Recipient Committee Campaign Statement Cover Page

Transcription

1 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 Type of Recipient Committee: All Committees Complete Parts 1, 2, 3, and 4 2. Type of Statement: 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 Primarily Formed Ballot Measure Committee Controlled Sponsored (Also Complete Part 6) Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) Preelection Statement Semi-annual Statement Termina ion Statement (Also file a Form 410 Termination) Amendment (Explain Below) X Quarterly Statement Special Odd-Year Report 3. Committee Information MITTEE NAME (OR CAND S NAME IF NO MITTEE) I D. NUMBER Committee to Support the Recall of Mike Bonin Treasurer(s) NAME OF TREASURER Thomas Montgomery MAIL NG ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CITY STATE ZIP CODE AREA NAME OF ASSISTANT TREASURER, IF ANY San Rafael, CA MA L NG ADDRESS ( F DIFFERENT) NO. AND STREET OR P.O. BOX MA L NG ADDRESS CITY STATE ZIP CODE AREA San Rafael, CA OPTIONAL: FAX / ADDRESS tom@politicalvisions.com CITY STATE ZIP CODE AREA OPTIONAL: FAX / ADDRESS 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 Executed on Executed on Executed on 11/03/ /03/ /03/ /03/2017 By By By By Thomas Montgomery Signature of Treasurer or Assistant Treasurer Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Signature of Controlling Officeholder, Candidate, State Measure Proponent Signature of Controlling Officeholder, Candidate, State Measure Proponent

2 Recipient Committee Campaign Statement Cover Page - Part 2 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee COVER PAGE - PART 2 Page 2 of 30 NAME OF OFFICEHOLDER OR CANDI NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER F APPLICABLE) RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE Z P 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 BALLOT NO. OR LETTER JURISDICTION SUPPORT OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CAND, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY MITTEE NAME NAME OF TREASURER CONTROLLED MITTEE? YES NO 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. MITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CAND OFFICE SOUGHT OR HELD SUPPORT CITY STATE ZIP CODE AREA NAME OF OFFICEHOLDER OR CAND OFFICE SOUGHT OR HELD OPPOSE SUPPORT MITTEE NAME NAME OF OFFICEHOLDER OR CAND OFFICE SOUGHT OR HELD OPPOSE SUPPORT NAME OF TREASURER CONTROLLED MITTEE? YES NO MITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CAND OFFICE SOUGHT OR HELD OPPOSE SUPPORT OPPOSE CITY STATE ZIP CODE AREA

3 Campaign Disclosure Statement Summary Page SUMMARY PAGE through Page 3 of Contributions Received 1. Monetary Contributions Loans Received SUBTOTAL CASH CONTRIBUTIONS Nonmonetary Contributions TOTAL CONTRIBUTIONS... Schedule A, Line 3 Schedule B, Line 3 Add Lines Schedule C, Line 3 Add Lines Column A TOTAL (FROM ATTACHED SCHEDULES) 41, ,000 61, , Column B TOTAL TO 41, ,000 61, , Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contr butions Received 21. Expenditures Made 1/1 through 6/30 7/1 to Date 30 Expenditures Made 6. Payments Made Loans Made SUBTOTAL CASH PAYMENTS Accrued Expenses (Unpaid Bills) Nonmonetary Adjustment TOTAL EXPENDITURES MADE... Current Cash Statement Cash Equivalents and Outstanding Debts 18. Cash Equivalents Outstanding Debts... Schedule E, Line 4 Schedule H, Line 3 Add Lines Schedule F, Line 3 Schedule C, Line 3 Add Lines Beginning Cash Balance... Previous Summary Page, Line Cash Receipts Miscellaneous Increases to Cash Cash Payments ENDING CASH BALANCE If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES... Column A, Line 3 above Schedule I, Line 4 Column A, Line 8 above Add Lines , then subtract Line 15 Schedule B, Line 2 See instructions on reverse Add Line 2 + Line 9 in Column B above 15, , , , , , , ,000 15, , 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). Expenditures Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) Total to Date *Amounts in this section may be different amounts reported in Column B.

