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ORANGE COUNTY LAFCO Project Application Forin Page 8 of 9 AIMP- MENT 3 LAFCO Disclosure of Political Expenditures Effective January 1, 2008, political expenditures related to a proposal for a change of organization or reorganization that will be or has been submitted to LAFCO are subject to the reporting and disclosure requirements of the Political Reform Act of 1974 and the Cortese -Knox -Hertzberg Act of 2000. Please carefully read tke jollmvinx htfi�ritiatlaii to detennlne if reporting and disclosure provisions apply to yoft. E4 Any person or combination of persons who, for political purposes, directly or indirectly contributes $1,000 or more, or expends $1,000 or more in support of, or in opposition to a proposal for a change of organization or reorganization that will be submitted to the Commission, shall disclose and report the contribution to the Commission pursuant to the requirements of the Political Reform Act of 1974 (Government Code Section 81000 et seq.) as provided for local initiative measures, and Section 56700.1 of the Cortese -Knox -Hertzberg Act of 2000. 2; Pursuant to Government Code Section 57009, any person or combination of persons who directly or indirectly contributes $1,000 or more, or expends $1,000 or more in support of, or in opposition to, the conducting authority proceedings for a change of organization or reorganization, must comply with the disclosure requirements of the Political Reform Act of 1974, (Government Code section 81000 et seq.). Applicable reports must be filedwith the Secretary of the State and the appropriate city or county clerk. Copies of the report must also be filed with the Orange County Executive Officer, Evaluation Checklist for Disclosure of Political Expenditures The following checklist is provided to assist you in determining if the requirements of Government Code Sections 81000 et seq. apply to you. For further assistance, contact the Fair Political Practices Commission at 428 J Street, Suite 450, Sacramento, CA 95814, (866) 275-3772 or at http://wwuv.f 1. Have you directly or indirectly made a contribution or expenditure of $1,000 or more related to the support or opposition of a proposal that has been or will be submitted to LAFCO? ❑ Yes ❑ No Date of contribution Amount$ Name/Rct.NooPLAFCOProposal Date proposal was submitted to LAFCO 2. Have you, in combination with other persoa(s), directly or indirectly contributed or expended $1,000 or more related to the support or opposition of a proposal that has been or will be submitted to LAFCO? ❑ Yes ❑ No Date of contribution Amount $__Name/ Ref. No of LAFC0 Proposal Date proposal was submitted to LAFCO 3. If you filed a report in accordance with FPPC requirements, has a copy of the report been filed with Orange County LAFCO? ❑ Yes ❑ No (TIte it fonnafion container/ Lt Otis applica/ion may be svrbfect to disc(ostwe ender the Cnlrfgrnia Public. Records'4a Covernntew Code Section 6250 et sey.) _ 75C-21