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2004, CANDIDATE ROMERO DAVE2004 0 0 Candidate Romero, Dave Elections I 702.02 Legislative & Legal � I( o I= 0 MEMORANDUM ? ^4^.aW i y ...su .�-..'a_, ,.�!.Y..CN41RsFt'�C.'l+ ;t> .,FF's"'d`'�ir�, �v"5yz., '' ' -rE e.• DATE: January 22, 2008 TO: Memo to Candidates Files FROM: Audrey Hooper, City Clerk SUBJECT: Late Form&470 — Officeholder Campaign Statement In reviewing elected officials' campaign files for the non -election years during which they have served in their current positions, the Clerk's staff discovered that California Forms 470 were not filed by many of them. When this error was discovered', we requested Council members submit the missing forms as required. Attached is the form speck to the election period contained in this file. No fines have been assessed because this oversight occurred for two reasons: due to a change in the City Clerk's staff over the years and a misunderstanding related to the City's election campaign regulations ordinance. Because all elected officials' campaign accounts were closed following each election as required by the City's ordinance, candidates were not advised they still needed to file the Form 470 per the State's requirement. /ah G.t702-11 Semi-armual Campaign Statements101-22-08 Memo re Late 470s.doc 01-22-08 Memo m /ate 470s U � Y-' cn Epr00)a S 3 o m 0. Mvm Cb O r CD m mCD: c0 da O o. m O ►.i (a CL CD nN m S 0) C 91 V - 0) S 3 ° � J D �. 0o c c ya gas ° 0 a) O d S m N O 3 a- (1) m vm N O CL M,< CD 0 3 CD. 0 3 V o- mcc vD D) � (0-0 =o' y' w y a N � m � (D D7 7 :E- CD 00 (D fD C. r CD c y 3 (D CD 3 3 69 92J M S (D (D 3 N O 0 0 na D1 C O co M. S N m w 0 K U] cn a w O r LI M m m z O rt K r• m A r �. O d� 3 CD o X10 0 CD vpi 'O'h oO m m z 01 D (j m O Z 0 3 o C _ a o m z m p M m �a (D S m m B N 0 CD _a O O O 3 n 3 �p m m c) O D O O O � m O m C m CD Vl O 0 CD a C Cl) CDO 3 0) m '^ 0 O m C l md C a m m D A 00O 00 L D V S oD 1I m V 0 t O m O c c m m :7 s 1 lTJ r rn �O� m. 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K ;u U ]CD C: \ ; � 2 / CD m ( o - 00 , ].$ o , ° $ � / � |� Major Donor and Independent Expenditure Committee T�'0O0fP"nt1n1n1` Campaign Statement (GoFaoneocadsaer5 80004sna.$) SdtmHentmverepaMd DateddecdaHBappSeaWx 01- WH OW.YOW) e n 01/01/2004 SEE eIBTRucnoNs Ok REVS aWaloi 12/31/2004 04/26/2005 (kW Oneme(s) dab anumad erias wase c0rmmufta we' HdMU eTelNrlerO_) San Luis Obispo Norketplaee Asaxiates, LLC - CRY SUTE 21PCODE Sas Lula Obispo. CA 91741 (Ri�ar is otheriflan an kldlvldtHeO William eitd 626-963-1505 Nature and Interests of Filer (carpimseamgocabbaalmni A FILER WHO S AN IHICIADUAL U= LW TW MA4E. ADCESS.AM BISaESS WERESM OF EWLOYER OIL IF SELFSPLOYED. THE MANE. ADDRESS, AND NRIIRE OF THE SISOESS MANE OF EMPLOYERIBVSOJESS susna S3 D(rEfESiS ADDRESS OF eZILOYEwwcaEss Z❑ A FILER TNR I6 A BUSINESS ENnrY WST DESCRIBE THE BUSINESS AC"VM IN MOM rr IS ENGAGED Real Rotate A FILER TNR S AN UAL- SUMMERS nNnTY, OR ASSOCLAIM MUST DESCRIBE THE OF TME GROUP OR aanY RECEIVED rt8 SLO CITY CLERK (ABWderney ee rcalded tOvdlale defers.) 1. FxpeAUtu es and contributions (QndUmng loom) of $100 or mom made the period. (Part S.) .................. 2 Unitemized e>rpendihaes and contributions ons (1ndudbg bans) under $10D made this period ........................ 3. Total and con0bnrbons made this period (Add Lines 1 + 2.).... 4. Tafel expenditures and contnbAons made from prior staiernot. (Enter amount from Line 5 of last statement filed. If 1Ms is the W statement for the OBlarldar yam enter Zero.) ..........., S. Totaf erperWiWres and contributions (Including loans) made amts January 1 of the amend calendar year. (Add tides 3 + 4.).— ......................... Pa. 1 Of 13 $ 140,236.48 ... $ 0.00 SUBTOTAL $ 140,236.48 $ 0.00 TOTAL $ 140.236.ae Verif athm 1 haw used all reasonable dliigerloe in prepoirg this smtemerd I have revievYed the Statement and to the beat of my knowledge Ste inibm dim contzrned herein Is true and complete. I certify under penalty of pork". render the laws of the State of California that FPPC Form 461( WAM ❑ Amendmerrt (E n): FPPC TOFFree tiagln SWA81F14301C sesc7sam Major Donor and Independent Expenditure Committee Campaign Statement Typeorpdrdlnb& Am,udsuMberouded 0o . . do6a3e. Sutermet,ovMepeebd from 01/01/2004 12/31/200{ Baa Luis Obispo Marketplace Associates, u,C. I Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expend -fires Made (/emreapaeeis ,e I I umadAi vwc gssaFV&P ge/oremLmogwaVeft) Pap 2 Of13 7% DATE FAME. STET ADDRESS. CRY, IOD Y, S11P CODE 'TYPE OF PAYMENT OESQBPIIOMOF FMYM9IT CANDIDATE AND OFROE.RE MEASURE AND JURISDICTION. AMOUNT THIS REINED THIS AMOUNT OF FAYEE OF OTERTNMI MOIEEOIRY OR COMMrrTEE PERIOD CANDIDATE, MEASURE. OF COMMO E &30 F La NUMM mm®unON OR LOW OR COMMRTF£ 08/09/3004 Davie Group ❑ MMma1 Consulting SeMical Nea,ure A-05, B-65 and 2,500.00 129,868.38 ConablYm C -OS ❑ Loss ❑ Cu City of Ban Lute Obispo Iami Beach, CA 90603 ® ® SInpON ❑ Oppose 08/30/2004 Andre, M,rria 6 Bsttrxy ❑ MMesT Legal fee, Measure A -OS, B-05 and 11,866.37 129,868.38 Ceeobeon C-05 13 Lose E] " I E] Cance City of San Luis Obispo San Lute Obispo, CA 93406 ® Enorm2kno OMa ® SUPW ❑ Oppose 08/31/2004 Barnett Cox i Associates ❑ MMMsy Public Relation, McsGUXe A-05, 8-05 and 185.26 129,868.38 Canal Services C-05 lose ❑ ❑ w City of San Lnie Obispo Ban Luis Obispo, CA 93401 ®Evendhre ® &Wport ❑ OPw 09/14/2004 Bell, MCAndrera 6 811tathk ❑ -Manes) ltgal fees Measure A-05, B-05 and 7,695.50 129,666.35 Contmdm C-05 ❑ Lose ❑ City of San Luis Obispo Santa Monica, CA 90401 53 ®SST ❑ Oppose SLB MAL f 22,247.13 : FPM Form 167 (JaII03) FM To4Fwo i o"= 8681ASKfPPC S8B27S4= Major Donor and Independent Expenditure Campaign Statement F? Committee Typear;Nw'n RIL Amomd6 uM ds�oTOIe48 io.ndadooaea Gom 01/01/2004 #=Qh 12/31/2004 I Ps3 13 pa of Sao Luis Obispo Marketplace Associates. LLC. 5 Contributions (including Loans, Forgiveness of Loans, and loan Guarantees) and Expenditures Made (dMoMWMiSnwd8A uwa&Worg lcapiwo(Mbpepa/orcwft Abnaheeb.) DATE NAM STREET ADDREOF SS. CRY. SWE AND ZP CODE TYPE OF PAYTAENT DESCRIPToMOF Iy1T3 CANDIONEAMOFFICE. &W-4SU RE AND JURISDICTION. AMPEFWD OUNT TMS Cu ILARVEAnouNr REWED TO TMS �m��In OR COMMITTEE AOR is mune: wso eM6aE in. M+®o =OR CdYTTEE 09/30/2004 ADdre, Norris 6 Buttery ❑ IImYs9 Legal feed Nft&21 a A-05, B-05 and 5,804.42 129,868.38 . CUMl4bm C-05 ❑ L= ❑ Nasi4wSM Ci411ae110N1 City Of Sao Luis Obispo San Luis Obispo, CA 93406 Q EVKWIONz ENlmmss ®SIIpDOIT [3 Oppose 10/22/2004 American Airlines ❑ Mvtlmy Cumamlm 137.60 NEW ❑ L. Subpayment made through: P.O. Boz 619612 ND 2400 ❑ *04ftMrr CNzdlwamn Davis Group DPM Airport, E 75261-9612 ❑ InaepmOela Eltpedaae ' ❑ support ❑ Oppose 10/22/2004 Davis Droop ❑ mmwkWy Consulting Services measure A -O5, B- os and 5,147.12 129,868.38 CveW4m C-05 ❑ Loss ❑ C add bodes City of San Luis Obispo Tang Beach, CA 90803 3'10npsT10sIa EttON�a ®SuPPoR ❑Oppose ow.meen,R a a....em m . sea A . nzl�se. 10/22/2004 Voter Consumer s =Ch, LW. ❑ MNNTay Conotwon 3.840.00 ❑ .ass Subpaymicat made thzough: T®p ❑ Nos4lmNsyDavis CueEiem Drop Nnahingtsn, DC 20002 ❑ EWmYses ❑ SIIppOfl ❑ Oppose MWOTAL S 10, 951.54 FPPC RN 401(JaRO» FPPC ToOFrae NNpR= SWMSK-FPPC SM2753M Major Donor and MA" C Independent Expenditure Committee A albeIm omen state�rdeoversaerwd Campaign Statement to 9 1 dnOma from 01/01/2004 through 12/31/2004 San Luis Obispo Marketplace Associates, LLC. 5 Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (tlrnore apeOais aeede4 ase addmorralcoptes of[f*PW for cor0aradonabods.) Page 4 DATE NAME STREET ADDRESS, CITY. SDO'E AND ZIP CODE TYPE OF PAYMENT DESCRIPTION OF PAYMENT CANDIDATE AND OFFICE. MEASURE AND JURISDICTION. AMOUNTTHS CUMULATIVE AMOUNT RELArEO TO THIS OF AWEE M corwmreL Am vrr6w W. mlrOV OF YPERIOD OR COMMITTEE PERIOD MEASURE. , COMMITTEE OR COI 10/26/2004 Sell, MCAJZSe c siltaehk ❑ ally Legal teas Measure A -OS. 5-05 and 51491.50 129,868.38 Conobuomr C-05 ❑ loan ❑ Non4luriWy Carrtrbrdm City of San Luis Obispo Santa Monica, CA 90401 1® EVWWM Support O ❑ oppose 10/30/2004 Aaron, Thomas 6 A960CiaLee ❑ Mason, Subvendor.to Mase 1,011.29 CarAdbu&n Mailing MEND ❑ 1.ubpayment made through: ❑ Cor Nh" avis Group Chatsworth, CA 91311 ❑ EVMXftn ❑ Support ❑ Oppose 10/30/2004 Aaron{ Thomas i A000tiates a Subvendor to Masa 1,011.29 Cona6rAmr Mailing M®l0 ❑ Imo Subpaymeat made through: ❑ M-4 mimy Comeliness Davis Group Chatsworth, CA 91311 ErgMdOas ❑ Support ❑ Oppose 10/30/2004 Aaron, Thomas 6 Aesotietes ❑ Mm1W, Subveadomr to Maso 1,011.29 ConOEUdmn Nailing MEMO ❑ I= Subpayment made through: ❑ " --- my Davin Group Chatsworth, CA 91311 CormYOmr ❑ E�mrdhse ❑ Support ❑ Oppose &NOTAL: FPPC From 461 pan=) FPPC To&Fres HetpDne. 8NIASI444111C Major Donor and Independent Expenditure Committee Campaign Statement ON TypsorpAntinlnk. Amourns uM be rounded to WwM doGma from 01/01/2004 61rough 12/31/2004 I Page 5 of13 San Luis Obispo Narketplaee Aasociatee,.LLC. 5 Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (amoreaP lg Deeded,UWB*WMWODPIWOf Bapepe%rCW W #a*M&tee@.) DATE NAME STREET ADOBESS. CrrY. SDOE AND DP CODE TYPE OF PAYMENT DESCR11PDONOF PAYMENT CANOIDOWE AND OFFICE, MEASURE AND JURISDICTION. AMOUNT THns CIAAAATIE AMOUNT RELAW TO 7WS OFFIRTEE OF OTHER TNMIMOIWWy OR COMMITTEE PERIOD CANDIDATE MEASURE. OF oamrtt8 Ma0 E r In, mamOO CONm®Ilnw OR LOAM OR. COMMITTEE 10/30/2004 Aaron. Thomas 6 Associates ❑ Cal SUCvendor to Mass 2,022.59 mailing Pam ❑ Loan 6uhpayment made through: ❑ w""emY Colmmiam Davis Group . Chatsworth, C - A 91311 410 r 13E�Kditn lda ❑ j{• Pw El oppose 10/30/2004 Aaron, Thomas 6 Associates ❑ 1-m.ra,1 Subvendor to Maas 11685.49 DawOam Mailing NEW Loss ❑ Subpayinent made through: ❑ N.Mmefor Contraem Davis Group Chatsworth, Q 91311 ❑ EVOWNwe SIIP W ❑ OppoSe 10/30/2004 Andre, Morris i Buttery ❑ Mm wy Legal fan Measure A-05, B-05 and 4,895.67 129,868.38 CO,IIIIAMW C-05 ❑me"Mml� ❑ conumKftn City of Ban Luis Obispo San Luis Obispo, CA 93406 10Mda9s,rMnol EgMn®re x❑ SuppOR ❑DOPA 10/30/2004 Blue Rocket Data ❑ Mone 1 Subvendor to News 129.37 CabOiOm Mailing MBMO ❑ Lam Subpayment made through: ❑ NNL+4NNrmyDavis GOMmmlon Group Ban Francisco, CA 94109 E�Mr®s ❑ SWW Cl Oppose sUffrorAL 4,895.67 ' FPPC Form 461(JMM FPPC TOG -Free NOW11ne: SWASK47K eefiff=m Major Donor and Independent Expenditure Committee Campaign Statement Typedrphdlnb& sunemantcovesperw AOourdenlay be rounded to 41d10104b8ma from 01/01/2004 12/31/2004 San Luis Obispo Marketplace Associates, LLC. 5. Contributions (including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (amoreapace 7s needed use add6malcopies oltldspeps/orcoaft dondwefa) DATE NICO:. STREET ADDRESS. CRY: STATE AND ZIP CODE TYPE OF PAYMENT DESCRw-nom OF ROYMENT CANDIDATE AND OFFICE, MEASURE AND JURISDICTION. AMOUNT TKS CUMULIITPVE AMOUNT REWED TO THIS OF PAYEE OFOTHER Y OR COMMITTEE P� CANDIDRE. MEASILM OF 0OWWRTEE loan t7tms t0. r4am00 � IC OR Cog 10/30/2004 Blue Rocket Data SubvendOr to Maes 107.61 Cmtrdabo Nailing Pam ❑ Lm Subpaynent made through: ❑ *"oadwy CanuarAm Davis Group San Prenaisco, CA 94109 ❑ EIOa _ ❑ support ❑ Oppose 10/30/2004 Davis Group ❑ MandAy DOIOAIAm Phone Bank Paul Brown 420.70 1,766.70 ❑ Paan City Council Member Nosy ConWbMm City of San Luis Obispo Long Beech, CA 90803 ® ESO © Supp0d ❑ Oppose 10/30/2004 Davis!Group ❑ Manley Ce0001Am Nave Mailing Paul Brown 1,366.00 1,786.70 [3 L. City Council member ❑ City of Baa Luis Obispo Long Beach, CA 90803 sdapsppa � ® Support ❑ Oppose ealnrMdee�, MI 7 Aaee ma Iwo ffimr�Cim B,u+iw. 10/30/2004 Davie Group ❑ Mmmay C * AAm mass Mailing Andrew Carter 1,366.00 1,786.70 ❑ Pero City Council Member ❑ conommmm City Of San Luis Obispo Long Beech, CA 90803 ® supped OPD�e Eapma®se © ❑ 8LOMAL6 3,152.70 `.. . FPPG FORA 451 WIOIW) FPPC TO&Fmo llalpOPs SSWA&GiAPC 86812754M Major Donor and Independent Expenditure Committee Amo���Oe�Mou Eed Campaign Statement to4rI ddWm 01/01/2004 through 12/31/2004 I Pape of 7 13 San Luie Obispo Marketplace Annoeiatl9.. LLC. S. Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (nmomspero(s DeedK UW ad'ffiloneJO0PW Of WSPer 10r=0%A fbnaheafa) DATE NAME STREET ADDRESS. CRY. STATE AND 2W CODE TYPE OF PAYMENT DESCRWTT0MOF R4YMfENT CANDIDATE AM OMCE, MEA4URE AND JUPoSDICTION. AMOUNT THIS CUMUUUWEA OU OF WEE OF GMER DIAN MOre:My OR CGasTfEE PERSOD CANDIDAE, MEASURE, OF commam1 Also rNIfR gym. Menem OONTRsXJT M OR {GAN) OR COM MFTTEE 10/30/2004 Davie Group ❑ MfmnslNY CanWadmn Mean Nailing Dave Romero 1,366.00 1,786.70 ❑ Lown Mayor ❑ Co City of Sam Line Obispo f®g Beach, CA 90803 ®E ® sow ❑ Oppose proweeor�. w 10/30/2004 ❑ mummy Conimxdm Mane Nailing Christine Mulbolland 2,276.00 2,276.00 ❑ Less City Council Member LZ. Ma"Mawy ❑Coue4lon City of Sam Luis Obispo A 90803 ®aisepm�Ona - ❑ Sopped ❑ Oppose AammomaLm 10/30/2004 Davie'OXWV ❑ Maiway Nass Mailing David Booker 2,732.00 2,732.00 ❑ Less Mayo ❑ Ckabbobon City of San Luis Obispo eti�s Enog Beach, CA 90903 T5� a w�eefur w ivtm�aclm e�nlcw ma ®apftleeyp,N�iO,ed mVr[iC"TiiFl� ❑ Support ® Oppose 10/30/2004 Davie Group ❑ almNtAy Camauew phone Bank Dave Romero 420.70 1,786.70 ❑ Lae Mayor N.,M d y City of San Luis Obispo Long Beach, CR 90803 Sint Oppose EVWW es In ❑ SL43*orAL i 6,794.70 , FPPC Form 461 (,Martie$) FPPC T01Wn se HOW= SW ASK4M Major Donor and Independent Expenditure Committee Campaign Statement ON REVERSE I na•a .�c a SIL St 7...�.!llla .amu 7ypeorpotte MdL.I statementoovemporlee AnwurdsmsybermaMMd to WI I dooms. from 01/01/2004 ftwigh 12/31/2004 I page B 13 San Luis Obispo Marketplace Associates, LLC. 5 Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (ymoreapaceis Daedeauwadmkwa coWw0/mlapWoibreaWnuadonalootL) DATE RAME FrREET ADDRESS. Cm, SWE Alm ZIP CODE TYPE OF PArMEMr DESC1aPnON OF PAYMENT CANDIDRE MID OMCE MEASURE AND JURISDICTION. AMOUNT TIPS CUMULaNE AMOIBJr RELAIM 701WS OFA OF01lmt7OVINIMMMY OR COMp0{TEE SOD CANDIDATE MFAS{AtE. OF GOMORRA Mao d1FM iD, r4a0Eie OONR MUTTON OR U MM OR OOMIATTEE 10/30/2004 Davie Group ❑ MMMby Phone Bank Andrew Carter 420.70 1,786.70 ❑ lam City Council Member ❑ N"Afis"MLMF CanadkAm City of San Luis Obispo 41Ucmma, Long Beach, CA 90803 ieim acme me. oe acbcreora swum. ® MO,pwWM Fin ® ` ❑Oppose 10/30/2004 Markettoucb Media ❑ MMrtq Sub-subvendor to 291.10 Cam Maze Mailing M8l10 ❑ Lou uhpeyment made through: ❑ Na.44MM0ay c4aftbAm ridian Pacific, Inc. Jacksonville, PL 33335 ❑ EXPOM " ❑Suppod ❑ Oppose 10/30/2004 Nar'ketteuch Media ❑ M, -'M Combudw Sub-6ubvendor to Ph®e Hoak 291.10 ❑ lam Subpayment made through. MEND ' ❑ NoaaM "y Cw0musan Meridian Pacific, Inc. Jacksonville, PL 32225 ❑ Evendt ❑ support ❑ Oppose 10/30/2004 NBrkettOUCh Media ❑ MnO,I CNAN:AM: -subvendor to Pbone M -k 291.10 . ❑ Lem Subpayment made through: Pam ❑ W"ft- y CMnlnlm Keridian Pacific, Inc. Jackacnville, PL 32225 ❑ EwMmua ❑ support ❑ Oppose 120.70 FPPC Form 461(.IMMM FPPC Teres HshAbm SBBIASIFFPPC 888r1754M Major Donor and Independent Expenditure Committee Campaign Statement Type orpMttrl tnk 8tatemeMaovmepoIlod Amm11118I!—, Tamdad to whole dollars. from 01/01/2004 11/31/3004 pap 9 San Luis Obispo Marketplace Associates, LLC. 5. Contributions (including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (Nmom space Is needed. Use aOAaMelcopies o/thIs~ for cw t huatlmaheeta.) DATE NAME. STREET ADDRESS. . SE MID MP CODE TYPE OF PAYMENT DESQWMMOF PAYMENT CANDIDRE AND OFRCE. MEASURE AND JURISDICTION. AMOUNT THIS CUMUUPA AMOUNT REI4TED TO IMS .CmDI OF OF OTHERTMAM MONEIIRT OR COMMITTEE PERIOD CANDIOME. MEASURE. OF Cowan . Luso mntn ,a. NAMM LONIRmnION OR LOA14 OR COMMITTEE. 10/30/3004 Meridian Pacific, Inc. ❑ MpMtey Cantddan Subvandor to Phone Beak 350.50 MEMO ❑ Loan Subpaymant made through: ❑ Nm,44ssay can44mm Davis Group Sacramento, CA 95833 ❑ ExPendbas - ❑ Support ❑ Oppose 10/30/1004 Meridian pacific, Tnc. ❑ MMPI canotwom Subvendur'to Phone Beak 350.50 TEND ❑ Loan subpayment made through: ❑ N-4laa Oy Cnu41" avis Group Sacremmto, G 95533 ❑ Ems ❑ SUpport ❑ Oppose 10/30/3004 Meridian Pacific, Inc. ❑ manift CwO40m Subvsndor to Phone Bank 350.50 MEND ❑ Loan Subpaymant made through: ❑ -say CansE,®m Davin Group Sacramento, CA 95933 ❑ F, 0 SUpp01t ❑ Oppose 10/30/1004 Neta Information Services ❑Y Subvendorto Maas 187.14 com4®m Manure MEW 0 Subpayment made through: ❑ CwmOi6m Davis Group Sacramento, CR 95814 ❑ Emen®.a ❑ sow ❑ Oppose MWCITAL S 0.00 .,- . F F'PPC Fare 01(JenIM FM Toll -Fm Helpline: 6881ASK FIM 8811015STrt Major Donor and Independent Expenditure Committee Campaign Statement Typeorprlortinhlk stater ad eovors9a Amarinsrosymlounded to whole dollars from 01/01/2004 through 12/31/2004 I Vage 10 of 13 San Lula Obispo Marketplace Associates LLC. 5 Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (nature spacefsneeded, use add'Vandwpks oftreapage foroorinnuaDon dwaea.) DATE NAME. STREET ADDRESS, DfiY. BTQE AND LP CODE , IE TYPE OF PAYMENT oESQOPHm OF IRYMENT DANDIDRE AND OFFICE. MEASURE AND JURISDICTION. TMrt OUMUWW AUDI= RELAIM 70 TWS _ OF PAYEE IF COMMYTEE. aaO ENTER nn WASM OFDTIERMUNNONOPRY OONTR0AN10N OR LOAM OR COMMITTEE PERIM .CANDIDAM EASURE, OR COMORrrEE 10/30/2004 Neta IsfermatiOn Services ❑ MMaanry Subvendor to Maas 112.28 CNmenetm wiling rho ❑ Lmn Subpayment made through: ❑ NyfMmW1W CaW1hubm Davis Group . Sacramento, CA 95814 ❑ Elm Support ❑ ❑ oppose 10/30/2004 Meta Information Services ❑ Subvendor to Mass 224.57 C] I. Subpayment made through: ❑ Non"swory conbbudm Davin Group Sacramento, CA 95814 ❑ ErPmnIkile _ ❑ Support ❑ Oppose 10/30/2004 Meta Information Services ❑ Moma7 Subvaador. to Mass 112.28 Com Mailing - Pam ❑ Uses Subpayment made through: ❑ rWtYOINNy canmmnsim Davis Group Sacramento, CA 9581413 sespe"Me Eswadhoa ❑ Support ❑ Oppose 10/30/2004 Meta Informati®'eervice8 ❑ .I to Masa 112.25 co Mailing M0W ❑ LoanSubpayment made through: ❑ Noweamm Mr Confession Davis Group Sacramento, CA 95814 ❑ F a ❑ Support ❑ Oppose 51.191`011AL { FPPC Form 461(JanIffill) FI PC Too -Frei HelplIns: 8881ASK-FPPC n Major Donor and Independent Expenditure Committee Campaign Statement ON P -� •- a nM - •• - n Typeorpdntinlnk. statelnerdooveesperw Amoums may be rounded. to doDam tram 01/01/2004 12/31/2004 paw 11 p{ 13. San Luis Obispo Marketplace Associates, LLC. 5. Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (if mom speck needed. useadAbnoloopfes ofBospW/erOOnflrwffwaheeta) DATE NAW- STREET ADDRESS. CITY, STATE AND ZIP CODE TYPE OF PAYYE44T DESCRIPIMOF PAYMEI4T CANDIDATE AND OFFICE. MEASURE AND JURISDICTION, AMOUNT THIS CUMUUDNE AYOUW RELATED TD TNIS Of WEE pF OTNER TMNI110NEPAY OR COMMITTEE PERIOD CANDIDATE, MEASURE, OF CaIaBILff. AtaO FMEII In. WARS 1 CONTWovn0N OR LOMQ OR COMMITTEE 10/30/2004 U.S. PostaMleter ❑ Mercury CasMdnn Mase Nailing 2,255.99 ❑ Lool SubpayInent made through: MEMO ❑ NO Mmody Carso dean Aaron. Thou&B 6 Associates Chatsworth, Q 91311 ❑ EI�eIIeMas ❑ Support ❑ Oppose 10/31/2004 Barnett Cmc i Associates ❑ MwleM1 Public Relations Neasu A-05, B-05 and 4,867.98 129,868.38 conubulan Services C-05 ❑ Lsen Nan4400rr" ❑ CoIebudon City of San Luis Obispo Sas Luis Obispo, CA 93101 ® n ® Support ❑ Oppose 11/18/2004 Bell,'MCABdrera 8 ailtachk ❑ MMMO" Legal fees Neaasre A-05, 8-05 and 5,940.58 129,868.38 Cacmoxam C-05 ❑ Lom ❑ we -City Corddbudw of San Luis Obispo Santa monica, CA 90401 ® ' X❑ Support ❑ Oppose 11/30/2004 Andre, Morrie i Buttery - ❑ money Legal fees Measure A-05, B-05 and 9,266.47 129,868.38 CasI bu ion C -OS ❑ Leen ❑ Nft Monism, Cplleb� City Of San Luis Obispo San Luis Obispo, CA 93406 Support Oppose Eap•IaBbas © ❑ SUBTUrAL S 20.077 03 1 -t -M Fom14167. tJnum1 FPPC ToU*me HetpHne: SSMASK*M 866c"s3m Major Donor and MA" I Typeorprknin Independent Expenditure Committee Amwmffis- aybo a.d $TBfB"'°"dcovers pa1vd Campaign Statement to wholedosars, from 01/01/2004 through 12/31/2004 Sas Luis Obispo Martetplaea Associates, LLC. 5 Contributions (including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (Bmomapacelsweded,ussaddlJOWto- I Oftldspage/0roOnthU0 nSIIss ) pap 12 Of 13 - DATE SE AND DP CODE NAME. snREET ADDRESS. DB TYPE OF PAYsffNf DES OWTION OF FAYAEtfi CANDIDKEANDOFFICE. MEASURE AND JURSDICTION. AMOUNT TMS PERIOD ClSIULOIIIE AMOUNT pEWED 10 TMS OF OTHER 7WIM MOMEwn ON COMMnrEE CANDIDRE. MEAS"c ry com ffrEL use DRER m 4usm0 OONTBONDW OR LOIW OR Com mrrTEE 11/30/2004 Barnett COX 6 Associates ❑ EEnmV Public Relations Measure A-05, B-05 and 4,192.87 129,868.38 CCIIEbudan Services C-05 ❑ Lean ❑ ConftuNwn City of can Luis Obispo Sas Irma Obispo, CA 93401 ® EWamaes ® SuppOM ❑ Oppose 12/15/2004 Bell, MVJWdrees i RiltaWc ❑ MMr/M3 Legal fees Mesaure A-05, 8-05 and 9,922.05 129,868.38 ConnRx9bn C-05 ❑ Lass ❑ NMFMvrioy 00nobull City of San Luis Obispo Santa Konica, CA 90401 ® F)pmW— . ❑ ❑ oppose El 12/30/2004 Andra, Morris 6 Buttery ❑ .. I Legal fees Measure A-05, B-05 and 21,418.12 129,868.38 CmmOewl C -OS L ❑❑ Ne"sa t" Cel City of em Lute Obispo San Luis Obispo, CA 93406ElISOopmmtA E © Support ❑ oppose 12/31/2004 Barnett Cmc 6 Associates ❑ M -A" Public Relations Measure A-05, B-05 and 1,894.00 129,868.38 ComTWlon Services C -OS ❑ iaan KEMMEOIWI CoImaYMc City of San Lute Obispo San Luis Obispo, CA 93401 ® b &ww Oppose EMIMs®ss MKIN a ❑ suerorAL S 37,427 04 _.;,"` FPPC Few 467 i nmW) FPPC ToDFKas HdPU : BBBIA9W:PPC 88&2163777 Major Donor and MAJOR I Independent Expenditure Committee Typeo„pbB"� Sateme"`coversAmounts° Campaign Statement to ... 1 dollars. from 01/01/2004 throughPape of 12/32/2004 13 13- _ Sao Luis Obispo Marketplace Associates, LLC. 5 Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (tlmom spacefsneeded, use ad:10oaa100bs efthlspsge TOrcorftuffbw Sheets.) . DATE NAME. STREET ADDRESS SOME AND ZIP CODE TYPE OF PAYMENT DESCRIPDOHOF PAYMENT CANDIDATEAND OFFICE, MEASURE AND JURISDICTION. AMOUNT THIS PERIOD CUMUUINE AMOUNT RElAFM TO TWS OF WEE Is, Co1Wmt7; &80 Ea W. NLIGIM OF OTNERTIMN MONEwtY 00HfRIBIn1aN OR LOAM OR COMMRTEE CANDIDATE MEASURE OR. COMMITTEE 12/31/2004 Bell, NCAndx 6 Siltaehk ❑ M -es" Legal fine Measure A-05, B-05 and 25,778.47 129,860.38 - C,,,am,III00 C-05 - ❑ 1. ' ❑ C0610budan City of San Luis Obispo . Santa Monica, CA 90401 ® aala9an4aat Etpane0oe ®Support❑ OppoSe ❑ M—a-Y CantrMlaMn ❑ Loss ❑ Non4ANMINy Conb®WW ❑ e3cps"CRIN6 ' ❑ Support ❑ Oppose 0' 1 CmmmWion ❑ Losa . ❑ No"t neWry Conaaa0m EapenmMaa ❑ Supped ❑ Oppose ❑ ContlOumn ❑ Loan ❑ N—MImM.9 COF&DAM ❑ ❑ Support ❑ Oppose SUHTO`rAL$ 25,771 47 - FPPC Fom 481(Jan103) FPPC ToDfree He1PNne:. 