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Form 461 Major Donor And Independent Exependiture Committe Campaign Statement Form. This is a California form and can be use in Fair Political Practices Commission Statewide.
Tags: Form 461 Major Donor And Independent Exependiture Committe Campaign Statement, 461, California Statewide, Fair Political Practices Commission
Major Donor and
Independent Expenditure
Committee Campaign Statement
Who Uses Form 461:*
Major Donors
• An individual or entity that makes monetary or
nonmonetary contributions (including loans)
to state or local officeholders, candidates,
and committees totaling $10,000 or more in a
calendar year.
“Contribution” includes direct monetary
contributions (e.g., tickets to campaign
fundraisers), loan guarantees and loan
forgiveness, nonmonetary contributions of goods
or services, and discounts not provided to the
public generally.
Independent Expenditure Committees
• An individual or entity that makes independent
expenditures totaling $1,000 or more in a
calendar year to support or oppose state or local
candidates or ballot measures.
An “independent expenditure” is an expenditure
for a communication that expressly advocates
the nomination, election or defeat of a clearly
identified candidate or ballot measure that is not
made to—or at the behest of—an officeholder,
candidate, or committee.
CALIFORNIA
FORM
Personal Contributions by Candidates
and Officeholders:
Form 461 is also required if, during a calendar
year, a candidate or officeholder uses personal
funds to make:
• Contributions totaling $10,000 or more to other
state or local candidates, officeholders or
committees; or
• Independent expenditures totaling $1,000 or
more to support or oppose other state or local
candidates, officeholders, or ballot measures.
Contribution Limits:
Candidates for elective state office are subject
to contribution limits. Contributions received
by committees for the purpose of making
contributions to candidates for elective state office
are also subject to limits. A chart identifying the
limits is located at www.fppc.ca.gov. In addition,
local candidates may be subject to contribution
limits imposed by local ordinance. Questions
about local limits should be directed to election
officials in the local jurisdiction.
461
• Exceptions to the definition of “contribution” and
“expenditure” for certain types of activities (e.g.,
volunteer personal services and communications
to members of an organization)
• Reporting “late contributions” and “late
independent expenditures” made during the 16
days immediately prior to an election
• Form 465–Supplemental Independent
Expenditure Report
• The Information Practices Act of 1977
This form was prepared by the Fair Political
Practices Commission (FPPC). Campaign
filing deadlines, forms, and other informational
materials are available on the FPPC website
(www.fppc.ca.gov). See reverse for general
information on where to file this form.
Additional Important Information:
Refer to the FPPC Campaign Disclosure Manuals
5 and 6 for important information about:
• When and where to file Form 461
*There are different forms and reporting
requirements for committees that receive
contributions totaling $1,000 or more during a
calendar year (“recipient committees”).
• Aggregation of contributions and expenditures
by certain combinations of individuals and
entities (e.g., parent and subsidiaries)
FPPC Form 461 (March/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
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www.FormsWorkFlow.com
Instructions for
Major Donor and
Independent Expenditure
Committee Campaign Statement
Where to File:
State Elections and Committees Active in
More Than One County: If more than 50% of
your contributions or independent expenditures
were made to support or oppose state candidates,
measures and committees, or to support or oppose
local candidates and measures being voted on in
more than one county. File in the following place:
• Secretary of State (original and one copy)
Political Reform Division
1500 11th Street, Room 495
Sacramento, CA 95814
Phone (916) 653-6224
Fax (916) 653-5045
www.sos.ca.gov
CALIFORNIA
FORM
461
City Elections: If you are not a state committee
and more than 50% of your contributions or
independent expenditures were made to support
or oppose candidates and measures being voted
on in a single city, file with the city clerk in that city
(original and one copy).
Electronic Filing:
Major donor and independent expenditure
committees that are required to file reports with the
Secretary of State must file Form 461 electronically
if they make contributions or independent
expenditures totaling $25,000 or more in a
calendar year. Paper reports are also required.
Some local jurisdictions also require reports to be
electronically filed.
County Elections: If you are not a state
committee and more than 50% of your
contributions or independent expenditures were
made to support or oppose candidates and
measures being voted on in a single county, file
with the election official in that county (original and
one copy).
This filing requirement also applies to contributions
or independent expenditures made to support or
oppose candidates and measures on the ballot in
more than one jurisdiction located within a single
county.
FPPC Form 461 (March/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
American LegalNet, Inc.
www.FormsWorkFlow.com
Major Donor and
Independent Expenditure Committee
Campaign Statement
MAJOR DONOR AND INDEPENDENT EXPENDITURE
COMMITTEE STATEMENT
Type or print in ink.
Date Stamp
(Government Code sections 84200-84216.5)
Statement covers period
Date of election if applicable:
(Month, Day, Year)
of
Page
For Official Use Only
from
SEE INSTRUCTIONS ON REVERSE
461
CALIFORNIA
FORM
through
3. Summary
1. Name and Address of Filer
NAME OF FILER
(Amounts may be rounded to whole dollars.)
