Type or print in ink. A~me..r-.+- Date of election If applicable: (Month, Day, Year) Ii2I Amendment (Explain below) Treasurer(s)

Transcription

1 Recipient Cmmittee Campaign Statement Cver Page (Gvernment Cde Sectins ) SEE INSTRUCTIONS ON REVERSE Type r print in ink. A~me..r frm Type f Recipient Cmmittee: All Cmmittees - Cmplete Parts 1, 2, 3, and 4. ~ Officehlder, Candidate Cntrlled Cmmittee 0 Primarily Frmed Ballt Measure State Candidate Electin Cmmittee Cmmittee Recall Cntrlled (Als Camplata Part 5) 0 Spnsred (Als Camplata Part 6) General Purpse Cmmittee Spnsred Primarily Frmed Candidate/ Officehlder Cmmittee Small Cntributr Cmmittee (Als Cmp/t. Part 7) Plitical Party/Central Cmmittee Date f electin If applicable: (Mnth, Day, Year) ~ I l E Date Stamp IN SAN BENITO COUNTY JAN COVER PAGE, CALIFORNIA 460 FORM Page Fr Official f Use Only Nvember 2, 2010JOE AULGONZALEZ,COUNlYCLE K BY ~r:d"" JOOw 2. Type f Statement: t:t' 121 Preelectin Statement Quarterly Statement Semi-annual Statement Special Odd-Year Reprt Terminatin Statement Supplemental Preelectin (Als file a Frm 410 Terminatin) Statement - Attach Frm 495 Ii2I Amendment (Explain belw) Errrs fund in additin/subtractin n riginal reprt created errrs ut reprts 17 It 3. Cmmittee Infrmatin I.D. NUMBER Treasurer(s) COMMITTEE NAME (OR CANDI'S NAME IF NO COMMITTEE) NAME OF TREASURER Paul Andrew Lcke MAILING ADDRESS P.O. Bx 1054 STREET ADDRESS (NO P,O. BOX) 1045 Wild Oak Drive CITY Hllister STATE Ca ZIP CODE AREA CODE/PHONE CITY Armas NAME OF ASSISTANT TREASURER, IF ANY STATE Ca ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS 1760 Suite F PMB 220 Airline Highway CITY STATE ZIP CODE Hllister Ca OPTIONAL: FAX / ADDRESS AREA CODE/PHONE CITY OPTIONAL: FAX / ADDRESS STATE ZIP CODE AREA CODE/PHONE 4. Verificatin I have used all reasnable diligence in preparing and reviewing this statement and t the best f my knwl~e the W'r attached schedules is true and cmplete. I certify under penalty f perjury under ~aws / Dat f the State f Califrnia that the freging is true and crrect. Executed n I {/ // By Executed n \-2.(" -1\ Date By Executed n Data By Executed n 'Dn:a;;;te;; By SignaturefCntrllingOfflcehtder,Candidate,StateMeasurePrpnent FPPC Tll-Free Helpline: 866/ASK FPPC (866/27S-3772) State 01 Calilrnia

2 Recipient Cmmittee Campaign Statement Cver Page - Part 2 Type r print In ink. COVER PAGE - PART 2 5. Officehlder r Candidate Cntrlled Cmmittee 6. Primarily Frmed Ballt Measure Cmmittee NAME OF OFFICEHOLDER OR CANDI Jhn Darren Thmpsn OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Sheriff; San Benit Cunty RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY 1045 Wild Oak Drive Hllister STATE ZIP Ca Related Cmmittees Nt Included in this Statement: List any cmmittees nt Included In this statement that are cntrlled by yu r are primarily frmed t receive cntributins r make expenditures n behalf f yur candidacy. NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION D SUPPORT D OPPOSE Identify the cntrlling fficehlder, candidate, r state measure prpnent. If any. NAME OF OFFICEHOLDER. CANDI, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES 0 NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDI CITY STATE ZIP CODE AREA CODE/PHONE 7. Primarily Frmed Candidate/Officehlder Cmmittee List names f fflcehlder(s) r candldate(s) fr which this cmmittee Is primarily frmed. NAME OF OFFICEHOLDER D OPPOSE OR CANDI D SUPPORT OFFICE SOUGHT OR HELD COMMITTEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES ONO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach cntlnuat/n sheets /f necessary FPPC Tll-Free Helpline: 866/ASK FPPC (866/ ) State t Califrnia

3 Campaign Disclsure Statement Summary Page Type r print in ink. frm SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE $ Clumn14, , A General Clumn (FROMATTACHED B Cntributins Received TOTALTHISPERIOD SCHEDULES) TOTAL TO Running 14,862.0 Electins 1/1 6/ t Cntributins Date Received 0 in Bth the State Primary and - $ $ S Expenditures $ Made ICalendar Year Summary fr Candldales 1. Mnetary Cntributins Schedule A, Line 3 S Page 1.0. NUMBER 3_ f 1_7_ 2. Lans Received Schedule S, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines $ 4. Nnmnetary Cntributins Schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines $ Expenditures Made 6. Payments Made Schedule E, Line 4 $ 7. Lans Made Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines $ 9. Accrued Expenses (Unpaid Bills) Schedule F. Line Nnmnetary Adjustment Schedule C, Line TOTAL EXPENDITURES MADE Add Lines $ Current Cash Statement 12. Beginning Cash Balance Previus Summary Page, Line 16 $ 13. Cash Receipts Clumn A. Line 3 abve 14. Miscellaneus Increases t Cash Schedule I. Line Cash Payments ClumnA. Line 8 abve 16. ENDING CASH BALANCE Add Lines , then subtract Line 15 $ If this /s a term/natin statement, Line 16 must be zer. 17, LOAN GUARANTEES RECEIVED Schedule S, Part 2 $ Cast! Equivalents and Outstanding Debts 18. Cash Equivalents See instructins n reverse $ 19. Outstanding Debts Add Line 2 + Line 9in Clumn Sabve $ $ $ $ 14, , , T calculate Clumn B. add amunts in Clumn A t the crrespnding amunts frm Clumn B f yur last reprt. Sme amunts in Clumn A may be negative figures that shuld be subtracted frm previus peridd amunts. If this is the first reprt being filed fr this calendar year, nly carry ver the amunts frm Lines 2, 7. and 9 (if any). Expenditure Limit Summary fr State Candidates 22. Cumulative Expenditures Made (If Subject 10 Vluntary expenditure Limit) Date f Electin Ttal t Date (mm/dd/yy) $ $---- Amunts in this sectin may be different frm amunts reprted In Clumn S, FPPC Frm 460 (January/05) FPPC Tll-Free Helpline: 866/ASK-FPPC (866/ )

4 Schedule A Mnetary Cntributins Received Type r print in Ink frm SCHEDULE A SEE INSTRUCTIONS ON REVERSE Page 4 f 17 I.D. NUMBER RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR I CONTRIBUTOR (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CODE. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED. ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO (JAN. 1 - DEC. 31) TO OS/25/10 Terry A. Medina ~IND cam ath scc Retired Plice Chief City f Watsnville /29/10 Verna Flynn ~IND cam ath scc Owner Verna's Hair Slutins /9/10 Richard Davis I2!IND cam ath scc Prject Manager Mid State Electric cam ath scc cam ath scc SUBTOTAL $ I I Schedule A Summary Cntributr Cdes 1. Amunt received this perid - itemized mnetary cntributins. IND-Individual (Include all Schedule A subttals.) $ COM- RecipientCmmittee (ther than PTYr SCC) 2. Amunt received this perid - unitemized mnetary cntributins f less than $100 $ ~;~ --pa:~.er 0 I Ica~~g., artybusinessentity) 3. Ttal mnetary cntributins received this perid. sec - SmallCntributrCmmittee (Add Lines 1 and 2. Enter here and n the Summary Page, Clumn A, Line 1.) TOTAL $ FPPC Frm 460 (January/05) FPPCTll-Free Helpline: 866/ASK-FPPC( )

