HomeMy WebLinkAbout06-30-2018 - Bernald Semi Annual 460 -Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period Date of election if applicable:
from I j I 11 S (Month, Day, Year)
through%l�
Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
Xj Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
Q Recall Q Controlled
(Also Complete Part 5)
Q Sponsored
F-1General Purpose Committee (Also Complete Part 6)
Q Sponsored ❑ Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
0 Political Party/Central Committee (Also Complete Part 7)
3. Committee Information
I.D. NUMBER
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Nb(rY-Ly nr1e Ber n q �d %(' Counc* 1 ao l $
STATE
6ar-atoaa C 1-N
ZIP CODE AREA CODE/PHONE
so 110
OPTIONAL. FAX / -MAIL ADDRESS
2. Type of Statement:
Date Stamp
RECEIVED
r! `l MPNAGER'S
2018 JUL 16 PM
11 ly:=i- SARATG
SARATOGA. Gi
❑ Preelection Statement
Ja Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
COVERPAGE
I of
For Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
Judy Johns+one
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL 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`` �V7
�' Date r
Executed on ilQ 1
Dateo
Executed on
Date
Executed on
Date
By
By
By
SignatureofControlling Officeholder, Candidate, State Measure Proponent
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
State of California
Recipient Committee Type or print in ink. COVER PAGE-PART2
CALIFORNIA
Campaign Statement• 1
Cover Page — Part 2 FORM
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Mari - Ly, nv�e f�)er,n(a 101
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Member, Soxato90- Ct4- j CoUY)Ct 1
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.
COMMITTFFNAhAT= I.D. NUMBER
NAM- ^- ToC:ARI IRFR CONTROLLED COMMITTEE?
_ ❑ YES ❑ NO
------ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME II.D. NUMBER
NAME OF TREASURERI CONTROLLED COMMITTEE?
❑ YES ❑ NO
UUMMI I I tt AUUKLJS b I KEE I AUUKESS (NU Y.U. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Page of 3
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
OFFICE SOUGHT OR HELD
BALLOT NO. OR LETTER
JURISDICTION
❑ SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
❑ SUPPORT
OFFICE SOUGHT OR HELD
DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee List names of
officeholder(s) or candidate(s) for which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)
State of California
Campaign Disclosure Statement Type or print in ink.
Summary Page Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Contributions Received
1. Monetary Contributions ........................................... Schedule A, Line 3 $
2. Loans Received...................................................... schedule e, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $
4. Nonmonetary Contributions .................................... Schedule c, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED ...... ••••.......••••.••.AddLines3+4 $
Expenditures Made
6. Payments Made .................................
7. Loans Made .......................................
8. SUBTOTALCASH PAYMENTS ..........
9. Accrued Expenses (Unpaid Bills) .....
10. Nonmonetary Adjustment .................
11. TOTAL EXPENDITURES MADE .........
...................... Schedule E, Line 4 $
Schedule H, Line 3
Add Lines 6 + 7 $
.... I... I ................. Schedule F, Line 3
......................... Schedule C, Line 3
.............. ......... Add Lines 8+9+10 $
SUMMARY PAGE
Statement covers period -NIA
4 f
from
I ,.
through (a-1.30 i S Page 3 of 3
I.D. NUMBER
Column A Column B
TOTALTHIS PERIOD CALENDAR YEAR
(FROMATTACHEDSCHEDULES) TOTALTODATE
Current Cash Statement
12. Beginning Cash Balance ....................... Previous summary Paye, Line 16 $
13. Cash Receipts ................................................... Column A, Line 3 above
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4
15. Cash Payments .................................................. Column A, Line 8 above
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, 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. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $
$
To calculate Column B, add
amounts in Column A to the
corresponding amounts
from Column B of your last
report. Some amounts in
Column A may be negative
figures that should be
subtracted from previous
period amounts. If this is
the first report being filed
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
:alendar Year Summary for Candidates
Running in Both the State Primary and
3eneral Elections iJ I A
1/1 through 6/30 7/1 to Date
20. Contributions
Received $ $
21. Expenditures
Made $ $
Expenditure Limit Summary for State
Candidates N ) in�'
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mmldd/yy)
__—J__—J$
$
Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)