HomeMy WebLinkAboutForm 460 093010 Committee to Elect Chuck WardRecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from 7/1/2010
through 9/30/2010
Typ,g of Recipient Committee All Committees —complete Parts 1 2, 3, and 4.
Iceholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
Q Recall Q Controlled
(Also Complete Part 5) Q Sponsored
(Also Complete Part 6)
F-1General Purpose Committee
Q Sponsored Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
Q Political Party/Central Committee (Also complete Part 7)
3. Committee InformationI LD %3 R
z
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Committee to Elect Chuck Ward for Council 2010
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
Atascadero CA 93423
OPTIONAL. FAX / E-MAIL ADDRESS
Date of election if applicable:
(Month, Day, Year)
Date Stamp
RECEIVED
OCT - 1 2010
1I
COVER PAGE ,
Page I of
For Official Use Only
11/2/2010 C1jrY OF ATASCADERO I
ITY CLERK'S OFFICE
2. Type of Statement:
Z 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)
Treasurer(s)
NAME OF TREASURER
David Frayer
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODEIPHONE
Atascadero CA 93422
NAME OF ASSISTANT TREASURER, IF ANY
Chuck Ward
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
Atascadero CA 93422
OPTIONAL. FAX / 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 of the State of California that the foregoing is true and correct_--------,,
10/1/2010
Executed on
By
Date
Signature of Treasurer or ssistant TNasurer
10/1/2010
I
Executed on
B�
y
Date
Sig ureofCorxrollingOfficehdder,Candidate,Sta Measure Proponent or Responsible Officer of Sponsor
Executed on
By
Date
Signature of Controlling Officeptilder, Candidate, State Measure Proponent
Executed on
By
Date
Signature of Controlling Officeholder Candidate, State Measure Proponent
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
State of California
Recipient Committee Type or print in ink. COVER PAGE PART 2
Campaign Statement� _ RRM 460
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Chuck Ward
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Seeking position City Council
RESIDENTIAUBUSINESS ADDRESS (NO AND STREET) CITY STATE ZIP
Atascadero CA 93422
Related Committees Not Included in this Statement: Listanycommittees
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
I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
RESS 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 P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Page 2 of I
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION I 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/06)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
State of California
Campaign Disclosure Statement
Summary Page
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
from 7/1/2010
SUMMARY PAGE
SEE INSTRUCTIONS ON REVERSE
through
9/30/2010
Page 3 Of
NAME OF FILER
LD NUMBER
CHUCK WARD
1331768
Contributions Received
Column
Column B
Calendar Year Summary for Candidates
TOTALTHISPERIOD
(FROMATTACHED SCHEDULES)
CALENDAR YEAR
TOTALTO DATE
Running in Both the State Primary and
General Elections
1 Monetary Contributions
Schedule A, Line 3
$ 1924 $
1924
2. Loans Received
Schedule B, Line 3
600
600
1/1 through 6/30 7/1 to Date
3. SUBTOTALCASH CONTRIBUTIONS
Add Lines 1 +2
$ 2524 $
2524
20 Contributions
Received $ $
4 Nonmonetary Contributions
Schedule C, Line 3
21 Expenditures
5 TOTAL CONTRIBUTIONS RECEIVED
Add Lines 3+4
$ 2524 $
2524
Made $ $
Expenditures Made
6. Payments Made
7 Loans Made
8. SUBTOTAL CASH 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 8 + g + 10 $
Current Cash Statement
12. Beginning Cash Balance Previous Summary Page, Line 16 $
13 Cash Receipts Column A, Line 3 above
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 B above $
1865 $
1865 $
0
1865 $
0
1924
600
1865
659
1865
1865
0
1865
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)
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(N 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)
Schedule A
Type or print in ink.
SCHEDULE A
monetary contributions Received "' ole dolof lars. Qy VW'""""G"
to
towhole
Statement covers period
7/1/2010
CALIFORNIA
•
from
FORM
Page 4 of
SEE INSTRUCTIONS ON REVERSE
through 9/30/2010
NAME OF FILER
I.D NUMBER
CHUCK WARD
1331768
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 DEC. 31)
(IF REQUIRED)
OF BUSINESS)
®IND
8/4/2010
David Frayer
❑COM
RETIRED
❑ OTH
100
100
❑ PTY
❑ SCC
®IND
8/4/2010
Chuck Ward
❑conn
RETIRED
100
100
❑ OTH
❑ PTY
❑ SCC
®IND
8/11/2010
Richard Hathcock
❑COM
RETIRED
500
500
❑ OTH
❑ PTY
❑ SCC
Jack Jones
®IND
8/27/2010
❑COM
RETIRED
200
200
❑ OTH
❑ PTY
❑ SCC
Jerry Clay
®IND
9/16/2010
EICOM
��
100
100
❑OTH
I l
❑ PTY
❑ SCC
SUBTOTAL$ 1000
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 j
$ 1,400
$ 524
TOTAL $ 1924
*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)
Schedule A (Continuation Sheet) TvDe or orint in ink. SCHEDULE (CONT)
Monetary Contributions Received Amounts may be rounded
Statement covers period
CALIFORNIA '
to whole dollars.
7/1/2010
FORM
from
9/30/2010
5 97
through
Page of
LD NUMBER
NAME OF FILER
1331768
CHUCK WARD
, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
FULL NAME,
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
Ted Jacobson
❑COM
Meridan Insurance
100
100
9/20/2010
E] OTH
❑ PTY
❑ SCC
David Sanford
a IND
COM
Sanford Stone Co Inc.
