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HomeMy WebLinkAboutForm 460 123110 Atascadero FirefightersRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 11/20/2010 through 1/31/2011 1. Type of Recipient Committee: All Committees -Complete Parts t, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part s) 0 Sponsored (Also Complete Part 6) 0 General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee InformationI I.D. NUMBER 1312619 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Atascadero Professional Firefighters Local 3600 STREET ADDRESS (NO P.O. BOX) 6005 Lewis Avenue CITY STATE ZIP CODE AREA CODE/PHONE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY NAL: FAX / E-MAIL ADDRESS P CODE AREA CODE/PHONE J COVER PAGE Ntlftt I V E Date of election if applicable: FEB 1 5 2011 Page of (Month, Day, Year) For Official Use Only CITY OF ATASCA ERO CITY CLERK'S OFF CE 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 Matt Vierra MAILING ADDRESS 6005 Lewis Avenue CITY STATE ZIP CODE AREA CODE/PHONE Atascadero CA 93422 NAME OF ASSISTANT TREASURER, IF ANY Bill White MAILING ADDRESS 6005 Lewis Avenue 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'nfor ti contained her in 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. Executed on 2/12/2011 By Date Signature of Treasurer or Assistant Treasurer Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/OS) 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 11/20/2010 SUMMARY PAGE Expenditures Made 6. Payments Made ....................................................... through 1/31/2011 page of SEE INSTRUCTIONS ON REVERSE Add Lines 6 + 7 $ $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 NAME OF FILER Add Lines 8+9+10 $ Zero $ I.D. NUMBER 1312619 Column Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD CALENDAR YEAR Running in Both the State Prima and 9 Primary (FROM ATTACHED SCHEDULES) TOTALTO DATE General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ $ 1/1 through 6/30 7/1 to Date 2. Loans Received...................................................... Schedule B, Line 3 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ $ Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ••••.........•• •. . . ••Add Lines 3+4 $ Zero $ Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ $ 7. Loans Made............................................................. Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8+9+10 $ Zero $ 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 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 $ 661.00 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* (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)