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Home My WebLink AboutForm 460 Committee to Elect Bob Kelley Amendment 093008Recipient Corno>nitte� Campaign Statement Cover Page (Government Code,Sections 84200-84216.5) SEEINSTRUCTIONS' ON REVERSE Type or print In ink. Statement covers period from 07/01/2008 through 09/30/2008. .1 Type,of Recipient Committee' All Committees - Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee 0 Recall Q Controlled (Also Complete Parr 5) O Sponsored. ❑ General Purpose 1 Committee (Also Complete Part 6) Q Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Complete Parr 7). 3. Committee Information Lo NUMBER -s 1247989 COMMITTEE NAME (OR CANDIDATE'S' NAME IF NO COMMITTEE) Committee to Elect Bob Kelley STREET ADDRESSI (NO PO BOX) CITY Z STATE ZIP CODE _ AREA CODE/PHONE MAILING, ADDRESS .(IF DIFFERENT) NO AND STREET OR PC BOX - - CITY -'STATE ZIP CODE AREA CODE/PHONE Date of election if applicable: (Month, Day Year) Nov 4, 2008 IM CITY OF ATASCADE CITY CLERK'S OFFIC -COVER Page - 1 of 6 For Official Use Only 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement Attach Form 495 Amendment (Explain below) Amend 9/30/08 Preelection Statement Treasurory ) NAME OF TREASURER David P Bentz MAILING ADDRESS," - V r r T 5TATI' ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER IF ANY - MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL. FAX / E-MAIL ADDRESS OPTIONAL. FAX / E-MAIL ADDRESS 4.'Verificatnioy . . s N.; I have used all reasonable diligence in preparingand reviewing this statement and to the best of my k ledge the information contained herein and in the attached schedules is true and complete. I certify under penalty. of per)'uryunder the laws of theState of California that the foregoing is true and wrre , Executed on 10/21/2008= By Executed: on Date " Executed on `Date --.. Executed om Data .. _ s By. C — Slgnature of Controlling Officeholder, Canddate, State Measure Proponent or Responsible Officer of Sponsor By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder. Canddate,State Measure Proponent FPPC Form. 460,(January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC;(86612754772) State of California Recigient.Cornmpttee 1 Campaign Statement 'Cover.Page —Part 2 Type or print in ink. S. Officeholder or Candidate Controlled Committee '' Ny NAME OF'OFFICEHOLDER OR CANDIDATE a Bob Kelley ,c OFFICE, SOUGHT OR, HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Atascadero City Council RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Belated 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 NAME' 1.0 NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? C] YES ❑;,,NO COMMITTEEA00RESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA'CODE/PHONE COMMITTEE NAME W.NUMBER NAME OF TREASURER a II CONTROLLED COMMITTEE? [3 YES' Q NO COMMITTEE ADDRESS STREETADDRESS (NO PO BOX)' CITY STATE "ZIP`CODE AREA CODE/PHONE Attach continuation Sheets if necessary T- COVER PAGE . PART 2 • - MAO Page 2 of 6 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO, OR LETTER JURISDICTION rl enoonor Identify the.. controlling officeholder candidate, or state measure proponent, if any NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT E SOUGHT OR HELD DISTRICT NO. IF ANY 7 Primarily Forr`ned Candidate/Officeholder Committee Ust 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 0 SUPPORT []:OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT Q OPPOSE FPPC Form 480 (January/05) FPPC Toll -Free Helpline, 888/ASK•FPPC (888/275-3772) State of California CampaignDiscl®sure Statemeht m- Summary Page SEElNSTRUCT10NS!ON-AEVERSE NAME'OF FILER Committee -to Elect -Bob Kelley Contributions (Received 1 Monetary Contributions 2. Loans Received. 