HomeMy WebLinkAboutForm 460 Dariz 123121Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from )uly 1, 2021
through December 31, 2021
1. Type of Recipient Committee: Ail Committees —Complete Parts 4, 2, 3, and 4.
Rfficeholder, Candidate Controlled Committee
V State Candidate Election Committee
0 Recall
(Also CnmpWe Part 5)
❑ General Purpose Committee
Sponsored
Small Contributor Committee
Political Party/Central Committee
❑ Primarily Formed Ballot Measure
Committee
J Controlled
0 Sponsored
(Aso Complete Part 6)
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Compiele 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 P.O. BOX)
STATE ZIP CODE AREACODElPHONE
Atascadero CA 93422
MAILINGADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL_ FAX I E-MAJL ADDRESS
COVER PAGE
Date Stamp
RECEIVE
Date of election if applicable: Page 1 of 3
(Month, Day. Year) JAN 5 lUtZ For Oficial Use Only
Nov' 3, 2020 1CITY OF ATASCADE O
f CITY CLERK'S OFFI E
wi iii. r
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
MAILING ADDRESS
CITY STATE ZIP CODE AREACODEIPHONE
Atascadero CA 93422
NAME OF ASSISTANT TREASURER. IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL_ FAX J E-MAIL. ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowled a the info 4aitncontained 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 foregoing is true and corre
Executed on
1/29122 By <--( ac`
Executed on 1/29/22 By
Date 5 of Controlling Officeholder GardicW Stat=
t or Responsibie Officer of Sponsor
Executed on By
Date Signature of Controthng Officehofder, Canddate, Slate Measure Proponent
Executed on By
Este Signature of Controlling Officeholder. 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
Pagefrom
Amounts may be rounded
to whole dollars.
Statement coven: period
SUMMARY PAGE
CALIFORNIASummary 11
FORM • 1
8. SUBTOTAL CASH PAYMENTS......... _.........................
SEE INSTRUCTIONS ON REVERSE
9. Accrued Expenses (Unpaid Bills) ....... _ __ ___
_ _
through
..__.........ScheduleC, Linea
Page 2 of 3
I.D. NUMBER
NAME OF FILER
Mark Dariz Committee to Elect for Atascadero City
Council 2020
1407272
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTAL THIS PERIO D
(FROATTACHED SCHEDIREsi
M
CALENDAR YEAR
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions...................................................
Schedule A, Linea
$ $
--
vt through 6130 7!1 to We
2. Loans Received................................................................
Schedule B, erre 3
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines I+2
$ $
Received $— $ --.--
4. Nonmonetary Contributions ............................................
5. TOTAL CONTRIBUTIONS RECEIVED. ..............................
Schedule C. tim 3
AddLkNbs3+4
$ $
-
21. Expenditures
Made $ S
Expenditures Made
6. Payments Made................................................................
schedule E, Line 4
7, Loans Made ....... .................... -.......... ...... ..__....
.............. Schedule H, Linea
8. SUBTOTAL CASH PAYMENTS......... _.........................
Add Lines 6+7
9. Accrued Expenses (Unpaid Bills) ....... _ __ ___
.._.......... I.Schedule F Linea
10. Nonmonetary Adjustment .......... _. ____
..__.........ScheduleC, Linea
11. TOTAL EXPENDITURES MADE..._.. ._
__............ Add Lines 8.9+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 8above
16. ENDING CASH BALANCE ..................Add Lines 12+ 13 + 14, then subtract Line 15
If this is a termination statement, Line 16 must be zero.
$ 0
$ 0
$ 0
$ 1,383
0
$ 1,383
17. LOAN GUARANTEES RECEIVED.. .... ..... -- ... .......... Schedule e.. Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents....._.... see instructions on reverse $
19. Outstanding Debts. ............. ................ Add L,ne 2 + L,ne 9 m Column B above 5
$
$
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'
(II Subject to Voluntary Expenditme Limit)
Date of Election Total to Date
(mm/dd/yy)
$
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