5 Schedule A (Cntinuatin Sheet) Mnetary Cntributins Received Type r print In Ink. frm SCHEDULE A (CaNT.) Page 5 f 17 I.D.NUMI IER. RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR I CONTRIBUTOR (IF COMMmEE. ALSO ENTER 1.0.NUMBER) CODE * IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF EMPLOYED. ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO (JAN. 1 - DEC. 31) TO OCOM OSCC QIND OCOM OSCC OCOM ath see eom ath sec QlND cam ath sec SUBTOTAL $ 0 I I Cntributr Cdes IND -Individual COM - Recipient Cmmittee (ther than PTY r SCC) OTH - Other (e.g., business entity) PTY -Plitical Party SCC - Small Cntributr Cmmittee FPpe Frm 460 (January/05) FPPC Tll-Free Helpline: 866/ASK-FPPC (866/ )

6 Schedule B - Part 1 lans Received Type r print In Ink. frm SCHEDULE B - PART 1 CALIFORNIA 460 FORM SEE INSTRUCTIONSON REVERSE Page _ 1.0. NUMBER f 17 FULL NAME,STREETADDRESSAND ZIP CODE OF LENDER (IF COMMITTEE. ALSO ENTER I.D. NUMBER) IF AN INDIVIDUAL,ENTER OCCUPATIONAND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) OUTStANDING AMOUNT AMOUNTPAID BALANCEAT BALANCE RECEIVEDTHIS OR FORGIVEN CLOSEOF THIS BEGINNINGTHIS a) I PERIOD (b) I THIS (e) PERIOD' I OUTsit~DING 0) INTEREST PAIDTHIS PERIOD I) ORIGINAL AMOUNTOF LOAN (0) CUMULATIVE CONTRIBUTIONS TO PAID $ _ FORGIVEN --_% RATE CALENDAR YEAR $ _ '" t IND 0 COM 0 OTH 0 PlY 0 SCC DUE INCURRED PAID $ ---- FORGIVEN --_% RATE t It\lD 0 COM 0 OTH 0 PlY 0 SCC DUE INCURRED PAID $ _ FORGIVEN --_% RATE CALENDAR YEAR '" t IfJD 0 COM 0 PlY 0 scc I I I I I DUE I I INCURRED I Schedule B Summary SUBTOTALS $ $ $ $ I I 1. Lans received this perid $ 0 (Ttal Clumn (b) plus unitemized lans f less than $100.) 2. LDans paid r frgiven this perid $ (Ttal Clumn (c) plus lans under $100 paid r frgiven.) (Include lans paid by a third party that are als itemized n Schedule A.) 3. Net change this perid. (Subtract Line 2 frm Line 1.) NET $ En ter the net here and n the Summary Page, Clumn A, Line 2. (May be a negative number) (Entr() n SehduIeE.Une3) tcntributr INO-Individual Cdes COM - Recipient Cmmittee (ther than PTY r SCC) OTH - Other (e.g., business entity) PTY - Plitical Party see - Small Cntributr Cmmittee Am unts frgiven r paid by anther party als must be reprted n Schedule A. If required. FPPC Tll-Free Helpline: B66/ASK-FPPC (866/ )

7 Schedule B - Part 2 Lan Guarantrs Type r print in ink. frm SCHEDULE B - PART 2 SEE INSTRUCTIONS ON REVERSE Page_ 7 17 f_ NAME OF FILER!.D. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE OF GUARANTOR (IFCOMMITTEE. ALSO ENTER 1.0.NUMBER) CONTRIBUTOR CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS LOAN AMOUNT GUARANTEED THIS PERIOD CUMULATIVE TO BALANCE OUTSTANDING TO em LENDER CALENDAR YEAR see OiND eom see LENDER CALENDAR YEAR eom see LENDER OiND em see LENDER SUBTOTAL $ 0 SUlTVT\aryPaga. Entern I I Una 17nly... === ~-'. FPPCTll-Free Helpline: 866/ASK-FPPC(866/ )