RESIDENTIAL OR MAILING ADDRESS
(NO. AND STREET)
1. Expenditures and contributions
(including loans) of $100 or more
made this period. (Part 5.)................................................ $
CITY
STATE
RESPONSIBLE OFFICER
AREA CODE/DAYTIME PHONE
ZIP CODE
(If filer is other than an individual)
2. Nature and Interests of Filer
(Complete each applicable section.)
A FILER WHO IS AN INDIVIDUAL MUST LIST THE NAME, ADDRESS, AND BUSINESS INTERESTS
OF EMPLOYER OR, IF SELF-EMPLOYED, THE NAME, ADDRESS, AND NATURE OF THE BUSINESS
NAME OF EMPLOYER/BUSINESS
BUSINESS INTERESTS
ADDRESS OF EMPLOYER/BUSINESS
A FILER THAT IS A BUSINESS ENTITY MUST DESCRIBE THE BUSINESS ACTIVITY IN WHICH IT IS
ENGAGED
A FILER THAT IS AN ASSOCIATION MUST PROVIDE A SPECIFIC DESCRIPTION OF ITS INTERESTS
A FILER THAT IS NOT AN INDIVIDUAL, BUSINESS ENTITY, OR ASSOCIATION MUST DESCRIBE THE
COMMON ECONOMIC INTEREST OF THE GROUP OR ENTITY
Amendment (Explain):
2. Unitemized expenditures and
contributions (including loans) under
$100 made this period...................................................... $
3. Total expenditures and contributions
made this period. (Add Lines 1 + 2.) ................SUBTOTAL $
4. Total expenditures and contributions
made from prior statement. (Enter
amount from Line 5 of last statement
filed. If this is the first statement for
the calendar year, enter zero.) ......................................... $
5. Total expenditures and contributions
(including loans) made since
January 1 of the current calendar year.
(Add Lines 3 + 4.)................................................... TOTAL $
4. Verification
I have used all reasonable diligence in preparing this statement. I have
reviewed the 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 that the foregoing is true and correct.
Executed on
By
DATE
SIGNATURE OF INDIVIDUAL DONOR OR
RESPONSIBLE OFFICER, IF OTHER THAN AN INDIVIDUAL
FPPC Form 461 (March/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
American LegalNet, Inc.
www.FormsWorkFlow.com
Instructions for
Major Donor and
Independent Expenditure
Committee Campaign Statement
CALIFORNIA
FORM
Period Covered by a Statement:
corporation) that must be aggregated and reported
on Form 461, list as the “Name of Filer” the name
of the individual or entity that directs and controls
the making of the contributions and independent
expenditures. In addition, you must:
The “period covered” by a campaign statement
begins the day after the closing date of the last
campaign statement you filed. For example, if the
closing date of the last statement was June 30,
the beginning date of the next statement will be
July 1.
• Indicate that the campaign statement includes
the contributions and independent expenditures
of other entities. For example, “ABC
Corporation, including aggregated contributions/
independent expenditures.”
For definitions and detailed information
about completing Form 461, refer to the FPPC
Campaign Disclosure Manuals 5 and 6.
If this is the first campaign statement for the
calendar year, begin with January 1.
The closing date of the statement depends on the
type of statement you are filing.
Date of Election:
Enter the date of the election if you are filing
Form 461 as a city or a county major donor or
independent expenditure committee and the city
or county’s election will be held this year.
1. Name and Address of Filer:
Enter the legal name of the individual or entity
filing the statement. If the filer is commonly known
to the public by another name, that name may
be used. When a person directs and controls
the making of contributions and independent
expenditures by a related entity (e.g., a parent
and subsidiaries or a majority shareholder of a
• Identify any entities added to this report that
were not included in a prior report filed for the
current calendar year, as well as any entities
included in a prior report for the current calendar
year that are no longer required to aggregate
under the name of filer.
• Identify both names if the “Name of Filer” listed
on a previous report filed for the current calendar
year is different than the name identified on
this report. For example, “John Lewis, formerly
identified as Lewis Construction.”
461
3. Summary:
Summary totals are calculated from the
information itemized in Part 5 of the Form 461 and
unitemized payments of less than $100. If this is
the first report being filed for a calendar year, enter
a zero on line 4 of the summary.
4. Verification:
A responsible officer of an entity or an entity filing
jointly with any number of affiliates must sign
the Form 461. An attorney or a certified public
accountant may sign on behalf of the entity or
entities. A statement filed by an individual must be
signed by the individual.
Amendments:
To amend previously filed Form 461, check the
“Amendment” box, enter the period covered by the
statement you are amending, and complete Part
1. Disclose the amended information, including
Part 3, if applicable, and complete the Verification.
Enter the name of the responsible officer of an
entity or organization filing the statement.
2. Nature and Interests of Filer:
When more than one person or entity is listed
under “Name of Filer,” identify the nature and
interests of each. (Use appropriately labeled
continuation sheets if necessary.)
FPPC Form 461 (March/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
American LegalNet, Inc.
www.FormsWorkFlow.com
Major Donor and
Independent Expenditure Committee
Campaign Statement
Type or print in ink.
Amounts may be rounded
to whole dollars.