88&ASK4VM 868Q754M RECEIVED FEB 0 2 2005 SLO CITY CLERK Supplemental Independent Type orFMInInL OFFICE SOuonT OR MELD MID DISOLC'T, IF APPLICABLE - Mayor sty of San loin Obispo SUPPLEMENTALINDEPENOENTEXPENDRURE Expenditure Report mi ie R'P0""x"'0°"0° OWN Stamp .- (l3OYenunetaCade $0L90n.84203.5) 01/01/2004 f)om . a SFE P49TRLCKMONREVERSE ❑ AMSGnt (Bobo 6ttoUgh 12/31/2004 10/30/2004 ' 1 _ . a1 2 . 1,766.70 Date of chwamn It appsce SubamdveW: Aaron, Sbamae i Associates, and Meta IX lormation Services. For OmdN use D* - . ' Warw . Day. Yes) '- 5375 E. tad St., Ste. 4 11/02/2004 _ 420.70. 1,786.70 10/]0/2004 - 1. Committee/Filer Information NUMBER(a mdP- LO.W oonafte) Treasurer prnwpraeeonerma.> - COAaOTIEFJFI BnNAAIE K4MEOF7REASURER San Imie Obispo Marketplace Associates. LK. William SSM KMJWADORESS STREETADORESS(NOPA.W)g ' CTTy STATE-LPCODE AREACODEIRIONE" CRY STATE TIPCODE AREACODEIPNONE' Sas Luis Ohiapo Q, 91741 626-963-1505 OFnONAL FAXIE414&AODRESS OPTIONAL FAXIE4 AILADDRESS . 2. Name of Candidate or Measure Supported or Opposed DxEtMDMrE . NAMEOFCANDMATE Daae Romero OFFICE SOuonT OR MELD MID DISOLC'T, IF APPLICABLE - Mayor sty of San loin Obispo mffl D OPPOSE 2 . - MAMEOFSAUZTMEASURE - &M=T NOAHrMR AOUSOCIM- . 3. Independent Expenditures Made Am3madabnabea=ouonmqwmpdawybbawcwoxmdwdmom CUMULAflVE TO DATE DATE WM ANDAODtESS OF PAYEE - - — — DESCRPMN OFEXPEN01TURE AMOUNT `'^ T� JA -DEQ 9 Davie Group - .. . .5375 K. tad St., Ste. 4 Maas Meiling 10/30/2004 ' -Long Beach, OR 90803 1,]66.00 1,766.70 SubamdveW: Aaron, Sbamae i Associates, and Meta IX lormation Services. ' Davis ' 5375 E. tad St., Ste. 4 Phane Bank _ 420.70. 1,786.70 10/]0/2004 LOsg Beach, CA 90803 Subveudorec Meridian Pacific, . Inc... and Marken Media. FPPC Fan 465(Jw M) FPPC Tm6Froo HOW= BWASK+M Supplemental Independent TM or in r ok: SUPPLEMENTAL INDEPENDENT EXPENDITURE - p.. Amounts may be roriridad . RopoR covers period Expenditure Report to whole dogam ' • from 01/01/1004 •' 11/31/3004 SEE 0i97Apl0ILERRiDl60N REVERSE - evOY„eA _- - - pop p{'..... 1 "AMO Obispo Marketplace Associates. LLC. _ LD. NMSER(11 edpw0 4. Summary 1. Total Independent expendihrres of $100 or more made this perlar7: (Part 3)..:..: ........::. 1,786.70 3 2 Total independent expenditures under $100 made t ft period. (Nat itemized.) ................... 0.00 & Total Independent expenditures made the period (Add Lines 1 + 2) ............ _.._. TOTAL i 1, 786.70 5. Filing Officers Enterew name and ad*=. creachmbgof»cerMdmwnom@reser'smost,ecwrtcampaign atstemeRts (Form 45R480oraet)have bow Red . 1) WAMOFFa.a100FRCER 8)-NIMtEOFFLLM R - - - City of sen loin Obispo - ADDRESS 99 .SL'. WO. NO STREET) ADDRESS PD. AND CITY STATE ZIPCODE San Luis Obispo„ CA 93401 Z) NAMEOFFILMOFFCER ADDRESS M. AND STREET) - .. CITY .. -.... - STATE ZIP CODE CITY _ STATE .ZIP CODE 4)-NANEOFFLLWOOFMM- . ADDRESS 90. AND STREET) - - CITY STATE . -ZIPCWE 6. Verification I have used all reasonable dmgence In preparftg and reyla" this statement and to the West of my imowledge the trNonmetlon oonmhned herein Is true and 0anplete. 1 cert fy wrier penally of perjury order the laws of to Sbft of California VW the foregoing Is true end correct E mod d• d� 05 TE Exeamedon COM OF SPONSOR By BOATOREOFOONTRCU!MOPFCMXDFA.GCWATE BTMTEMASLIREPROPONN MBMY REOFCONMOUMOFFCOUXOERCROMMSrATEMFiWIREPROPONENT _ FPPC Pam 40 PWM) FPPC Ta1FFM H*IpUm SWASK47M T T CD CD CL `> > i `C T V V n 0 c < Q n a c > > a C OAi d A d O m m 7 0 o IT 5r CD G N G ' } ° o m Q O CD o fo n� m v o m 3� m � m 6t � ? fA ID m r LU Co f0 m O 7 ED d N =) _a C O Ill a 0 cr CD i� Zo i 0 O c::E Z= �m Om TO 00 O M n� mm N D O Z O m m m m Z 1 I�7 C C n a 1 \ A _ a >y 9 a m 9 N M m 3 ❑ N O v I o � � O �I I p � m D .+ O N ID m _ D p O 7,774.::, 3 a N 7 .. O � O fro 3 N .z c �. 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A fD O « EC m al cn k @ ; . . . � ) n \ � \ \ ) c F §;o \ �� \ § § § § CD \ \ i m \ \ as $ $ ƒ $ $ m 2 2 / / E E / + ® @ E Q& ---I 0 CD ƒ« k f o § - CD 0 \ [ a k oo C 2) E CL E 0 g CL / o \,8 / m \ f , , § $ e g \ } } / ) M. @ CD5 8 / �k z f / )\in \ w E 0 § / \ ƒ 2 q / \ \ / 2 C0 / / k \ 65' § I 0 .� % \ CD / M % -• § C e °cr r 7 o § § w 5 , CL 0 % a 7 ) { 0 E - § CL } ! / i [CD CL ( M S § _ ƒ 0 0 S. g f 0 cr \ \ a J ' g e0 CD . , » ƒ \ E { _.cr } � § D \ 0 _\ g ( X -n E \ \ \o ■§ \\ m / �; E ;§ 2 « EC m al cn k ; ) n ] . §;o \ ! )� \ \ % Oil � ¥ N 4 m 011 ■ E � • Audrey Hooper - Form 410 - Terminating Your Committee From: Audrey Hooper To: Romero, Dave Date: 12/16/2004 6:27 PM Subject: Form 410 - Terminating Your Committee Dave, Page 1 of 1 Although you have closed your campaign bank account and filed that termination form (form 460 and form 101) with me, until you file form 410 with the Secretary of State's office, you committee has not been terminated with them. While in most cities the committee does not need to be terminated, in reviewing SLO's campaign finance regulations, I note that your committee must also be terminated. I have put a copy of the form 410 in your in - box. Both you and your treasurer will need to file it as well. The original and one copy of this form must be sent directly to the Secretary of State's office and one copy must be submitted to my office. I'm assuming you have done this after each election. Diane will doublecheck your previous filings to ensure this was done, but if not, I'll talk to you about it next week. I will be out of the office tomorrow and Monday — or we can talk about it after the holidays. Hope you're having a good week and if I don't see you next week, that you and Mary Belle and family have a good holiday! Audrey file://C:\Documents%20and%2OSettings\slouser\Local%2OSettings\Temp\GW }000O1.H... 12/16/2004 FORM 101 CAMI iN DISCLOSURE STATEMENT SUMMf ,'AGE Municipal Code Section 2.40.070 EIVED Used by: Controlled Recipient Committees (Committees under the direct control or guidance Eca;n@&Ge) of C2004 Y 0'I.R^,� Name of Committee: Column A Column B Column C Formation - 10/25/04 10/26/04-12/31/04 Cumulative Totals Due 10/26/04 at noon Due 1/31/05 at 5p (Col. A+B) CONTRIBUTIONS RECEIVED 1. Monetary Contributions a. Under $25 (from worksheet) 1a.$ #A_10 $1 `/3•�,�#�� $ 037,a,Z b. $25 and over (Schedule A) 1 b. �233rl 2R, 00- 2. Loans Received (Schedule B) 2. /per ; r7U0 !J U 3. Non -monetary Contributions (Schedule B) 3. 9; S3 7, 4. Total Contributions (lines 1 a,1 b,2,3) 4. $ 7 $ - !J� EXPENDITURES 5. Expenses Incurred/Paid (Schedule C) 5.$,2,r 3• 7 $ �6- s— $o2oza 6. Loans Paid 6 -64 1 7L x`7.70 7. Total Expenditures 7• $ /S3. $ �9a VERIFICATION I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California and the City of San Luis Obispo that the foregoring is true and correct. on / at I have reviewed this Statement and to the best of my knowledge the information contained is and complete. I certify under penalty of perjury under the laws of the State of Calif omia and the City of San Luis Obispo that the foregoing is a true and correct. Executed on 1 ?//o /o y at S�4 L. u S U (, rS;,v . Ca /,,Z. Form 101 Print 2004 Page 1 T x F I ,gym m s m n m Q �r m CL c Q m w CD m CL 3 v m ,m ( m 47 n n � 0 ❑ Z: mA� m; 0009 1003 m 'MS'a'o ~ mow= ;p ca CD g a3$�imFo o wm 2mm O 3m 3 a mCD w m _� m r m 3 y CD V. m z 3 n O m 3 z000m 3 CL m c 3 �fR? 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O 0 CL 7 C m ..FOS m CL ren .N+ fA •—�,7 O '•'07 N ^D m O N �A N N M tG ca O_ 3 m Co O ,� D m � G g• C m e p m 3 CD m D C S M j CD m m _(=A c y C .. •o -. � O �0 CD a O 0 C m 'v p m N CD N ° C !Z Q 7 � CL 'mm m_ c� ��om o 0 3 W m m�.a m m CD m ai0 G _T.m o 0* 0 CD 3 cDrD o =a CL m m E. �a<==.=a m o`am c a d m C m 3 m a° p3mmDm m m m N m ohn w m33 'o mymD�acci 0: CD °om CD n $0 CO o C 03ca 0 CL Z cog CD CL m q3c.� El a 0 �� O�' m „m m y ° 3 � 7 m cD 3 (D= S?. m o Amor o m o. �g M p<c,CD ° m ° a o n CD N m o p•O m -o °C CL_�� < m Co ^^ CO m m ..N p_m Cl. �p am o m 3co 0892-33 3 m = ii N ai C oma — .. C O o B r a m 0 c D® d o om -. ?�fA mm m (a w CD� t ono 0– CL 3® c � 3 .a 0 m C�.�am c 0 6 co CL CL m o nm co -n m m y � m n °2 CL c 2 3 N O MAY C4 of • n luis oBispo Oath: of Off-_- I, Dave Romero, do sotemnCy swear that I wid support and defend the Constitution of the United States andthe Constitution of the State of California against aCCenemies foreign anddomestic, that I widbear true faith and allegiance to the Constitution of the United States and the Constitution of the State of California; that I take this obCigation freely, without any mentaCreservation orpurpose of evasion; and that I tivitC wed and faithfuCCy discharge enter. Mayor Subscribedandsworn to beforeme, this i -11 -day: of December 2004:. Audr Hooper, City Clerk } FORM 101 CAMPJ�.,_.,J DISCLOSURE STATEMENT SUMMAR ,-wAGE KC�E�VED Municipal Code Section 2.40.070 Lofati 1. ) "J Used by: Controlled Recipient Committees (Committees under the direct control or guidanceandidate) Li 041,O CITY CLERK Name of Committee: Romero for Mayor Committee Column A Column B Column C Formation -10/25/04 10/26/04-12/31/04 Cumulative Totals Due 10/26/04 at noon Due 1/31/05 at 5p (Col. A+B) CONTRIBUTIONS RECEIVED 1. Monetary Contributions a. Under $25 (from worksheet) la. $ 2,464.00 #166_ $ 0 0 2,464.00 b. $25 and over (Schedule A) 1b. 23,112.00 0 23,112.00 2. Loans Received (Schedule B) 2. 1,000.00 0 1,000.00 3. Non -monetary Contributions (Schedule B) 3. 295.53 0 295.53 4. Total Contributions (lines 1a, 1b, 2, 3) 4. $ 26,871.53 $ 0.00 $ 26,871.53 EXPENDITURES 5. Expenses Incurred/Paid (Schedule C) 5. $ 21,513.47 $ 0 $ 21513.47 6. Loans Paid 6. 0 0 0.00 7. Total Expenditures 7. $ 21513.47 $ 0.00 $ 21513.47 VERIFICATION I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California and the City of San Luis Obispo that the foregoring is true and correct. Executed on /Q at (City & I have reviewed this Statement and to the best of my knowledge the information contained is true and complete. I certify under penalty of perjury under the laws of the State of California and the City of San Luis Obispo that the foregoing is a true and correct. on /D— ZS'- y at Form 101 Formulas 2004 Page 1 O Q13D O mO J ON J O J OO J O J OV O O O� OOD O o�O OCo O`zP• fi4$� J J JQ p1D mJ COD 1O0 2 50 2 t° OJ C O tO3 O N N N OO O O N O D Vt J O� (T O V• V• d A Ol OI J O 01 f7i O O -� O Ol O '�{ J J O J m m A A W W W W W W W W W CO W W W Oo W 0o m Co Co W W W W W W D D m ;La m c c c 2 2 0 0' a°° £ £ m x m x m m m m '° '° m m m c m Q c m m< m m m m m m m m m m O v c m n co wi 3 o m O �p m T n O .3 m o CD m o m m m m m° Co O m ism c m o m m A m N m m = m m w a a- m cc' 3 --Io mm N m m m a. ° °' m 0 N m z CD w - m $= 2 12; I'D A 10 m $ D D= to to W In W Cn G> UJ v) W fn V> r W y fn W m w r w r r r< r r r r r r r r m r a r o r r r r w O m$ 0 0 0 0 0 0 0 0 0 0 0 0 O O 0 0 0 0 Co o 0 0 0 m W Q° w M M CD m m m m N 7 rJ nS m O m N a m D D D D D D- D D D D D D D N D D D D D D D D D 1c, D D D D m m w co m M f° m m m m m C° m m m, m m m m m m w m m m O Wpm O O O N O O O w O O O J L A O O O O t O O N O O m m m. m Vt Of A J J VI J Vt Vt J O J {p J N O V7 Vt J 'n 5 Vi A m $ $ O W W - W y 1 m n s m m r m m mm CD m 3 m m z z o m m 3 3� an d O = m o O M m m _� } m d 3 A y c 3, o D w a 1 m -i m a w y m o o � o M �. m w i o v m m m oo co y i i m m v m w 90 O 3 3 m m w c m ami m al w W m m A (2 N w m ° cWc 4g> m A m ;o M � m A -n mA W W = m D Sa m m �. ° c m 'm O CL m m m 3 c c n n a m n n 3 c m c m m m 19' w w w w o y^ W m m m C m N A m y W m ^ ^ m T m go m Y 0 ffO880 C J O J Z O 0 0 O O OO O O O O O T 0 0 0 0 0 0 0 0 D D D D D D D D m D m o 0 3 g o o _ 3 m 3 m m m n m w Q. 