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• <br /> Schedule A Type or print in ink. SCHEDULE A <br /> Amounts may be rounded <br /> Monetary Contributions Received to whole dollars. Statement covers period <br /> CALIFORNIA 460 <br /> from 1/1/2010 FORM <br /> through 6/30/2010 Pa e 4 of 7 <br /> SEE INSTRUCTIONS ON REVERSE 9 9 <br /> NAME OF FILER I.D. NUMBER <br /> JOHN SEYBERT 1313963 <br /> DATE FULL NAME,STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION <br /> RECEIVED (IF COMMITTEE,ALSOENTERI.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE <br /> (IF SELF-EMPLOYED,ENTER NAME PERIOD (JAN.1-DEC.31) (IF REQUIRED) <br /> OF BUSINESS) <br /> UNITED UNION OF ROOFERS IND <br /> 1/6/2010 CoM 500 500 <br /> 1660 L ST, N.W. ❑OTH <br /> WASHINGTON DC 20636 ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> ❑IND <br /> ❑COM <br /> ❑OTH <br /> ❑PTY <br /> ❑SCC <br /> SUBTOTAL$ <br /> Schedule A Summary *Contributor Codes <br /> 1. Amount received this period—itemized monetary contributions. IND—Individual <br /> (Include all Schedule A subtotals.) 500 COM-Recipient Committee <br /> (other than PTY or SCC) <br /> 2. Amount received this period—unitemized monetary contributions of less than$100 $ 0 OTH—Other(e.g.,business entity) <br /> PTY—Political Party <br /> 3. Total monetary contributions received this period. SCC—Small Contributor Committee <br /> (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ 500 <br /> FPPC Form 460 Janua /05 <br /> ( ry ) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br />