8 Schedule C Nnmnetary Cntributins Received Type r print in Ink. frm SCHEDULE C SEE INSTRUCTIONS ON REVERSE Page~f~ I.D. NUMBER RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) CONTRIBUTOR I OCCUPATION IF AN INDIVIDUAL. AND EMPLOYER ENTER CODE * (IF SELF.EMPLOVED, ENTER I GOODS DESCRIPTION OR SERVICES OF NAME OF BUSINESS) AMOUNTI FAIR MARKET VALUE CUMULATIVE TO (JAN 1 DEC 31) TO eom DPTY see eom DPTY see eom see eom ath DPTY see Attach additinal infrmatin n apprpriately labeled cntinuatin sheets. SUBTOTAL $ Schedule C Summary 1. Amunt received this perid - itemized nnmnetary cntributins. 0 (Include all Schedule C subttals.) $ _ 2. Amunt received this perid - unitemized nnmnetary cntributins f less than $100 $ 0 3. Ttal nnmnetary cntributins received this perid. 0 (Add Lines 1 and 2. Enter here and n the Summary Page, Clumn A, Lines 4 and 10.) TOTAL $ _ 'Cntributr Cdes IND-Individual COM - Recipient Cmmittee (ther than PTY r See) OTH - Other (e.g. business entity) PTY - Plitical Party sce - Small Cntributr Cmmittee FPPC Tll-Free Helpline: 866/ASK-FPPC (866/ )

9 Schedule D Summary f Expenditures Supprting/Oppsing Other Candidates, Measures and Cmmittees SEE INSTRUC110NSON REVERSE Type r print In ink 'rm SCHEDULE D Page_ LD. NUMBER 0'_ 9 17 NAME OF CANDI.OFFICE,AND DISTRICT,OR MEASURENUMBEROR LETTERAND JURISDICTION. OR COMMITTEE Mnetary --- Mnetary 'TYPEOF PAYMENT --- Expenditure Cntributin Mnetary Nnmnetary Independent DESCRIPTION AMOUNTTHIS PERIOD CUMULATIVETO (JAN. 1 - DEC. 31) TO D Supprt D Oppse D Supprt D Oppse Nnmnetary Cntributin Independent D Supprt D Oppse I Expenditure SUBTOTAL $ 0 I I Schedule D Summary 1. Itemized cntributins and independent expenditures made this perid. (Include all Schedule 0 subttals.) $ 0 2. Unitemized cntributins and independent expenditures made Ihis perid f under $100 $ 0 3. Ttal cntributins and independent expenditures made this perid. (Add Lines 1 and 2. D nt enter n the Summary Page.) TOTAL $ 0 FPPC TlI Free Helpline: 866/ASK FPPC (866/ )

10 Schedule D (Cntinuatin Sheet) Summary f Expenditures Supprting/Oppsing Other Candidates, Measures and Cmmittees Type r print In Ink. frm Page_ f _ I.D. NUMBER NAME OF CANDI, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE Mnetary --- Mnetary TYPE OF PAYMENT --- Mnetary Expenditure Cntributin Independent Nnmnetary DESCRIPTION AMOUNT THIS PERIOD CUMULATIVE TO (JAN. 1 DEC. 31) TO Supprt Oppse Supprt Oppse Supprt Oppse Independent Supprt 0 Oppse I Expenditure I I I I SUBTOTAL $ 0 I \ FPPC Tll-Free Helpline: 866/ASK-FPPC (866/ )

