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HomeMy WebLinkAboutForm 460 Keen 123121Recipient Committee Campaign Statement Cover Page Statement covers period from 7/1/2021 SEE INSTRUCTIONS ON REVERSE I through 12/31/2021 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. m Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Flection Committee Committee O Recall Controlled 8 (AlsoCompwe Pad sl V Sponsored Atascadero (Also Cumple,'* Pan 6J ❑ neral Purpose Committee MAILING ADDRESS (IF DIFFERENT) Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political Party/Central Committee (Alsc Carnpleie Pan 1) 3. Committee Information I ID: NUMBER �1 Keen for Council 2020 STREET ADDRESS (NO P.O. BOX) CIIY STATE ZIP CODE AREA COOEIPHONE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NOL AND STREET OR PO. BOX CITY �� STATE ZIP CODE AREACODEI�PH N—E� Atascadero CA 93423 OPTIONAL: FAX 1 E-MAIL ADDRESS Rate of election if applicable: (Month, Day, Year) Date Stamp ECEIVED 7,= For Offtdal COVER PAGE TY OF ATASCADERO 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement m Semi -arcual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) © Amendment (Explain below) Treasurers) NARIE OF MEX.MPER Rachel McElhinny MAILING ADDRESS of Atascadero CA 93422 NAML OFASSI TANTTREASURER,IFANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODElPHONE OPTIONAL FAX I E-MAIL ADDRESS Verification I have used all reasonable diligence in preparing and rerhewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. certify under penalty of perjury under the laws of the State of California that the for g Is t fn Correct. Executed on O Z Z Bye y Date ture of I reasureror Xssisilant Treasuw Executed on I I Date ature of Controlling Officeholder, Candidate, State Measuro Proponent or kesponsible0floer of Sponsor Executed on ale Executed on Pale By Signature of controlling Officilhalder, candidate, StaW sure Proponent By Signature of controlling CifficeWder, Candidate, Mate lvlensure Proponent FPPC Form 496 (Feb/2019) 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 Victoria Keen OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE? Atascadero City Council RESIDENTIA BUSINESSADDRES (NO.ANDSTREET) CITY S ATE 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 I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO ADDRESS STREET ADDRE CITY STATE ZIP CODE AREACODEWHONE COMMITTEE NAME I I.D. NUMBER NAME OF I [:]YES NO P.O. BOX) CITY STATE ZIP CODE AREA GOD EIPHONE COVER PAGE - PART 2 Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTERI JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT HELD DISTRICT NO W ANY 7. Primarily Formed Candid atelOfficeholde r Committee List names of officeholder(s) or candidates) 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 Attach continuation sheets if necessary FPPC Form 460 (Jan/20161 FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summa Pato whole dollars. Statement covers period e . Summary Page from 7/1/2021 e• g• 1 ON REVERSE NAME OF FILER Victoria Keen Contributions Received 1. Monetary Contributions................................................... schedule A, Litre 3 2. Loans Received............................................................h... schedule B. Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines f +2 4. Nonmonelary Contributions........................................I... schedule c, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 TOTAL THIS (FROMATTACHED $ 337.39 $ 337.39 $ 337.39 through 12/31/2021 Column B CALENDAR YEAR TOTAL TO DATE $ 463.87 $ 463.87 $ 463.87 Expenditures Made 6. Payments Made................................................................ schedule E, Line 4 $ 307.46 $ 478.42 7. Loans Made....................................................................... schedule H. Line 3 _,- 8. SUBTOTAL CASH PAYMENTS ........................... _.......... Add Lima e+7 $ 307.46 $ 478.42 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F,, Line 3 T 10. Nonmonetary Adjustment..... ......... ........................................... schedule C, Lina 3 11. TOTAL EXPENDITURES MADE .................................... Add Lima 8+9+10 $ 307.46 $ 478.43 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 13. Cash Receipts........................................................... Golumn A. Line 3 above 14. Miscellaneous Increases to Cash.............................I.... schedule i, Line 4 15. Cash Payments......................................................... Column A, Line a above 16. ENDING CASH BALANCE __._...........Addunes 12+13+ 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ............ ................... schedule B, Pane Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see i"I"d ns on mmI 19. Outstanding Debts .............................. Add Line 2+ Line 9 in column B above $ 100.85 337.39 E 307.46 130.78 $ _ 1 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). Page of 1428685 Calendar Year Summary for Candidate: Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (e Subject to voluntary Exi,oneiture 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 496(Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A to whole dollars. Statement covers period Monetary Contributions Received • - , 60 from 7/1/2021 . SEE INSTRUCTIONS ON REVERSE through 12/31/2021 Page —t�—of NAME OF FILER I.D. NUMBER Victoria Keen 142$685 PATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN iNDIV1DUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE.ALSO ENTER I.D. NUMBER) (1F SELF-ELIPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIREp) IND 12/08/2021 Deborah Keen El retired 126.48 ❑ OTH Atascadero,CA 93422 ❑ PTY ❑ SCC ®IND 07/02/2021 Victoria Keen ❑COM paralegal 208.00 ❑ OTH Gary Faucette, 555 Chorro Atascadero, CA 93422 ❑ PTY St, Suite A2, SLO CA 9340 ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC St)BTOTAL $ Schedule A Summary Amount received this period — itemized monetary contributions. 334.48 (Include all Schedule A subtotals.).........................................................................................................$ 2.91 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 Summa Page, Column A, Line 1. .TOTAL $ 337.39 "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 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON Victoria Keen Amounts may be rounded to whole dollars. CODES: If one of the following codes accurately describes the payment, you may enter the code. CMP campaign paraphemalia/misc. MBR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetaryr OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)` POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads 7/1/2021 through 12/31/2021 Page 15 of 1 1428655 Otherwise, describe the payment RAD radio airtime and production costs RFD retumed contributions SAL campaign workers'salaries TEL Lv. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internal, e-mail) NAME AND ADDRESS OF PAYEE QF COMMITTEE, ALSO ENTERID. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID wix web 290.95 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS Schedule E Summary 1. Itemized payments made this 290.95 P Yrn Period. (Include all Schedule E subtotals.)............................................................................................................. $ 2. Unitemized payments made this period of under $100....................................................................................................... ....... $ 16.51 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ 307.46 FPPC Form 496(Feb/2019) FPPC Advke: advlce@sfppc.ca.gov (866/275-3772) www.fppc.ca.gov