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Home My WebLink AboutForm 460 Mark Dariz 063020Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 1/1/20 through 6/30/20 1. Type of Recipient Committee: Ali committees - complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee Q Recall O Controlled (A)soCamplelePart 5; O Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also complete Part rI 3. Committee InformationI I.D-NUMSER 1407272 COMMITTEE NAME (OR CANDIDATE S NAME IF NO COMMITTEE) Mark Dariz Committee to Elect for Atascadero City Council ,7C j SF3 City STATE ZIP CODE AREA CODEIPHONE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO, AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX I E-MAILADDRCSS COVER PAGE Date Stamp RECEIVED Date of election if applicable: page 1 of 3 (Month, Day, Year) L 20LU For Official Use Only tJov. Cry 2_Gtl� iTyOFATASCADEROI -- CITY CLERK'S OFFICE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Sue Dariz MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE 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 of the State of California that the foregoing is true and correct. Executed on 7/27/20 By s Dale sigrofNireasugg or ASSztant Treasurer Executed on 7/27/20 B Gate 5i 1 of Controlling Officeholder, Ca c Measure Proponent or Responsible macer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate. Slate Measure Proponent Executed on By Date Signature of Controlling Dtficeholder. Candidate, Slate Measure Proponent FPPC form 460 (Jan/2016} FPPC Advice: advice@fppc.ca.gov (866/275-3772) www fnne ra anv Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Mark Dariz OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council, City of Atascadero RES IDENTIALIBUSINESSADDRESS (NO.ANDSTREET) 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 I I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O, BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 3 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state treasure 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 (Jan/2416) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. REVERSE NAME OF FILER Contributions Received 1. Monetary Contributions................................................... Schedule A, Line 3 $ 2. Loans Received................................................................ Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines l+2 $ 4. Nonmonetary Contributions ............................................ schedule G Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ..... ....... ......... ........ ....... Add Lifts 3+4 $ Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 0 $ $ $ from Statement covers period 1/1/20 SUMMARY PAGE through 6/30/20 Page 3 of 3 Column B CALENDAR YEAR TOTAL TO DATE 0 Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ $ 7. Loans Made....................................................................... Schedule li une 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 $ $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 0 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above add amounts in Column A to the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 amounts from Column B 15. Cash Payments......................................................... Column A, une E above of your last report Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12+ 13 + 14, then subtract Line 15 $ 0 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ Schedule 8,Part 2 $ filed for this calendar year. only carry over the amounts from Lines 2, 7, and 9 (d 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 $ 0 11407272 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* to subj t to voluntary Expendaure Limit) Date of Election Total to Date (mm/dd/yy) 3 3 *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov