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Home My WebLink AboutForm 460 Dariz 063021Recipient Committee COVER PAGE P Date Stamp Campaign Statement RE.,VEi Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from Ian. 12, 2021 through Tune 30, 2021 1. Type of Recipient Committee: All Committees — Complete Farts 1, 2, 3, and 4. Zfficeholder, Candidate Controlled Committee 8 State Candidate Election Committee O Recall (Also Complele Part 5) ❑ General Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee ❑ Primarily Formed Ballot Measure ornmittee Controlled Sponsored (Also Compkte Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Aso Complete Part 7) 3. Committee Information I.D. NUMBER 1407272 COMMITTEE NAME {OR CANDIDATE'S NAME IF NO COMMITTEE) Mark Dariz Committee to Elect for Atascadero City Council 2020 STREET ADDRESS NO F.O. BOX) 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 CODEIPHONE OPTIONAL: FAX/ E-MAIL ADDRESS Date of election if applicable: .J — 2 Q 21 Page 1 of 3 (Month, Day. Ye; I For Official Use Only CITY OF ATASCADER Nov. 3, 2020 CITY CLERK'S OFFICE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement 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 Atascadero CA 93422 NAME OF ASSISTANT TREASURER, IF ANY MAILINGADDRFSS CITY STATE ZIP CODE AREA CODE/PHONE 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 knowledge the inf certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 7/29/21 By Date _ Sionature r ined herein and in the attached schedules is true and complete. I Executed on 7/29/21 By Date S"vrevre—of�roiling=fleece oolder Caanndiddale rate Measure Pro Responsible Officer of Sponsor Executed on By Dale Srgnalure of Controlling Officeholder, Candidate, State Measure Proponent E=xecuted on By Date Src}nature of Controlling O%cehelder, Candidate. State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Statement coven period Summary Page to whole dollars. CALIFORNIA from • , • 0 SEE INSTRUCTIONS ON REVERSE through Page 2 of 3 NAME OF FILER I.D. NUMBER Mark Dariz Committee to Elect for Atascadero City Council 2020 1407272 Contributions Received 1. Monetary Contributions................................................... schedu/eA Linea 2. Loans Received................................................................ schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 4. Nonmonetary Contributions ............................................ schedule c, 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 8. 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 a+9+ 10 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page. Line 16 13. Cash Receipts........................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 15. Cash Payments......................................................... column A, Line b above 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) Column B CALENDAR YEAR TOTAL TO DATE $ 1,000 $ 1,000 $ 2,383 1,000 $ 1,383 17. LOAN GUARANTEES RECEIVED ................................ schedule B, Part2 $ I Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ $ $ $ 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections Ill through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' IN Subject to Voluntary Ecpenr m Limit) Date of Election Total to Date (mm/ddtyy) $ '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 E Payments Made Amounts may be rounded to whole dollars. Statement covers period from SCHEDULE SEE INSTRUCTIONS ON REVERSE through Page 3 of 3 NAME OF FILER I.D. NUMBER Mark Dariz Committee to Elect for Atascadero City Council 2020 1407272 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/mist. 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' salafies CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC Candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staffispouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)" POS postage. delivery and messenger services TSF transfer between committees of the same candidateisponsor 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) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Atascadero Kiwanis Club Foundation CVC s 1,000 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,000 Schedule E Summary 1. Itemized payments made this period. (include all Schedule E subtotals.)............................................................................................................. $ 1,000 2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Pari 1, Column(e).)............................................................................. $ 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column AT Line 6. .... TOTAL $ 1,000 FPPC Form 460 Oan/20161} FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov