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Home My WebLink AboutForm 460 Nic Mattson 092420Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 07/01/2020 through 09/19/2020 1. Type of Recipient Committee: All Committees -Complete Parts 1,2,3, and 4. ❑X Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot O State Candidate Election Committee Measure Committee O Recall O Controlled (Also Complete Part 5) O Sponsored ❑ General Purpose Committee (Also Complete Part 6.) O Sponsored ❑ Primary Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee {Also complete Part 7.) I.D.NUMBER 3. Committee Information 1 000000 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Nic Mattson for Atascadero City Council 2020 CITY STATE ZIP CODE AREA CODEIPHONE Fresno CA 93710 nnnorec sic nec�co�uT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE Fresno CA 93710 OPTIONAL FAX/E-MAIL ADDRESS COVER WAGE Date Stamp CALIFORNIA �� FORM RECEINED Date of election if applicable: Page 1 / 6 of (Month, Day, Year) )LH k 02o For Official Use Only 11/03/2020 I,,ITY OF 2. Type of Statement: Pre-election Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Varinder Bains. CPA ❑ Quarterly Statement ❑ Special Odd -Year Report MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE Fresno CA 93710 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX/E-MAI LADD R ESS 4. Verification 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 theS to California that the foregoing is true and correct. Executed on 09/21/2020 By Varinder Bains CPA DATE SIGNATURE OF R U E tIR TA Executed on 09/21/2020 By Nic Mattson DATE SIGNATURE OF CONTROLLING OFFICEHOLD , CANDIDATE, STATE MEASU NENT OR RESPONSIBLE OFFICER OF SPONSOR Executed on DATE Executed on DATE By By SIGNATURE OF CONTROLLING OFFICEHOLDFR, CANDIDATE, STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppe.ca.gov (68612753772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Nic Mattson OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Sought: City Council Member Atascadero Ci Council City City of Atasca ero RESIDENTIALBUSINESS 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 to make expenditures on behalf of your candidacy. COMMITTEE NAME I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O.SOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O.BOX) CITY STATE ZIP CODE AREA COD EIPHONE C;JVLH I',%GE - PART 2 CALIFORNIA 4f 0 FORM 2r6 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT 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 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 HELP ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Campaign Disclosure Statement SUMMARY PAGI Page Amounts may be rounded Statement covers period CALIFORNIA Summa /� CO to whole dollars. from 20200701 46 FORM SEE INSTRUCTIONS ON REVERSE through 20200919 316 NAME OF FILER - I.D. NUMBER Nic Mattson for Atascadero City Council 2020 nnnnnn Contributions Received 1. Monetary Contributions ............................................. 2. Loans Received......................................................... 3. SUBTOTAL CASH CONTRIBUTIONS ........................... 4. Nonmonetary Contributions ................................... 5. TOTAL CONTRIBUTIONS RECEIVED .......................... 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 Column A 0.00 Column B Calendar Year Summary for Candidates Schedule H, Line 3 TOTAL TMS PERIOD 0.00 CALENDAR YEAR Runningin Both the State Prima and Add Lines 6 + 7 (FROM ATTACHED SCHEDULES) 0.00 TOTAL TO DATE lPrimary General Elections Schedule A, Line 3 $ 100.00 $ 100.00 150.00 Schedule C, Line 3 $ 0.00 1/1 through 6130 7/1 to Date Schedule B, Line 3 500.00 150.00 500.00 150.00 0.00 Cash Equivalents and Outstanding Debts 20. Con dons Add Lines 1 + 2 $ 600.00 $ 600.00 Received Received $ 0.00 $ 0.00 Schedule C, Line 3 0.00 0.00 21. Expenditures Add Lines 3 + 4 600.00 $ 600.00 Made 3L-- 0.00 $ 0.00 Schedule E, Line 4 $ 0.00 $ 0.00 Schedule H, Line 3 0.00 0.00 Cash Receipts ................................................. Column A, Line 3 above 0.00 Add Lines 6 + 7 $ 0.00 $ 0.00 Schedule F, Lina 3 Cash Payments ................................................. Column A, Line 8 above 150.00 0.00 150.00 Schedule C, Line 3 $ 0.00 0.00 Add Lines 8 + 9 + 10 $ 150.00 $ 150.00 Current Cash Statement 12. Beginning Cash Balance..................... Previous Summary Page, Line 16 $ 0.00 13. Cash Receipts ................................................. Column A, Line 3 above 600.00 14. Miscellaneous Increases to Cash .................................... Schedule 1, Line 4 0.00 Cash Payments ................................................. Column A, Line 8 above 0.00 16. ENDING CASH BALANCE.... Add Lines 12 + 13 + 14, then subtract Line 15 $ 600.00 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 0.00 19. Outstanding Debts ....................... Add Line 2 + Line 9 in Column B above $ 650.00 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 