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HomeMy WebLinkAboutHuntington Beach Firefighters Association - 2009 FPPC Campai (2) Type or print in ink. COVER PAGE-PART 2 Recipient Committee Campaign Statement 'CAGIF�oRNi;a " Cover Page — Part 2 FORM 2/29 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO,OR LETTER F�7 ION ❑ SUPPORT ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS(NO.AND STREET) CITY STATE ZIP Identify the controlling officeholder,candidate,or state measure proponent,if any. NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Included in this Statement: List any committees OFFICE SOUGHT OR HELD DISTRICT NO.IF ANY not included in this statement that are controlled by you or are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME I.D.NUMBER 7. Primarily Formed 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 NAME OF TREASURER CONTROLLED COMMITTEE? ❑ SUPPORT ❑YES ❑NO ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [:] SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD COMMITTEE NAME I.D.NUMBER ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑YES ❑NO OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary i FPPC Form 460(June/01) FPPC Toll-Free Helpline:866/ASK-FPPC Cfafe of rnlifn►nin Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period CALIFQRNIA` Summary Page to whole dollars. JUL O 1 2009pR� ®. from SEE INSTRUCTIONS ON REVERSE DEC 3 1 2009 through 3/29 NAME OF FILER I.D.NUMBER HUNTINGTON BEACH FIREFIGHTERS ASSOCIATION 902235 Column oA ColumnD CALENDARAB Calendar Year Summary for Candidates Contributions Received TOTAL (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions............................................. Schedule A, Line 3 $ 14040.00 $ 34740.00 1/1 through 6/30 7/1 to Date 2. Loans Received Schedule B, Line 7 0.00 0.00 20. Contribution 3. SUBTOTAL CASH CONTRIBUTIONS............................ Add Lines 1 +2 $ 14040.00 $ 34740.00 Received $ 0.00 $ 0.00 4. Nonmonetary Contributions ................................... Schedule C, Line 3 0.00 0.00 21, Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED........................... Add Lines 3+4 14040.00 $ 34740.00 Made $ 0.00 $ 0.00 Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................................................ Schedule E,Line 4 $ 3194.00 $ 3569.00 Candidates 7. Loans Made .............................................................. Schedule H, Line 7 0.00 0.00 22. Cumulative Expenditures Made" 8. SUBTOTAL CASH PAYMENTS................................... Add Lines 6+7 $ 3194,00 $ 3569.00 (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses(Unpaid Bills) ............................. Schedule F, Line 3 0.00 0.00 Date of Election Total to Date (mm/dd/yy) 10. Nonmonetary Adjustment ......................................... Schedule C, Line 3 0,00 0.00 11, TOTAL EXPENDITURES MADE............................. Add Lines 8+9+ 10 $ 3194.00 $ 3569.00 $ Current Cash Statement $ 12. Beginning Cash Balance ..................... Previous Summary Page, Line 16 $ 199944.56 To calculate Column B,add amounts in Column A to the $ 13, Cash Receipts ................................................. Column A,Line 3 above 14040.00 corresponding amounts 14. Miscellaneous Increases to Cash " """""'" Schedule I, Line 4 1779.00 from Column B of your last report.Some amounts in $ Cash Payments ................................................. Column A,Line 8 above 3194.00 Column A may be negative 16. ENDING CASH BALANCE..... Add Lines 12+13+ 14,then subtract Line 15 $ 212569.56 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 $ for this calendar year,only r 17, LOAN GUARANTEES RECEIVED........................... Schedule B,Part 2 $ 0.00 carry over the amounts from Lines 2,7,and 9(if Cash Equivalents and Outstanding Debts any). `Since January 1, 2001.Amounts in this section may be 18. Cash Equivalents ........................................ See instructions on reverse $ 0.00 different from amounts reported in Column B. 19. Outstanding Debts ....................... Add Line 2+Line 9 in Column B above $ 0.00 FPPC Form 460(June/01) FPPC Toll-Free Helpline:866/ASK-FPPC a Schedule I Type or print in ink. L SCHEDULEI Miscellaneous Increases to Cash Amounts may be rounded Statement covers period to whole dollars. JUL 0 1 2009 CALIFORNIA60 from =FORwrfl,.,. . DEC 3 1 2009 29/29 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER LID.NUMBER HUNTINGTON BEACH FIREFIGHTERS ASSOCIATION 902935 DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF RECEIVED (IF COMMITTEE,ALSO ENTER I.D.NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH R /2 cot : ID: Deposit Made In Error-Corrected 12/31/09-See Sch u- 1755.00 Huntington Beach Firefighters le E PO Box 757 Huntington Beach CA 92648 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 1755.00 Schedule I Summary 1755.00 1. Increases to cash of$100 or more this period....................................................................................................................................... $ 2. Unitemized increases to cash under$100 this period. ....................................................................................................................... $ 24.00 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).)................................................ $ 4, Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14,).......................................................................................................................................................... TOTAL $ 1779.00 FPPC Form 460(June/01) FPPC Toll-Free Helpline:866/ASK-FPPC .40 Recipient Committee Type or print in ink. COVER PAGE-PART 2 ,z Campaign Statement cALi%oRNia, Cover Page — Part 2 FORM 460 2 /27 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO,OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE RESIDENTIAL/BUSINESS ADDRESS(NO.AND STREET) CITY STATE ZIP Identify the controlling officeholder,candidate,or state measure proponent,if any. NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT 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 OFFICE SOUGHT OR HELD DISTRICT NO,IF ANY contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME I.D.NUMBER 7. primarily Formed 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 NAME OF TREASURER CONTROLLED COMMITTEE? ❑ SUPPORT ❑YES ❑NO ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD COMMITTEE NAME I.D.NUMBER ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑YES ❑NO ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(June/01) FPPC Toll-Free Helpline:866/ASK-FPPC Cfa10 nf ralifnrnia Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Summary Page Amounts may be rounded Statement covers period g to whole dollars. CALIi`.ORNiA from JAN 01 2N9 ,,fORI through JUN � 0 2,009 3/27 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER HUNTINGTON BEACH FIREFIGHTERS ASSOCIATION 902935 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL CHEDS HED TOTAL TOCALENDA DATE Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 1, Monetary Contributions............................................. Schedule A, Line 3 $ 20700.00 $ 20700.00 2. Loans Received ......................................................... Schedule B,Line 7 0.00 0.00 1/1 through 6/30 7/1 to Date 20, Contribution 3. SUBTOTAL CASH CONTRIBUTIONS............................ Add Lines 1 +2 $ 20700.00 $ 20700.00 Received $ 0.00 $ 0,00 4. Nonmonetary Contributions ................................... Schedule C, Line 3 0.00 0,00 21, Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED........................... Add Lines 3+4 20700.00 $ 20700,00 Made $ 0.00 $ 0.00 Expenditures Made Expenditure Limit Summary for State 6. Payments Made ........................................................ Schedule E, Line 4 $ 375.00 $ 375.00 Candidates 7. Loans Made .............................................................. Schedule H,Line 7 0.00 0.00 22, Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS................................... Add Lines 6+7 $ 375.00 $ 375.00 (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses(Unpaid Bills) ............................. Schedule F, Line 3 0.00 0.00 Date of Election Total to Date (mm/dd/yy) 10. Nonmonetary Adjustment ......................................... Schedule C, Line 3 0,00 0.00 11. TOTAL EXPENDITURES MADE............................. Add Lines 8+9+ 10 $ 375.00 $ 375.00 $ Current Cash