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C m_ ^ m O 3 ^ C C.mi .m•. 0 .mi m CD 3 y o 3 c a$ a n a CL a s mo. o m a C o. a 0 m nl �3 i3 m m m m m = m n a n n a n CD m ai a (D 0 0 x m N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Vt Vt Vt CT Vt tT V1 (]1 V1 V1 V1 V1 V1 V1 611 V1 V7 VI V7 Vt V1 U VI V1 Vt V1 V1 N Vt Vt V1 VI V1 U1 (71 C11 r r r r O O O O N N Sm N W CA a 0 A N 0 0 0 0 A O n O co cWo m(� m A A A A G7 N cA G m N (D m G m mm 3 c c v m m a m m m m at o mo mm 0 v m m m o m m m n n n CD S m m N N Sm N W CA a 0 A N 0 0 0 0 WORKSHEET FOR SCHEDULE A Monetary Contributions Received Under $25 166 Contributors NAME OF CONTRIBUTOR TOTAL $2,464.00 AMOUNT OR VALUE SUBTOTAL $2.464.00 NAME OF CONTRIBUTOR age 1 AMOUNT OR VALUE SCHEDULE B LOANS AND NON -MONETARY CONTRIBUTIONS RECEIVED Name of Committee: Romero for Mavor Committee Column A Column B Column C Formation -10/25/04 10/26/04-12/31/04 Cumulative Totals Due 10/26/04 @ 12 N Due 1/31/05 @ 5 P (Cols. A & B) 1. LOANS RECEIVED: $ 1,000.00 Formation -10/25/04 $ 0 $ 1000 DATE NAME OF CONTRIBUTOR LAST FIRST RESIDENCE ADDRESS AMOUNT 8/4/2004 Romero, David F. 1,000.00 2. LOANS RECEIVED: 10/26/04 -12/31/04 TOTAL (inserted in column A above) $ 1000 DATE NAME OF CONTRIBUTOR LAST FIRST RESIDENCE ADDRESS AMOUNT TOTAL (inserted in column B above) $ 0 Page 1 Schedule B Formulas 2004 SCHEDULE B (continued) Column A Column B Column C Formation -10/25/04 10/26/04-12/31/04 Cumulative RESIDENCE ADDRESS Totals Due 10/26/04 @ 12 N Due 1/31/05 @ 5 P (Cols. A & B) $ 295.53 $ 0 $ 3. NON-MONETARYCONTRIBUTIONS RECEIVED: Formation -10/25/04 295.53 DATE NAME OF CONTRIBUTOR LAST FIRST RESIDENCE ADDRESS AMOUNT 10/8/2004 Pierre Rademaker DESIGN 96.53 TOTAL (inserted in Column A above) 4. NON-MONETARYCONTRIBUTIONS RECEIVED: 10/26/04-12/31/04 $ 295.53 DATE NAME OF CONTRIBUTOR LAST FIRST RESIDENCE ADDRESS AMOUNT TOTAL (inserted in Column B above) $ 0 Page 2 Schedule B Formulas 2004 Name of Committee: Romero for Mayor Committee Column A Formation -10/25/04 Due 10/26/04 @ 12 N $ 21513.47 1. EXPENDITURES: Formation -10/30/04 SCHEDULE C EXPENDITURES Column B Column C 10/26/04-12/31/04 Cumulative ... Totals Due 1/31/05 @ 5 P (Cols. A & B) $ 0 $ 21513.47 DATE NAME AND ADDRESS DESCRIPTION OF PAYMENT AMOUNT OF PAYEE OR RECIPIENT 9/4/2004 Califomia Voter Guide 20705 S. Westem Ave, Torrance CA 90501 Lit & Mailings 450 9/4/2004 Voter Information Guide 13701 Riverside, Sherman Oaks CA Lit & Mailings 900 9/4/2004 Net Tracks 7225 Sombrilla Ave., Atascadero, CA 93422 Web Site 130 9/4/2004 San Luis Mailing Service 281 Pacific St., SLO, CA 93401 Mailing 201.42 9/4/2004 Pam Ruggles Petty Cash -Office 100 9/10/2004 SLO County Clerk County of SLO San Luis Obispo CA 93406 Voter Registration 120 9/10/2004 Blastpoint Intemet P.O. Box 1808 Pismo Beach CA 93448 Web Site 90 9/21/2004 The Sign Place 812 Fiero Lane Ste F SLO CA 93401 Signs 1903.15 _9/21/2004 Pierre Rademaker Design 738 Hi uera St. Ste F SLO CA 93401 Brochures 2489.63 9/21/2004 Pierre Rademaker Design 738 Hi uera St Ste F SLO CA 93401 Stationary 1152.67 9/21/2004 San Luis Mailing Service 281 Pacific St SLO CA 93401 Mailing 99.67 9/27/2004 Pierre Rademaker Design 738 Hi uera St. Ste F SLO CA 93401 Print Ads 281.25 9/27/2004 Pam Ruggles Petty Cash -Office 100 9/27/2004 Bank One P.O. Box 8650 Palatine IL 60094-4014 Office Supplies 161.9 9/27/2004 San Luis Mailing Service 281 Pacific. St: SLO CA 93401 Mailing 134.12 9/292004 The Tribune 3825 S. Hi uera St SLO 93401 Print Ads 2,000.00 10/112004 Central Coast Printing 921 Huston St Grover Beach CA93433 Promotional 1069.34 10/112004 Pierre Rademaker Design 738 Higuera St Ste F SLO CA 93401 Print Ads 2,762.25 10/112004 San Luis Mailing Service 281 Pacific St SLO CA 93401 Mailing 1247.04 10/162004 SLO Chamber of Commerce 1039 Chorro St, SLO CA 93401 BBQ Flyer 110 10/162004 Pierre Rademaker Design 738 Hi uera St.Ste F SLO CA 93401 Mustang Daily 108 Page 1 Schedule C formulas 2004 10/16/2004 Pierre Rademaker Design 738 Higuera St., Ste F, SLO, CA 934L, . The Tribune 2000 10/16/2004 San Luis Mailing Service 281 Pacific St., SLO, CA 93401 Mailing 198.92. 10/22/2004 Pierre Rademaker Design 738 Higuera St., Ste F, SLO, CA.93401 Mustang Daily 108 10/24/2004 Pierre Rademaker Design 738 Higuera St., Ste F, SLO, CA 93401 The Tribune 2712.63 10/24/2004 Pierre Rademaker Design 738 Higuera St., Ste F, SLO, CA 93401 SLO Journ/Plus Mag 675 10/24/2004 San Luis Mailing Service 281 Pacific St., SLO, CA 93401 Mailing 208.48 TOTAL (inserted in Column A above) $ 21513.47 SCHEDULE C (continued) 2. EXPENDITURES: 10/31/04 -12/31/04 DATE NAME AND ADDRESS DESCRIPTION OF PAYMENT AMOUNT OF PAYEE OR RECIPIENT Page 2 Schedule C Formulas 2004 www.RomeroforMayor.com Mayor Dave's SLO=Style Barbecue Friday, October 22, 2004 Odd Fellows Hall 520 Dana Street 5-7pm $15 Donation For more information, call 594-1335 m CD CD m 6 3 R CD m c OON O w 3 'O G � (DCDNCA O CD 3 w CD CD o CD T LnW I 0 00o=S%C dU.< m -07 CD �0a80� aim o N QD o r -C co cfDi 'O m °c '• co m rn > .. 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N m n° a � m o g �' C m o o cv g °+ 7 a <_ m m o �m N c m m ^� a m a m> CL > 5, (DCLcm xma 2 00 o Q m CD m o �'m m m m o.p g° CL 3 OL T 9 V O 0 T a m m on 9 0 m m P Q! 01 O A c in 7 m A Q N CL 7 3 C� C 0 0 C) nd O 00 �1 cr O 3 - >. 0 Mi Page 1 of 1 V. - Audrey Audrey Hooper - Form 460 - Second Filing From: Audrey Hooper To: Romero, Dave Date: 10/18/2004 1:49 PM Subject: Form 460 - Second Fling Dave, Just wanted to remind you that that your second pre-election statement (form 460) is due in my office by 5:00 p.m. this Thursday, October 21st. This is the second state form. Form 101 is due by noon next Tuesday, October 26. I'd like to review the form with you again, if we. can work that out. In addition, when you have a moment, will you stop by and see me regarding the filings for the 2002 election. I left a note on your desk to do this and if I don't see you today, I may give you a call. Thanks, Dave. 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O m pCD CD m O. m O m d •^p CD m f0 00 OL { Co Co (D m Q a 7 m a 7 CD (D '7 0>> >> x s vo.m m0. =0 CD= a. m m o=ems °;=o mo o.c� 8cn =o_ <mm o^M m cpm 3o as °.m> 0 z CL mmo. d m cc 0Cl) eta m m 2� nmg Sm -0m °om mem 0 > m 5.8 5� a 3 ° . m - 3 ° m D. 0 d so m N O N m O= m �[ CL 3 � W 7 CID Q N CD 0 CL � 3 D) 3 CD �w d O 3 �to O rp3 O Z A 7 W 2 CL c ,0. O O G) N O Audrey per -Candidate's Campaign F'-•ement - _ _Page_ 1 Dave, as mentioned, I just want to remind you that your campaign statement is due in the City Clerk's office by 5:00 p.m. on October 5th. I'd like to encourage you or your treasurer to give me a call and set up an appointment so that I can be on hand to review the form when it is brought in. This, of course, is not a necessity, but I have found that it is often helpful to take this step. At any rate, please feel free to call me if I can be of any assistance as you near this deadline. Audrey Hooper City Clerk (805)781-7104 From: Audrey Hooper To: Romero, Dave Date: 9/23/04 5:15PM Subject: Candidate's Campaign Statement Dave, as mentioned, I just want to remind you that your campaign statement is due in the City Clerk's office by 5:00 p.m. on October 5th. I'd like to encourage you or your treasurer to give me a call and set up an appointment so that I can be on hand to review the form when it is brought in. This, of course, is not a necessity, but I have found that it is often helpful to take this step. At any rate, please feel free to call me if I can be of any assistance as you near this deadline. 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E m I-•• N N LL 'C O m aj m m 7 N . fa O w p m 0 C II C V r iy C a) 3 m. m. o ai E o m �-o m o c = E E E� N o� cm �Y�m�+ 0c O oc w�°E m e T o c; m o E IIi N O c C m X Q II LL O E L U O c0 m C `� N O o Co >` O cQ LL y U m N C_ O_ N m Q E --o V. c r 0 m ca U Ia m r O c m •O C U m m m E L O T m y 0(D c `•.m- 'O c0 :+ m m y= L c 2S w E m 4- m p m O N m> Nm o m m c N E E °c''c Q m m o m m E N V C E m �' y m A .0 a Q m t m m 8 0 -� m m y m a a 8 _ m y C >, N o co a.(D m 8 C w Of N T •- m ~ m m O) >+ m ., C O M m m m m m y M m E •m0 f+ m NII E Q me o o me c m`o m$� : m E N' m E m o E m E m E D w m L� w m m cmi ?� m m L ami E m m E m c x y c o CD d �e c E N o m m o m vi c m m m a�Ei o Qom o c, E ca 75 0 o N L c 8 N € t O S E c o E +�+ r m E d m c m E m m ami �aV m� c�L, o E m y yi5 V o o t °•o Cl) I— r o= v v Q io b •••• 3 o f 0 F a 0 �- Q 0 STATEMENT OF CANDIDATE FOR MAYOR City of San Luis Obispo DAVE ROMERO Age: 75 Occupation: Mayor Education and Qualifications: As your current Mayor, Councilman for 8 years, and Public Works Director for 36, 1 have devoted over 46 years to protecting and enhancing the unique quality of iffe we enjoy in our city. I am known for a common sense approach to issues, for honesty, and for keen negotiating skills. For years I have worked closely with officials from nearby cities, with the Board of Supervisors, with city representafives in the Tri - Counties (as League of Cities Division president), with Cal Poly, Cuesta, CMC, and with our state and federal legislators. With my extensive background and reputation for integrity, I have unmatched qualifications to serve as Mayor. During my Mayor's term, your city made major progress in addressing housing problems, obtaining a reliable long term water supply, and relieving increasing traffic congestion. Being retired, I can devote full time and effort to city issues. I will follow through in resolving our water supply and housing needs, completion of the Margarita and Airport Area annexations, meeting downtown parking needs, continuing to improve and enhance downtown, and protecting and preserving our city's neighborhoods. I will continue to support acquisition of open space, development of the Youth Sports Complex, improved Senior Center Facilities, and, most importantly, enhancement of our quality of life. I have dedicated my life to public service and will continue to be accessible to everyone. You can trust me to continue leading our City to an even better future. Personal: City Resident, 1956 -present Wife: MaryBelle, married 52 years Children: Cathie, Teresa, Bruce (deceased), 11 grandchildren Education: BS in Civil Engineering, UNM, Albuquerque Registered Civil Engineer, California Professional Experience: Commissioned officer— USC&GS 1950-54 LA County Road Department 1954-56 Public Works Director, City of San Luis Obispo, 1956-92 Lecturer, Cal Poly 1967-97 Memberships and Activities: San Luis Obispo Chamber of Commerce Downtown Association Rotary Club Retired Active Men Residents for Quality Neighborhoods The Land Conservancy American Public Works Association Old Mission Church, Newman Center (President), Grace Church La Fiesta (1987 EI Presidente) City Councilmember 1992-2000 (vice -mayor 2+yrs) Integrated Waste Management Authority (president) Economic Opportunity Commission Performing Arts Center Commission California Mens Colony Citizens Advisory Committee Student -community Liaison Committee North County Water Task Force Airport Land Use Commission California League of Cities (Division president 2 yrs) San Luis Obispo Council of Governments (president) San Luis Obispo Regional Transit Authority (president) L@IM�-MIra STATEMENT OF CANDIDATE FOR '"type Contest Name" "Type Candidate Name" Occupation: 'Type Candidate Designation" Education and Qualifications: SPANISH FOR DAVE ROMERO Age: "Type Age" CANDIDATES PUBLIC INFORMATION RESUME Candidate for the Office of N1,-:3 4,o r RECEIVED !UL 2 9 2004 SLO CITY CLERK General Municipal Election, Tuesday, November 2, 2004 Upon receipt of nomination papers, the news media is notified of prospective candidates. Usually the news media will want to contact you to receive additional information. Please fill in as much or as little of the information requested that you would like to make public. If you wish this information to remain confidential, please indicate by marking the box below. The Office of the City Clerk requests that you do provide at least a telephone number and address to reach you if additional information is needed concerning filing requirements. Candidate's Name 07iz j�-) F Z&rn-ene Date '7 - 2Z -'S1 Residence Address - Phone Business Address 9!qz� Pa Ire f' t. Phone Present Occupation Email 0teomz 20 r -p I V?A y612 . w m Name of Employer (if any) C77," f, f- Sgi L..vil Z -)h Address of Employer !q go S /t SLy ca. !Fz / Professional Experience: 37 YQ�rs as Cb1tZ7 4-1,Joe-4r 0/reG Civic related positions held in the City or elsewhere: SLD /yl�csar ZvU2- .Di-�SP��f Campaign Treasurer's Name (if applicable) s - No r. -:S Phone (Signature) ❑ Please keep the above material confidential NO M I N A ... V N OFFICIAL FILING FORM PAPER RECEIVED rk or Deputy City lerk l9 2JuIt JUL. SLO CITY CLERK Date We, the undersigned voters, hereby nominate Q,:7Le 12vr g,e ,o for the office of M -p Vd r for the City of .......................... 5 a n L [li "S d h to be voted for at the Geo tPra o it e Election to be held on Tuesday, No o 52m h -P r 2 , 2D d 1f 1 Genoml Low 120 -tat- 20W N:T0RMSN=1ra00n 13=u ns'NOMINATION PAPERS 20N Md MC EMcOao DECLARATION OF CIRCULATOR (on next page) (Only 1 registered voter may circulate a municipal nomination paper, Elections Code Sections 104, 10220, 10222) AFFIDAVIT OF NOMINEE AND OATH OR AFFIRMATION OF ALLEGIANCE (on next page) (A candidate may sign his or her own nomination paper.) CANDIDATE'S INFORMATION O�,�e....f2or.. - r..a.................................... ........ Candidate's name ....................................................................................... City State Zip Email MA` &e .Coif Standard Page 312004 7 DEQ' .ARATION OF CIRCULA'" R Any person registered to veto at the 01, end qualified to vote for the elective office for which this nomination i.. _4a may circulate a nomination paper. (only 1 circulator may circulate this nomination paper per Elections Code Sections 104, 10220, 10222) /� (Do not type this section. It MUST be filled out in your own handwriting.) I, �7 /J -e / C G✓YI el -0 residing at 2 1,7 t- G17 • , circulated the petition and witnessed the appended signatures being written. That according to the best information hnd belief each signature is the genuine signature of the person whose name it purports to be. The signatures were obtained between J 4.l Ll 2 2 71)6 and ) u/ti 2 e I certify (or declare) under the penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed by me at S e7*1 101Oi Ca, on��%T Zdd (Signature o Irculator) AFFIDAVIT OF NOMINEE AND OATH OR AFFIRMATION OF ALLEGIANCE State of California County of ss. (Print Name of Nominee) being duly swom, says that he or she is the above-named nominee for the office of: ..... .... MfeT P,-. n r i amen ,ee that he or she will accept the office in the event of his or her election, that he or she desires his or her name to appear on the ballot as follc and that he or she desires the following designation* to appear on the ballot under his or her name: .................... Name & Occupation as it will appear on OHial Ballot & In Voter Pamphlet: ici name and lowercaso I, do solemnly swear (or affirm) that I will support and defend the Constitution of the United States and the Constitution of the State of California against all enemies, foreign and domestic; that I will bear true faith and allegiance to the Constitution of the United States and the Constitution of the State of California; that I take this obligation freely, without any mental reservation or purpose of evasion; Subscribed and Sworn to Before Me on (Signature of Candidate) * BALLOT DESIGNATION REQUIREMENTS At the option of the candidate. ONLY ONE of the following designations may be used: 1. Words designating the elective city, county, district, state or federal office which the candidate holds at the time of filing the nomination papers to which he or she was elected by veto of the people, or to which he or she was appointed. in the case of a superior or municipal court judge. 2. The word "Incumbent" if the candidate is a candidate for the same offles which he or she holds at the time of filing the nomination papers, and was elected to that office by a vote of the people, or In the case of a superior or municipal court jutlge, was appointed to that office. 3. No mora than three words designating either the current principal processions, vocations, or occupations of the candidate. or the principal professions, vocations, or occupations of the candidate during the calendar year immediately preceding the filing of nomination documents. For purposes of this section, all California geographical names shall be considered to be one word. Hyphenated words that appear in any generally available standard reference dictionary, published in the U.S. at any time within the 10 calendar years immediately preceding the election for which the words are counted, shall be considered as one word. Each pan of all other hyphenated words shall be counted as a separate word. The use of the word "Retired' by itself or as a prefix is acceptable, but not after any other word or words (e.g. 'Retired and 'Retired Amy Officer' is pennlssiblo:'U.S.M.C., Retired. is not). 4. The phrase 'Appointed Incumbent- if the candidate holds office by virtue of appointment, but may not use tho unmodified word Incumbent". No candidate shall assume a designation which would mislead the voters. (Soo Section 13107, 13107.5, Elections Code) Standard Page 4 / 2004 CANDIDATE'S STATEMENT INFORMATION SHEET Complete the top portion L. .,s form. Use a SEPARATE SHEET of pal -ar your candidate statement. Please use upper and lower case letters (do not use all caps). The candidate statement is a brief description of no more than 200 words, of the candidate's education and qualifications. Be sure to include the official title of the office you are a candidate for, your name, age, and occupation. (see reverse side for sample format) STATE LAW PROVIDES: 1. A Candidate Statement is optional and available to all candidates for nonpartisan offices only. 2. The statement may include candidate's age, occupation and a brief description of education and qualifications. 3. Each local jurisdiction determines: a. the maximum number of words allowed, usually 200 words b. responsibility for payment, the candidate or the jurisdiction c. whether the costs are to be paid in advance. 4. No reference to political party affiliation nor mention of any partisan political membership or activity is permitted. 5. No changes of any kind are allowed AFTER the statement is filed. 6. The statement may be withdrawn (in writing) up to 5:00 pm of the next working day after the close of the nomination period. 7. Statements are confidential until after the close of the nomination period. 8. A candidate may request that the statement also be printed in other languages and included in the Sample Ballot Voter Information Pamphlet mailed to all voters in the election area. An additional fee may be required to print the additional languages. CANDIDATE'S STATEMENTS MUST BE FILED AT THE TIME NOMINATION PAPERS ARE FILED. COST INFORMATION: The estimated cost is determined prior to all information being available, therefore, it is an approximation of the actual cost that varies from election to election and may be significantly more or less depending on the actual number of candidates filing statements. For Election Official's use only: Estimated Cost of Printing Candidate's Statement in: English: $ Spanish: $ $ : $ : $ If applicable, the below estimated cost is for Translations and Typesetting (and formatting if translation is provided by the candidate) and this cost does not include printing, which cost is noted above: Spanish: $ : $ : $ : $ $ Election Official: a. Send one copy of this page and the candidate statement to the vendor/printer b. keep Original set for your riles c. make one copy for the candidate d. make one or more copies for the translator(s) if necessary. (more Information on reverse side) '1 Forms/Candidate Statement 2004 Enter the jurisdictions' name and the candidates' name in all CAPS. 46 Check the box of the We of Office for which the person is a candidate. C I T �/ p 57.4 A/ U i 5 D MAYOR §FCEIVED ❑ MEMBER OF THE CITY OUN (?► Jurisdiction's name in CAPS) (District . ) JUA 2 9 2084 ❑ CITY CLERK _ ❑ CITY TREASURER SAO CITY RK ,A i2®' ( ❑ MEMBER OF THE BOA (T Candidate's name in CAPS) (District ) ❑ Other: ❑ I DO NOT WANT a candidate statement to appear in the Sample Ballot Voter Pamphlet. Signature of candidate: For cities conducting their own elections, in Los Angeles County: I DO WANT my Candidate Statement to appear in the following languages in the Sample Ballot Voter Pamphlet: 111,Mnglish fta'Spanish / Colloquial (informal) ❑Chinese / Mandarin (informal) ❑Japanese ❑Korean ❑Tagalog ❑ Spanish / Castillian (formal) ❑Chinese / Cantonese (formal) ❑Vietnamese ❑ STATE LAW PROVIDES: 1. A Candidate Statement is optional and available to all candidates for nonpartisan offices only. 2. The statement may include candidate's age, occupation and a brief description of education and qualifications. 3. Each local jurisdiction determines: a. the maximum number of words allowed, usually 200 words b. responsibility for payment, the candidate or the jurisdiction c. whether the costs are to be paid in advance. 4. No reference to political party affiliation nor mention of any partisan political membership or activity is permitted. 5. No changes of any kind are allowed AFTER the statement is filed. 6. The statement may be withdrawn (in writing) up to 5:00 pm of the next working day after the close of the nomination period. 7. Statements are confidential until after the close of the nomination period. 8. A candidate may request that the statement also be printed in other languages and included in the Sample Ballot Voter Information Pamphlet mailed to all voters in the election area. An additional fee may be required to print the additional languages. CANDIDATE'S STATEMENTS MUST BE FILED AT THE TIME NOMINATION PAPERS ARE FILED. COST INFORMATION: The estimated cost is determined prior to all information being available, therefore, it is an approximation of the actual cost that varies from election to election and may be significantly more or less depending on the actual number of candidates filing statements. For Election Official's use only: Estimated Cost of Printing Candidate's Statement in: English: $ Spanish: $ $ : $ : $ If applicable, the below estimated cost is for Translations and Typesetting (and formatting if translation is provided by the candidate) and this cost does not include printing, which cost is noted above: Spanish: $ : $ : $ : $ $ Election Official: a. Send one copy of this page and the candidate statement to the vendor/printer b. keep Original set for your riles c. make one copy for the candidate d. make one or more copies for the translator(s) if necessary. (more Information on reverse side) '1 Forms/Candidate Statement 2004 CANDIDATE'S STATEMENT GUIDELINES Please type using uoner and lowercase letters, do not use all CAPS. Type your statement clearly and legibly as it will be scanned by a scanner that cannot not read handwriting or printing. Section 13307 of the Elections Code of the State of.Califomia sets forth guidelines for candidate's statements. Pleasjfollow them: 1. The statement of each candidate shall be printed in type of uniform size and darkness and with uniform spacing. 2. The statement shall not include any party affiliation or membership or activity in partisan political organizations,. 3. Your statement will be printed as submitted; therefore you are advised to carefully check f_or errors in punctuation and grammar. Spelling however, will be corrected by the computer automatically. 4. Remember to sign this form and any supplemental sheets if used and attach them to your statement. If you wish to have a Foreign language translation of your statement prepared for printing in the Voter's Pamphlet, be .sure to check the space(s) provided on the front of this form. WORD COUNT STANDARDS As stated in Section 9 of the Elections Code. (a) Counting of words, for purposes of this code, shall be as follows: (1) Punctuation is not counted. (2) Each word shall be counted as one word except as specified in this section. (3) All geographical names shall be considered as one word; for example, "City and County of San Francisco" shall be counted as one word. (4) Each abbreviation for a word, phrase, or expression shall be counted as one word. E.G. UCLA, PTA, L.A.P.D. (5) Hyphenated words that appear in any generally available standard reference dictionary, published in the United States at any time within the 10 calendar years immediately preceding the election for which the words are counted, shall be considered as one word. Each part of all other hyphenated words shall be counted as a separate word. (6) Dates consisting of a combination of words and digits shall be counted as two words. E.G. April 10, 1990. Dates consisting only of a combination of digits shall be counted as one word. E.G. 4/10/90. (7) Any number consisting of a digit or digits shall be considered as one word. Any number which is spelled, such as "one," shall be considered as a separate word or words. "One" shall be counted as one word whereas "one hundred" shall be counted as two words. °100° shall be counted as one word. (8) Telephone numbers shall be counted as one word. (9) Internet web site and email addresses shall be counted as one word: (b) This section shall not apply to counting words for ballot designations under Sections 13107 and 13107.5. SAMPLE OF CANDIDATE STATEMENT FORMAT FOR MEMBER OF THE CITY COUNCIL JOHN SMITH Age: 45 Occupation: Businessman I have been a 30 year resident of this City and thoroughly enjoy living here. I would like to increase citizen education and police resources to stop the gang and graffhi activity that are overtaking our city. I would like to implement environmental standards for cleaner water and air quality. I respectfully ask for your support and thank those of you who cast your vote for me. A vote for me is a vote fora better City Council. MC Elections • 2004 (Amended 10/03) f •� 7/29/04 San Luis Obispo County Elections Page 1 16:09 Petition Statistics Report PT.STA.R DAVE DAVE ROMERO, CITY OF SAN LUIS OBISPO, MAYOR Petition Control Information ----------------------------- ----------------------------- Last Calculated: 7/29/04 at 4:09PM Petition ID: DAVE Description: DAVE ROMERO, CITY OF SAN LUIS OBISPO; MAYOR District ID: District Checking: None Election: NOV. 2, 2004 Measure/Prop Id: Candidate Last/First: ROMERO, DAVE Office ID: Authority Name: CITY OF SAN LUIS OBISPO Contact: Street Address: Line 2: City/State/Zip: Phone/Extension: Valid Sigs Required: 20 Percent to Check: 100.00% Filing Date: 7/29/04 First Valid Signing: 7/22/04 Last Valid Signing: 7/28/04 Decision Due: Checking Completed: -------------------------------------------------------------------------------- Comments / Special Instructions: 7/29/04 San Luis Obispo County Elections 16:09 Petition Statistics Report DAVE DAVE ROMERO, CITY OF SAN LUIS OBISPO, MAYOR Petition Statistics --------------------- --------------------- Valid Signers Required: 20 Signatures Collected: 30 on 1 Pages Less: 0 on 0 Invalid Pages ---------------------------------------------------------------- Available for Checking: 30 on 1 Valid Pages Signers to Check: 30 Signers Checked: Incomplete Validation: Invalid Signing Date: Not Registered: Illegible: Valid Duplicate: Valid Dup on Related: Address Rejected: Address Questionable: Out of District: Signature Rejected: Signature Questionable: 30 (100.00% of Signers to Check) 0 0 1 0 0 0 0 0 0 0 0 Total Invalidated: 1 ( 3.33% of Signers Checked) -------------------------------------------------------------------- Validated: 29 ( 96.67% of Signers Checked) Valid Withdrawals: 0 ( 0.00% of Signers Checked) -------------------------------------------------------------------- Total Validated: 29 ( 96.67% of Signers Checked) (145.00% of Valid Signers Required) Signers Left to Check: 0 ( 0.00% of Signers to Check) Over: 9 Page 2 PT. STA. R 7/29/04 San Luis Obispo County Elections 16:09 Petition Statistics Report DAVE DAVE ROMERO, CITY OF SAN LUIS OBISPO, MAYOR Explanation of Validation Codes ---------------=----------------- --------------------------------- OK = Valid IN = INcomplete SD = Signing Date invalid NR = Not Registered IL = ILlegible VD = Valid Duplicate on petition VR = Valid duplicate on Related petition AR = Address Rejected AQ = Address Questionable DI = District Invalid SR = Signature Rejected SQ = Signature Questionable WD = WithDrawn Page 3 PT. STA. R 7/29/04 San Luis Obispo County Elections Page 4 16:09 Petition Statistics Report PT.STA.R DAVE DAVE ROMERO, CITY OF SAN LUIS OBISPO, MAYOR Validation History Sigs Total Pages Col- Signers Total Valid - Date Filed lected Checked IN SD NR Ii. VD Vit AR AQ DI SR SQ Invalid ated ------------ ------- ------- ------- ------ -- ---- ------ ------ ------ ------ ------ ------ ------ ------ ------ ------- ------- Thu 7/29/04 1 30 30 0 0 1 0 0 0 0 0 0 0 0 1 29 City of San Luis Obispo Mayor Statement of Candidate Dave Romero Age 75 Occupation: Mayor As your current Mayor, Councilman for 8 years, and Public Works Director for 36, I have devoted over 46 years to protecting and enhancing the unique quality of life we enjoy in our city. I am known for a common sense approach to issues, for honesty, and for keen negotiating skills. For years I have worked closely with officials from nearby cities, with the Board of Supervisors, with city representatives in the Tri -Counties (as League of Cities Division president), with Cal Poly, Cuesta, CMC, and with our state and federal legislators. With my extensive background and reputation for integrity, I have unmatched qualifications to serve as Mayor. During my Mayor's term, your city made major progress in addressing housing problems, obtaining a reliable long term water supply, and relieving increasing traffic congestion. Being retired, I can devote full time and effort to city issues. I will follow through in resolving our water supply and housing needs, completion of the Margarita and Airport Area annexations, meeting downtown parking needs, continuing to improve and enhance downtown, and protecting and preserving our city's neighborhoods. I will continue to support acquisition of open space, development of the Youth Sports Complex, improved Senior Center Facilities, and, most importantly, enhancement of our quality of life. I have dedicated my life to public service and will continue to be accessible to everyone. You can trust me to continue leading our City to an even better future. Personal: City Resident , 1956 -present Wife: MaryBelle, married 52 years Children: Cathie, Teresa, Bruce (deceased), 11 grandchildren Education: BS in Civil Engineering, UNM, Albuquerque Registered Civil Engineer, California Professional Experience: Commissioned officer = USC&GS 1950-54 LA County Road Department 1954-56 Public Works Director, City of San Luis Obispo., 1956-92 RECEIVED Lecturer, Cal Poly 1967-97 jUL 2 9 2004 SLO CITY CLERK C Memberships and Activities: San Luis Obispo Chamber of Commerce Downtown Association Rotary Club Retired Active Men Residents for Quality Neighborhoods The Land Conservancy American Public Works Association Old Mission Church, Newman Center (President), Grace Church La Fiesta (1987 El Presidente) City Councilmember 1992-2000 (vice -mayor 2+ yrs) Integrated Waste Management Authority (president) Economic Opportunity Commission Performing Arts Center Commission California Mens Colony Citizens Advisory Committee Student -community Liaison Committee North County Water Task Force Airport Land Use Commission California League of Cities (Division president 2 yrs) San Luis Obispo Council of Governments (president) San Luis Obispo Regional Transit Authority (president) CODE 6P FAIR CAMPAIGN PKACTICES There are basic principles of decency, honesty, and fair play which every candidate for public office in the State of California has a moral obligation to observe and uphold, in order that, after vigorously contested, but fairly conducted campaigns, our citizens may exercise their constitutional right to a free and untrammeled choice and the will of the people may be fully and clearly expressed on the issues. THEREFORE: (1) 1 SHALL CONDUCT my campaign openly and publicly, discussing the issues as I see them; presenting my record. and policies with sincerity and frankness, and criticizing without fear or favor the record and policies of my opponents or political parties which merit such criticism. (2) 1 SHALL NOT USE OR PERMIT the use of character defamation, whispering campaigns, libel, slander, or scurrilous attacks on any candidate or his or her personal or family life. (3) 1 SHALL NOT USE OR PERMIT any appeal to negative prejudice based on race, sex, religion, national origin, physical health status, or age. . (4) 1 SHALL NOT USE OR PERMIT any dishonest or unethical practice which tends to corrupt or undermine our American system of free elections, or which hampers or prevents the full and free expression of the will of the voters including acts intended to hinder or prevent any eligible person from. registering to vote, enrolling to vote, or voting. (5) 1 SHALL NOT coerce election help or campaign contributions for myself or for any other candidate. from my employees. (6) 1 SHALL IMMEDIATELY AND. PUBLICLY REPUDIATE support deriving from any individual or group which resorts, on be.haff of my candidacy or in opposition to that of my opponent, to the methods and tactics which I condemn. I shall accept responsibility to take firm action against any subordinate who violates any provision of this code or the laws governing elections. (7) I SHALL .DEFEND AND UPHOLD the right of every qualified American voter to full and equal participation in the electoral process. I, the undersigned, candidate for election to public office inthe State of Califomia or treasurer or chairperson of a committee making any independent expenditures, hereby voluntarily endorse, subscribe to, and solemnly pledge myself to conduct my campaign in accordance with the above principles and practices. 