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Home My WebLink AboutForm 460 Moreno 123121Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 07/01/2021 through 12/31/2021 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored {Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Pert 7) 3. Committee InformationI LD NUMBER 1400944 COMMITTEE NAME {OR CANDIDATE'S NAME IF NO COMMITTEE) Friends of Heather Moreno for Atascadero Mayor 2022 STREET ADDRESS (NO P.D. BOX) CITY STATE ZIP CODE AREACODElPHONE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT} NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODEIPHONE OPTIONAL: FAX ! E-MAIL ADDRESS COVER PAGE Date Stamp RECEIVED Date of election if applicable: Page 1 of 6 (Month, Day, Year); e1 For Off Use Only 2 0 2022 r ,TAY/ OF A_TASCADE ..ii I I CLE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement V Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurers) NAME OF TREASURER Scott R. Hayner MAILING ADDRESS CITY STATE ZIP CODE AREACODEPHONE Atascadero CA 93422 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX 1 E-MAILADDRESS 4. Verification I 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 foregoing is true and correct. n Executed on + r — "' 7"0 Z -Z— Date Executed on z 3 —'; C Date Executed on Executed on Oate By ag cir-Trsurer or BY By Signature of Controlling Officeholder Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate. State Measure Proponent FPPC Form 460 ()an/2016) 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 Heather Moreno OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Mayor, City of Atascadero RESIDENTIALBUSINESS ADDRESS (NO. AND STREET) 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.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME LD. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) COVER PAGE - PART 2 Page 2 of 6 6. Primarily 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 CITY STATE ZIP CODE AREACODEIPHONE Attach continuation sheets if necessary FPPC Form 460 {tan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. Statement covers period from 07/01/2021 through 12/31/2021 SUMMARY PAGE Page 3 of 6 NAME OF FILER Friends of Heather Moreno for Atascadero Mayor 2022 6. Payments Made................................................................ schedule E, Line 4 7. Loans Made....................................................................... I.D. NUMBER 1400944 Contributions Received Add Lines 6+7 Column A TOTAL Schedule F Linea Column B Calendar Year Summary for Candidates 11. TOTAL EXPENDITURES MADE ........................................ Add Lines s +y + 10 THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 297.00 $ $ 497.00 D 0 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ schedule a, Line 3 297.00 497.00 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1.2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ schedule C, Line 3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 $ 297.00 $ 497.00 Made $ $ 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 Linea 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 11. TOTAL EXPENDITURES MADE ........................................ Add Lines s +y + 10 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summery Paye, 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. $ 379.16 $ 1,819.16 0 0 $ 379.16 $ 1,819.16 0 0 0 0 $ 379.16 $ 1,819.16 $ 5,663.70 297.00 0 379.16 $ 5,581.54 17. LOAN GUARANTEES RECEIVED ................................ Schedule e, Part 2 $ I Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2+ Line 9 in Column a above $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (e Sublect to Voluntary Eapendlhne Lime) Date of Election Total to Date (mmJddlyy) I I $ $ To calculate Column B, add amounts in Column A to the corresponding *Amounts in this section may be different from amounts amounts from Column B reported in 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). FPPC Form 460(Jan/2016) FPPC Advice: advice@fppc.ca.gov )866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A lV �IIIVItl V VIIOfi. Monetary Contributions Received Statement covers period 07/01/2021 . • from e 12/31/2021 4 6 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. MB NUER Friends of Heather Moreno for Atascadero Mayor 2022 1400944 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED OF COMMITTEEALSO ENTER I.D. NUMBER) CODE + OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN.1-DEC. 31) (IF REQUIRED) OF SUVNESS) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ scc SUBTOTAL$ 0 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 297.00 297.00 IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committe FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) v W.fppc.ca.gov Schedule D SCHEDULE D Junnllaly ul CAp. -IIUILUICb "" 011�"'dy"e"U11UUU Statement covers period Supporting/Opposing Other to whole dollars. CALIFORNIA.' Candidates, Measures and Committees from 07/01/2021 • RM SEE INSTRUCTIONS ON REVERSE through 12/31/2021 Page 5 of 6 NAME OF FILER I.D. NUMBER Friends of Heather Moreno for Atascadero Mayor 2022 1400944 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE (IF REQUIRED) PERIOD (,IAN. 1 -DEC. 31) (IF REQUIRED) Stacy Korsgaden for Supervisor 2022 0 Monetary 12/3/2021 FPPC ID# 1439436 Contribution 250.00 250.00 ❑ Nonmonetary Contribution ❑ Independent 0 Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.)....................................................... $ 250.00 2. Unitemized contributions and independent expenditures made this period of under $100.................................................................................... $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.).......... TOTAL.. $ 250.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Friends of Heather Moreno for Atascadero Mayor 2022 Amounts may be rounded to whole dollars. nt covers period from 07/01/2021 through 12/31/2021 I Page F CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment 1400944 or 8 CMP campaign paraphernaliatmisc. 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 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 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 (intemet, e-mail) NAME AND ADDRESS OF PAYEE OF COMMun EE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Atascadero Greyhound Foundation CVC 100.00 Stacy Korsgaden for Supervisor 2022 FPPC ID# 1439436 CTB 250.00 Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 350.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 350.00 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 379.16 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 Page, Column A, Line 6.) ........................... TOTAL $ 379.16 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (666/275-3772) www.fppc.ca.gov