11 Schedule Payments E Made Type r print in ink. frm SCHEDUL E SEE INSTRUCTIONS ON REVERSE NAME a= FILER Page_ f_ 1.0. NUMBER CODES: If ne f the fllwing cdes accurately describes the payment, yu may enter the cde. Otherwise, describe the payment. Q\;f> campaignparaphernalia/misc. MBR membercmmunicatins RAD radi airtime and prductin csts CNS campaigncnsultants MTG meetingsand appearances RFD returned cntributins CTB cntributin(explain nnmnetary)' OFC ffice expenses SAL campaign wrkers' salaries CVC civic dnatins PET petitin circulating TEL t.v. r cable airtime and prductin csts FlL candidatefiling/ballt fees PHO phne banks 1RC candidatetravel, ldging, and meals FND fundraising events POL plling and survey research 1RS staff/spuse travel, ldging, and meals II'D independentexpendituresupprting/ppsingthers (explain)' POS pstage, delivery and messengerservices TSF transfer between cmmittees f the same candidate/spnsr LEG legaldefense PRO prfessinal services (legal, accunting) VOT vter registratin LIT campaignliteratureand mailings PRT print ads WEB Infrmatintechnlgy csts (Internet, ) OR DESCRIPTION OF PAYMENT AMOUNTCODE PAID (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) NAME AND ADDRESS OF PAYEE Lit prt prductin Theater Rural mailing Adf Csts 2 4x8 signs Westbrk Creative Designs Sign Cmpany Payments that are cntributins r Independent expenditures must als be summarized n Schedule D. SUBTOTAL $ Schedule E Summary 1, Ite mized payments made this perid. (Include all Schedule E subttals.) $ Unitemized payments made this perid f under $100 $ T01alinterest paid this perid n lans. (Enter amunt frm Schedule B, Part 1, Clumn (e).) $ T1alpayments made this perid. (Add Lines 1,2, and 3. Enter here and n the Summary Page, Clumn A, Line 6.) TOTAL $ FPPCTll-Free Helpline: 866/ASK-FPPC(866/ )

12 Schedule E (Cntinuatin Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE Type r print In Ink. frm SCHEDULE E (CO NT.) Page_ 01_ 1.0. NUMBER CODES: If ne f the fllwing cdes accurately describes the payment, yu may enter the cde. Otherwise, describe the payment. 0vP campaign paraphernalia/misc. MBR member cmmunicatins RAD radi airtime and prductin csts CNS campaign cnsultants MTG meetings and appearances RFD returned cntributins CTB cntributin (explain nnmnetary)" OFC ffice expenses SAL campaign wrkers' salaries CVC civic dnatins F T petitin circulating TEL t.v. r cable airtime and prductin csts FIL candidate filing/ballt fees PHO phne banks IRC candidate travel, ldging, and meals FND fundraislng events POL plling and survey research IRS staff/spuse travel, ldging, and meals N) independent expenditure supprting/ppsing thers (explain)" POS pstage, delivery and messenger services TSF transfer between cmmittees f the same candidate/spnsr LEG legal defense PRO prfessinal services (legal, accunting) VOT vter registratin LIT campaign literature and mailings PRT print ads WEB infrmatin technlgy csts (Internet, ) OR DESCRIPTION OF PAYMENT AMOUNT CODE PAID NAME AND ADDRESS OF PAYEE Printing Electin and Night Laminating GatheringServices Pstal Graphics * Payments that are cntributins r Independent expenditures must als be summarized n Schedule D. SUBTOTAL $ FPPC Tll-Free Helpline: 866/ASK-FPPC (866/ )

