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Type or print in ink. SCHEDULEB-PART1 <br /> Schedule B—Part 1 Amounts may be rounded Statement covers period CALIFORNIA <br /> Loans Received to whole dollars. from 7/1/09/09 FORM 460 <br /> 9/19/09 11 16 <br /> SEE INSTRUCTIONS ON REVERSE through Page of <br /> NAME OF FILER I.D. NUMBER <br /> JOHN SEYBERT 1313963 <br /> FULL NAME,STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING (b) (c) (d) (e) (f) (g) <br /> OCCUPATION AND EMPLOYER AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE <br /> OF LENDER BALANCE RECEIVED THIS BALANCEAT <br /> (IFCOMMITTEE,ALSOENTERI.D.NUMBER) (IF SELF-EMPLOYED,ENTER BEGINNING THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT Of CONTRIBUTIONS <br /> PERIOD <br /> NAME OF BUSINESS) PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE <br /> JOHN SEYBERT CHURCH ADMIN. ❑PAID CALENDAR YEAR <br /> PCC $ 0 $ 1,000 0 % $ 1,000 $ 0 <br /> REDWOOD CITY CA 94061 FORGIVEN RATE <br /> ❑ PER ELECTION** <br /> $ 1,000 $ 0 $ 0 NA $ 12/3/08 $ 1,000 <br /> tE IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED <br /> ❑PAID CALENDAR YEAR <br /> $ $ % $ $ <br /> RATE <br /> ❑FORGIVEN PER ELECTION** <br /> $ $ $ S $ <br /> to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED <br /> ❑PAID CALENDAR YEAR <br /> $ $ % $ $ <br /> RATE <br /> ❑FORGIVEN PER ELECTION** <br /> 1.0 IND ❑ COM ❑ OTH $ $ $ $ S <br /> ❑ PTY 0 DATE DUE DATE INCURRED <br /> SUBTOTALS <br /> $ <br /> (Enter(e)on <br /> Schedule B Summary Schedule E,Line 3) <br /> 1. Loans received this period $ 0 <br /> (Total Column(b)plus unitemized loans of less than$100.) tContributor Codes <br /> 2. Loans paid or forgiven this period $ 0 IND—Individual COM—RecipientCommittee <br /> (Total Column(c)plus loans under$100 paid or forgiven.) (other than PTY or SCC) <br /> (Include loans paid by a third party that are also itemized on Schedule A.) OTH—Other(e.g.,business entity) <br /> PTY—Political Party <br /> 3. Net change this period. (Subtract Line 2 from Line 1.) NET $ 0 SCC—Small Contributor Committee <br /> Enter the net here and on the Summary Page,Column A, Line 2. (May be a negative number) <br /> *Amounts forgiven or paid by another party also must be reported on Schedule A. <br /> **If required. FPPC Form 460(January/05) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br />