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Home My WebLink AboutForm 460 101610 Committee to Elect Chuck Ward 2010Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 10/1/2010 through 10/16/2010 Typ of Recipient Committee All Committees — Complete Parts 1, 2, 3, and 4. fiOffceholder Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee 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 1331768 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 same OPTIONAL. FAX / E-MAIL ADDRESS COVER PAGE Date Stamp RECEIVED Date of election if applicable: page 1 of 9 (Month, Day Year) OCT 19 2010 For Official Use Only 11/2/2010 TY OF ATASCADERO 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) Treasurer(s) NAME OF TREASURER David Frayer MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE 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 co Executed on �� /' ' , By If D&Te ff,, SignatureotTreasurerorAssistantT surer Executed on 6; V By _ Zdi e e Signet ofContrdlingOfficedder,Can, State Measure Proponent or Responsible Officer of Sponsor Executed on Date Executed on Date By Signature of Controlling Officeholder. Candidate, State Measure Proponent By Signature ofControlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Type or print in ink. Recipient Committee Campaign Statement 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 STATE ZIP RESIDENTIALIBUSINE SS ADDRESS (NO AND STREET) CIT rO CA 93422 any mittees Related Committees Not Included in this Statement: rmarilytformedrto receive not included in this statement that are controlled by y contributions or make expenditures on behalf of your candidacy. �[,D.UMBER COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS CONTROLLED COMMIT I ttz ❑ YES ❑ NO STREETADDRESS (NOPO BOX) CODE AREA STATE ZIP EA CODEIPHONE CITY COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS J.U. NUNIDC1 CONTROLLED COMMIT I tt r ❑ YES ❑ NO STREETADDRESS (NO PO BOX) STATE ZIP CODE AREA CODE/PHONE CITY 6. Primarily Formed Ballot Measure Comminee NAME OF BALLOT MEASURE BALLOT NO, OR LETTER COVER PAGE PART 2 Page 2 of r- ❑ SUPPORT ❑ OPPOSE re proponent, if any. Identify controlling officeholder, candidate, or state measu NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT DISTRICT NO IF ANY OFFICE SOUGHT OR HELD formed. 7 officfeholder(F orneandida Candidate/officeholder (didas) for �hl0ffiich „ eho Im�iQCommittee primarily List names o OFFICE SOUGHT OR HELD ❑ SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE ❑ OPPOSE OFFICE SOUGHT OR HELD ❑ SUPPORT NAME OF OFFICEHOLDER OR CANDIDATE ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD I ❑ SUPPORT ❑ OPPOSE OFFIOFFI OUGHT OR HELDI C]SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FpPC Form 460 (Januaryl05) FpPC Toll -Free Helpline: 866/ASK FPState ofCalifornia Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 10/1/2010 SUMMARYPAGE 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 $ 509 $ 2374 Schedule H, Line 3 through 10/16/2010 Page 3 of 9 SEE INSTRUCTIONS ON REVERSE 2374 0 0 Schedule F Line 3 NAME OF FILER Schedule C, Line 3 Add Lines 8 + 9 + 10 $ I.D. NUMBER CHUCK WARD 1331768 ColumnA Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDARYEAR Running in Both the State Primary and g r (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 1 Monetary Contributions Schedule A, Line 3 $ 617 $ 2541 1/1 through 6/30 7/1 to Date 0 600 2. Loans Received Schedule B, Line 3 617 3141 20 Contributions 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 $ $ Received $ $ 0 500 4 Nonmonetary Contributions Schedule C, Line 3 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+4 $ 617 $ 3641 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 $ 509 $ 2374 Schedule H, Line 3 509 767 Add Lines 6 + 7 $ 509 $ 2374 0 0 Schedule F Line 3 Schedule C, Line 3 Add Lines 8 + 9 + 10 $ 509 $ 2374 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 $ 659 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) 617 0 509 767 - 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) SCHEDULE A Type or print in ink. Schedule A Amounts may be rounded Statement covers period CALIFORNIA J • ' Monetary Contributions Received to whole dollars. 10/1/2010 FORM from 10/16/2010 Page 4 of 9 through SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER 1331768 CHUCK WARD IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR DATE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CONTRIBUTOR OCCUPATION AND EMPLOYER CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 DEC 31) (IF REQUIRED) RECEIVED OF BUSINESS) David Frayer ®IND []COM RETIRED 0 100 8/4/2010 ❑ OTH Atascadero t✓A x ❑ PTY3422 ❑scC Chuck Ward BIND ❑COM RETIRED 0 100 8/4/2010 ❑ OTH Atascadero CA 93422 ❑ PTY ❑SCC Richard Hathcock ®IND ❑COM RETIRED 0 500 8/11/2010 ❑ OTH Shell Beach CA 93449 E] PTY E] Jack Jones IND [:]COM RETIRED 0 200 8/27/2010 ❑ OTH San Luis Obispo CA 93401 ❑ PTY ❑ SCC Jerry Clay ®IND F-1 COM City Councilman 0 100 9/16/2010 ❑ OTH Atascadero, CA 93422 ❑ PTY ❑ SCC SUBTOTAL$ 0 *Contributor Codes Schedule A Summary 300 IND—Individual COM—Recipient Committee 1 Amount received this period —itemized monetary contributions. $ (other than PTY or SCC) (Include all Schedule A subtotals.) 317 OTH — Other (e.g.. business entity) received this period — unitemized monetary contributions of less than $100 $ PTY —Political Party SCC —Small Contributor Committee 2. Amount 3. Total monetary contributions received this period. Summary Page, Column A, Line 1) TOTAL $ 617 FPPC Form 460 (January/05) (Add Lines 1 and 2. Enter here and on the FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period . to whole dollars. 10/1/2010 • - f from 5 9 10/16/2010 through page of NAME OF FILER I.D. NUMBER CHUCK WARD 1331768 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) OFBUSINESS) Ted Jacobson �O E3M Meridan Insurance 9/20/2010 E] OTH 0 100 Atascadero, CA 93422 ❑ PTY ❑ SCC David Sanford ®CND (]COM Sanford Stone Co Inc. 9/29/2010 0 300 ❑ OTH Atascadero CA 93422 ❑ PTY ❑ SCC Andrew Peterson IND OCOM Self Writer 10/1 /2010 — 100 100 ❑ OTH Bradley CA 93426 R PTY ❑ SCC John Oberg W)COM Retired 10/1/2010 100 100 E] OTH Arroro Grange, CA 93420 ❑ PTY ❑ SCC Tim Haley E]COM Retired 10!4/2010 0 100 100 OTH Atascadero CA 93422 ❑ PTY ❑ SCC SUBTOTALS '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) Tvae or print in ink SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded dollars. Statement covers period CALIFORNIA460 to whole 10/1/2010 • RM from 10/16/2010 6 9 through Page of NAME OF FILER NUMBER CHUCK WARD 1I.D 331768 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 (E COMMITTEE, ALSANDZIO ENTER .D.NDEO CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 DEC. 31) (IF REQUIRED) OF BUSINESS) ❑IND THIS PAGE INTENTIONALLY BLANK ❑COM 10/1/2010 ❑ OTH ❑ PTY ❑ SCC RIND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC RIND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ '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) 6101:1:1pill 8� 307Via Schedule B— Part 1 '"` v' ","� I.....�. Amounts may be rounded Statement covers period P . e ' ' Loans Received to whole dollars. 10/1/2010 .. from 10/16/2010 7 9 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER LD NUMBER CHUCK WARD 1331768 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUALENTER , a OUTSTANDING (b) AMOUNTOUTSTANDING (c) AMOUNTPAID (d) (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN gALANCEAT CLOSE C THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE Barbara Ward RETIRED ❑ PAID CALENDAR YEAR $ $ 500 500 500 $ $ ❑ FORGIVEN Atascadero CA 93422 RATE PER ELECTION** $ 500 $ 0 $ 11/2/2010 $ 0 9/24/10 $ 500 DATE DUE DATE INCURRED tv IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Chuck Ward RETIRED ❑ PAID CALENDARYEAR $ $ 100 100 $ 100 $ ❑ FORGIVEN PER ELECTION*" Atascadero CA 53422 RATE $ 100 $ 0 $ 11/2/2010 $ 0 9/24/10 $ 100 DATE DUE DATE INCURRED t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR ❑ FORGIVEN RATE PERELECTION— $ $ $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0 $ $ 600 $ 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 parry 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. 0 N NET $ 0 (May be a negative number) (triter (e) on 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. A A - SCHEDULE C m w ». L... ...�.. Nonmoneta Contributions Received ""'" ole " Mars. � ri to whole dollars.CALIFORNIA Statement covers period 460 . , from 10/1/2010 - Page $ of 9 SEE INSTRUCTIONS ON REVERSE 10/16/2010 h through 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 RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED. ENTER GOODS OR SERVICES VALUE CALENDAR YEAR TO DATE (IF REQUIRED) NAME OF BUSINESS) JAN 1 DEC 31 ( ) WJIND 8/4/2010 David Fraver ❑COM RETIRED CREATE DOTH WEBSITE 0 500 Atascadero CA 93422 El PTY D SCC []IND ❑COM DOTH ❑ PTY ❑ SCC ❑IND ❑COM DOTH D PTY ❑ SCC ❑ IND ❑COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 0 Schedule C Summary 1 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 ) *Contributor Codes 0 IND—Individual $ COM — Recipient Committee 0 (other than PTY or SCC) $ OTH — Other (e.g.. business entity) PTY — Political Party TOTAL $ 0 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 10/1/2010 SEE INSTRUCTIONS ON REVERSE through 10/16/2010 Page 9 of 9 NAME OF FILER LD NUMBER CHUCK WARD 1331768 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/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Atascadero News Atascadero CA 93422 PRT Advertisement 413 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 413 Schedule E Summary 1 Itemized payments made this period. (Include all Schedule E subtotals.) 2. Unitemized payments made 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 ) $ 413 $ 96 TOTAL $ 509 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)