13 . Schedule Accrued F Expenses (Unpaid Bills) Type r print in ink. f rm _ SCHEDULE F SEE INSTRUCTIONS NAME a= FILER ON REVERSE Page _1_3 _ 1.0. NUMBER f _~_1_7_~ CODES: If ne f the fllwing cdes accurately describes the payment, yu may enter the cde. Otherwise, describe the payment. avp campaign paraphernalia/misc. MBR member cmmunicatins RAD radi airtime and prductin csts CNS campaign cnsultants MTG meetings and appearances RFD returned cntributins CTE cntributin (explain nnmnetaryj< OFC ffice expenses SAL campaign wrkers' salaries CVC civic dnatins PET petitin circulating TEL t.v. r cable airtime and prductin csts FIL candidate filing/ballt fees PI-O phne banks mc candidate travel, ldging, and meals FNO fundraising events POL plling and survey research TRS staff/spuse travel, ldging, and meals NO independent expenditure supprting/ppsing thers (explain» POS pstage, delivery and messenger services TSF transfer between cmmittees f the same candidate/spnsr LEG legal defense PRO prfessinal services (legal, accunting) VOT vter registratin UT campaign literature and mailings PRr print ads WEB Infrmatin technlgy csts (internet, ) BALANCE AMOUNT (b) THIS OUTSTANDING (c) (d) CODE OR OUTSTANDING OFAMOUNT THIS PERIOD BALANCE INCURRED AT PERIOD CLOSE PAID (ALSO REPORT BEGINNING DESCRIPTION EI OF PAYMENT (a) Payments that are cntributins r Independent expenditures must als be summarized n Schedule D. SUBTOTALS $ $ $ $ Schedule F Summary 1. Ttal accrued expenses incurred this perid. (Include all Schedule F, Clumn (b) subttals fr 0 accrued expenses f $100 r mre, plus ttal unitemized accrued expenses under $100.) INCURRED TOTALS $ _ 2. Ttal accrued expenses paid this perid. (Include all Schedule F, Clumn (c) subttals fr payments n 0 accrued expenses f $100 r mre, plus ttal un itemized payments n accrued expenses under $100.) PAID TOTALS $ _ 3. Ne1 change this perid. (Subtract Line 2 frm Line 1. Enter the difference here and 0 n the Summary Page, Clumn A, Line 9.) NET $ -_--~ May be a negative number FPPC TlI Free Helpline: 866/ASK-FPPC (866/27S-3772)

14 Schedule F (Cntinuatin Sheet) Accrued Expenses (Unpaid Bills) Type r print In Ink. frm SCHEDULE F (CONT.) Page~ f_1_7_ 1.0. NUMBER CODES: If ne f the fllwing cdes accurately describes the payment, yu may enter the cde. Otherwise, describe the payment. avp campaign paraphernalia/misc. MBR member cmmunicatins RAD radi airtime and prductin csts CNS campaign cnsultants MTG meetings and appearances RFD returned cntributins CTB cntributin (explain nnmnetary) OFC ffice expenses SAL campaign wrkers' salaries CVC civic dnatins FEr petitin circulating TEL t.v. r cable airtime and prductin csts FIL candidate filing/ballt fees PHO phne banks TRC candidate travel, ldging, and meals FND fundraislng events POL plling and survey research TRS staff/spuse travel, ldging, and meals IND Independent expenditure supprting/ppsing thers (explain) POS pstage, delivery and messenger services TSF transfer between cmmittees f the same candidate/spnsr LEG legal defense PRO prfessinal services (legal, accunting) VOT vter registratin UT campaign literature and mailings PRT print ads WEB infrmatin technlgy csts (internet, ) * Payments that are cntributins r independent expenditures must als be summarized n Schedule D. BALANCE AMOUNT (e) OUTSTANDING THIS (b) (d) OFAMOUNT THIS PERIOD BALANCE AT INCURRED PERIOD CLOSE PAID (ALSO REPORT BEGINNING DESCRIPTION E) CODEOFORPAYMENT (a) SUBTOTALS $ $ $ $ FPPC Tll-Free Helpline: 866/ASK-FPPC 1866/ )

