The URL can be used to link to this page

Home My WebLink AboutForm 460 Mattson Termination 04152022Recipient Committee Date Stamp COVER PAGE Campaign Statement RECEIVEDin= Cover Page SEE INSTRUCTIONS ON REVERSE $teterttent covers period *� 1/1/2022 through 4/15/2022 1. Type of Recipient Committee: All committees – Complete Parts 1, 2, 3. and 4. mceholder, Candidate Controlled Committee ( State Candidate Election Committee 0 Recall (Asap Camyete Part S) ❑ eneral Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee 3. Committee Information NAME IF Nic Mattson for Atascadero City Council 2020 ❑ Primarily Formed Ballot Measure ommittee Controlled Sponsored (A)- Pert a) ❑ Pnmanly Formed Candidate/ Officeholder Committee (Abn C rri" PW 7) I,D.NUMBER 1431600 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE Atascadero CA 93422 805-466-4086 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL- FAXIE-MAILADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best o my certify under penalty of perjury under the laws of the State of California that the foregoing is tru ark Executed on 4/15/2022 Date By I Date of election If applicable: (Month, Day, Year) t11 N 0 1 2022 Page 1TY OF ATASCADER 11/03/2020 CITY CLERK'S OFFIC 2. Type of Statement: ❑ Preelection Statement ❑ Semi-annual Statement (� Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurers) NAME OF TREASURER MAILING ADDRESS Of - Use Only ❑ Quarterly Statement ❑ Spacial Odd -Year Report CITY STATE ZIP CODE AREA CODFJPHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODrJPHONE OPTIONAL: FAX i E-MAIL ADDRESS or and in the attached schedules is true and complete. I Executed on 4/15/2022 SySignature o antra ng eTTd§ , ate, titate assureropenent or Respa�rw 6Io b car o�"""T�r'"""por�sor"— Executed on By Date ftnature of Controllng Ofi candidate, State Measure Proponent Executed on By Dale S4gnature of ConlroBing Oficeholdar, candidate. state Measure Proponent FPPC Form 460 (Jan/2tli6j} FPPC Advice. advice@fppc.ca.gov (666/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE NIC MATTSON OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL MEMBER, CITY OF ATASCADERO RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP ATASCADfi 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 beholfof your candidacy. ID NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO ESS STREETADDRESS CITY STATE ZIP CODE AREACODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE7 ❑ YES ❑ NO COMM ITTEFADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE COVER PAGE - PART 2 Page of 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 OR NEW DISTRICT NO. IF ANY 7. Primarily Formed Candldate/Officeholder Committee Listnamesot 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 shoots If necessary FPPC Form 460 Oan/2016) FPPC Advice: advlce@fppc.ca.gov (866/275.3772} www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE to whole dollars. Statement Cows erlod Summary Page from 7/1/2021 e - ON REVERSE through 12/31/2021 Page of NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 Ll 1431600 Contributions Received Column A TOTAL THIS Column B Calendar Year Summary for Candidates PERIOD (FROMATTACHEDecH ILFS) CALENDAR YEAR TOTAL TO DATE Running In Both the State Primary and General Elections 1. Monetary Contributions........._........................................ Schedule A. Line 3 $ $ 0 0 0 111 through 5/30 711 to Date 2. Loans Received................................................................ schedule e, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. add Lines 1.2 $ 0 $ 0 20. Contributions Received $ _ $ 4. Nonmonetary Contributions ............................................ schedule C, LIM3 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ................ ___......... Add Lines 3«4 $ 0 $ 0 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ schedule e, Line 4 $ 46.09 $ 46.09 Candidates 7. Loans Made.. ........ ........................................... Schedule H, Lire 3 0 0 8. SUBTOTAL CASH PAYMENTS Add Lines B«7 $ 0 $ 0 22. Cumulative Expenditures Made* ............................. _........ Bf SI to voient. EepmMnurt Umtn 9. Accrued Expenses (Unpaid "'. ,LIM3 0 0 Date M Election Total to Date 10. Non monetary Adjustment..____ .............._._..___....______.... schedule C. Line 3 0 0 (mmlddlyy) 11. TOTAL EXPENDITURES MADE ......... ..................... Addunese+9.10 $ 0 $ 0 Current Cash Statement 12. Beginning Cash Balance ............................ pmvbus Summary page, Line 16 $ 46.09 13. Cash Receipts........................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 15. Cash Payments......................................................... Column A, Line 9 above 16. ENDING CASH BALANCE .Add thea 12 « 13 « 14, than subtract Une 15 $ 0.00 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule e, pert 2 $ 0 18. Cash Equivalents ................................................ See instructions on reverse $ 0 19. Outstanding Debts .............................. AddLM2+Lbm eat Column a above $ 903.91 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). 'Amounts in this section may be different from amounts ,eported In Column B. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wvovtJppc.Ca.gov Schedule A Amounts may be rounded SCHEDULE A W wh I d II Monetary Contributions Received ° ° oars. Statement coven period CALIFORNIA from 7/1/2021 FORM• Page Of SEE INSTRUCTIONS ON REVERSE through 12/31/2021 NAME OF FILER I.Q. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, 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) (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ®IND 10/06/2020 ROBERT DAVIS El COM OWNER, APS AUTO 250 250 G20 { ) ❑ OTH ATASCADERO, CA 93422 ❑ PTY ❑ SCC ®IND 10/1/2020 ROLFENELSON ❑COM RETIRED 100 100 (G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTY ❑ SCC ®IND 10/9/2020 ROLFE NELSON ❑ coM RETIRED 250 250 (G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTY ❑ Scc ZIND 10/16/2020 RON KRALL ❑ COM GENERAL MANAGER 250 250 (G20) ❑OTH MID -STATE SOLID TEMPLETON, CA 93465 ❑ PTY WASTE ❑ SCc ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 0 Schedule A Summary 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 $ '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 460 (Jan/2016)) FPPC Advice: advice@fpKca.gov (866/275-3772) www.fppc.ca.gov Amounts may be rounded SCHEDULE B - PART 1 Schedule B — Fan: -1 to whole dollars. Statement covers period Loans Received CALIFORNIA 460 from 7/1/2021 FORM page of SEE INSTRUCTIONS ON REVERSE through 12/31/2021 NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 FULL NAME, STREETAQDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT ° AMOUNT PAID OUTSTANDING • INTEREST ORIGINAL CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER 1.6. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN THISPERIOD, BALANCEAT CLOSE OF THlS PAID THIS PERIOD AMOUNT OF LOAN CONTRIBUTIONS TO DATE NAME OF BUSIHE95) PERIOD PERIOD E] PAID AL NDAR Y HAYLEY MATTSON 13 STARS MEDIA $.46.09 s 0 % 3 950 i CO-FOUNDER, RATE ATASCADERO, CA 93422 PRESIDENT, COO ❑ FORGIVEN PER £LECTION~ s 950 $ 0 s 903.91 $ 10/16/20 $ to IND ❑ COM ❑ OTH ❑ PTY ❑ SCG DATE DUE DATE INCURRED PAID CALENDAR YEAR $ $ % $ S L] FORGNEN PER ELECTION RATE t ❑ IND ❑ COM 0 OTH ❑ PTY E] SCC $ S 9 $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ S _ % $ s Q FORGIVEN RA'r PER ELECTION" t❑ INC) Q COM ❑ 07H ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0 $ 0 $ 0 $ 0 Schedule B Summary 1. Loans received this period ............................... ..................................................................................... $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.......................................................................................................$ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.)..............................................................NET $ Enter the net here and on the Summary rage, Column A, Line 2. (May be a negatam number) 'Amounts forgiven or paid by another parry also must be reported on Schedule A. " If required. (Enter (e) on Schedule F. Line 3) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH —Other (e.g., business entity) PTY — Pulibcai r arty SCC — Small Contributor Committee FPPC Form 460 ()an/20161? FPPC Advice: advice@fppc.ca.gov (866/275.3772) www.fppc.ca.gov Schedule E Payments Made SEE NIC MATfSON FOR ATASCADERO CITY COUNCIL 2020 CODES: If one of the following codes accurately describes CMP campaign paraphemalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)' CVC civic donations FIL candidate filing/ballot fees FND fundraising events IND independent expenditure supporting/opposing others (explain)• LEG legal defense LIT campaign literature and mailings Amounts may be rounded to whole dollars. the payment, you may enter the code MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional servicas (legal, accounting) PRT print ads from element covers 7/1/2021 through 12/31/2021 I Page of 1431600 Otherwise, describe the payment RAD radio airtime and production costs RFD returned contributions SAL campaign workere'salaries TEL t.v. 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 (internet, e-mail) Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 2. Unitemized payments made this period of under $100............................................................................................:............................................. $ 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 $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded (Continuation Sheet) to whole dollars. Payments Made SEE INSTRUCTIONS ON REVERSE NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 SCHEDULEE(CONT) Staprnent cows periodr1431600 nom711/2021through 12/31/2021 of CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the CMP campaign paraphernalia/misc. MBR CNS campaign consultants MTG CTB contribution (explain nonmonetary)' OFC CVC civic donations PET FIL candidate filingrballot fees PHO FND fundraising events POL IND independent expenditure supporting/opposing others(explain)* POS LEG legal defense PRO LIT campaign literature and mailings PRT payment. member communications RAD radio airtime and production costs meetings and appearances RFD returned contributions office expenses SAL campaign workers' salaries petition circulating TEL t.v. or cable airtime and production costs phone banks TRC candidate travel, lodging, and meals polling and survey research TRS staff/spouse travel, lodging, and meals postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor professional services (legal, accounting) VOT voter registration print ads WEB information technology costs (internet, e-mail) - FWM6r a Inst are corttrlbUtIMS or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ FPPCForm 460 tan 2016 FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE F Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE CODE OR DESCRIPTION OF PAYMENT Amounts may be rounded whole dollars. (b) AMOUNT INCURRED THIS PERIOD Statement rovers periodCALIFORNIAto P• ' nom 7/1/2021 FORM through 12/31/2021 Pape of NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/mise. MBR member communications RAD radio airtime and production costs CNS campaign consultants WTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC officer 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 END 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 pent ads WEB Information technology costs (Internet, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, AL80 ENTER I.D. NUMa") CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (C) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD • Paymenls that ere contrbulons or Indeperiderd lapandums must also be SUBTOTALS j j j 0 j summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.)............................................INCURRED TOTALS $ 2. Total accrued expensespaid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) .................................. PAID TOTALS $ 3. Net change this period.(Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) ............................................ _................................................................................................................. ......... ........... NET $ Mabe an the number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275.3772) www.fppc.ca.gov