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Home My WebLink AboutForm 460 Committee to Elect Bob Kelley 123108Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print In ink. Statement covers period from 10/19/2008 through 12/31/2008 Date of election if applicable - (Month, Day, Year) 11/04/2008 1 Type of Recipient Committee- All Committees — Complete Parts 1 2, 3, and 4. 1 2. Type of Statement: F E B - 2 2008 CITY OF ATASCADEI CITY CLERK'S OFFIC 11 COVER PAGE Page ' of ' For Official Use Only ® Officeholder Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement Q State Candidate Election Committee Committee ® Semi-annual Statement ❑ Special Odd -Year Report Q Recall (Also Complete Part 5) Q ControlledE]Termination Q Sponsored Statement Supplemental Preelection Also file a Form 410 Termination ( ) Statement Attach Form 495 ❑ General Purpose Committee (Also Complete Part 6) ❑ Amendment (Explain below ( P ) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D NUMBER 1247989 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Bob Kelley STREET ADDRESS (NO P.O BOX) CITY STATE ZIP CODE AREA CODE/PHONE Atascadero Ca 93422 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR PO 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 Atascadero Ca 93422 NAME 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 nowledge the information contained herein and in the attached schedules is true and complete. 1 certify under penalty of perjury under the laws of the State of California that the foregoing is true and car CE. Executed on 01/30/2008 By Date j S' re ofTre ref rAssistant Treasurer Executed on 01/30/2008 By /J Data Signature of Controlling OfflosholcipfoCandidate, State Measure Proponent or Responsible Officer of Sponsor Executed on Date By Signature of Controlling Offceholder,Candidate, State Measure Proponent Executed on By Date Signature of Controlling Ofilcelwlder, Candidate, State Measure Proponent FPPC Form 480 (January/05 FPPC Toll -Free Helpline: 888/ASK-FPPC (888/275-3772 State of Califomi, Recipient Committee Type or print in ink. COVER PAGE PART2 CALIFORNIA A Campaign Statement • 1 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 RESIDENTIAUBUSINESS 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 ILD NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME LD NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE 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 candidete(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 Toil -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. SUMMARY PAGE Statement covers period frnm 10/19/2008 through 12/31/2008 Page 3 of 6 NAME OF FILER LD NUMBER Committee to Elect Bob Kelley 1247989 Expenditures Made Column A Column B Calendar Year Summary for Candidates Contributions Received Schedule E, Line 4 TOTALTHISPERIOD CALENDARYEAR Running In Both the State Primary and g r 7 Loans Made Schedule H, Line 3 (FROM ATTACHED SCHEDULES) TOTALTO DATE 0 8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ 227089 General Elections 1 Monetary Contributions Schedule A, Line 3 $ 94600 $ 233700 0 10. Nonmonetary Adjustment Schedule C, line 3 328.89 911.24 1/1 through 6130 7/1 to Date 2. Loans Received Schedule B, Line 3 $ 227089 $ 3423.24 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2 $ 127489 $ 3248.24 20. Contributions Received $ $ 12. Beginning Cash Balance 4 Nonmonetary Contributions Schedule C, Line 3 0 0 21 Expenditures Column A, Line 3 above 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 + 4 $ 127489 $ 3248.24 Made $ $ Expenditures Made 6. Payments Made Schedule E, Line 4 $ 2270.89 $ 3423.24 7 Loans Made Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 $ 227089 $ 3423.24 9. Accrued Expenses (Unpaid Bills) Schedule F Line 3 0 0 10. Nonmonetary Adjustment Schedule C, line 3 0 0 11 TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10 $ 227089 $ 3423.24 Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 $ 123168 To calculate Column B, add 13 Cash Receipts Column A, Line 3 above 127489 amounts in Column A to the 0 corresponding amounts 14 Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B of