15 Schedule G Payments Made by an Agent r Independent,Cntractr (n Behalf f This Cmmittee) Type r print in Ink frm SCHEDULE G SEE INSTRUCTIONS NAME OF FILER ON REVERSE Page_ 1.0. NUMBER f_ NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If ne f the fllwing cdes accurately describes the payment, yu may enter the cde. Otherwise, describe the payment. GNP campaign paraphernalia/misc. MBR member cmmunicatins RAD radi airtime and prductin csts CNS campaign cnsultants MTG meetings and appearances RFD returned cntributins CTE cntributin (explain nnmnetary)' OFC ffice expenses SAL campaign wrkers' salaries CVC civic dnatins FEr petitin circulating TEL t.v. r cable airtime and prductin csts FIL candidate filinglballt fees PliO phne banks TRC candidate travel, ldging, and meals FND fundralsing events POL plling and survey research TRS staff/spuse travel, ldging, and meals M independent expenditure supprting/ppsing thers (explain)' POS pstage. delivery and messenger services TSF transfer between cmmittees f the same candidate/spnsr LEG legal defense PRO prfessinal services (legal, accunting) VOT vter registratin UT campaign literature and mailings PRT print ads WEB infrmatin technlgy csts (internet, ) " Payments that are cntributins r Independent expenditures must als be summarized n Schedule D. OR DESCRIPTION OF PAYMENT AMOUNT PAID CODE NAME AND ADDRESS OF PAYEE OR CREDITOR Attach additinal infrmatin n apprpriately labeled cntinuatin sheets. TOTAL" $ D nt transfer t any ther schedule r t the Summary Page. This ttal may nt equal the amunt paid t the agent r independent cntractr as reprted n Schedule E. FPPC Tll-Free Helpline: 866/ASK FPPC (866/ )

16 Schedule H Lans Made t Others* Type r print In ink. frm SCHEDULE H SEE INSTRUCTIONS ON REVERSE Page ~ f 17 NAME OF FILER I.D.NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE OF RECIPIENT (IF COMMITTEE, ALSOENTER1.0.NUMBER) IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAMEOF BUSINESS) (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD (b) AMOUNT LOANED THIS PERIOD (c) INTEREST REPAYMENT RECEIVEDOR FORGIVENESS THIS PERIOD' (e) (I) OUTST~~DlNG LOAN INCURRED RATE I BALANCE -_II AT II Il0S I CLOSE OF THIS S PERIOD AMOUNT CUMULATIVE TORIGINAL Ig) LOANS OF '" I PER ELECTlDN'" PAID FORGIVEN S _ DUE PAID s _ FORGIVEN OATE DUE *Lans that are cntributins t anther candidate r cmmiuee must als be summarized n Schedule D. Lans frgiven must als be reprted n Schedule E. SUBTOTALS 1$ 01$ 1$ 1$ (Enter (e) n Schedule I, Line 3) Schedule H Summary 1. Lans made this perid $ 0 (Ttal Clumn (b) plus unitemized lans f less than $100.) 'If Required 2. Payments received n lans, $ 0 (Ttal Clumn (c) plus unitemized payments f less than $100.) 3. Net change this perid. (Subtract Line 2 frm Line 1.) NET $ 0 (May be a negative number) (Enter the net here and n the Summary Page, Clumn A, Line 7.) FPPC Tll-Free Helpline: 866/ASK-FPPC (866/ )

17 Sch'edule I Miscellaneus Increases t Cash Type r print In ink. frm SCHEDULE I SEE INSTRUCTIONS NAME OF FILER ON REVERSE Page _1_7 n f _1_7_ I.D. NUMBER RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additinal infrmatin n apprpriately labeled cntinuatin sheets. SUBTOTAL $ Schedule I Summary 1. Itemized increases t cash this perid " $ 0 2. Unitemized increases t cash f under $100 this perid, $ 0 3. Ttal f all interest received this perid n lans made t thers. (Schedule H, Clumn (e).) $ 0 4. Ttal miscellaneus increases t cash this perid. (Add Lines 1, 2, and 3. Enter here and n the Summary Page, Line 14.),,, TOTAL $ 0 FPPC Frm 460 (January/05) FPPC Tll-Free Helpline: 8661ASK-FPPC (866' )