3: SUBTOTAL CASH CONTRIBUTIONS 4 Nonmonetary Contributions 5: TOTAL CONTRIBUTIONS'RECEIVED Expenditures Made 6. Payments Made 7- Loans__Made 8. SUBTOTALCASH PAYMENTS 9. Accrued Expenses (Unpaid Bills) ,10 Nonmonetary Adjustment 11 TOTAL EXPENDITURESMADE Type or print in ink. Amounts may be rounded Statement covers period to whole dollars. from 07/01/2008 Column A TOTAL THIS PERIOD (FROMATTACHED SCHEDULES) Schedule A, Line 3 $ 745.00 Schedule 8, Line 3 253.46 Add Lines Y + 2 $ 998.46' Schedule C, Line 3 0 Add Lines 3 t 4 $ 998.46 Schedule E, Line 4 $ _ Schedule H, Line'3 _ Add Llnes'6 + 7 $ _ Schedule F, Line 3. _ Schedule C Line 3' _ Add Lines 8 + 9 + 10 '$ _ 573.46 0 573.46 0 0 57346 Current Cash Statement 12 Beginning Cash 'Balance Previous.Summary Page, Line 16 $ 16068 4 13 Cash Receipts CoNmnA; Line'3aDove: 998 46 14 Miscellaneous 'Increases to Cash Schedule 1, Line 4 0 15 Cash -Payments Column A, Line s, above 573.46 16. ENDING CASH ]BALANCE Add Lines, 12 + 13 +14, tnerrsubtract Line, 15 $ 585.68 ff this is a termination statement,, Line 16 mustbe zero.. 17 LOAN GUARANTEES RECEIVED' Scnedule e, Part 8 $ 0 Cash Equivalents arid.°Outstanding Debts 18 Cash Equivalents See instructions:on reverse_ $ 19 Outstanding Debts Add Line 2 + Line 9 in Column B above $ through Column B CALENDAR YEAR TOTALTODATE $ 745.00 253.46 $ 998.46 0 $ 998.46 $ 823.46 0 $ 823.46 0 0 $ 823.46 To calculate, Column B add amounts 1n 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) a SUMMARY. -PAGE 09/30/2008 Paye 3 of 6' . I.D. NUMBER 1247989 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6130 711 to Date 1 20. Contributions Received $ $ 21 Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" (if Subject to 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 (866/275-3772) Tvna nr nrint in ink. 1I -SCHEDULE'A, Amounts may be rounded Statement covers period IVlonetary C+ontl' butions Received to whole dollars. 07/01/2008 - from through 09/30/2008 Page 4 of 6 ° SEE INSTRUCTIONS'ON REVERSE - NUMBER NAME OF FILER s ' 1247989I.D. 1 Committee<to Elect Bob FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF.AN OCCUPATION.ANINDIVIDUAL, : ENTER AND EMPLOYER' AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED. ENTER NAME (IF PERIOD (JAN. 1 DEC 31) (IF REQUIRED) OF BUSINEM -QIND - - CREPAC ID# 890106 (Atascadero AOR) ®COM 25000 25000 9/24/0& E)OTH - a PTY - - - ❑'Scc MND Michael: Frederick Paving Corp PCOM 9900 9900 9/17/08 BOTH _ [] PTY - - [:]SCC ®IND Michael Frederick investments pcOM 9900 19800 9/ 17/08+ p OTH PTY [:]SCC _ ®IND 6Michael;Frederick ❑COM 9900 29700 9617/08 Q OTH 3 PTY E) SCC MND" ` E)COM, D OTH ❑PTY - 4 ;QSCC I SUBTOTAL$ 54,7 00¢ Schedule A,Sumnnaiy 1 Amount received this. period -hemi 8ea, monetary "contributions, v (Include all ScheduleA, subtotals4) 2. Amount received this period' uritemized monetary contributions ofless than $100 3 Total monetary contributions recelvedthis period Lines T,and 2 'Enter here and`on'the Summary Page Column A, Line 1 p 4 � j 'Contributor eoaes IND -Individual $ 54700 COM -Recipient Committee (other than PTY or SCC) $ 19800 OTH - Other (e.g., business entity) PTY - Political Party SCC-malFContributor Committee -TOTAL $ _ 745 00 B FPPC Form 460 (January/05) FPPC'Toll-Free Helpline: 8661ASK-FPPC (866/275.3772) SCHEDULE B PART 1. Scheduie t3, Part 1 Amounts may be rounded Statement covers period • LoansReceived to Whole dollars. 07/01/2008 a �' from • 1pag, 5 6 09/30/2008 'SEE INSTRUCTIONS ON.RL""VERSE through 9 of NAME,OF'FILER: 1.0 NUMBER Committee to Elect -Bob Kelley 1247989 FULL NAME, STREETADDRESS'AND 'ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT 19) AMOUNT PAID OUTSTANDING SALANCEAT INTEREST ORIGINAL CUMULATIVE OF LCNDER pFSELF•EMPLOYED;ENTER BEGINN NG THIS RECEIVED THIS OR FORGIVEN' C OSE THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER LD. NUMBER) NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD LOAN TO DATE Bob -Kelley, Bob Kelley Realty ❑.PAID CALENDAR YEAR Owner E 0 25346 0% 25346 E 253.46 E E ❑.FORGIVEN PER ELECTION - RATE 0 0 253.46 E 0 Demand E_ 0 8/25/08 E Tm; IND ❑: COM ❑, OTH ❑ PTY ❑ SCC E DATE INCURRED DATE DUE PAID CALENDAR YEAR C] FORGIVEN PER ELECTION RATE E E E E_ E DATE DUE DATE INCURRED is❑ IND ❑ COM ❑BOTH ❑ PTY ❑, SCC ❑,PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION DATE DUE DATE INCURRED T❑ IND ❑ COM ❑ OTW .❑ PTY ❑ SCC 's SUBTOTALS $ 253.46$ 0 $ 25346 $ 0 .Q Schedule B Summary 1 'Loans received this, period' (Total Column (b); plus unitemizetl-loans of less than $100 ) 2'. Loans paid' or forgiven,tfiis'period_ (Total Column (c).plus''loans,unddr $100 paid or forgiven.). (Include loans paid6y°a Third party thatia a also itemized`onSchedule A.) 3 Net change'this periods (Subtraci1ine 21rom Line 1 j Enter"the net here andon the Summary Page Column A, Line 2. Amounts forgiven or paid by,another party also must be reported on:§6bdule A. If required. _ Icmar Ie) — Srne aule E. Line 3) 253.46 9 NET $ 253.46 '(May be a neeaav number) r tContributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) 0TH — Other (e.g. business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: $66/ASK-FPPC (866/275.3772) 4� k- s CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID U Printin :con, . r Schedule E type or print in ink. BCHEDULEE Statement covers period • Payments Made Amounts may be. rounded �. ' • to whole dollars. 07/01/2008 ., from 09/30/2008 6 6 < SEE' INSTRUCTIONS ON REVERSE through 9 Page of ' NAME OF,FILER I.D. NUMBER Committee to Elect bob Kelley F' 1247989 CODES. If one of the following codes accurately describes the :payment, you may enter the code Otherwise describe the payment. Clvf?'° campaign paraphernalia/mist. ' MBR ntembercominunicsdons RAD radio airtime and production costs CNS :campaign consultants MTG meetings and appearances RFD returned contributions CTBcontribution (explain, nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET :petition circulating TEL t.v or cable airtime and production costs FiL candidate filing/ballot fees PHO phone -banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and, survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services: TSF transfer between committees of the same candidate/sponsor LEG legal; defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature: and mailings PRT ,print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID U Printin :con, . LIT 253.46 City of Atascadero 'i FIL 32000 " Payments that are contributions or)ndependent ezpendltures must also be summarized on Schedule 'D SUBTOTAL$ 573.46 Schedule E Summary 1 'Itemized payments made tHis,period' (Include all Schedule,E subtotals.) $ 57346 2. Unitemized payments made this period of under $100 $ 0 3 Total interest.paid.this period on loans (Enter amount from ScheduleB Pari1 Column (e)) $ 0 4 Total payments made thisperiod. (Add,Lines'1' 2, and 3 Enter here and on the Summary Page Column A, Line 6) TOTAL $ 573.46 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275.3772) It