your last 227089 report.amounts in 15. Cash Payments Column A, Line 8 above Column Aomay be negative 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 23568 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17 LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ 0 for this calendar year only carry over the amounts from Lines 2, 7 and 9 (if Cash Equivalents and Outstanding Debts any) 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2 + line 9 in Column B above $ 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) J� $ *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 Ar -had iila A Type or print in ink. SCHEDULE Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period 10/19/2008CALIFORNIA from • • RM 12/31/2008 4 6 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER LD NUMBER Committee to Elect Bob Kelley 1247989 DATE FULL NAME, STREET 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 DEC. 31) (IF REQUIRED) OF BUSINESS) ® IND Donald D Idler ❑coM Owner, Idler Appliances 15000 15000 10/31/08 - ❑ 0TH Paso Robles, Ca 93446 ❑ PTY ❑ SCC Z IND Ted A. Jacobson ❑COM Owner, California 10000 10000 10/31/08 _i ❑OTH Meridian Atascadero, Ca 93422 ❑ PTY ❑ ScC ❑ IND HBBACC-PAC #1279679 ®coM 25000 25000 10/31/08 ❑ OTH San Luis Obispo, Ca 93401 ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 500 00 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 $ 50000 44600 94600 *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/05 FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772 Tu e — rint in Ink SCHEDULEB-PART1 Schedule B — Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. 10/19/2008 .. • from 5 6 12/31/2008 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Committee to Elect Bob Kelley 1247989 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE ibi AMOUNT (c) AMOUNT PAID OUTSTANDING BALANCEAT e INTEREST ORIGINAL 9 CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IFSELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN CLOSE OF THIS PAID THIS PERIOD AMOUNT OF LOAN CONTRIBUTION! TO DATE NAMEOFBUSINESS) THIS PERIOD"` Bob Kelley Realtor Bob Kelley ❑ PAID CALENDARYEAR Realty $ 0 $ 328.89 0 % $ 328.89 $ 328.89 Atascadero, Ca 93422 ❑ FORGIVEN RATE PER ELEc nON' $ 0 $ 32889 $ 0 Demand $ 0 10/19/08 $ DATE DUE DATE INCURRED to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR Bob Kelley Realtor Bob Kelley 0 $ 32889 0 32889 328.89 Realty $ % $ $ Atascadero, Ca 93422 ❑ FORGIVEN RATE PER ELECTION $ 328.89 $ 0 $ 0 Demand $ 0 10/01/08 $ DATE DUE DATE INCURRED t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Bob Kelley Realtor, Bob Kelley ❑ PAID CALENDAR YEAR ■ Realty $ 0 $ 25346 0 % $ 25346 $ 25346 PER ELECTION" Atascadero, Ca 93422 ❑ FORGIVEN RATE $ 25346 0 0 Demand $ 0 8/25/08 $ $ $ DATE DUE t® IND E] COM ❑ OTH El PTY El SCC DATE INCURRED SUBTOTALS $ 328.89$ 0 $ 911.24 $ 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 ) Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. $ (i nter (e) on Schedule E, Line 3) 328.89 tContributor Codes N NET $ 328.89 (May be a negative number) 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/05 FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Elect Bob Kelley Type or print in ink. Amounts may be rounded to whole dollars. Statement covers periodCALIFORNIA ' from 10/19/2008 FORM through 12/31/2008 Page 6 of 6 LD NUMBER 1247989 CODES If one of the following codes accurately describes the payment, you may enter the code. Otherwise describe the payment. CMP campaign paraphernalia/misc. 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/sponsc 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 Cross & Oberlie LIT 328 8( Neonah, WI 54956 Atascadero News PRT 1900 0( Aascadero, Ca 93422 ` Payments that are contributions or independent expenditures must also be summarized on Schedule D SUBTOTAL$ 2228 8! Schedule E Summary 1 Itemized payments made this period (Include all Schedule E subtotals.) $ 222889 2 Unitemized payments made this period of under $100 $ 4200 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 $ 227089 FPPC Form 460 (January/05 FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772