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HomeMy WebLinkAboutThe Lincoln Club of Orange County State PAC - 2012 FPPC Camp (2)Supplemental Independent Expenditure Report (Government Code Section 84203.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. ❑ Amendment (Explain Below) I.D. NUMBER (If recipient committee) 1. Committee/Filer Information 970861 COMMITTEE/FILER'S NAME The Lincoln Club of Orange County State PAC STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Rancho Santa Margarita CA, 92688 949-451-4115 OPTIONAL: FAX / E-MAIL ADDRESS SUPPLEMENTAL INDEPENDENT EXPENDITURE Report covers pe riod Date QC'ALIFORNIA 465 10/01/2012 Ffrom ORM through 10/20/2012 Date of election if applicable: (Month, Day, Year) Treasurer (If recipient committee) NAME OF TREASURER Betty Presley MAILING ADDRESS rek Page 1 of 2 For Official Use Only CITY STATE ZIP CODE AREA CODE/PHONE Rancho Santa Margarita CA, 92688 949-858-7448 OPTIONAL: FAX / E-MAIL ADDRESS 2. Name of Candidate or Measure Supported or Opposed CHECK ONE NAME OF CANDIDATE OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE SUPPORT OPPOSE Barbara Delgleize City Council Member City of Huntington Beach X NAME OF BALLOT MEASURE BALLOT NO./LETTER JURISDICTION SUPPORT OPPOSE 3. Independent Expenditures Made Attach additional information on appropriately labeled continuation sheets. CUMULATIVE TO DATE DATE NAME AND ADDRESS OF PAYEE DESCRIPTION OF EXPENDITURE AMOUNT JAN. 1 - DEC 31 10/16/2012 Continuing the Republican Revolution (#598041) Newport Beach, CA 92660 Slate Card 600.00 600.00 FPPC Form 465 (June/09) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Supplemental Independent Expenditure Report Type or print in ink. Amounts may be rounded to whole dollars. from SUPPLEMENTAL INDEPENDENT EXPENDITURE Report covers period a R1, 10/01/2012 2 O through 10/20/2012 Page f SEE INSTRUCTIONS ON REVERSE g 2 NAME OF FILER I.D. NUMBER (If recipient corn.) The Lincoln Club of Orange County State PAC 970861 4. Summary 600.00 1. Total independent expenditures of $100 or more made this period. (Part 3.)........................................................................................... $ 2. Total independent expenditures under $100 made this period. Not itemized. $ 0.00 3. Total independent expenditures made this period (Add Lines 1 + 2.) TOTAL $ 600.00 5. Filing ®fficerS Enter the name and address of each filing officer with whom the filer's most recent campaign statements (Form 450, 460 or 461) have been filed. 1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER Secretary of State ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET) CITY STATE ZIP CODE CITY STATE ZIP CODE Sacramento, CA 95814 2) NAME OF FILING OFFICER 4) NAME OF FILING OFFICER ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET) STATE ZIP CODE CITY STATE ZIP CODE 6. Verification I certify that the" independent expend iture(s)" disclosed in this statement were not" made at the behest of" the candidate or committee that benefitted from the expenditure(s) as those terms are defined in Government Code Section 82031 and FPPC Regulation 18225.7. 1 have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein is true and complet I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 2' (4 - 1-2- By DATE k SIGNATURE OF FILE PyJREASURER OR ASSISTANT TREASURER Executed on DATE Executed on DATE Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT. OR RESPONSIBLE OFFICER OF SPONSOR By By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 465 (June/09) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Page 1 of 1 From: (949) 858-7448 Origin ID: JORA Betty Presley BETTY PRESLEY 1£ ASSOCIATES INC RANCHO SANTA MARGARI, CA 92688 J12201209200325 SHIP TO: (714) 536.5511 BILL SENDER City of Huntington Beach City Clerk HUNTINGTON BEACH, CA 92648 Date: 250CT12 CAD:985995NNET3300 Delivery AAddress iBar Code i�w Ref # reports Invoice # PO # Dept # FRI - 26 OCT Al TRK# 7939 32661005 PRIORITY OVERNIGHT 0201 92648 CA US WZ APVA SNA After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. 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