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

Transcription

1 Recipient Cmmittee Campaign Statement Cver Page (Gvernment Cde Sectins ) 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 VALLE...! f,: 2114 JAN 3 I PI1 3: J Fr Official Use On y OFF~F C/[Y CLERK;' 1. Type f Recipient Cmmittee: All Cmmittees - Cmplete Parts 1, 2,3, and 4. It2! Officehlder, Candidate Cntrlled Cmmittee Primarily Frmed Ballt Measure State Candidate Electin Cmmittee Cmmittee Recall Cntrlled (Als Cmplete Part 5) Spnsred (Als Cmplete Part 6) General Purpse Cmmittee Spnsred Primarily Frmed Candidatel Small Cntributr Cmmittee Officehlder Cmmittee (Als Cmplete Part 7) Plitical Party/Central Cmmittee 3. Cmmittee Infrmatin COMMITTEE NAME (OR CANIATE'S NAME IF NO COMMITTEE) 2. Type f Statement: Preelectin Statement It2! Semi-annual Statement Terminatin Statement (Als file a Frm 410 Terminatin) Amendment (Explain belw) Treasurer(s) SARIT JUGE MAILING ARESS Quarterly Statement Special Odd-Year Reprt Supplemental Preelectin Statement - Attach Frm 495 CITY STATE ZIP COE AREA COE/PHONE CITY STATE ZIP COE AREA COE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ARESS (IF IFFERENT) NO. AN STREET OR P.O. BOX MAILING ARESS CITY STATE ZIP COE AREA COE/PHONE CITY STATE ZIP COE AREA COE/PHONE OPTIONAL: FAX / ARESS OPTIONAL: FAX / ARESS 4. Verificatin I have used all reasnable diligence in preparing and reviewing this statement and t the best f my knwledge the inflll),8ti!}cn~ined herein and in the attached schedules is true and cmplete. I certify under penalty f pe~ury under the laws f the State f Califmia that the freging is true and crrect. 1/31/14 1/31/14 Y'I'~~ Sitfnature:aJ?t ~anttreasurer ~,..~ "' ~._,.f_.~ "'"_._ ~._._ Uu_.. " u_u' "uu '.'_ Signature. a f' Cntrlling Officehlder, Ca ndl 'd ate, S tate Measure Prpnent Signature f Cntrlling Officehlder, Candidate, State Measure Prpnent FPPC TlI Free Helpline: 866/ASK FPPC (866/ ) State f Califrnia

2 Recipient Cmmittee Campaign Statement Cver Page - Part 2 COVER PAGE - PART 2 isea 5. Officehlder r Candidate Cntrlled Cmmittee 6. Primarily Frmed Ballt Measure Cmmittee (INCLUE LOCATION AN ISTRICT NUMBER IF APPLICABLE) CITY COUNCIL (SIMI VALLEY) RESIENTIAUBUSINESS ARESS (NO. AN STREET) CITY STATE ZIP NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISICTION Identify the cntrlling fficehlder, candidate, r state measure prpnent, if any. NAME OF OFFICEHOLER, CANIATE, OR PROPONENT 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. ISTRICT NO. IF ANY COMMITTEE NAME I..NUMBER COMMITTEE ARESS CONTROLLE COMMITTEE? YES NO 7. Primarily Frmed Candidate/Officehlder Cmmittee List names f fficehlder(s) r candidate(s) fr which this cmmittee is primarily frmed. CITY STATE ZIP COE AREA COE/PHONE COMMITTEE NAME COMMITTEE ARESS CONTROLLE COMMITTEE? YES NO CITY STATE ZIP COE AREA COE/PHONE Attach cntinuatin sheets if necessary FPPC Tll-Free Helpline: 866/ASK-FPPC (866/ ) State f Califrnia