MAJOR DONOR AND INDEPENDENT EXPENDITURE
COMMITTEE STATEMENT
Statement covers period
CALIFORNIA
FORM
from
through
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Page
461
of
5. Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made
(If more space is needed, use additional copies of this page for continuation sheets.)
DATE
NAME, STREET ADDRESS, CITY, STATE AND ZIP CODE
OF PAYEE
TYPE OF PAYMENT
DESCRIPTION OF
PAYMENT
(IF OTHER THAN MONETARY
CONTRIBUTION OR LOAN)
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CANDIDATE AND OFFICE,
MEASURE AND JURISDICTION,
OR COMMITTEE
AMOUNT THIS
PERIOD
CUMULATIVE AMOUNT
RELATED TO THIS
CANDIDATE, MEASURE,
OR COMMITTEE
Monetary
Contribution
Loan
Non-Monetary
Contribution
Independent
Expenditure
Support
Oppose
Monetary
Contribution
Loan
Non-Monetary
Contribution
Independent
Expenditure
Support
Oppose
Support
Oppose
Support
Oppose
Monetary
Contribution
Loan
Non-Monetary
Contribution
Independent
Expenditure
Monetary
Contribution
Loan
Non-Monetary
Contribution
Independent
Expenditure
SUBTOTAL $
FPPC Form 461 (March/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
American LegalNet, Inc.
www.FormsWorkFlow.com
Instructions for
Major Donor and
Independent Expenditure Committee
Campaign Statement
5. Contributions and Expenditures:
When itemizing contributions and expenditures
made by more than one entity (e.g., a parent and
subsidiaries), note which entity made each payment.
Date of Contribution
A monetary contribution is made on the date it is
mailed, delivered, or otherwise transmitted to the
candidate or committee. A nonmonetary contribution
is made on the earlier of the following: 1) the date
you made an expenditure for goods or services at
the behest of the candidate or committee; or 2) the
date the candidate or committee or an agent of the
candidate or committee obtained possession or
control of the goods or services.
Name and Address of Payee
If a total of $100 or more is contributed or expended
during a calendar year to support or oppose a
single candidate, committee or measure, disclose
the name and address of the payee. If the payee is
a committee, also disclose the identification number
assigned to that committee by the Secretary of
State. If no ID number has been assigned to a
committee, provide the name and address of that
committee’s treasurer.
Contributions and expenditures of less than $100
to support or oppose a single candidate, committee
or measure during a calendar year are totaled and
reported as a lump sum on Line 2 of the Summary.
Candidate, Measure or Committee
Identify the candidate, measure or committee
supported or opposed by the contribution or
expenditure. Disclose the name of the candidate
and the office sought or held; the name of the
ballot measure and its jurisdiction; or the name of
CALIFORNIA
FORM
461
the committee if a nonmonetary contribution was
made to a general purpose committee. Check the
appropriate box to indicate whether the payment
was made to support or oppose the candidate or
measure listed.
Loans to state candidates are subject to
contribution limits. If the candidate repays all or a
portion of a loan, the lender may make additional
contributions subject to the applicable contribution
limit.
Amount/Cumulative Amount
Disclose the amount of the contribution or
expenditure made this period.
Non-Monetary Contributions:
If a single payment supports or opposes more than
one candidate or measure, provide the name and
address of the vendor. Enter the amount paid to
the vendor in the “Description of Payment” column.
Identify each candidate or measure, and enter the
amount of the contribution or expenditure attributable
to each in the “Amount this Period” column.
For each contribution, also disclose the cumulative
amount contributed to the candidate (including all
of the candidate’s controlled election committees)
or to the committee (in the case of a ballot measure
or other type of committee) since January 1 of
the current calendar year. For each independent
expenditure, disclose the cumulative amount of
independent expenditures made since January 1 of
the current calendar year related to the candidate
or ballot measure supported or opposed by the
expenditure.
Reporting Loans:
Check the “loan” box under “Type of Payment”
if you make, forgive, or guarantee a loan. You
need not report loan repayments received. If you
make and forgive a loan during the same calendar
year, report the amount of the forgiveness under
“Description of Payment.” The same is true if you
guarantee a loan and you make payments to the
lender during the same calendar year.
Report the fair market value of non-monetary
contributions. The fair market value is the amount
it would cost to purchase the goods or services
on the open market, which may be more than the
amount it cost to provide them. For example, the
fair market value of donated catering services
would normally be higher than the actual cost to the
caterer.
Reporting Subvendors:
If an agent (including an independent contractor)
makes payments on your behalf (“subvendor
payments”), disclose those payments in addition
to the payments made to the agent. For example,
you pay a public relations firm, which pays for an
advertisement supporting a ballot measure. In
addition to disclosing the payment(s) made to the
public relations firm, itemize payments of $500 or
more made by the firm related to the advertisement.
Do not include payments that are not for the
purpose of making contributions or independent
expenditures (e.g., for overhead or operating
expenses).
Report the name and address of the agent followed
by the name and address of each subvendor.
Disclose amounts paid to the agent and subvendor
in the “Description of Payment” column.
FPPC Form 461 (March/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
American LegalNet, Inc.
www.FormsWorkFlow.com