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Home My WebLink AboutForm 460 Mattson 123120Recipient Committee COVER PAGE Campaign Statement Da>as'P NEM Cover Page RECEIVED SEE tNSTRUCTIONS ON REVERSE Statement covers period from through 12/31/2020 9. Type of Recipient Committee: An Committees - complete Parts t, z, 3, and 4. m 91fteholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure V State Candidate Election Committee mmittee 0 Recall Controlled 4UWC rg*fePairs> (((�� Sponsored (A&W C ro&% Pett 6) ❑ neral Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee 3- Committee Information Nic Mattson for Atascadero City Council 2020 ❑ Primarily Formed Candidate/ Officeholder Committee fAW 00006 Part 7) I.D.NUMBER 1431600 CITY STATE ZIP CODE AREA CODEIPHONE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL. FAX I E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the est of my certify under penalty of perjury under the laws of the State of California that the foregoin is true and Executed on 7/21/2020 BY Date Date of election If applicable: (Month, Day, Year) 11/03/2020 JUL 2 3 2021 ITY OF ATASLADER TY CLERK'S OFF1C 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 MAILING ADDRESS Page of — For Otflciel Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report CITY STATE ZIP CODE AREA CODWHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL' FAX I E-MAIL ADDRESS the inforgfation �ontairled herein and inihe attached schedules is true and complete. I Exectuted on 7/21/2020 BY ` Date 3Watue of Lwb'olilng , State Measure Prpppner%or Rpspombe Officer of SpMlQor Executed on By Date Slgnatrre of Corrtrdlvg ORoerglder, Candidate, State Measure Proposer! Executed on Date BY Signature or Controlling 011lce#wlder, Candidate, Sate Measure Proponent FPPC Form 460 (Jar/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) WWWJPPC.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 S. Offlcehoider or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE NIC MATTSON OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL MEMBER CITY OF ATA5CADERO RESIDENTIAMUSINESS ADDRESS (NO-ANDSTREET) CITY STATE MID ATASCADi6 CA 93422 Related Committees Not Included in this Statement: LJstanycommlttees not Included In this statement that are controlled by you or are primarily formed to receive contributions or make expenditures an behalf of your candidacy NAME NAME OF TREASURER I.D. NUMBER ❑ YES ❑ NO STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE COMMffTEE NAME I -D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P_0 BOX) CITY STATE ZIP CODE AREACODEIPHONE COVER PAGE - PART 2 Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE ❑ SUPPORT BALLOT NO. OR LETTER JURISDICTION ❑ OPPOSE Identify the controlling officeholder, candidata, 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 ofl5cehoider4) or candidate(s) for which this committee is primarily Fanned_ 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.gov (866/275-3772) vrww.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars- Statement covers period . 1 from • - SEE INSTRUCTIONS ON REVERSE through 12/3112021 —Of NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 Schedule A Summary 1. Amount received this period — itemized monetary contributions- 0 (Include all Schedule A subtotals.)---------------------------------------------------------------------------------------------------------$ — 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 0 3. Total monetary contributions received this period - (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ '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 Advke: advice@fppc.ca.gov (866/275-3772) %rww.fppC-ca.gov 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 CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID. NUMBER) CODE (IF SELF -EMPLOYE, ENTER NAME PERIOD {JAN. 1 -DEC. 31} (IF REQUIRED) IND 10/06/2020 ROBERT DAVIS ❑ COM OWNER, APS AUTO 0 250 250 (G20) OTH ATASCADERO, CA 93422 ❑ PTY ❑ sec ZIND 1011/2020 ROLFE NELSON COMA O CCI RETIRED 0 100 100 (G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTY ❑ SCC ®IND 10/9/2020 ROLFE NELSON ❑ COM RETIRED 0 250 250 (G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTY ❑ SCC ®IND 10/16/2020 RON KRALL ❑ COM GENERAL MANAGER 0 250 250 (G20) ❑ OTH MID -STATE SOLID TEMPLETON, CA 93465 Li SCC WASTE ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 750 Schedule A Summary 1. Amount received this period — itemized monetary contributions- 0 (Include all Schedule A subtotals.)---------------------------------------------------------------------------------------------------------$ — 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 0 3. Total monetary contributions received this period - (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ '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 Advke: advice@fppc.ca.gov (866/275-3772) %rww.fppC-ca.gov SCHEDULE B - PART 1 Schedule B — Part 1 �to whole dollars. Statement covers period CALIFORNIA 460, Loans Received from FORM Page of through 12131(202I SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF ONTRIBUTIONS COMMITTEE, ALSO FNTFR I.D. NUMBER) (IF $ELF -EMPLOYED, ENTER BEGINNING THIS PERIOD THIS PERIOD. CLOSE OF THIS PERIOD LOAN TO DATE (IF NAME OF BUSINESS) PERIOD PERIOD ❑ PAID CALENDAR YFAR HAYLEY MATTSON t3 STARS MEDIA S 0 s 950 % s 950 $ E] FORGIVEN PER ELEGTI01r CO-FOUNDER RATE ATASCADERO, CA 93422 PRESIDENT, COO 950 0 s s 0 s 10/16/208 s s DATE DU DATE INCURRED t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC PAID CALENDAR YEAR s s ti s s ❑ FORGIVEN RATE PER ELECTION- DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN RA7F PER ELECTION" DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY 0 SCC SUBTOTALS $ 450 $ 0 $ 0 $ 0 Schedule B Summary 0 1 _ Loans received this period--------------------------------------------------------------------------------------------------------------------$ — (Total Column (b) plus unitemized loans of less than $100.) 2- Loans paid or forgiven this period ------------------------------------------------------------------- (Total Column (c) plus loans under $100 paid or forgiven-) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net Change this period. (Subtract Line 2 from Line 1.) ................................. Enter the net here and on the Summary Page, Column A, Line 2_ 'Amounts forgiven or paid by another party also must be reported on Schedule A. " if required. ...................................$ NET $0 (May be a negative number) (Enter (e) Of, Sd*dUle E, Line 3) tContributor 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) wwwJppc_ca.gov Schedule E Amounts may be rounded Statement covers to whole dollars. Payments Made I hon, ylria.0 12/31/2021 I POPor NIC MATTSON FOR ATASCADERO CITY COUNCIL 2070 1 1431600 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemaliatmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nor monetary)' DEC office expenses SAL campaign workers'salanes CVC civic donations PET petition circulating TEL l.v. or cable airtime and production costs FIL candidate filinglballot fees PHO phone banks TRC candidate travel, lodging, and meals END fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supportirglopposing 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 pant ads WEB information technology costs (internet e-mail) NAME ANDADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITIEE,,LLSO ENTER I.O. NUMBER) Payments Mat ere contributions a independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1140.63 Schedule E Summary 0 t. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 2. Unitemized payments made this period 0od of under $100.......................................................................................................................................... $ --- 3. Total interest paid this period on loans. (Enter amount from Schedule 8, Part 1, Conran(e).)............................................................................. $ 0 4. Total payments made this period- Add Lines 1, 2, and 3. Enter here and on the Stun P 0 P Y Pe ( Summary 808. Column A L1t18 8.) ........................... TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made Amounts may be rounded to whole dollars. SCHEDULE E (CONT) Sibia"•r't covers ��Od from •• SEE INSTRUCTIONS ON REVERSE through 12/31/2021 Page of NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)' CVC civic donations FIL candidate filing/ballot fees END fundraising events IND independent expenditure supporting/opposing others (explain)' MBR MIG OFC PET PHO POL POS member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services RAD RFD SAL TFL TRC TRS TSF radio airtime and production costs returned contributions campaign workers' salaries Lv. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor LEG legal defense LIT campaign literature and mailings PRO PRT professional services (legal, accounting) print ads VOT WEB voter registration information technology costs (Internet, e-mail) ' Payments that are contributions m independent expenditures must also be summarized on Schedule D. SUBTOTALS 98228 FPPC Form 460(Jan/2016ff FPPC Advice: acIWce@fppc.ca.gov (866/275-3772) www.fppc.ca.gov