.state.mn.us Email at: cfb.reports@state.mn.us. Report

More information

APPENDIX A BLANK DISCLOSURE REPORTS

APPENDIX A BLANK DISCLOSURE REPORTS APPENDIX A BLANK DISCLOSURE REPORTS C-1 Appointment and Certification of Political Treasurer C-2 Campaign Disclosure Forms Detailed Summary Page C-4 Independent Expenditures C-5 48 Hour Notice of Contributions/Loans

More information

State of West Virginia Campaign Financial Statement (Long Form) in Relation to the 2012 Election Year

State of West Virginia Campaign Financial Statement (Long Form) in Relation to the 2012 Election Year State of West Virginia Campaign Financial Statement (Long Form) in Relation to the 2012 Election Year Candidate or Committee Name Candidate or Committee's Treasurer Political Party (for candidates) Treasurer's

More information

3. COMMITTEE MAILING ADDRESS 4. COMMITTEE TELEPHONE NUMBER 1204 South Bridgewood Drive

3. COMMITTEE MAILING ADDRESS 4. COMMITTEE TELEPHONE NUMBER 1204 South Bridgewood Drive Missouri Ethics Commission COMMITTEE DISCLOSURE REPORT COVER PAGE C180543 M.E.C. ID NO. INSTRUCTIONS ON REVERSE SIDE 2. FULL NAME OF COMMITTEE 1. DATE OF REPORT OFFICE USE ONLY 3. COMMITTEE MAILING ADDRESS

More information

CAMPAIGN FINANCE OVERVIEW LOCAL CANDIDATES. March 2016

CAMPAIGN FINANCE OVERVIEW LOCAL CANDIDATES. March 2016 CAMPAIGN FINANCE OVERVIEW LOCAL CANDIDATES March 2016 Government Accountability Board 212 E Washington Ave, 3 rd Floor Madison, WI 53703 Phone: 608 261 2028 Fax: 608 264 9319 E mail: gabcfis@wi.gov Website:

More information

FINAL CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For State and District Candidates Only For assistance in completing

FINAL CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For State and District Candidates Only For assistance in completing FINAL CAMPAIGN CONTRIBUTION AND EXPENDITURE REPORT For State and District Candidates Only To be filed with: Mark Martin, Secretary of State For assistance in completing this form contact: Arkansas Ethics

More information

Date of election if applicable: (Month, Day, Year) Statement covers period 9/25/ /8/ /22/2016

Date of election if applicable: (Month, Day, Year) Statement covers period 9/25/ /8/ /22/2016 Recipient Committee Campaign Statement Cover Page Date of election if applicable: (Month, Day, Year) Date Stamp 2001/02 Page 1 of 46 For Official Use Only COVER PAGE 11/8/2016 1. Type of Recipient Committee:

More information

JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT

JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM JC/OH COVER SHEET PG 1 The JC/OH Instruction

More information

FOR CANDIDATES AND COMMITTEES (Please Print or Type)

FOR CANDIDATES AND COMMITTEES (Please Print or Type) C-1 APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER Rev. 11/17 FOR CANDIDATES AND COMMITTEES (Please Print or Type) Pursuant to Section 67-6603(c1), Idaho Code. No contribution shall be received or

More information

o Primarily Formed Candidatel

o Primarily Formed Candidatel Recipient Committee Campaign Statement Cover Page...------------.---------..,:'\/'111; - I Date of Election if applicable I.

More information

TEXAS ETHICS COMMISSION

TEXAS ETHICS COMMISSION TEXAS ETHICS COMMISSION CANDIDATE/OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM C/OH INSTRUCTION GUIDE Revised January 4, 2016 Texas Ethics Commission, P.O. Box 12070, Austin, Texas 78711 (512) 463-5800 FAX

More information

1 Filer ID ( Ethics Commission Filers) 2 Total pages filed: 3 CANDIDATE/ MS/ MRS MR FIRST MI OFFICE USE ONLY OFFICEHOLDER 7 S.

1 Filer ID ( Ethics Commission Filers) 2 Total pages filed: 3 CANDIDATE/ MS/ MRS MR FIRST MI OFFICE USE ONLY OFFICEHOLDER 7 S. CANDIDATE / FICEHOLDER FORM C/ OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The C/OH Instruction Guide explains how to complete this form. 1 Filer ID ( Ethics Commission Filers) 2 Total pages filed: 3 CANDIDATE/

More information

(CA Civil Code Section 8400 et seq) MATERIALS UNDER SECTION 8416 ET. AL., UPON THE PREMISES HEREINAFTER DESCRIBED, AND UPON EVERY

(CA Civil Code Section 8400 et seq) MATERIALS UNDER SECTION 8416 ET. AL., UPON THE PREMISES HEREINAFTER DESCRIBED, AND UPON EVERY Recording Requested By: When Recording Mail To: SPACE ABOVE THIS LINE FOR RECORDERS USE MECHANICS LIEN (CA Civil Code Section 8400 et seq) THE UNDERSIGNED CLAIMANT, (correct full name and address as on