3 Campaign isclsure Statement Summary Page SUMMARY PAGE Cntributins Received 1. Mnetary Cntributins.... Schedule A, Line 3 2. Lans Received.... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS... Add Lines Nnmnetary Cntributins... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVE... Add Lines ClumnA TOTAL THIS PERIOO (FROMATIACHE SCHEULES) ClumnB CALENOARYEAR TOTAL TO OATE thrugh 12/31/13 Page 3 f 5 Calendar Year Summary fr Candidates Running in Bth the State Primary and General Electins 1/1 thrugh 6/30 7/1 t 20. Cntributins Received Expenditures Made 0 0 Expenditures Made 6. Payments Made Schedule E, Line 4 7. Lans Made... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS... AddLines Accrued Expenses (Unpaid Bills)... Schedule F. Line Nnmnetary Adjustment... Schedule C, Line TOTAL EXPENITURES MAE... Add Lines Expenditure Limit Summary fr State Candidates 22. Cumulative Expenditures Made' (If Subject t Vluntary Expenditure Limit) f Electin (mm/dd/yy) Ttal t 0 Current Cash Statement 12. Beginning Cash Balance... Previus Summary Page, Line Cash Receipts... Clumn A, Line 3 abve 14. Miscellaneus Increases t Cash... Schedule I, Line Cash Payments Clumn A, Line 8 abve 16. ENING CASH BALANCE... Add Lines , then subtract Line 15 If this is a terminatin statement, Line 16 must be zer. 17. LOAN GUARANTEES RECEIVE Schedule B, Part 2 Cash Equivalents and Outstanding ebts 18. Cash Equivalents See instructins n reverse 19. Outstanding ebts Add Line 2 + Line 9 in Clumn B abve 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 perid 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) ~ 0 Amunts in this sectin may be different frm amunts reprted in Clumn B. FPPC TlI Free Helpline: 866/ASK FPPC (866/ )

4 ScheduleC Nnmnetary Cntributins Received SCHEULEC thrugh 12/31/13 Page I..NUMBER f S- ATE RECEIVE FULL NAME, STREET ARESS AN ZIP COE OF CONTRIBUTOR (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) IF AN INIVIUAL, ENTER CONTRIBUTOR I OCCUPATION AN EMPLOYER COE * (IF SELF-EMPLOYE, ENTER NAME OF BUSINESS) ESCRIPTION OF GOOS OR SERVICES AMOUNT! FAIR MARKET VALUE CUMULATIVE TO ATE CALENAR YEAR (JAN 1 - EC 31) PER ELECTION TO ATE (IF REQUIRE) IN COM OTH PTY SCC IN COM OTH PTY SCC IN COM OTH PTY SCC IN COM OTH PTY SCC Attach additinal infrmatin n apprpriately labeled cntinuatin sheets. SUBTOTAL Schedule C Summary 1. Amunt received this perid - itemized nnmnetary cntributins. (Include all Schedule C subttals.) Amunt received this perid - unitemized nnmnetary cntributins f less than Ttal nnmnetary cntributins received this perid. (Add Lines 1 and 2. Enter here and n the Summary Page, Clumn A, Lines 4 and 10.)... TOTAL Cntributr Cdes IN -Individual COM - Recipient Cmmittee (ther than PTY r SCC) OTH - Other (e.g., business entity) PTY - Plitical Party SCC - Small Cntributr Cmmittee FPPC TlI Free Helpline: 866/ASK FPPC (866/ )

5 ScheduleE Payments Made SCHEULEE thrugh 12131/13 Page --S- f c;:;- COES: If ne f the fllwing cdes accurately describes the payment, yu may enter the cde. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member cmmunicatins RA radi airtime and prductin csts CNS campaign cnsultants MTG meetings and appearances RF 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 lrc candidate travel, ldging, and meals FN fundraising events POL plling and survey research lrs staff/spuse travel, ldging, and meals INindependent 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, ) NAME AN ARESS OF PAYEE (IF COMMITIEE. ALSO ENTER 1.0. NUMBER) COE OR ESCRIPTION OF PAYMENT AMOUNT PAI * Payments that are cntributins r independent expenditures must als be summarized n Schedule. SUBTOTAL Schedule E Summary 1. Itemized payments made this perid. (Include all Schedule E subttals.) Unitemized payments made this perid f under Ttal interest paid this perid n lans. (Enter amunt frm Schedule S, Part 1, Clumn (e).) Ttal payments made this perid. (Add Lines 1,2, and 3. Enter here and n the Summary Page, Clumn A, Line 6.)... TOTAL FPPC Tll-Free Helpline: 866/ASK FPPC (866/ )