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Home My WebLink AboutFIRES PAC - Form 410 - Termination - 02-10-15Statement of Organization Recipient Committee Statement Type ❑ Initial ❑ Amendment Notyetqualified ❑ or List I.D. number: # Date qualified as committee Date qualified as committee (If applicable) 1. Committee information NAME OFCOMMITTEE N LTermination -See Part 5 t I.D. number: # gS2_ i8o Date of Termination f `;tff�fFM7 -6 _#4*t.a }Zt7tlrrJfl STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS OF Date Stamp - - RECEIVED FEB 10 20151 S IJ CITY C'_. -_. 2. Treasurer and Other Principal Officers 'J NAME OF TREASURER I el For Official Use Only STREET ADDRESS (NO P.O. 300 � CITY STATE ZIP CODE AREA CODE /PHONE OF ASSI5iANT TREASURER, IF ANY FAX/ E -MAIL ADDRESS STREET ADDRESS (NO P.O. BOX) DOMICILE I JURISDICTION WHERE COMMITTEE IS ACTIVE Attach additional information on appropriately labeled continuation sheets. Verification I have used all reasonable diligence in preparing this penalty of perjury under the laws of the State of ,r SiGNA7UUWF TREASURER OR OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Dec /2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period 1_-�/4 from ,JA -t.) through ;'�o /dam Z6/5 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part 5) O Sponsored General Purpose Committee (Also Complete Part 6) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Part) 3. Committee Information I.D. NUMBER �.-+ 7 _ COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) STREET ADDRESS (NO P.O... BOX)) CITY STATE ZIP CODE AREA CODE/PHONE , t I ,6;7rU MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX / E -MAIL ADDRESS 4. Verification 1 have used all reasonable diligence in preparing and reviewing this statement and to the best of my k under penalty of perjury under the laws of the State of California t. 7that the foregoing is true and correc Executed on �J ` / L ��J By -- Date Executed on 2--1 15 By Sy tatu eof [ Executed on BY Date Executed on — By Date Date of election if applicable: I (Month, Day, Year) Date Stamp 2. Type of Statement: ❑ Preelection Statement ❑ Semi - annual Statement >`fermination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) COVER PAGE Page I of For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E -MAIL ADDRESS information contained herein and true and complete. I certify `en FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612753772) State of California ~Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period Summary Page to whole dollars. so /3 . ' J from Z� • / 6 3 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER � - I.D NUMBER 0 - �Lz Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTALTODATE General Elections 1. Monetary Contributions ............ ............................... Schedule A, Line $ $ �--� 1/1 through 6130 711 to Date 2. Loans Received ................ _ ....... __ ....... __ ....... ..,... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ........................ Add Lines 1 +2 $ $ 20. Contributions Received $ $ 4. Nonmonetary Contributions ..... ............................... Schedule c, Line 3 _ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............ .............. Add Lines 3 + 4 $ $ Made $ $ Expenditures Made Expenditure Limit Summary for State Candidates 6. Payments Made ..... .......... ............................... Schedule E, Line 4 $ $ 7. Loans Made .............................. ............................... Schedule H, Line 3 �w 1, 22. Cumulative Expenditures Made` Subject to Voluntary Expenditure Limit) 8. SUBTOTAL CASH PAYMENTS ..... ............................... Add Lines 6 +7 $ $ (If 9. Accrued Expenses (Unpaid Bills) ........ ....................... Schedule F Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 (mm /dd /yy) 11. TOTAL EXPENDITURES MADE .... ............................Add Lines s + s + 10 $ $ _�� $ Current Cash Statement t �,, 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 a above'` oil 1 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 7 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 $ 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). *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) SchYdule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers Mriod from through *j,)/ /a 12-015 SCHEDULE E (CONT.) Page of NAME OF FILER I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CHIP campaign paraphernalia /misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants UM meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing /ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals IND independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration Lfr campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER LID NUMBER) DE OR DESCRIPTION OF PAYMENT AMOUNT PAID 4 _. )3/ z0 .. a * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)