300
300
9/29/2010
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
[_]OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL b 400
w '
`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)
Tvnn — —Inf :n Onl.
SCHFnI H F R PART 1
VVI1=UU1C 92 — rCll L I Amounts may be rounded
Statement covers periodFftge___�_
Loans Received to whole dollars.
7/1/2010
_
• 1
from
of
SEE INSTRUCTIONS ON REVERSE
through 9/30/2010
NAME OF FILER
I.D NUMBER
CHUCK WARD
1331768
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OUT
(b)
AMOUNT
(c)
(d)
OUTSTANDING
(e)
r)
(g)
OF LENDER
OCCUPATION AND EMPLOYER
BALANCE
RECEIVED THIS
AMOUNT PAID
BALANCEAT
INTEREST
ORIGINAL
CUMULATIVE
(IFCOMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF-EMPLOYED, ENTER
BEGINNING THIS
PERIOD
OR FORGIVEN
CLOSE OF THIS
PAID THIS
AMOUNT OF
CONTRIBUTIONS
NAME OF BUSINESS)
PERI
THIS PERIOD*
PERIOD
PERIOD
LOAN
TO DATE
Barbara Ward
RETIRED
❑ PAID
CALENDAR YEAR
$
$ 500
%
$ 500
$ 500
❑ FORGIVEN
PER ELECTION"
RATE
$ 0
$ 500
$
11/2/2010
$ 0
9/24/10
$ 500
t® IND ❑COM ❑ OTH ❑PTY [-] SCC
DATE DUE
DATE INCURRED
Chuck Ward
RETIRED
❑ PAID
CALENDARYEAR
$
$ 100
%
$ 100
$ 100
E] FORGIVEN FORGIVEN
PER ELECTION "'•
$ 0
$ 100
$
11/2/2010
$ 0
9/24/10
$ 100
t IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION "
RATE
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
$
$
$$
$
DATE DUE
DATE INCURRED
SUBTOTALS $ $ $ $
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.
$ (66V
NET $
(May be a negative number)
(inter (e) cn
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
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule C Type or print in ink. SCHEDULE C
Amounts may be rounded
NonmonetM Contributions Received to Whole dollars.
Statement covers period
• - ,
7/1/2010
FORM
from
7 �-
9/30/2010
through
Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
CHUCK WARD
1331768
DATE
FULL NAME, STREET ADDRESS AND
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
DESCRIPTION OF
AMOUNT/
FAIR MARKET
CUMULATIVE TO
DATE
PER ELECTION
TO DATE
RECEIVED
ZIP CODE OF CONTRIBUTOR
CODE *
(IF SELF-EMPLOYED, ENTER
GOODS OR SERVICES
VALUE
CALENDAR YEAR
(IF REQUIRED)
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
NAME OF BUSINESS)
(JAN 1 DEC 31)
®IND
David Fray er
❑COM
RETIRED
CREATE
500
500
8/4/2010
WEBSITE
❑OTH
❑ PTY
[:]SCC
❑IND
❑COM
❑ OTH
❑ PTY
❑ SCC
[-]IND
❑COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑COM
❑ OTH
❑ PTY
❑ SCC
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ .�
° _k 777
Schedule C Summary
Amount received this period — itemized nonmonetary contributions.
(Include all Schedule C subtotals.)
2. Amount received this period — unitemized nonmonetary contributions of less than $100
3. Total nonmonetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page Column A, Lines 4 and 10 )
TOTAL $ S42 Z)
*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)
Schedule E Type or print in ink. Statement covers period
Amounts may be rounded
Payments Made to whole dollars. from 7/1/2010
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
CHUCK WARD
through
9/30/2010
CODES If one of the following codes accurately describes the payment, you may enter the code. Otherwise describe the payment.
Page 8 of
I.D. NUMBER
1331768
CWP
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
FIND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
USD
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 AMOUNT PAID
Premium Graphicx Signs
5512 Mitchelldale CMP 382
Houston TX 77092
All Signs CMP Signs
658
2732 EI Camino Real
Atascadero CA 93422
USPS Postage
Atascadero CA 93422 POS 205
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,245
Schedule E Summary
1 Itemized payments made this period. (Include all Schedule E subtotals.) $ 1,573
2. Unitemized payments made this period of under $100 $ 292
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 $ 1,865
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule ESCHEDULEE(CONT.)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Wilkins Printing
6405 EI Camino Real
Atascadero, CA 93422
LIT
Brochures/Buttons
(Continuation Sheet)
Type or print in ink.
Amounts may be roundedCALIFORNIA
Statement covers period
460
Payments Made
to whole dollars.
7/1/2010
FORM
from
SEE INSTRUCTIONS ON REVERSE
through 9/30/2010
Page 9 Of
NAME OF FILER
I.D. NUMBER
CHUCK WARD
1331768
CODES If one of the following codes accurately describes the payment, you may enter the code. Otherwise
describe the payment.
CNP campaign paraphemalia/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS campaign consultants
MTG
meetings and appearances
RFU
returned contributions
CTB contribution (explain nonmonetary)'
OFC
office expenses
SAL
campaign workers' salaries
CVC civic donations
PEr
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
M 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
AMOUNT PAID
Wilkins Printing
6405 EI Camino Real
Atascadero, CA 93422
LIT
Brochures/Buttons
228
Colony Days Committee
PO Box 1913
Atascadero CA 93423
CMP
Booth for local Colony Days Celebration
100
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 328
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)