Schedule A Monetary Contributions Received
Amounts may be rounded to whole dollars.
SCHEDULE A
460
Statement covers period
CALIFORNIA FORM
x/x/20xx
from
xx
x
x/x/20xx
Page
of
through
SEE INSTRUCTIONS ON REVERSE NAME OF FILER
I.D. NUMBER
Committee to Elect Gerard for County Supervisor 2024
CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31)
PER ELECTION TO DATE (IF REQUIRED)
AMOUNT RECEIVED THIS PERIOD
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER)
IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS)
DATE RECEIVED
CONTRIBUTOR CODE *
IND COM OTH PTY SCC IND COM OTH PTY SCC IND COM OTH PTY SCC IND COM OTH PTY SCC IND COM OTH PTY SCC
10/xx/20xx Gerard for City Council 20xx (Transfer, see below) 49 J Street, Sacramento, CA 95814 (ID 1914287)
09/25/20xx Taylor Smith
Orthodontist, Smith Smiles $1,000
$1,000
P20xx: $1,000
7239 Hemingway Blvd. Rancho Palos Verdes CA 90274
11/03/20xx Z Corporation 2500 7th Avenue
$4,900
$4,900
P20xx: $4,900
Los Angeles, CA 90013
12/10/20xx Riley Thomas
Dispatcher, La Habra Heights Police Department
$900
$4,900
P20xx: $4,900
1095 Euclid Street La Habra Heights, CA 90631
The committee making the transfer must maintain records that identify the specific contributors to whom any transferred contributions have been attributed. If the transferring committee is no longer required to maintain detailed records, the receiving committee shall maintain either: SUBTOTAL $ Schedule A Summary 1. Amount received this period – itemized monetary contributions. (Include all Schedule A subtotals.) .........................................................................................................$ 2. Amount received this period – unitemized monetary contributions of less than $100 ...........................$ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)...................... TOTAL $ • The full name of the contributor; • The date and amount being transferred for each contributor, and if the contribution is a loan, the interest rate for the loan; and • The cumulative amount of contributions transferred attributed to that contributor. CLEAR FORM PRINT FORM
*Contributor Codes IND – Individual COM – Recipient Committee
(other than PTY or SCC) OTH – Other (e.g., business entity) PTY – Political Party SCC – Small Contributor Committee
FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov
OR
• Copies of the transferring committee’s original verified and filed campaign reports that show the original contribution received from each contributor to whom a transferred contribution is attributed.
Fair Political Practices Commission advice@fppc.ca.gov
Chapter 1.9
Campaign Manual 2 August 2023 Page 114
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