Linea 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/ddiyy) $ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppe.ca.gov (866/275-3772) www.fppc.ca.gov Qwhnrl111n A SCHEDULE A Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period l from 20200701€ I: 4/6 through 20200919 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. Number Nic Mattson for Atascadero City Council 2020 00000a FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE" OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Rcppt Dt: 0 IND Director of Sales and 100.00 100.00 100.00 G20 D9118/2020 [] COM Marketing ❑ OTH ❑ PTY Lighthouse Coffee Atascadero CA 93422 ❑ SCC SUBTOTAL $ 100.00 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 $ 100.00 1 11 100.00 'Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other PTY - Political Party SCC- Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 *cneouie is - rare -I Amounts may be rounded Statement covers period CALIFORNIA Loans Received to whole dollars. �� from 20244701 FORM 516 through 20200919 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Nic Mattson for Atascadero City Council 2020 000000 (a) (b) (c) (d) (e) M (g) FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTION: (IF COMMITTEE. ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS THIS PERIOD THIS PERIOD' CLOSE OF THIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD PERIOD 13 Stars Media ❑ PAID CALENDAR YEAR Haley Mattson s 0.00 $ 500.00 0.00 $ 500.00 $ 500.00 % ❑FORGIVEN PER ELECTION" Co -Founder, President & RATE Atascadero CA 93422 COO 500.00 G 20 $ 0.00 $ 500.00 S 0.00 $ o.00 09/18/2020 DATE DUE DATE INCURRED ❑X IND ❑ COM ❑ QTH ❑PTY ❑ SCC SUBTOTALS $ 500.00 $ 0.00 $ 500.00 $ 0.00 Schedule B Summary (Enter (a)on 1. Loans received this period. $ 500.00 Schedule E, Line 3) (Total Column (b) plus unitemized loans less than $100.) 'Contributor Codes 2. Loans paid or forgiven this period $ 0.00 IND -Individual (Total Column (c) plus loans under $100 paid or forgiven.) COM -Recipient Committee (othehan PTY or SCC)Include loans paid by a third party that are also itemized on Schedule A.) OTH-Other (e.g. business entity) 3. Net � (Subtract Line 2 from Line 1. period, this change Net $ 500.00 PTY -Political Party p Enter the net here and on the Summary Page, Column A, Line 2. (may be a negative number) SCC -Small Contributor Committee Amounts forgiven or aid b another a also must be reported on Schedule A. FPPc Form (86 (27513742) ** If required. g p Y p p FPPC Advice: advlce�fppc.ca.gov{B6sl2753772j Schedule F Accrued Expenses (Unpaid Bills) Amounts may be rounded to whole dollars. Statement covers period from 20200701 SCHEDULEF CALIFORNIA ��O FORM SEE INSTRUCTIONS ON REVERSE (a) through 20200919 6/6 NAME OF FILER CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID 1.0, NUMBER Nic Mattson for Atascadero City Council 2020 DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) a00000 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 nonmonelary)* OFG office expenses SAL, campaign workers' salaries GVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filinglballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS stafflspouse travel, lodging, and meals IND independent expenditure supportinglopposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, email) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS $ Q,QQ $ 150.00$ 0.00 $ 150.00 Schedule F Summary 1, Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) .................................................. INCURRED TOTALS $ 150.00 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ..................................... PAID TOTALS $ 0.00 3. Net change this period. ( Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)........................................................................................................................................................... NET $ 150.00 May be a negative number. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (6661275-3772) ........ A--- -- ...... (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING pF coMMIrrEE, ALSO EKFTER LD. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD 0.00 150.00 0.00 150.00 Integrated Solutions: Political Online Disclosure Service PanPieqo= CA 92116 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS $ Q,QQ $ 150.00$ 0.00 $ 150.00 Schedule F Summary 1, Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) .................................................. INCURRED TOTALS $ 150.00 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ..................................... PAID TOTALS $ 0.00 3. Net change this period. ( Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)........................................................................................................................................................... NET $ 150.00 May be a negative number. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (6661275-3772) ........ A--- -- ......