Statement $ 12, Beginning Cash Balance ..... Previous Summary Page,Line 16 $ 179619.56 To Calculate Column B.add amounts in Column A to the $ 13, Cash Receipts ................................................. Column A,Line 3 above 20700.00 corresponding amounts 14. Miscellaneous Increases to Cash Schedule I, Line 4 0.00 from Column B of your last report.Some amounts in $ Cash Payments ................................................. Column A, Line 8 above 375.00 Column A may be negative 16. ENDING CASH BALANCE..... Add Lines 12+ 13+ 14,then subtract Line 15 $ 199944.56 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 $ for this calendar year,only 17, LOAN GUARANTEES RECEIVED........................... Schedule B, Part 2 $ 0,00 carry over the amounts ' from Lines 2,7,and 9(if Cash Equivalents and Outstanding Debts any). `Since January 1, 2001,Amounts in this section may be 18. Cash Equivalents See instructions on reverse $ 0.00 different from amounts reported in Column B. 19. Outstanding Debts ....................... Add Line 2+Line 9 in Column B above $ 0.00 FPPC Form 460(June/01) FPPC Toll-Free Helpline:8661ASK-FPPC Type or print in ink. COVER PAGE PART 2 Recipient Committee Campaign Statement CALI�taR�ll� FORiIA Cover Page — Part 2 ' 2/3 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO.OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS(NO.AND STREET) CITY STATE ZIP Identify the controlling officeholder,candidate,or state measure proponent,if any. NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Included in this Statement: List any committees OFFICE SOUGHT OR HELD DISTRICT NO.IF ANY not included in this statement that are controlled by you or are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME I.D.NUMBER 7. Primarily Formed 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 NAME OF TREASURER CONTROLLED COMMITTEE? El SUPPORT ❑YES []NO ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD COMMITTEE NAME I.D.NUMBER El SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑YES ❑NO ❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) P CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(June/01) FPPC Toll-Free Helpline:866/ASK-FPPC State of California Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Aunts may be rounded Statement covers eriod Amounts Summary Page to whole dollars. p CALIFQRNIA from d71e/"1 &�W i=©RM SEE INSTRUCTIONS ON REVERSE through '121011' DES 3/3 NAME OF FILER I.D.NUMBER HUNTINGTON BEACH FIREFIGHTERS ASSOCIATION 902935 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTAL TO PATE g Primary General Elections 1. Monetary Contributions ............................................. Schedule A, Line 3 $ 0.00 $ 3390.00 2. Loans Received ......................................................... Schedule B, Line 7 0.00 0.00 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS............................ Add Lines 1 +2 $ 0.00 3390.00 20. Contribution $ Received $ 0.00 $ 0.00 4. Nonmonetary Contributions ................................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED........................... Add Lines 3+4 0.00 $ 3390.00 Made $ 0.00 $ 0.00 Expenditures Made Expenditure Limit Summary for State 6, Payments Made ........................................................ Schedule E, Line 4 $ 0.00 $ 0,00 Candidates 7. Loans Made .............................................................. Schedule H, Line 7 0.00 0.00 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS................................... Add Lines 6+7 $ 0.00 $ 0.00 (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ............................. Schedule F, Line 3 0.00 0.00 Date of Election Total to Date (mm/ddlyy) 10, Nonmonetary Adjustment ......................................... Schedule C, Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE............................. Add Lines 8+9+ 10 $ 0.00 $ 0.00 $ Current Cash Statement $ 12. Beginning Cash Balance ..................... Previous Summary Page, Line 16 $ 183509.56 To Calculate Column B,add amounts in Column A to the $ 13. Cash Receipts ................................................. Column A, Line 3 above 0.00 corresponding amounts 14. Miscellaneous Increases to Cash ....................................Schedule I, Line 4 0.00 from Column B Of your last report.Some amounts in $ Cash Payments ................................................. Column A, Line 8 above 0.00 Column A may be negative 16. ENDING CASH BALANCE..... Add Lines 12+ 13+ 14,then subtract Line 15 $ 183509.56 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 $ for this calendar year,only 17. LOAN GUARANTEES RECEIVED........................... Schedule B, Part 2 $ 0.00 carry over the amounts from Lines 2,7,and 9(if Cash Equivalents and Outstanding Debts any). 