More information

POLITICAL PARTY REPORT REGARDING FUNDS FROM CORPORATIONS AND LABOR ORGANIZATIONS

POLITICAL PARTY REPORT REGARDING FUNDS FROM CORPORATIONS AND LABOR ORGANIZATIONS POLITICAL PARTY REPORT REGARDING FUNDS FROM CORPORATIONS AND LABOR ORGANIZATIONS FORM PTY-CORP COVER SHEET PG 1 Form PTY-CORP Instruction Guide explains how to complete this form. 1 Filer ID (Ethics 2

More information

JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT

JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JUDICIAL CANDIDATE / FICEHOLDER CAMPAIGN FINANCE REPORT FORM JC/OH COVER SHEET PG 1 The JC/OH Instruction Guide explains how to complete this form. CANDIDATE / FICEHOLDER NAME MS / MRS / MR Ms. NICKNAME

More information

TEXAS ETHICS COMMISSION

TEXAS ETHICS COMMISSION TEXAS ETHICS COMMISSION GENERAL - PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT FORM GPAC INSTRUCTION GUIDE Revised January 1, 2017 Texas Ethics Commission, P.O. Box 12070, Austin, Texas 78711 (512) 463-5800

More information

(Month, Day, Year) 01/22/17. 02/18/17 March El Amendment (Explain below) Treasurer(s) NAME OF TREASURER Bill Neiman

(Month, Day, Year) 01/22/17. 02/18/17 March El Amendment (Explain below) Treasurer(s) NAME OF TREASURER Bill Neiman .. - Recipient Committee Campaign Statement Cover Page Statement covers period Date of election if applicable: Ct, 01/22/17 (Month, Day, Year) Date Stamp -ly r r from ZflFEO2I P 02/18/17 March 7 2017.

More information

B arespomllleoi!dirorsponsor &e tooon

B arespomllleoi!dirorsponsor &e tooon Recipient Committee Campaign Statement Cover Page (Government Code Section 842-84216.5) from Type or print In Ink. 11 1 1 2 14 Date of election if applica (Month, Day, Year) Date Stamp MAR 2 4 214 COVER

More information

STATE OF MARYLAND PETITION FUND REPORT

STATE OF MARYLAND PETITION FUND REPORT Page 1 of Pages STATE OF MARYLAND PETITION FUND REPORT Statewide Referendum Petition to: The Secretary of State Public Local Law Referendum to: The Secretary of State Charter Board Petition to: County

More information

CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT

CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM C/OH COVER SHEET PG 1 The C/OH Instruction Guide explains how to complete this form. 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: 3 CANDIDATE

More information

FORM CIOH CAMPAIGN FINANCE REPORT COVER SHEET PG 1. 1 Filer ID 2 Total pages filed: NICKNAME LAST SUFFIX 1.\ MAILING Receipt# Amount ADDRESS

FORM CIOH CAMPAIGN FINANCE REPORT COVER SHEET PG 1. 1 Filer ID 2 Total pages filed: NICKNAME LAST SUFFIX 1.\ MAILING Receipt# Amount ADDRESS CANDIDATE / FICEHOLDER FORM CIOH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The C/ OH Instruction Guide explains how to complete this form. 1 Filer ID 2 Total pages filed: 6 3 CANDIDATE/ MS/ MRS/ MR FIRST

More information

Date of election if appii (Month, Day, Year) Statement covers period. Treasurer(s) MAJL.ING ADDRESS. CITY Oxnard AREA CODE/PHONE MAILING ADDRESS

Date of election if appii (Month, Day, Year) Statement covers period. Treasurer(s) MAJL.ING ADDRESS. CITY Oxnard AREA CODE/PHONE MAILING ADDRESS Recipient Committee Campaign Statement Cover Page Statement covers period &.rom 9/25/216 _ Date of election if appii (Month, Day, Year) t: Ul tlm:iugh 1/22/216 November 8, 216 1. Type of Recipient Committee:

More information

Major Donor and Independent Expenditure Committee Campaign Statement (Government Code Sect ons )

Major Donor and Independent Expenditure Committee Campaign Statement (Government Code Sect ons ) I Committee (Government Code Sect ons 8400-846.5) MAJOR DONOR AND INDEPENDENT EPENDITURE COMMITTEE STATEMENT Date Stamp CALIFORNIA 46 FORM Amendment from Statement covers period 07/0/04 Date of election

More information

2010 Campaign Disclosure Manual

2010 Campaign Disclosure Manual 2010 Campaign Disclosure Manual for County Candidates and Political Committees PREPARED BY Idaho Association of Counties P.O. BOX 1623 700 WEST WASHINGTON BOISE, IDAHO 83701 PHONE: (208) 345-9126 FAX:

More information

FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1. Leonard

FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1. Leonard etad CANDIDATE/OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: The C/OH Instruction Guide explains how to complete this form.

More information