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Home My WebLink AboutFarley, Blair - 2011 FPPC Campaign Disclosure Forms for 2012 (2)Type or print in ink. COVER PAGE - PART 2 Recipient Committee Campaign Statement �CALIFORNIA RMI ®® Cover Page — Part 2 Page 2 of 4 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Blair Farley OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 4702 Madrid Way Huntington Beach CA 92649 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. COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period ME= Summary gage to whole dollars. from 07/01/2011 SEE INSTRUCTIONS ON REVERSE through 12/31/2011 Page-3 of 4 NAME OF FILER I.D. NUMBER Blair Farley for Council 2012 1270004 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR Running in Both the State Primary and g (FROMATTACHED SCHEDULES) TOTAL TO DATE 7 General Elections 1. Monetary Contributions ........................................... Schedule A, Line $ $0.00 $ $0.00 1/1 through 6/30 7/1 to Date 2. Loans Received...................................................... Schedule B, Line $0.00 $0.00 3. SUBTOTALCASH 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 $ $204.00 7. Loans Made............................................................. Schedule H, Line 3 $0.00 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ $204.00 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 $0.00 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 $0.00 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8+9+10 $ $204.00 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 13. Cash Receipts ................................................... Column A, Line 3above 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15.Cash Payments .................................................. Column A, Line 8above 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 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2+ Line 9 in Column B above $ $1,665.14 $0.00 $0.00 $204.00 $1,461.14 $0.00 $0.00 $0.00 $ $204.00 $0.00 $ $204.00 $0.00 $0.00 $ $204.00 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* (It Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) JJ � 1 1 $ 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) Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement covers period Env= Summary Page to whole dollars. from01/01/2011 through 06/30/2011 Page 3 of 3 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Blair Farley for Council 2012 1270004 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR Running In Both the State Primary and r (FROM ATTACHED SCHEDULES) TOTALTO DATE g General Elections 1. Monetary Contributions ........................................... Schedule A, Line $ $0.00 $ $0.00 1/1 through 6/30 7/1 to Date 2. Loans Received...................................................... Schedule B, 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 •••..•. ...•..••........•••AddLines3+4 $ $0.00 $ $0.00 Made $ $ Expenditures Made 6. Payments Made... .................................................... Schedule E, Line 4 $ $0.00 $ $0.00 7. Loans Made............................................................. schedule H, Line 3 $0.00 $0.00 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ $0.00 $ $0.00 9. Accrued Expenses (Unpaid Bills) ............................... Schedule FLine 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 $ $0.00 $ $0.00 Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ $1, 665.14 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above $0.00 amounts in Column A to the corresponding amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 $0.00 from Column B of your last 15. Cash Payments .................................................. Column A, Line 8 above $0.00 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ $1, 665 . 14 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 e, Part 2 $ $0. 00 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Equivalents and Outstanding Debts Cash E q g 18. Cash Equivalents ........................................ See instructions on reverse $ $0.00 any). 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ $0.00 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subjectto 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) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee ®'= M INSTRUCTIONS ON REVERSE Page 3 Blair Farley for Council 2012 11270004 4. Type of Committee (Continued) 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 List additional sponsors on an attachment. NAME OF SPONSOR STREETADDRESS NO.AND ❑ _J 1 Date qualified GROUP OR AFFILIATION OF SPONSOR 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. -- 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 (June/09) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)