The URL can be used to link to this page

Home My WebLink AboutForm 460 Mark Dariz 123120Recipient Committee Campaign Statement Cover Page from Statement covers period 10/18/2020 SEE INSTRUCTIONS ON REVERSE I through 12/31/2020 1. Type of Recipient Committee: All Committees—Complete Parts t, 2, 3, and 4. VI Officeholder, Candidate Controlled Committee O State Candidate Election Committee 0 Recall (Also Cwnpkie Pad 5) ❑ General Purpose Committee O Sponsored O Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also C—Plefe Part 5) ❑ Primarily Formed Candidate! Officeholder Committee (Also Cw pkie Part 7) I.D. NUMBER 1407272 I Mark Dariz Committee to Elect for Atascadero City Council 2020 CITY STATE ZIP CODE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODEIPHONE OPTIONAL_ FAX ! E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my certify under penalty of perjury under the laws of the State of Califofnia that the foregoing is true and Executed on 1/28/2021 Dale Executed on 1/28/2021 Data Executed on Date Executed on Date COVER PAGE Reception Date of election if Applicable:AN 2 9 221 Page 1 of 3 (Month, Day, Year) For Official Use Only City of Atascadero November 3, 2020 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Q� Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Sue Dariz MAILING ADDRESS Atascadero_ CA 93422 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAILADDRESS By r - Signature of Controlling Office By Signature of herein and in the attached schedules is true and complete. or By Signature of Controlling ONicetw(der, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www fnnr ra onv Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers periodCALIFORNIA Summary Page 10/18/2020 FORM ' • from SEE INSTRUCTIONS ON REVERSE through 12/31/2020 page 2 of 3 NAME OF FILER I.D. NUMBER Contributions Received 1. Monetary Contributions................................................... schedule A, Line 3 $ 2. Loans Received................................................................ schedule a, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1+ $ 4. Nonmonetary Contributions ............................................ schedule G Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ....................... ............. Add Lines 3+4 $ Expenditures Made 6. Payments Made................................................................ schedule E, Line 4 $ 7. Loans Made .................. --..... .......... .......... ........................ schedule H Line 3 6. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7 $ 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 11. TOTAL EXPENDITURES MADE... ..................................... Add Lines 8+9+10 $ i 01umn N TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 750 750 750 current casn statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 1,633 13. Cash Receipts........................................................... Column A, Line 3 above 750 14. Miscellaneous Increases to Cash .................................. schedule t, Line 4 15. Cash Payments......................................................... Column A, Line a above 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + r4, then subbact cine r5 $ 2,383 If this is a termination statement Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule 6, Part2 $ I Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. add Line 2+ Line sin Column B above $ �cnumn Its CALENDAR YEAR TOTAL TO DATE $ 2,583 11407272 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 2,583 20. Contributions Received $ $ 21. Expenditures 2,583 Made $ $ To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made (If subject b Valunta Ea ndW LhM) Date of Election Total to Date (mMdd/yy) 3 `Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers pedod 0. ' • 1 10/18/2020 from • 12/31/2020 3 3 SEE INSTRUCTIONS ON REVERSE through Page or NAME OF FILER I.D. NUMBER 1407272 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMnTEE, ALSO ENTER I.D. NUMBER) CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF -EMPLOYE, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ❑ IND Central Coast Propane, Inc ❑ coM P.O. Box 3152 10/14/2020 500 500 171 OTH Paso Robles, CA 93447 ❑ PTY ❑ SCC [I IND 10/23/2020 Waste Mana Management 9 ❑ pTM Box 3027 250 250 P.O. 0 Houston, TX 77253 ❑PTY ❑ SCC ❑ IND ❑ COM ❑ oTH ❑ PTY ❑ scc ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) .............................................. 2. Amount received this period — unitemized monetary contributions of less than $100 .......... 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) .................. $ 750 ........... $ TOTAL $ 750 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www-fppc-ca-gov