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Home My WebLink AboutForm 460 Tori Keen 123120Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period frog.{ 10/18/2020 th'rtiugh 12/31/2020 1. Type of Recipient Committee: All Committees — Complete Part's 1, 2, 3, and 4. m Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall -Controlled (Also Complete Pan s) 8, Sponsored (Also Complete Part 6) ❑ General Purpose Committee U Sponsored ❑ Primarily Formed Candidate/ 8 Small Contributor Committee Officeholder Committee Political Party/Central Committee (Also complete Pan 7) 3. Committee Information I.D. NUMBER 1428685 COMMITTEE NAME (OR,CANDIDATE'SNAME IF NO COMMITTEE) Keen for Council 2020 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Atascadero CA 93422; Atascadero CA 93423' Date of election if applicable: (Month, Day, Year) 11/3/2020 2. Type of Statement: ❑ Preelection Statement m Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Rachel McElliinney MAILING ADDRESS COVER PAGE Central Reception Page L of 11� FLO 2W1 i For Official Use Only City of Atascadero ❑ Quarterly Statement ❑ Special Odd -Year Report Atascadero CA 93423 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/ E-MAIL ADDRESS 4. Verification have used all reasonable diligence in preparing and reviewing this statement and to the best of "my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoi e d rrect. Executed on _ _. 1 llt stn a _ c ate By, g re reasurer or Assistant Treasurei Executed on!' L. `1 WBy Date.. ---"-- Executed on Date Executed on Date By, Signature of Controlling Officeholder, Candftlate, State Measure Proponent By, Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 496(Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page -- Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Victoria Keen OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Atascadero City Council RESIDENTIAL/BU SIN ESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP Atascadero CA 93422 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME i I.D. NUMBER NAME OF TREASURER ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO STREET ADDRESS (NO P.O. CITY STATE ZIP CODE AREACODE/PHONE COVER -PAGE - PART 2 Page a of Is 6. Primari,k Formed Ballot Measure Committee NAME OF.BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice @fppc.ca.g4v (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. Statement covers period from 10/18/2020 SUMMARY PAGE Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 4,614.80 7. Loans Made....................................................................... schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 4,614,80 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 0 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 4,614.80 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 3,527.97 13. Cash Receipts ........................................................... Column A, Line 3 above 1,232.16 14. Miscellaneous Increases to Cash ................................... schedule 1, Line 4 0 15. Cash Payments......................................................... Column A, Line 8 above 4,614,80 16. ENDING CASH BALANCE .Add Lines 12 + 13 + 14, then subtract Line 15 $ 145.33 Jf this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 $ 9,555.70 0 $ 9,555.70 0 316.76 $ 9,872.46 To calculate Column B, add amounts in Column Ato 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 j Candidates 22. Cumulative Expenditures Made* IIT Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mmldd/yy) $ *Amounts in this section may be different from amounts reported in Column'B. FPPC Form 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov through J 12/31/202 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Keen for Council 2020 1428685 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Primary (FROM ATTACHED SCHEDULES) TOTAL TO DATE and General Elections 1. Monetary Contributions................................................... schedule A, Line 3 $ 1,232.16 $ 9,701.03 0 0 1/1 through 613® 7!1 to Date 2. Loans Received................................................................ schedule B, Line 3 1,232.16 9,701.03 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ schedule C, Line 3 0 316.76 _ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ............................... Add Lines 3 + 4 $ 1,232.16 $ 10,017.79 Made $ $ Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 4,614.80 7. Loans Made....................................................................... schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 4,614,80 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 0 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 4,614.80 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 3,527.97 13. Cash Receipts ........................................................... Column A, Line 3 above 1,232.16 14. Miscellaneous Increases to Cash ................................... schedule 1, Line 4 0 15. Cash Payments......................................................... Column A, Line 8 above 4,614,80 16. ENDING CASH BALANCE .Add Lines 12 + 13 + 14, then subtract Line 15 $ 145.33 Jf this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 $ 9,555.70 0 $ 9,555.70 0 316.76 $ 9,872.46 To calculate Column B, add amounts in Column Ato 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 j Candidates 22. Cumulative Expenditures Made* IIT Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mmldd/yy) $ *Amounts in this section may be different from amounts reported in Column'B. FPPC Form 496 (Feb/2019) 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 wnoie avuars. Statement covers period CALIFORNIA , ' from 10/18/2020 • 12/31/2020 Page q of 5 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Keen for Council 2020 1428685 FULL NAME STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDARYEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) m IND 10/19/2020 Ron Sullivan ❑COM retired $50.00 $100.00 ❑ OTH ❑ PTY ❑ SCC ❑ IND 10/19/2020 Atascadero Democratic Club ❑ COM $250.00 $750.00 ® OTH ❑ PTY ❑ SCC El IND 11/8/2020 Deborah Keen ❑COM retired $42.16 $126.48 ❑ OTH ❑ PTY ❑ SCC m IND 12/1/2020 Victoria Keen COM Paralegal $500.00 $610.50 ❑ OTH Law Offices of William ❑ PTY Ausman ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 842.16 Schedule A Summary 1. Amount received this period — itemized monetary contributions. 842.16 (Include all Schedule A subtotals.).........................................................................................................$ _ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 390.00 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the .Summary Page, Column A, Line 1.).......... .....TOTAL $ 1,232.16 *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 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Keen for Council 2020 Amounts may be rounded to whole dollars. SCHEDUL Statement covers period CAEIFORNIA from 10/18/2020 FORM through 12/31/2020 Page I; of CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1428685 CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)" OFC office expenses SAL campaign workers' salaries GVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filingiballot fees PHO phcne banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Facebook Political Data, Inc. Cornerstone Printing CODE OR DESCRIPTION OF PAYMENT promoting Facebook posts voter information AMOUNT PAID $244.46 $256.00 $4,056.10 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4,556.56 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. 4,556,56 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 58.24 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Pager Column A, Line 6.) ........................... TOTAL $ 4,614,80 FPPC Form 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov E