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Home My WebLink AboutForm 460 Committee to Elect Tom OMalley 123109Recipient Committee Campaign Statement Cover Page Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 7/1/2009 through 12/31/2009 Date of election if applicable: Month, Day, Year) COVER PAGE Date Stamp RECEIVE JAN 2 1 20101 Page 1 of 7 For Official Use Only CITY OF ATASCAI CITY CLERK'S OF 1 Type of Recipient Committee All Committees -Complete Parts 1 2, 3, and 4. 2. Type of Statement: MAILING ADDRESS (IF DIFFERENT) NO AND STREET OR P.O BOX CITY STATE ZIP CODE AREA CODE/PHONE Atascadero CA 93423 OPTIONAL. FAX / E-MAIL ADDRESS Treasurer(s) NAME OF TREASURER William b Ausman MAILING ADDRESS CITY STATE ZIP CODE Atascadero CA 93422 ( NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL. FAX I E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete I certify under penalty of perjury under the laws f theStateof California that the foregoing is true and act. Executed on ` r " % By Date Sign o e erorAssistantTreasurer Executed on ' By Date Signature of Co olfing hol , dldat Proponent or Responsible Officer ofSponsor Executed on By Date Signature of Controlling Officeholderr, Candidate, State Measure Proponent Executed on BY Dam Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/2753772) State of California Type or print in ink. COVERPAGE PART2 Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Tom O'Malley OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Council Member, City of Atascadero RES IDENTIAUBUSINESS 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. COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? YES NO COMMITTEE ADDRESS STREET ADDRESS (NO PO. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? YES NO CALIFORNIAA FORM _r60 Page 2 of 7 6. Primarily Formed Ballot Measure Committee NAME OFBALLOT MEASURE 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 Fomled Candidate/Officeholder Committee List names of officeholder(s) or candidates) for which this committee Is primarily formed. COMMITTEE ADDRESS STREET ADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets If necessary 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 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 888/ASK-FPPC (868/275-3772) State of California Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period frnm 7/1/2009 SUMMARY PAGE Expenditures Made 6. Payments Made 7 Loans Made 8. SUBTOTALCASH PAYMENTS 9 Accrued Expenses (Unpaid Bills) 10 Nonmonetary Adjustment 11 TOTAL EXPENDITURES MADE Schedule E, Line 4 $ Schedule H, Line 3 Add Lines 6 + 7 $ Schedule F, Line 3 Schedule C, Line 3 Add Lines 6 + 9 + 10 $ 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 i,Line 4 15 Cash Payments Column A, Line 8above 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 B above $ 75480 $ 754.80 0 0 through 12/31/2009 Page 3 of 7 SEE INSTRUCTIONS ON REVERSE 0 0 754.80 $ 754.80 NAME OF FILER the first report being filed 0 I.D. NUMBER CTETO any) 1245724 Column A Column B Calendar Year Summary for CandidatesContributionsReceivedTOTALTHISPERIODCALENDARYEARPrimaryRunninginBoththeStatePrimaand FROMATTACHEDSCHEDULES) TOTALTODATE General Elections 1 Monetary Contributions Schedule A, Linea 119200 $ 1192.00 0 0 1/1 through 6/30 7/1 to Date 2. Loans Received Schedule B, Line 3 3 SUBTOTAL CASH CONTRIBUTIONS Add Lines i + 2 1192.00 $ 1192.00 20, Contributions Received $ $ 4 Nonmonetary Contributions Schedule C,Line 3 0 0 21 Expenditures 5 TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 1192.00 $ 119200 Made $ $ Expenditures Made 6. Payments Made 7 Loans Made 8. SUBTOTALCASH PAYMENTS 9 Accrued Expenses (Unpaid Bills) 10 Nonmonetary Adjustment 11 TOTAL EXPENDITURES MADE Schedule E, Line 4 $ Schedule H, Line 3 Add Lines 6 + 7 $ Schedule F, Line 3 Schedule C, Line 3 Add Lines 6 + 9 + 10 $ 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 i,Line 4 15 Cash Payments Column A, Line 8above 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 B above $ 75480 $ 754.80 0 0 754.80 $ 754.80 0 0 0 0 754.80 $ 754.80 47164 To calculate Column B, add 1192.00 amounts in Column A to the corresponding amounts0 from Column B of your last report. Some amounts in Column A may be negative 754.80 34 44 figures that should be subtracted from previous 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) Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" If Subject to Voluntary Expenditure Llmlt) 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 Type or print in ink. SCHEDULE A Amounts may be rounded Statement covers period < to whole dollars. 7/1/2009 • ' from 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 $ 400 729 1192 IND— Individual COM — Recipient Committee other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC —Small Contributor Committee FIR PC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 12/31/2009 4 7 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER CTETO 1245724 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 COMlvly 100 100 9/30/2009 El OTH a Atascadero, CA 93422 PTY SCC ZIND K. Retired 100 10010/03/2009 OTH Atascadero, CA 93422 PTY cc IND R. Mc Daniel n 00 Sheriff's Property Officer 100 100 10/09/2009 OTH San Luis Obispo County Atascadero, CA 93422 PTY SCC IND J o El COM Retired 100 100 10/30/2009 0TH Atascadero, CA 93422 PTY ScC IND COM OTH PTY SCC SUBTOTAL$ 400 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 $ 400 729 1192 IND— Individual COM — Recipient Committee other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC —Small Contributor Committee FIR PC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) SCHEDULEB PART1 yNc vi Niuu u wn. Schedule B — Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. 7/1/2009 from 12/31/2009 5 7 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER CTETO 1245724 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER DENIFSELF-EMPLOYED, EN BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNTaF CONTRIBUTIONS IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAMEOFBUSI PERIOD PERIOD THIS PERIOD" PERIOD LOAN TO DATE PAID CALENDAR YEAR Tom O'Retired 0 2192440 NA Atascadero, CA 93422 FORGIVEN RATE PER ELECTION- LECTION- 2192440 2192440 0 0 DATE DUE DATE INCURREDtvIND COM OTH PTY SCC 0 PAID CALENDAR YEAR PER ELECTION"" FORGIVEN RATE DATE DUE DATE INCURRED tEl IND COM OTH PTY SCC PAID CALENDAR YEAR FORGIVEN RATE PER ELECTION" DATE DUE DATE INCURREDtElIND COM OTH PTY SCC SUBTOTALS $ $ $ 2192440 $ 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. S; 4 6 NET $ 0 Maybe a negedve number) k--, Schedule E, Line 3) tContributor Codes IND — Individual COM — Recipient Committee other than PTY or SCC) OTH — Other (e,g business entity) PTY—Political Party SCC —Small Contributor Committee Amounts forgiven or paid by another party also must be reported on Schedule A. Il FPPC Form 460 (January/05) If required. j FPPC ToiWree Helpline: 866/ASK-FPPC (866!2753772) Schedule C Type or print in ink. SCHEDULE Cemn"nlc mom,. 4,n •"u...4 A IVO(tmonetary C ontrioutions Received to whole dollars. yc Statement covers period ELSY-11 1-4 1 from 7/1/2009 IN • SEE INSTRUCTIONS ON REVERSE through 12/31/2009 Pae 6 of 7 g NAME OF FILER I.D. NUMBER CTETO 1245724 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION RECEIVED IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE IF SELF-EMPLOYED, GOODS OR SERVICES VALUE CALENDAR YEAR TO DATE IF REQUIRED) NAME OF BUSINESSS)) JAN 1 DEC 31) IND COM 0TH PTY SCC IND COM OTH PTY SCC IND COM 0TH PTY SCC MIND COM 0TH PTY SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1 Amount received this period —itemized non monetary contributions Include all Schedule C subtotals.) 2 Amount received this period — unitemized nonmonetary contributions of less than $100 3 Total non monetary contributions received this period Add Lines 1 and 2 Enter here and on the Summary Page, Column A, Lines 4 and 10 ) Contributor Codes 0 IND — Individual COM — Recipient Committee 0 ( other than PTY or SCC) OTH — Other (e.g. business entity) PTY—Political Party 0 SCC—Small Contributor Committee TOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2753772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7/1/2009 through 12/31/2009 Page 7 of 7 NAME OF FILER I.U. NUMOtr% CTETO 1245724 CODES. If one of the •following codes accurately describes the payment, you may enter the code Otherwise, describe the payment. CMP campaign paraphemalia/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 fundralsing 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 Portola Event ning tables, chairs, sound system, decorations, FND event venue, planning 500 Atascadero, CA 93423 Ad Pro website annual hosting fees, registration fees WEB 254.80 Paso Robles, CA 93446 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 754.80 Schedule E Summary 1 Itemized payments made this period. (Include all Schedule E subtotals) $ 754 80 2 Unitemized payments made this period of under $100 $ 0 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 $ 754.80 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2753772)