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Home My WebLink AboutForm 460 Committee to Elect Bob Kelley 100608Recipient Committee Campaign Statement Cover Page Government Code Sections 84200-84216.5) fro m Type or print in ink. Statement covers period (Date of election if applicable 07/01/2008 (Month. Day. Year) SEE INSTRUCTIONS ON REVERSE I through 09/30/2008 1. Type of Recipient Committee: All Committees _ Complete Parts 1, 2, 3, and 4. Nov. 4, 2008 2. Type of Statement: Dara stamp RECEIV OCT ` c 2M Page CITY OF ATASCAD CITY CLERK'S OFF COVER PAGE of_5 For Official Use Only Officeholder, Candidate Controlled Committee Primarily Formed Ballot Measure Preelection Statement Quarterly Statement O State Candidate Election Committee Committee Semi-annual Statement Special Odd -Year Report Q Recall Q Controlled Termination Statement Supplemental Preelection Also complete Pall 5) Sponsored Also file a Form 410 Termination Statement -Attach Form 495 F-1GeneralPurpose Committee A/soCompletePaR6) Amendment (Explain below) 0 Sponsored Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee Also Complete Part 7) 3. Committee Information I I.D. NUMBER 1247989 COMMITTEE NAME (OR CAIIIDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Bob Kelley STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification Treasurer(s) NAME OF TREASURER David P. Bentz MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NA E OF ASSISTANT TREASURER IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the inform under penalty of perjury under the laws of the State of California that the foregoing is true and corm . 1 .-,i '- Executed Executed on 10/02/2008 Date Executed on If -1 v Dat Executed on Date Executed on Date By By contained herein and in the attached schedules is true and complete. I certify or As!rwanea reasurer or By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05 FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772 State of California Type or print in ink. COVER PAGE - PART 2 Recipient Committee Campaign Statement CALIFORNIAFORM ' • Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Bob Kelley OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Atascadero City COUncil RES I DENTIAUBUS I NESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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 OFFICE SOUGHT OR HELD I.D. NUMBER OPPOSE NAME OF TREASURER OFFICE SOUGHT OR HELD CONTROLLED COMMITTEE? YES F-1 NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) SUPPORT CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD COMMITTEE NAME I.D. NUMBER OPPOSE NAME OF TREASURER CONTROLLED COMMITTEE? YES [] NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Paye 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOTMEASURE BALLOT NO. OR LETTERI JURISDICTION I 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 Attach continuation sheets if necessary FPPC Form 460 (January/05 FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772 State of Californi; Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 07/01/2008 through 09/30/2008 NAME OF FILER Committee to Elect Bob Kelley To calculate Column B. add amounts in Column A to the corresponding amounts from Column B of your last 0 253.46 report. Some amounts in Column A may be negative figures that should be subtracted from previous 652.22 period amounts. If this is Column A the first report being filed Column B Contributions Received for this calendar year. only carry over the amounts from Lines 2, 7, and 9 (if TOTAL THIS PERIOD CALENDAR YEAR FROM ATTACHED SCHEDULES) TOTALTO DATE 1. Monetary Contributions ........................................... schedule A, Line 745.00 745.00 2. Loans Received .................................. .................... Schedule B, Line 3 0 0 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines 1 +2 745.00 745.00 4. Nonmonetary Contributions ................................... Schedule c, Line 3 0 0 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3+4 745.00 745.00 Expenditures Made 6. Payments Made ....................................................... schedule E. Line 4 253.46 503.46 7. Loans Made............................................................. Schedule H. Line 3 0 0 8. SUBTOTALCASH PAYMENTS .................................... Acid Lines 6 + 7 253.46 503.46 9. Accrued Expenses (Unpaid Bills) ............................... schedule F. Line 0 0 10. IVonmonetary Adjustment .......................................... schedule C. Line 3 0 0 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 253.46 503.46 Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 13. Cash Receipts ................................................... column A, Line 3above 14, Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15. Cash Payments .................................................. Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract line 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column 8 above $ 160.68 745.00 To calculate Column B. add amounts in Column A to the corresponding amounts from Column B of your last 0 253.46 report. Some amounts in Column A may be negative figures that should be subtracted from previous 652.22 period amounts. If this is the first report being filed 0 for this calendar year. only carry over the amounts from Lines 2, 7, and 9 (if any). SUMMARY PAGE Page 3 of _ 5 I.D. NUMBER 1247989 Calendar Year Summary for Candidates 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' If Subjectto Voluntary Expenditure 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 (January/05 FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2753772 Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Bob Kelley Type or print in ink. Amounts may be rounded Statement covers period to whole dollars. from 07/01/2008 through 09/30/2008 SCHEDULE CALIFORNIA' FORM Page 4 of 5 I.D. NUMBER 1247989 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED IIF COMMITTEEALSOENTERI.D.NUMBERI CODE * IIFSELF-EMPLOYED. ENTER NAME PERIOD JAN. 1 -DEC. 31) IF REQUIRED) OF BUSINESS! CREPAC ID# 890106 (Atascadero AOR) oM 9/24/08 1-1 OTH 250.00 250.00 PTY SCC IND Michael Frederick Paving Corp. CoM 99.00 99.009/17/08 OTH PTY SCC IND Michael Frederick Investments coM 99.00 198.009/17/08 F-1 OTH PTY SCC IND 9/17/08 Michael Frederick COM 99.00 297.00 OTH PTY SCC IND COM OTH PTY SCC SUBTOTAL$ 547.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. Include all Schedule A subtotals.) $ 547.00 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.) ...... 198.00 TOTAL $ 745.00 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 (January/06 FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 07/01/2008 through 09/30/2008 page 5 of 5 NAME OF FILER I.D. NUMBER Committee to Elect Bob Kelley 1247989 1 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 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/sponse LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads UVEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT U LIT 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 rnade 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 $ AMOUNT PAID 253.4E 253.4E 253.46 0 0 253.46 FPPC Form 460 (January/05 FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772