'Since January 1, 2001.Amounts in this section may be 18. Cash Equivalents ........................................ See instructions on reverse $ 0.00 different from amounts reported in 6olumn B. 19. Outstanding Debts ....................... Add Line 2+Line 9 in Column B above $ 0.00 FPPC Form 460(June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC Type or print in ink, COVER PAGE-PART 2 Recipient Committee Campaign Statement CALIFORNIA FORM 00, Cover Page — Part 2 2/5 5. Officeholder or Candidate Controlled Committee 6. Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO,OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE RESIDENTIAUBUSINESS ADDRESS(NO.AND STREET) CITY STATE ZIP Identify the controlling officeholder,candidate,or state measure proponent, if any. NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT Related Committees Not Included in this Statement: List any committees OFFICE SOUGHT OR HELD DISTRICT NO.IF ANY not Included In this statement that are controlled by you or are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME I.D.NUMBER 7, Primarily Formed 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 NAME OF TREASURER CONTROLLED COMMITTEE? ❑ SUPPORT ❑YES ❑NO ❑,OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO P.O,BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD COMMITTEE NAME I.D.NUMBER ❑ SUPPORT ❑ OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑YES ❑NO '❑ OPPOSE COMMITTEE ADDRESS STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460(June/01) FPPC Toll-Free Helpline:866/ASK-FPPC Cfsta of 1%aiifnrnis Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Summary Page Amounts may be rounded Statement covers period CALIF©17iVIA to whole dollars. from Ol�bt��DDS FORD SEE INSTRUCTIONS ON REVERSE through io(o h.Sb l g b o 3/5 NAME OF FILER I.D.NUMBER HUNTINGTON BEACH FIREFIGHTERS ASSOCIATION 902935 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THISPERIOD TOTAL TOCALENDARDATE Running in Both the State Prima and (FROM ATTACHED SCHEDULES) TOTAL TO DATE 9 Primary General Elections 1. Monetary Contributions............................................. Schedule A, Line 3 $ 3390.00 $ 3390.00 2. Loans Received ......................................................... Schedule B,Line 7 0.00 0.00 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS............................ Add Lines 1 +2 $ 3390.00 3390.00 20. Contribution $ Received $ 0.00 $ 0.00 4. Nonmonetary Contributions ................................... Schedule C,Line 3 0.00 0.00 21, Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED........................... Add Lines 3+4 3390.00 $ 3390.00 Made $ 0.00 $ 0.00 Expenditures Made Expenditure Limit Summary for State 6. Payments Made........................................................ Schedule E, Line 4 $ 0.00 $ 0.00 Candidates 7. Loans Made .............................................................. Schedule H, Line 7 0.00 0.00 22. Cumulative Expenditures Made' 8. SUBTOTAL CASH PAYMENTS................................... Add Lines 6+7 $ 0.00 $ 0,00 (If Subject to Voluntary Expenditure Limit) 9, Accrued Expenses(Unpaid Bills) ............................. Schedule F, Line 3 0.00 0.00 Date of Election Total to Date (mm/dd/yy) 10, Nonmonetary Adjustment ......................................... Schedule C,Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE............................. Add Lines 8+9+ 10 $ 0.00 $ 0.00 $ Current Cash Statement $ 12. Beginning Cash Balance ..................... Previous Summary Page,Line 16 $ 179619,56 To calculate Column B,add amounts in Column A to the $ 13. Cash Receipts ................................................. Column A,Line 3 above 3390.00 corresponding amounts 14, Miscellaneous Increases to Cash ....................................Schedule I,Line 4 500.00 from Column B of your last report,Some amounts in $ Cash Payments ................................................. Column A, Line 8 above 0.00 Column A may be negative 16. ENDING CASH BALANCE.,... Add Lines 12+ 13+14,then subtract Line 15 $ 183509.56 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 $ for this calendar year,only 17, LOAN GUARANTEES RECEIVED........................... Schedule B, Part 2 $ 0,00 carry over the amounts o from Lines 2,7,and 9(if Cash Equivalents and Outstanding Debts any). "Since January 1,2001.Amounts in this section may be 18. Cash Equivalents See instructions on reverse $ 0,00 different from amounts reported in Column B. 19. Outstanding Debts ....................... Add Line 2+Line 9 in Column B above $ 0.00 FPPC Form 460(June/01) FPPC Toll-Free Helpline:866/ASK-FPPC Schedule A Type or print in ink. SCHEDULE A Amounts may be rounded Statement covers period W' Monetary Contributions Received to whole dollars. CALIFOR A', from 0 i)b I )Z b D 9i FC)RM 4610 SEE INSTRUCTIONS ON REVERSE through 1)1, 4/5 NAME OF FILER I.D. Number HUNTINGTON BEACH FIREFIGHTERS ASSOCIATION 902935 FULL NAME,MAILING ADDRESS IF AN INDIVIDUAL,ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE AL CONTRIBUTOR OC CONTRIBUTOR CUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED AND ZIP CODE CODE IF SELF-EMPLOYED,ENTER NAME (IF COMMITTEE,ALSO ENTER I.D.NUMBER) ( PERIOD (JAN.1-DEC.31) (IF REQUIRED) OF BUSINESS) ❑ IND ❑ COM ❑ OTH ❑ PTY ID: ❑ SCC SUBTOTAL $ 0.00 Schedule A Summary Contributor Codes 1. Amount received this period - contributions of$100 or more. 0.00 IND -Individual (Include all Schedule A subtotals.) $ COM -Recipient Committee 339000 (other than PTY or SCC) 2. Amount received this period - unitemized contributions of less than $100 . OTH $ -Other PTY-Political Party 3. Total monetary contributions received this period. 3390.00 SCC-Small Contributor Committee (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) .................... TOTAL $ FPPC Form 460(JUNE101) FPPC Toll-Free Helpline:866/ASK-FPPC STATEMENT OF ORGANIZATION Statement of Organization ® � Recipient Committee ° INSTRUCTIONS ON REVERSE Page 3 of 4 COMMITTEE NAME I.D.NUMBER HUNTINGTON BEACH FIREFIGHTERS ASSOCIATION 902935 4. Type of Committee Complete the applicable sections, ® 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. EFFECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE/OFFICE HOLDER/STATE MEASURE PROPONENT INCLUDE DISTRICT NUMBER IF APPLICABLE YEAR OF ELECTION PARTY ❑ Non-Partisan ❑ Non-Partisan ® List the financial institution where the campaign back account is located (controlled"candidate election"committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE n Primarily formed to support or oppose specific candidates or measures in a single election, List below: CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION CANDIDATES NAME OR MEASURES FULL TITLE INCLUDE BALLOT NO.OR LETTER INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE CHECK ONE SUPPORT OPPOSE FPPC Form 410(January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC(8661275.3772) 1388708-1 STATEMENT OF ORGANIZATION Statement of Organization c iFtilkNiA 1 Recipient Committee • ' 411 INSTRUCTIONS ON REVERSE Page 4 of 4 COMMITTEE NAME I.D,NUMBER HUNTINGTON BEACH FIREFIGHTERS ASSOCIATION 902935 4. Type of Committee (Continued) eo o 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 TO SUPPORT OR OPPOSE CANDIDATES WHICH FURTHER THE GOALS OF THE ORGANIZATION List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR HUNTINGTON BEACH CITY FIREFIGHTERS ASSOCIATION SPONSORING ORGANIZATION STREET ADDRESS CITY STATE ZIP CODE PO BOX 757 HUNTINGTON BEACH CA 92626 ° ° ° ° ❑ _ Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Date qualified small contributor committee on January 1,2001,enter 1/1/01. 5. Termination RequirementS 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. 9 m 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, FPPC Form 410(January105) FPPC Toll-Free Helpline: 866/ASK-FPPC(866/275-3772) 1388708-1