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HomeMy WebLinkAboutFarley, Blair - 2013 FPPC Campaign Disclosure Forms for 2012 (2)Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE STATEMENT OF ORGANIZATION COMMITTEE NAME I.D. NUMBER Blair Farley for Council 2012 1270004 4. Type of Coltlmi tee Complete the applicable sections. o s o e ® List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election. • List the political party with which each officeholder or candidate is affiliated or check "non -partisan." • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHTAP HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Blair Farley Council Member 2012 ❑X Non -Partisan ❑ Non -Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION ADDRESS AREA CODEIPHONE CITY ACCOUNTN STATE ZIP CODE Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE FPPC Form 410 (April/2011) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Blair Farley for Council 2012 4. Type of Committee (Continued) e o e Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY e a o - e • List additional sponsors on an attachment. NAME OF SPONSOR STREETADDRESS NO. AND CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR ZIP STATEMENT OF ORGANIZATION Page 3 1270004 rear. uo<naenaeu[►ceat�3o�euuue e:aa� ❑ _J_J Date qualified 5. Termination RegluirementS By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. -- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511 - 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (April/2011) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. Statement covers period from 01/01/2013 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE through 04/17/2013 Page 3 of 4 NAME OF FILER I.D. NUMBER Blair Farley for Council-2012 1270004 Contributions Received Column A Column B Calendar Year Summary for Candidates " TOTALTHISPERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 0.00 $ 0.00, 111 through 6/30 7/1 to Date 2. Loans Received...................................................... Schedule e, Line 3 0.00 0.00 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 0.00 $ 0.00 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3+4 $ 0.00 $ 0.00 Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 825.14 $ 825.14 7. Loans Made............................................................. Schedule H, Line 3 0.00 0.00 8._. SUBTOTALCASH-PAYMENTS..................................... Add Lines -6+7 $ 825.14 $ -825.14. 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 0.00 0.00 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 825.14 $ 825.14 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 /, 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 e, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column a above $ 825.14 To calculate Column B, add 0.00 amounts in Column A to the corresponding amounts from Column B of your last 0.00 825.14 report. Some amounts in Column A may be negative 0.00 figures that should be subtracted from previous period amounts. If this is the first report being filed 0.00 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 0.00 0.00 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 (866/275-3772) IAnAI a/ nnfi'i/a nnm