7- Signature ��lii� � 1CpYrl�rO - Printed Name Date of Election MC Sections (Amanded 1995) N:IF0HMSC4d9 of Fair Campaign PracYices.doc RECEIVE JUL2 4 1-0 CITY CLERK CODE L. FAIR CAMPAIGN PR.-.vTICES (Division 20, Chapter 5, Elections Code.) Chapter 5.. Fair Campaign Practices Article 1. General Intent 20400. The.Legislature hereby declares that the purpose of this chapter is to encourage every candidate for public office in this state to subscribe to the Code of Fair Campaign Practires. It is the ultimate intent of the Legislature that every candidate for public office in this state who subscribes to the Code of Fair Campaign Practices will follow the basic principles of decency, honesty, and fair play in order that, after vigorously contested, but fairly conducted campaigns; the citizens of this state may exercise their constitutional right to vote, free from dishonest and unethical practices which tend to prevent the full and free expression of the will of the voters. The purpose in creating the Code of Fair Campaign Practices is to give voters guidelines in determining fair play and to encourage candidates to discuss issues instead of untruths or distortions. Article 2. Definitions 20420. As used in this Chapter, "Code" means the Code of Fair Campaign Practices. Article 3. Code of Fair Campaign Practices 20440. At the time an individual is issued his or her declaration of candidacy, nomination papers, or any other paper evidencing an intention to be a candidate for public office, the Elections Official, shall give the individual a blank form of the Code of Fair Campaign Practices and a copy of this . chapter. The Elections Official shall inform each candidate for public office that subscription to the code is voluntary. In the case of a committee making an independent expenditure within the meaning of Section 82031 of the Government Code, the Secretary of State shall provide a blank form and a copy of this chapter to the individual filing, in accordance with Title 9 (commencing with § 81000) of the Government Code, an initial campaign statement on behalf of the committee. The text of the Code shall read, as follows: (See "CODE OF FAIR CAMPAIGN PRACTICES" on reverse side). 20442. The Elections Official shall accept, at all times prior to the election, all completed forms which are properly subscribed to by a candidate for public office and shall retain- them for public inspection until 30 days after the election. 20443. Every code subscribed to by a candidate for public office pursuant to this chapter is a public record open for public inspection. 2044,4:. In- no event shall a candidate for public office be required to subscribe to or endorse the code. MC sections (Amended 1995) NIFORMSGode of Felr Camper PrecticesAoe m m CD m a c IT IW W CDD m m d m = A Q G C y n 7 z O. m ai CD O w ID O m m 3 m °1 0 fFa � � Q CD CD o �cc m m C m' O CD 7 d o m a 3 m of z d 7 so CD v, d m `D 0C O.Dm 7 to m N � o. 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S n a-0 0 N O m O C .r T 3 N 7 C O C N M Cl N 3 c o 7 v m 'O< O.< m< a 7 7 N� O C) O °m Amo �$Q$ �,A- 01 am m 7 0330 a a' F.N' d 0T o mvT �r 7 a a m o m c.m 7 ,.m �I c m D : c CO = 7 T $ �v a� ; NCO f m g me 7 mCD 0 0mloo SD y �-n N g- CLO O f0 n m 7. m o m 7 m m A w o v< T n g O a m 7 l< m CD 7 m 7C L 01 T CD m O. �. 7 N• C O- 7 0 CD m ACL nrl 0� m ° a i STATEMENT OF ECONOMIC INTERESTS Date Received OR - e OdirJ w'al &W orgy COMMISSIONFAIR POLITICAL PRACTICES COVER PAGE RECEIVED Please type or print in ink A Public Document JUL 2 9 210004 NAME (LAST) (FIRST) (MIDDLE) I BE (�orr1ery Oau IBJ F MAILING ADDRESS STREET CITY STATE ZIP CODE S,:7I1Lvi f40ld(rAo6 (?Sqo/ Aem,;f nn.�Mcnn� 1. Office, Agency or Court Name of Office, Agency or Court: Division, Board, District, if applicable: Your Position: M? yo r If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: - 2 Jurisdiction of Office (Check at /east one box) ❑ State ❑ County of [R city Of S';J'" L.&S l7br9102o ❑ Multi -County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office/Initial Date: J—l— ❑ Annual: The period covered is January 1, 2003, through December 31, 2003. -or- o The period covered is .. / through December 31. 2003. ❑ Leaving Office Date Left: _J_! (Check one) O The period covered is January 1, 2003, through the date of leaving office. .or - 0 The period coveted is ��—, through the date of leaving office. GKandidate 4. Schedule Summary (Check applicable schedules or "No reportable interests.'q -*During the reporting period, did you have any reportable interests to disclose on: Schedule A-1 2-1es - schedule attached Investments (Less orae toss ownerzwp) Schedule A-2 ❑ Yes - schedule attached Investments (toss or grostar ownership) Schedule B es - schedule attached Real Property Schedule C ❑ Yes - schedule attached Income 8 Business Positions (Income ower d,m, Loans, cars. and Trawl) Schedule D ❑ Yes - schedule attached Income - Loans Schedule E ❑ Yes - schedule attached Income - Gifts Schedule F ❑ Yes - schedule attached Income - Travel Payments -or- o ❑ No reportable interests on any schedule Total number of pages completed including this cover page: 3 5. Verification I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct Date Signed 7 - ZG -O -'/ � (month, day. year) Signaturec__ ( official.) FPPC Form 700 (200312004) FPPC Toll -Free Helpline: BBB/ASK-FPPC WHAT SCHEDULE DO I USE TO REPORT? Business positions.......................................................................................................... Schedule A-2 or Schedule C Commission income............................................................................Schedule A-2 or Schedule C (see Appendix -5) Gifts received by family members ................................................... Disclosure may not be required, see Schedule E Gifts received from family members............................................................. Disclosure not required, see Schedule E Income to my business ..................................... ....................................................... Schedule A-2 Individual Retirement Account..........................................................Schedule A-1 or Schedule B (see Appendix -10) Investments.................................................................................................................. Schedule A-1 or Schedule A-2 Loans made to others ................................................Disclosure not required, but report repayments on Schedule C Loans received......................................................................................... Schedule B for real property or Schedule D Loansto my business.............................................................................................................................Schedule A-2 Owning a business or partnership IfI own less than 10%........................................................................................................................Schedule A-1 IfI own 10% or more..........................................................................................................................Schedule A-2 Real estate holdings.......................................................Schedule B (Schedule A-2 if held by a business entity/trust) Rentalincome................................................................................................................... — Rental property ...............................................................Schedule B (Schedule A-2 if held by a business entity/trust) Sale of my home/automobile/boat..............................................................................................................Schedule C Soleproprietorship..................................................................................................................................Schedule A-2 Spouse's income............................................................................................................. Schedule A-2 or Schedule C Stock holdings If I own less than 10% of a company's stock.....................................................................................Schedule A-1 If I own 10% or more of a company's stock.......................................................................................Schedule A-2 Ticketsand passes.................................................................................................................................... Schedule E Travel reimbursements or payments.......................................................................................................... Schedule F Trusts....................................................................................................................... Schedule A-2 (see Appendix -11) FPPC Form 700 (2003/2004) FPPC Toll -Free Helpline: 866/ASK-FPPC Instructions -2 • SCHEDULE A-1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. > NAME OF BUSINESS ENTITY - - -- MIl S4�_On CnmW"uhl u. GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE p-$2-000 - $1D,000 p $10.001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000.000 NATURE OF INVESTMENT ©tock QOther . . (Describe) .. IF APPLICABLE. UST DATE . . ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE , ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1.000,000 ❑ Over $1,600,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, UST DATE —J—J 03 __J -__J_23 ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2.000 - $10.000 ❑ $10,001 - $100,000 ❑ $100.001 $1,000,000 ❑ over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: � / 03 . 03 ACQUIRED DISPOSED Comments: NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 . ❑ $100,001 - $1.000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock a. Omer (Describe) IF APPLICABLE. LIST DATE: 03 ACQUIRED DISPOSED > NAME OF GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 p $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock. ❑ Other _ (Describe) IF APPLICABLE. LIST DATE: 03 _j� .03 ACQUIRED . . DISPOSED OF GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE. ❑ $2,000 - $10.000 ❑ $10,001 - $100,000 ❑ $160,001 - $1,000,000 ❑ over $1,000,000 NATURE 00 -INVESTMENT ❑ Stock ❑ Othei (Dasoibe) . IF APPLICABLE, UST DATE __j__j03 �_j 03 ACQUIRED DISPOSED FPPC Form 700 (200312004)Soh. A-1 FPPC Toll -Free Helpline: 8661ASK-FPPC INSTRUCTIONS - SCHEDULE A-2 INVESTMENTS Use Schedule A-2 to report investments in a business entity or trust (including a living trust), in which you, your spouse, or your dependent children had a 10% or greater interest, valued at $2,000 or more, during the reporting period and which is located in, doing business in, planning to do business in, or which has done business during the previous two years in your agency's jurisdiction (see Appendix -9). A trust located outside your agency's jurisdiction is reportable if it holds assets that are located in or doing business in the jurisdiction. You are not required to report a. trust that contains no reportable interests. Also report on Schedule A-2 investments and real property held by that entity or trust if your pro rata share of the interest was $2,000 or more during the reporting period. For example, if you had a 20% partnership interest in a business entity and the entity owns real property, you would report that real property if your pro rate share of the value of the property was $2,000 or more (for example, if the property's value was at least $10,000). TO COMPLETE SCHEDULE A-2: Part 1. Disclose the name and address of the business entity or trust. If you are reporting an interest in a business entity, complete the box as follows: • Provide a general description of the business activity of the entity. • Check the box indicating the fair market value of your investment. • If you acquired or disposed of this interest during the reporting period, enter the date acquired or disposed. • Identify the nature of your investment. • Disclose the job title or business position you held with the entity, if any (for example, if you were a director, officer, partner, trustee, employee, or held any position of management). Part 2. Check the box indicating yourrg_oss income. (This includes your pro rata share of the cross income received by the business entity or trust, as well as your community property interest in your spouse's income.) Part 3. Disclose the name of each source of income which is located in, doing business in, planning to do business in, or which has done business during the previous two years in your agency's jurisdiction, as follows: • Disclose each source of income and outstanding loan to the business entity or trust identified in part 1 if your pro rata share of the cross income (including your community property interest in your spouse's income) to the business entity or trust from that source was $10,000 or more during the reporting period. Loans from commercial lending institutions made in the lender's regular course of business on terms available to members of the public without regard. to your official status are not reportable. • Disclose each individual or entity that was a source of commission income of $10,000 or more during the reporting period through the business entity identified in part 1. (See Appendix -5 for an explanation of commission income.) You may be required to disclose -sources of income located outside your jurisdiction. For example, you may have a client who resides outside your jurisdiction but who does business on a regular basis with you. Such a client, if a reportable source of $10,000 or more, must be disclosed. Leave this section blank if you do not have any reportable $10,000 sources of income to disclose. Adding phrases such as "various clients" or "not disclosing sources pursuant to attomey-client privilege" may trigger a request for an amendment to your statement. (See Appendix -10 for details about privileged information.) You may be required to disqualify yourseff from decisions affecting sources of $500 or more in income, even though you are not required to report them. Income, business positions, and real property reported on Schedule A-2 are not required to be disclosed on Schedules B or C. Part 4. Report any investments or interests in real property held by the entity or trust identified in part 1 if your pro rata share of the interest held was $2,000 or more during the reporting period. • Check the applicable box indicating if the interest held is real property or an investment. • If an investment, provide the name and description of the business entity. • If real property, report the address or other precise location, such as an assessor's parcel number, of the real property. • Check the box indicating the fair market value of your interest in the real property or investment. • Identify the nature of your interest. If you acquired or disposed of your interest in the property or investment during the reporting period, enter the date acquired or disposed. FPPC Form 700 (200312004) FPPC Toll -Free Helpline: 866/ASK-FPPC Instructions -5 SCHEDULE B Interests in Real Property > STREET ADDRESS OR PRECISE LOCATION City San Luir l,(oiA. - Cir FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2.000 - $10,000 [j Emool - $100,aao ❑ $100,001 - $1.000.000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ❑ Rental Property a6w'nership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remalnirig Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $ass ❑ $500 - $1,000 ❑.$1,001 - $10,060 ❑ $10,001 - $100.000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER' INTEREST RATE TERM (MonthsfYears) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $Soo - $1.000 ❑ $1.0ol - $10,000. ❑ $10,001 - $100.000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: Name > STREET ADDRESS OR PRECISE LOCATION CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2.000 - $10,000 ❑ $1o,001 - $100,000 —j--j-L3- _ JJ 03 ❑ $100.001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ❑ Rental Property ❑ Ownership/Deed of Trust ❑ Easement ❑ Leasehold 11. Yrs. romoining Other ' IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL.INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER INTEREST RATE TERM (MonthsNears) % , ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100.000 ❑ OVER $100,000 ❑ Guarantor, if appllceble FPPC Form 700 (2003/2004) Sch. B FPPC Toll -Free Helpline: 666/ASK-FPPC INSTRUCTIONS — SCHEDULE C INCOME & BUSINESS POSITIONS (Income Other than Loans, Gifts, and Travel Payments) Report the source and amount of gross income received if the amount totals $500 or more and was received from any source which is located in, doing business in, planning to do business in, or which has done business during the previous two years in your agency's jurisdiction (see Appendix -7). Gross income is the total amount of income before deducting expenses, losses, or taxes. Do not use this schedule to report income from or to a business entity in which you have a 10% or greater ownership interest. Use Schedule A-2 instead. Also use Schedule C to report the job title or business position you held with a business entity (for example, if you were a director, officer, partner, trustee, employee, or held any position of management) during the period covered by the report unless you have already reported this position on Schedule A-2. This requirement applies even if you received no income from the business entity during the period. Commonly reportable income includes: • Salary/wages, per diem, reimbursement for expenses. • Community property interest (50%) in your spouse's income - report the employer's name and all other required information. • Income received from investment interests, such as partnerships, reported on Schedule A-1. • Commission income not required to be reported on Schedule A-2. (See Appendix -5). • Gross income from any sale, including the sale of a house or car. The total sale price is reportable. • Rental income not required to be reported on Schedule B. • Prizes or awards not disclosed as gifts. • Payments received on loans you made to others, including loan repayments from a campaign committee. • An honorarium received prior to becoming a public official. (See Appendix -7 concerning your ability to receive future honoraria.) • Incentive compensation (See Appendix -8).. You are not required to report: • Salary, reimbursement for expenses and per diem received by you or your spouse from a federal, state, or local government agency. • Campaign contributions. REMINDERS • If you or your spouse is self-employed, report the business entity on Schedule A-2. • Do not disclose on Schedule C income already reported on Schedules A-2 or B or business positions reported on Schedule A-2. • A cash bequest or cash inheritance. • Returns on a security registered with the Securities and Exchange Commission, including dividends, interest, or proceeds from a sale of stocks or bonds. • Payments received under an insurance policy. • interest, dividends, or premiums on a time or demand deposit in a financial institution, shares in a credit union, an insurance policy, or a bond or other debt instrument issued by a government agency. • Your spouse's income which is legally "separate" income. • Income of dependent children. • Automobile trade-in allowances from dealers. • Loan repayments received from your spouse, child, parent, grandparent, grandchild, brother, sister, parent - in -law, brother-in-law, sister-in-law, nephew, niece, aunt, uncle, or first cousin unless he or she was acting as an intermediary or agent for any person not covered by this provision. • Alimony or child support payments. • Payments received under a defined benefit pension plan qualified under IRS Code section 401(a). TO COMPLETE SCHEDULE C: • Disclose the name and address of each source of income or each business entity with which you held a business position. • Provide a general description of the business activity of the source or business entity (for example, law firm). • Disclose the job title or business position, if any, you held with the business entity. • If you received $500 or more during the reporting period from a source or business entity, check the box indicating the amount of gross income. • Identify the consideration for which the income was received. • For income from commission sales, check the box indicating the gross income received and list the name of each source of commission income of $10,000 or more (see Appendix -5). For income from rental property that is not required to be listed on Schedule B, enter "Rental Income" under "Name," check the box indicating the gross income received, and, if you had a 10% or greater interest in the rental property, list the name of each tenant if your pro rata share of the gross income from that tenant was $10,000 or more during the reporting period. FPPC Form 700 (20032004) FPPC Toll -Free Helpline: SWASK-FPPC mstruclions-7 T V A O m T m 9 _0 m O m 3 ma D y L 7C c �O 90 9 A. ^I ns_ mdm� lD 2 w O y � a Mm n m ac P -P =ry CD m 0. CD m CD co 0 m rCDcq o:3=v rm.=mCD c CD c N m a CL p� O a�m ~ O N N Q + u CL -x m 0 0f O CDCD a m v _ m m 0] ? Cc y 59 N N w 0] _ (D F. 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