Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-842165) SEE INSTRUCTIONS ON REVERSE Statement covers period 10/21/2012 from through 12/31/2012 Date of election if applicable: (Month, Day. Year) 1 1/06/2012 I as am CALIFORNIA FORM 460 Page 1 of 55 5? I?f? ~5 .- ?t ForOft'icial Use Only 2. Type of Statement: 1. Type of Recipient Committee: Ail Committees - Complete Parts 1, 2, and 4. El Of?ceholder, Candidate Controlled Committee I: Primarily Formed Ballot Measure Preelection Statement I: Quarterly Statement State cand'date Elem'o" Committee IE Semi-annual Statement El Special Odd-Year Report 0 Recall Controlled I {Also Complete Part 5) Dnsored Termination Statement Supplemental Preelection (Also ?le a Form 410 Termination) Statement Attach Form 495 {Also Complete Part 6) General Purpose Committees El Amendment (Explain below) Sponsored Primarily Formed Candidate! . . 0 Small Contributor Committee Of?ceholder Committee Amendmg Per Elecnon TOtal Political Party/Central Committee 7? . . ID. NUMBER 3. Committee Information 1343915 Treasurer(s) COMMITTEE NAME (OR NAME IF NO COMMITTEE) NAME OF TREASURER Dave Roberts for Supervisor 2012 Gary CITY STATE ZIP CODE AREA CODEIPHONE Long Beach CA 90802-8018 STATE ZIP CODE AREA CODEIPHONE NAME OF ASSISTANT TREASURER. IF ANY Escondido CA 92025-2554 MAILING ADDRESS (IF DIFFERENT) No. AND STREET OR P.O. Box MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAXI E-MAIL ADDRESS Verification have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledg under penalty of perjury under the laws of the State of California that the forgoing is true and correct. OPTIONAL: FAX I E-MAIL ADDRESS ched schedules is true and complete. I certify Signatu oi? Treasurkor As nt Treasurer Ola/J IIV 3 Signature oi Controlling Of?cer, Candidate, State Measure Proponent or Responsmie Of?cer of Sponsor Signature of Controlling Officer, Candidate, State Measure Proponent Executed on 1! Date? ?7 f, Executed on I I 1 By Date Executed on By Date Executed on By Date Powered by CompleteCampaigns.com 888-217-9600 Signature of Controlling Of?cer, Candidate, State Measure Propunent FPPC Form 460 (JanuaryIOS) FPPC Toll-Free Helpline: BSSIASK-FPPC (866I275-3772) State of California Type or print in ink. Amounts may be rounded SUMMARY PAGE Campaign Disclosure Statement Pa State ers Summary 9 to whole dollars. CALIFORNIA from 10/21/2012 FORM through 12/31/2012 Page of 65 SEE INSTRUCTIONS 0N REVERSE NAME OF FILER ID. NUMBER Dave Roberts for Supervisor 2012 1343915 0 .b . . Column A Column Calendar Year Summary for Candidates ?ghters: Running in Both the State General Elections 1. Monetary Contributions Schedule A, Line 3 111 through also to Date 2. Loans Received . . . . Schedule 3, Line 3 . . $563 388 13 20. ContnbutIons 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 2 Received 5 . . . $0.00 $5,118.56 4. Nonmonetary Contnbuhons Schedule C, Lme 3 21- Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED Add Unesa 4 Made Expenditures Made Expenditure Limit Summary for State 6. Payments Made Schedule E. Line 4 Candidates 7. Loans Made Schedule H, Line 3 $000 xpen was a e? a. SUBTOTAL CASH PAYMENTS Add Lines 6 7 9. Accrued Expenses (Unpaid Bills) . . Schedule F, Line 3 Dale of Election Total to Date 1U. Nonmonetary Adjustment Schedule C, Line 3 (mm W) 11. TOTAL EXPENDITURES MADE AddLl'nes a +9 +10 5 Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 1?6 $44 731 14 To calculate Column B. add 13. Cash Receipts . . . . . . . Column A, Line 3 above amounts in Column A to the 14. Miscallaneous Increases to Cash . . . . Schedule l, Line 4 corresponding amounts $187 624 61 from Column of your last 15. Cash Payments Column A, Line above report. Some amounts in 16. ENDING CASH BALANCE Add Lines 12 13 14, then subtract Line 15 A may be "ega?we ?gures that should be If this is a termination statement, Line 16 must be zero. subtracted from pen?od amounts. If this is the ?rst report being ?led 17. LOAN GUARANTEES RECEIVED Schedule a, Part2 5 $000 for this calendar year. only cal-W over the amounts *Amounts in this section may be different from amounts - from Lines 2, 7, and 9 (if reported in Column B. Cash EquIvalents and Outstandan Debts any). 18. Cash Equivalents See instructions on reverse 19. Outstanding Debts Add Line 2 Line 9 in Column 8 above 5 14?072'73 FPPC Form 460 lJanuaryIDS) FPPC Toll-Free Helpline: (866l275-3772i Powered by CompleteCampaigns.com 888-217-9600 Schedule A (continuation Sheet) SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA from 10/21/2012 FORM through Page _U.of NAME OF FILER ID. NUMBER Dave Roberts for Supervisor 2012 1343915 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED i" ?50 ENTER NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE IIF NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 10/21/2012 Edward Gill CEO $20000 G12 San Diego $100.00 $200.00 San Diego, CA 92101-4302 CI PTY El 300 10/27/2012 El IND Retired DCOM $100.00 P12 am one $35.00 $235.00 PTY $135.00 G12 soc 10/28/2012 IND Retired El COM $100.00 P12 El PTY $100.00 G12 El 300 11/05/2012 lei/$3M Retired $1,750.00 P12 0TH $500.00 $2,250.00 El PTY $500.00 G12 El 800 SUBTOTAL 5 Contributor Codes IND - Individual COM - Recipient Committee (Other than PTY or 500) 0TH - Other business entity) PTY - Political Party SCC - Small Contributor Committee . FPPC Form 460 (January/05) Powered by Comp'Etecampa'gns'com i 888'217'9600 FPPC Toll-Free Helpline: (ass/275.3772) CA a USPS NUMBER 9505 5101 0897 3212 4890 87 County of San Diego Registrar Of Voters San Diego CA 92123-1693 UNITED STATES POSTA SERVICE 1006 92123 00010897-11 u.s. POSTAGE P910 7' LONG BEQCH .ca - 90802 JUL 13