HomeMy WebLinkAboutForm 461 Brad Goodrow (Atascadero Citizens for Accountability) 080120 to 063021Major Donor and
Independent Expenditure Committee
Campaign Statement
SEE INSTRUCTIONS ON REVERSE
1. Name and Address of Filer
NAME OF FILER
(If filer is other than an individual)
Statement covers period
from
through
CODF/DAYTIME PHONE
2. Nature and Interests of Filer(Complate each applicable section.)
A FILER WHO IS AN INDIVIDUAL MUST LIST THE NAME, ADDRESS. AND BUSINESS INTERESTS
OF EMPLOYER OR, IF SELF-EMPLOYED, THE NAME, ADDRESS, AND NATURE OF THE BUSINES
NAME OF EMP�OY�gRlBI�SJ $ r . %J�� BUSINESS INTERESTS
� �L �AA�rAA1I �� 55 fi��
ADDRESS -(IF EMPLOYER/BUSINESS/
A
ENGAGED
► "14 S F F' , i' ` I;<- it c %4' r VO/r
A FILER THAT It, AN ASSOCI TION MUST WOVIDE A SPE
Date Stamp
RECE__ IV CALIFORNIA 461:
FORM
Date of election if applicable: AUG 2 4 20211Pageof 14�_
(Month, flay, Year)
CITY OF A7ASCAE ERO For Official Use Only
CITY CLERK'S OF ICI=
3. Summary
(Amounts may be rounded to whole dollars.)
1. Expenditures and contributions
(including loans) of $100 or more Q ��
made this period. (Part 5.) ................................................ $
2. Unitemized expenditures and
contributions (including loans) under
$100 made this period ...................................................... $
3. Total expenditures and contributions
made this period. (Add Lines 1 + 2.)................SUBTOTAL $6W
4. Total expenditures and contributions
made from prior statement. (Enter
amount from Line 5 of last statement
filed. If this is the first statement for
the calendar year, enter zero.) ......................................... $
5. Total expenditures and contributions
(including loans) made since
January 1 of the current calendar year. OG�a o0
(Add Lines 3 + 4.)...................................................TOTAL $
BUSINESS ACTIVITY IN WHICH IT IS 14. Verification
FIC DESCRIPTION OF ITS fNTE
AFILER THAT IS NOT AN INDIVIDUAL. BUSINESS ENTITY, ORASSOCIATION MUST DESCRIBE THE
COMMON ECONOMIC INTEREST OF THE GROUP OR ENTITY
❑ Amendment (Explain):
I have used all reasonable diligence in preparing this statement. I have
reviewed the statement and to the best of my knowledge the information
contained herein is true and complete. I certify under penalty of perjury under
the laws of the State of California that the foregoing is true and correct.
Executed on 41 By
ATE VSIGNATURE F INDIVIDUAL DONOR OR
RESPONSIBLE OFFICER, IF OTHER THAN AN INDIVIDUAL
FPPC Form 461 (Jan/2016)
FPPC Advice: advice@fppe.ca.gov (866/275.3772)
vrww.fppc.ca.gov
Major Donor and
Independent Expenditure Committee
Campaign Statement
SEE INSTRUCTIONS ON REVERSE
Amounts may be rounded
to whole dollars.
Statement covers period
from _
through
5. Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made
(if more space is needed, use additional copies of this page for continuation sheets.)
Page _/_ of
DATE
NAME, STREET ADDRESS, CITY, STATE AND ZIP CODE
OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D.NUMBER)
TYPE OF PAYMENT
DESCRIPTION OF
PAYMENT
(IF OTHER THAN MONETARY
CONTRIBUTION OR LOAN)
CANDIDATE AND OFFICE,
MEASURE AND JURISDICTYON,
OR COMMITTEE
AMOUNT THIS
PERIOD
CUMULATIVE AMOUNT
RELATED TO THIS
CANDIDATE, MEASURE,
OR COMMITTEE
Monetary
G w
Contribution
❑ Loan
�L
❑ Non -Monetary
Contribution
P• ! 'r
❑ Independent
Expenditure
❑ Support ❑ Oppose
r3 r3ayb�
❑ Monetary
.�
Contribution
❑ Loan
❑ Non -Monetary
Contribution
❑ Independent
Expenditure
❑ Support ❑ Oppose
❑ Monetary
Contribution
❑ Loan
❑ Non -Monetary
Contribution
❑ independent
Expenditure
❑ Support ❑ Oppose
❑ Monetary
Contribution
❑ Loan
❑ Nan -Monetary
Contribution
❑ Independent
Expenditure
❑ Support ❑ Oppose
SUBTOTAL $��
FPPC Form 461 (Jan12016)
FPPC Advice: advice@fppc.ca.gov (8661275.3772)
www.fppc.ca.gov