4 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 4 of 30 9/18/2017 Richard Bernstein Los Angeles, CA PER ELECTION TO Retired P /18/2017 9/26/2017 9/26/2017 9/29/2017 Richard Bernstein Los Angeles, CA Jen Bilik Venice, CA Jen Bilik Venice, CA David Byrne Anaheim, CA Retired P-2018 CEO P-2018 Knock Knock CEO P-2018 Knock Knock EE Engineer P-2018 So. Cal. Packaging Equipment, SUBTOTAL 1,350

5 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 5 of 30 9/29/2017 Al Casas La, CA PER ELECTION TO Carpet P /26/2017 8/16/2017 8/16/2017 9/28/2017 Gregory Chambers Los Angeles, CA Terry Cricksman Los Ángeles, CA Terry Cricksman Los Ángeles, CA Elizabeth Dalling Beverly Hills, CA P-2018 Retired P-2018 Retired P-2018 President P-2018 Special Artists Agency SUBTOTAL

6 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 6 of 30 9/21/2017 Diane Dayton Pacific Palisades, CA PER ELECTION TO Retired P /19/2017 9/15/2017 8/18/2017 9/30/2017 Frank Defurio Venice, CA kevin john dixon Playa Vista, CA David J. Dukesherer Hawthorne, CA Alexis Edelstein Los Angeles, CA P-2018 Textiles P-2018 CEO P-2018 SurfCargo, LLC retired 1 20,004 20,004 P-2018 SUBTOTAL 551

7 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 7 of 30 8/28/2017 Judith A. Esposito Venice, CA PER ELECTION TO Retired P /28/2017 8/16/2017 8/19/2017 9/20/2017 David Fults Newport Beach, CA Jo Ann Ganz Los Angeles, CA Kent Genzlinger Los Angeles, CA Parish German Inglewood, CA Sales P-2018 Voit Retired P-2018 Retired P-2018 Home Maker P-2018 SUBTOTAL 1,475.65

8 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 8 of 30 9/21/2017 laura govoni bachelder manhattan beach, CA PER ELECTION TO architect P-2018 gehry partners 9/22/2017 9/27/2017 8/16/2017 9/16/2017 Todd Gray Hermosa Beach, CA Robert Green La, CA Alix Gucovsky Venice, CA Laura Guglielmo Playa del rey, CA Advertising P-2018 RPA Entrepreneur 1,000 1,000 1,000 P-2018 Talent Agent P-2018 WME Faculty P-2018 Santa Monica College SUBTOTAL 2,375.65

9 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 9 of 30 8/16/2017 Julie Hall Playa Del Rey, CA PER ELECTION TO Therapist P /22/2017 9/15/2017 9/15/2017 9/29/2017 Ken Harrison Redondo Beach, CA mike hartmeier los angeles, CA Phil Howitt Los Angeles, CA Ray Joseph Manhattan Beach, CA Pilot P-2018 Paramount Pictures banking P-2018 mh farming retired P-2018 retired Realtor P-2018 Palm Realty SUBTOTAL 1,375.65

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11 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 11 of 30 8/25/2017 Geniella Lester Playa Del Rey, CA PER ELECTION TO Social Worker P-2018 Hospital 8/16/2017 9/11/2017 9/18/2017 8/16/2017 Avi Levy Los Angeles, CA Erik Ludwick Pacific Palisades, CA Timothy C. Macker Pacific Palisad, CA David Mallchok Altadena, CA Producer P-2018 Freelance Entrepreneur 2,500 2,500 2,500 P-2018 real estate P-2018 Coldwell Banker Commercial Yes P-2018 HSD SUBTOTAL 3,516.12

12 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 12 of 30 8/16/2017 Russell Mark Playa del Rey, CA PER ELECTION TO Technical Consultant P-2018 Third Millennium Business 8/16/2017 9/18/2017 8/29/2017 9/19/2017 Russell Mark Playa del Rey, CA Robert McKeon Venice, CA Eileen Neill Manhattan Beach, CA Laura Nobles Marina del Rey, CA Technical Consultant P-2018 Third Millennium Business Film Producer P-2018 Investment consultant P-2018 Wilshire Associates Inc. Healthcare marketing P-2018 SUBTOTAL

13 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 13 of 30 8/25/2017 Peter Nott Sacramento, CA PER ELECTION TO Retired 1,000 1,000 1,000 P-2018 Retired 8/29/2017 8/22/2017 8/16/2017 9/28/2017 Vince Otte. Los Angeles, CA Larry Patt Downey, CA Thomas Paul Los Angeles, CA Thomas Paul Los Angeles, CA President 1,000 1,000 1,000 P-2018 Barrister Executive Suites, Inc. Construction P-2018 Retired P-2018 Retired 10,000 10, , P-2018 SUBTOTAL 13,175.65

14 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 14 of 30 8/16/2017 Carolyn Powers Manhattan Beach, CA PER ELECTION TO Retired P /16/2017 8/17/2017 9/28/2017 9/24/2017 Matthew Reiser Los Angeles, CA Blake Richardson Redondo Beach, CA Donald Rubin Los Angeles, CA David Ruhoff Marina del Rey, CA Retired P-2018 Law Enforcement P-2018 US Government Real Estate Broker P-2018 Rubin Investment & P-2018 SUBTOTAL 1,325.65

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16 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 16 of 30 9/8/2017 James Sumption Playa Del Rey, CA PER ELECTION TO Retired P-2018 NA 8/16/2017 9/13/2017 9/28/2017 9/15/2017 Raymond Jess Torres Menifee, CA richard veerman los angeles, CA Trinidad P. Veyna La, CA John Whitley Santa Ana, CA Pilot P-2018 Contractor financial services P-2018 proprietary P-2018 TV Plumbing Inc P-2018 SUBTOTAL

17 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 17 of 30 8/16/2017 Joe Williamson Marina Del Rey, CA PER ELECTION TO Actor P-2018 N/A 9/15/2017 9/26/2017 9/21/2017 9/14/2017 Christopher Wilson Los Angeles, CA Ricky Yeager Marina del Rey, CA JERRY ZAMARIN L.A., CA Susan Zolla Los Angeles, CA Compliance Analyst P-2018 CBIZ Real Estate Finance P-2018 Benefit Mortgage FINANCIAL MGR P-2018 Hotel owner 1,000 1,000 1,000 P-2018 Inn at Playa del Rey SUBTOTAL 1,531.21

18 Schedule A Monetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) SCHEDULE A through Page 18 of 30 8/16/2017 Christopher Zonnas Marina Del Rey, CA PER ELECTION TO Real Estate P-2018 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 Total monetary contributions received this period. (add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL 31, , , * Contributor Codes IND - Individual - Recipient Committee (other than or ) - Other (e.g., business entity) - Political Party - Small Contributor Committee SUBTOTAL

19 Schedule B - Part 1 Loans Received SCHEDULE B - PART 1 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF MITTEE, ALSO ENTER ) (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD through Page of Alexis Edelstein Los Angeles, CA retired (b) AMOUNT THIS PERIOD (c) AMOUNT PAID OR FORGIVEN ** PAID FORGIVEN (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD 20,000 (e) INTEREST PAID THIS PERIOD 0 RATE % (f) ORIGINAL AMOUNT OF LOAN 20,000 (g) CUMULATIVE CONTRIBUTIONS TO 20,003 PER ELECTION** 20,004 P-2018 * 20,000 DUE 09/28/2017 INCURRED Schedule B Summary 1. Loans received this period (Total Column (b) plus unitemized loans of less than 100.) 20,000 * Contributor Codes 2. Loans paid or forgiven this period (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 Line 1.) Enter the net here and on the Summary Page, Column A, Line 2 NET 20,000 (May be a negative number) IND - Individual - Recipient Committee (other than or ) - Other (e.g., business entity) - Political Party - Small Contributor Committee SUBTOTALS 20, ,000 *Amounts forgiven or paid by another party also must be reported on Schedule A ** If required. (Enter (e) on Schedule E, Line 3)

20 Schedule B - Part 2 Loans Received SCHEDULE B - PART 2 through Page 20 of 30 FULL NAME, STREET ADDRESS AND ZIP CODE OF GUARANTOR (IF MITTEE, ALSO ENTER ) CODE IF AN INDIVIDUAL, ENTER (IF SELF-EMPLOYED, ENTER LOAN AMOUNT GUARANTEED CUMULATIVE TO BALANCE OUTSTANDING TO LENDER CALENDAR IND PER ELECTION SUBTOTAL Enter on Summary Page. Line 17 only.

