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Home My WebLink AboutBohr, Keith - 2009 FPPC Campaign Disclosure Forms - SuccessfRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. State e t ov s/"�pe�riod from through [2-17 Date of election if applicable: (Month, Day, Year) Date Stamp 21,31? DEC 21 PM COVER PAGE I of For Official Use Only 1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. 2. Type of Statement: Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd -Year Report Q Recall . Q Controlled ❑ Termination Statement ❑ Supplemental Preelection (Also Complete Part5) O Sponsored (Also file a Form 410 Termination) Statement - Attach Form 495 (Also Complete Part 6) i ❑ General Purpose Committee Amendmen (Explain elo Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part7) 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME MM N_�AMEE IF NO COMMITTEE) F0';C4'5 '—� E' STREET ADDRESS (NO P.O. BOX) C V^t , /J STATE ZIP CODE AREA CODE/PHONE (� c� 4r_"00q '?26VsK 71y- s-w-92, MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY II� // Oh%STATE ZIP CODE AREA CODE/PHONE ' c:,44- �-�G1 tlC C! OPTIONAL: FAX / E-MAIL ADQRfSS Treasurer(s) NAME OF TREASURER MAILING ADDRESS 1, CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY 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 M21-7- latate of California that the foregoing is true and correct. Executed on By � Dale Signature of Treasurer orAssistant Treasurer Executed on By Date Signature of Controlling Officeholder,Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) State of California Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statemer t c vers period Date of election if appli (Month, Day, Year) from through & D CKe1vL :7:7_Lelci Date Stamp 12 0.F.-C 2 1 PHI 1<3 i Page of ___' For Official Use Only 1. Type of Recipient Committee: All committees - Complete Parts 1, 2, 3, and 4. 2. Type of Statement: Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd -Year Report Q Recall Q Controlled ❑ Termination Statement ❑ Supplemental Preelection (Also Complete Part5) Sponsored 0 p (Also file a Form 410 Termination) Statement -Attach Form 495 ❑ General Purpose Committee (Also Complete Part 6) Amendment (Explailelo Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee 4LLec Q Political Party/Central Committee (Also complete Part7) 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Fel-r_-J's 0-p t- ao4r STREET ADDRESS (NO P.O. BOX) CJT'Y /J STATE ZIP CODE AREA CODE/PHONE t (/�/J/ CA 4,2c y9' 71Y- s-,)1, .? MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX AREA CODE/PHONE CITY STATE ZIP CODE k M OPTIONAL: FAX / E-MAIL ADbRtSS Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY 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 th laws of a State of California that the foregoing is true and correct. Executed on 24 l Z__ By Date Sign tureofTreasurerorAssistant Treasurer -�! Executed on / By Datd Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Data Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) State of California Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. SEE INSTRUCTIONS ON REVERSE SUMMARYPAGE Statement covers period C-ALIFORNU I • 1 from 7/1/09 FORM through 12/31/09 Page 3 of 3 NAME OF FILER I.D. NUMBER Friends of Keith Bohr 1242607. Contributions Received ColumnA Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD CALENDARYEAR Running In Both the State Prima and Primary (FROM ATTACHED SCHEDULES) TOTALTO DATE g General Elections 1. Monetary Contributions ........................................... schedule A, Line 3 $ 0 $ 0 0 0 1/1 through 6/30 7/1 to Date 2. Loans Received...................................................... Schedule a, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 $ 0 $ 0 20. Contributions ......................... Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ......... .................. Add Lines 3+4 $ 0 $ 0 Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 0 $ 7. Loans Made............................................................. schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 0 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 0 10. Nonmonetary Adjustment .......................................... schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8+9+10 $ 0 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, 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 $ 19,314.76 0 0 0 19,314,.78 0 0 0 r 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) *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 (866/276-3772) Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Statement covers period Amounts may be rounded Summary Page to whole dollars. imm 1/1/09 from SEE INSTRUCTIONS ON REVERSE through 6/30/09 Page 3 of 3 NAME OF FILER I.D. NUMBER Friends of Keith Bohr 1242607 Contributions Received ColumnA Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ Q $ Q 0 0 1/1 through 6/30 7/1 to Date 2. Loans Received...................................................... Schedule a, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 0 $ 0 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED•..........••..............AddLines3+4 $ 0 $ 0 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ....................................................... Schedule E, Line 4 $ 0 $ 0 Candidates 7. Loans Made............................................................. Schedule H, Line 3 0 0 0 0 22. Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ $ (if Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... ScheduleC, Line 0 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 0 $ 0 ^ J� $ $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 19,314,78 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above 0 amounts in Column A to the 14. Miscellaneous Increases to Cash ........................... Schedule /, Line 4 0 corresponding amounts from Column B of your last *Amounts in this section may be different from amounts reported in Column B. 15. Cash Payments .................................................. Column A, Line 8 above Q report. Some amounts inColumn A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 19,314.78 figures that should be subtracted from previous If this is a termination statement Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... Schedule A Part 2 $ 0 for this calendar year, only carry over the amounts from Lines 2, 7, ands (if Cash Equivalents and OutstandingDebts � any). 18. Cash Equivalents ........................................ See instructions on reverse $ 0 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column a above $ 0 FPPC Form 460 (January/05) FPPC ToWFree Helpline: 866/ASK-FPPC (866/275-3772)