21 Schedule C Nonmonetary Contributions Received FULL NAME, STREET ADDRESS AND ZIP CODE OF (IF MITTEE, ALSO ENTER ) CODE * AMOUNT/ FAIR MARKET VALUE SCHEDULE C through Page 21 of IND DESCRIPTION OF GOODS OR SERVICES CUMULATIVE TO (JAN 1 - DEC 31) 30 PER ELECTION TO Schedule C Summary 1. Amount received this period - itemized nonmonetary contr butions. (Include all Schedule C subtotals.) 2. Amount received this period - unitemized nonmonetary contributions of less than Total nonmonetary contr butions 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 - Recipient Committee (other than or ) - Other (e.g., business entity) - Political Party - Small Contributor Committee SUBTOTAL

22 Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures, and Committees SCHEDULE D through Page 22 of 30 NAME OF CANDI, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR MITTEE TYPE OF PAYMENT DESCRIPTION AMOUNT CUMULATIVE TO (JAN. 1 - DEC. 31) PER ELECTION TO Support Oppose Monetary Contribu ion Nonmonetary Contribu ion Independent Expenditure 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 Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) SUBTOTAL TOTAL

23 Schedule E Payments Made SCHEDULE E through Page 23 of 30 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, ) NAME AND ADDRESS OF PAYEE (IF MITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Rosa A. Bedoyauribe Equipment Los Angeles, CA OFC 3,900 Democracy Engine Credit Card Fees Washington, DC OFC Democracy Engine Credit Card Fees Washington, DC OFC Alexis Edelstein Admin consulting retainer Los Angeles, CA CNS 2,500 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL 6,598.74

24 Schedule E Payments Made SCHEDULE E through Page 24 of 30 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, ) NAME AND ADDRESS OF PAYEE (IF MITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Alexis Edelstein con Los Angeles, CA CNS 3,500 Alexis Edelstein Air travel for consultant: Dominque Medina Los Angeles, CA CNS Integrated Solutions: Political Bookkeeping software subscription San Diego, CA PRO Dominique Medina Website Design Phoenix, AZ OFC 3,500 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL 7,539.12

25 Schedule E Payments Made SCHEDULE E through Page 25 of 30 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, ) NAME AND ADDRESS OF PAYEE (IF MITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Dominique Medina Domain Names Phoenix, AZ OFC NationBuilder Website Design Los Angeles, CA WEB 199 Political Visions Bookkeeping San Rafael, CA PRO 750 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL 1,032.93

26 Schedule E Payments Made SCHEDULE E through Page 26 of 30 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, ) NAME AND ADDRESS OF PAYEE (IF MITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) 2. Unitemized payments made this period of under , 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 15, * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL

27 Schedule F Accrued Expenses (Unpaid Bills) SCHEDULE F through Page 27 of 30 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads RAD radio airtime and production costs RFD returned contr butions SAL campaign workers salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, ) NAME AND ADDRESS OF CREDITOR (IF MITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF (b) AMOUNT INCURRED (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF 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.) 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.) 3. Net change this period. (Subtract Line 2 Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) INCURRED TOTALS PAID TOTALS NET * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS

28 Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) SCHEDULE G through Page 28 of 30 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. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads RAD radio airtime and production costs RFD returned contributions SAL campaign workers salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, ) NAME AND ADDRESS OF PAYEE (IF MITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * Payments that are contributions or independent expenditures must also be summarized on Schedule D. 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.

29 Schedule H Loans Made to Others* SCHEDULE H FULL NAME, STREET ADDRESS AND ZIP CODE OF RECIPIENT (IF MITTEE, ALSO ENTER ) (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD through Page 29 of 30 (b) AMOUNT LOANED THIS PERIOD (c) REPAYMENT OR FORGIVENESS * (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD (e) INTEREST (f) ORIGINAL AMOUNT OF LOAN (g) CUMULATIVE LOANS TO PAID FORGIVEN RATE % PER ELECTION** DUE INCURRED SUBTOTALS *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E

30 Schedule I Miscellaneous Increases to Cash SCHEDULE I through Page 30 of 30 FULL NAME AND ADDRESS OF SOURCE (IF MITTEE, ALSO ENTER ) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH 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 Summary Page, Line 14.) TOTAL SUBTOTAL