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Home My WebLink AboutForm 460 Tori Keen 102220Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 9/20/2020 through 10/I712020 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. [� Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee committee 0 Recalll J Controlled (A130 compwe F'an 5) Sponsored lAlsc Compi le Pan fiJ ❑ eneral Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political PartylCentral Committee iAlm Complete Pan 1) 3. Committee Information I,D. NUMBER 1428685 Keen for Council 2020 CA 93422 Atascadero CA 93423 OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification Date of election if applicable; (Month, Day, Year) Date Stamp RECEIVED OCT 2 2 2020 COVER PAGE= Page _L_ of For Official Use Only 11/3/2020 rolITY TY OF ATASCADER� CLERK'S OFFIC 2. Type of Statement: Z Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Repoli ❑ Termination Statement (Also file a Farm 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Rachel McElhinnev MAILING ADDRESS C{TY STATE ZIP CODE AREACODEIPHONE Atascadero CA 93423 NAME OF ASSkSTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODF/PHONE OPTIONAL: FAX,E-MAIL ADDRESS 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 perju ry under the laws of the State of California that the fofeggi Is t e e Executed on i i) j o` d G �Lc By le ,gnat o asurer or ssrstaM reasurer Executed on —1 `r�� r & 1 " zoB Z' Date IF 3ronatoleNC,22jLgWQOfficeholder, Candidate, Slate Measure Proponent or Responsible Officer of Sponsor Executed on I ate Executed on ate By Signature of Contrcikig Offic,ehoider, randrate. State MeasLre Proponent By Signature of ConlrulfiN Officeholder, candidate, State Measure Proponent FPPC Form 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov {866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Victoria Keen OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Atascadero City Council RESIDENTIALIBUSINESSADDRESS (NO.ANDSTREET) CITY STATE ZIP Atascadero CA 93422 Related Committees Not Included in this Statement: List any committees not Included in this statement that ane controlled by you or are primarily formed to receive contributlons or make expenditures on behalf of your candidacy. NOW1 i NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE TTEE NAME NAME OF TREASURER I.D. NUMBER ❑ YES ❑ NO CITY STATE ZIP CODE AREACODEIPHONE COVER PAGE - PART 2 Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER! JURISDICTION IFi ❑SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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 shoots if necessary FPPC Form 450 ilan/2016} FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded to whole doll.ns. Summary Page SEE INSTRUCTIONS ON REVERSE Statement towns period from 9/20/2020 through 10/17/2020 Page -zit— of I NAME OF FILER I.D. NUMBER Keen for Courna12020 1428685 Contributions Received Column A Column B TOTAL THIS PERIOD CALENDAR YEAR (FR(XM ATTACHED SCHEDULES) TOTAL TO DATE 1. Monetary Contributions................................................... schedule A, Line 3 $ 1,678.03 _ $ 8,468.87 2. Loans Received................................................................ schedule B. Line 3 0 0 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 1,678.03 $ 8,468.87 4. Nonmonetary Contributions ............................................ schedule C, Lim 3 66.76 316.76 5. TOTAL CONTRIBUTIONS RECEIVED ........................ ........ Add Lines 3+4 $ 1,74479 $ 8,785.63 _ 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 Bilis).......................................... Schedule F Line 3 10. Nonmonetary Adjustment ........................................................ schedule C, Line 3 11. TOTAL EXPENDITURES MADE .................................... Add Lines 8+ 9+ to Current Cash Statement 12. Beginning CEsh Balance ............................ Previous summary Page, Line 16 13. Cash Receipts ........................................................... Cclurrm A Line 3 above 14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 15. Cash Payme its ......................................................... Cclurrin A, Line s above 16. ENDING CASH BALANCE ................. Addunee 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Lin) 16 must be zero. 17. LOAN GUARANTEES RECEIVED $ 2,802.08 0 $ 2,802.08 0 66.76 $ 2,868.84 $ 4,652.02 1,678.03 0 2,802.08 _ $ 3,527.97 Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see insbuc6ons on reverse $ 0 19. Outstanding Debts .............................. Add Line 2+ Line 9 in Column B above $ 0 $ 4,940.90 0 $ 4,940.90 0 316.76 $ 5,257.66 To calculate Column B, add amounts in Column A to the corresponding amounts fron Column B of your last niport. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the fir report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). C21lendar Year Surtlmary for Candidates Running in Both the State Primary and General Elections 1/1 Through 6/30 7/1 to Date 20 Contributions Received $ _ $ 21 Expenditures Made $ _ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made` in Subject M, voluntary E> mdiEWn Linn) Date of Election Total to Date (mm/dd/yy) 'Arnounts in this section may be different from amounts rerorted in Column B. FPPC Form 495(Feb/2019) FPPC Advice: ad lice@fppc.ca.gov (SE6/275-3772) wwvl.fppc.ca.gov Schedulo A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whale dollars. Statement covers period • , 4 ' from 9/20/2020 • through 10/17/2020 SEE INSTRUCTIONS ONREVERSE NAME OF FILET I.D. NUMBER Keen for Council 2020 1428685 FULL NAME, STREET ADDRESS MID ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * PCCUPATiON AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED QF C(WMITTEE,ALSO ENTER ID, NDMBER) CODE tIF SELF-EMPLOYED, LNTeR NAME PERIOD (JAN.1-DEC. 31) (IF REQUIRED) JZ IND 9/20/2020 Susan Funk El COM Consultant $21.29 $371.29 ❑ OTH The Kailos Group, Inc Atascadero, CA 93,422 ❑ PTY ❑ SCC -_— ❑ IND 9/21/2020 Law Office of W illiam Ausman ❑ COM $250 $250 ® OTH Atascadero, CA 93422 ❑ PTY ❑ ScC ® IND 9/25/2020 Donna McCloske ❑ COM Siopist $104.15 $104.15 ❑ OTH Donna McCloskey Clovis, CA 9361 a ❑ PTY ❑ $CC ® IND 9/28/2020 V Pierce ❑COM unemployed $62.62 $266.77 ❑ OTH Atascadero, CA 93422 ❑ PTY ❑ SCC ®I N D 10/2/2020 Victoria Carrawa ❑ COM Ps enatal & Postpartu at $100 $100 ❑ OTH Wellness Advocate Atascadero, CA 93422 41 El Victoria Carranza [3 SCC SUBTOTAL $ 538.06 1 1 Schedule A Summary Amount roceived this period — itemized monotary contributions. (Include all Schedule A subtotals.).......................................................................................................$ 2. Amount roceived this period — unitemized monetary contributicGns of less than $`100 1,248.06 429.97 ...................... $ 3. Total monetary contributions received this period. Add Lines 1 and 2. Inter I -ere and on the Summa Page, Column A, Line 1. .......TOTAL $ 1,678.03 "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 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov 1866/275-3772) www.fppc.ca.gov Schedule! A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period • . from 9/20/2020 • through 10/17/2020 Page of NAME OF FILES I.D. NUMBER Keen for Council 2020 1428685 FULL NAME, STREET ADDRESSAND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * C,CCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMIT7EE,ALSO ENTER I.D. Nl1M6ER) CODE (IF SELF-EMPLOYED, ENTER NAME) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) ❑ IND 10/2/2020 Central Coast Liubor Council ® COM $300 $300 ❑ OTH Camarillo, CA 93012 ❑ PTY Cil ❑ SCC ® IND 10/6/2020 Kathie Asdel ❑ COM F.mily Therapist $110 $110 ❑ OTH K;ithie Asdel Atascadero, CA 93422 ❑ PTY ❑ SCC ®IND 10/14/2020 BethanyFish Fisher ❑ COM Nurse Practitioner $300 $300 ❑ OTH Al for Health Atascadero, CA 93422 ❑ PTY ❑ SCC ❑IND ❑ coM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY SC C SUBTOTALS 710 *Contributor C odes IND — Individt at CDM — Recipient Committee (other than PTY or SCC) OTH — Other, e.g., business entity) PTY — Pohfictd Party SCC — Small Contributor Committee FP PC Form 496(Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded SCHEDULE C 14onmonetanr Contributions Received �r vvvv •� Statement ewers period e. I t frorn 9/20/2020 0. • through 10/17/2020 r- Page of EEE INSTRUCTIONS 014 REVERSE -10— 61Al2€6F-FICE{F— I.D.NUMBER Keen for Council 2420 • 1428685 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR FAN INDIVIDUAL, EWER OCCUPATION AND EMPLOYER DESCRIPT ON OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION DATE RECEIVED ZIP CODE OF CONTRIBUTOR OF COMMITTEE, ALSO EN TER I.D. NUMBER) CODE ♦ (IF SEMEOF OOOD30R SERVICES FAIR MARKET VALUE CALETO (IF REQUIRED) BUSINESS) NAME OF BUSINE93) (JAN 1- DECDAR 31) (.IAN 1 -DEC 31) ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ oTH ❑ PTv ❑ scc Attach additional nformalion on apAropriately labeled continuation sheets. SU13TOTAL $ Schedule C Summary i, Amount received this period — itemized nonmonetelry contributions. 0 (Include all Schedule C subtotals.)......................................................................................................................$ 66.76 S:. Amount received this period - unitemized nonmon3tary contributions of less than $10D ..................................$ _ ;I, Total nonmonetary contributions received this period. 66.76 (Add Lines 1 and 2. Enter here slid on the Summary Page, Column A, Lines 4 and 10.).....................TOTAL $ _ 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 496(Feb/2019) FPPC Advice: advice@fppc.ca.gov (666/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Keen for Council 2020 Amoints may be rounder! :o whole dollars. Stateme it covers period from 9/20/2020 through 10/17/2020 CODES: If one of the following codes accurately describes the peyment, you may enter the code. Otherwise, describe the payment. Page It 1428685 CMP campaign paraphernalia/misc. MBR rrember communications RAD radio airtime and production costs CNS campaign consultants MTG rreetings and appearar ces RFD retumed contributions CTB contribution (explain nonmonetary)' OFC ofioe expenses SAL campaign workers' salaries CVC civic donations PET p.tition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO prone banks TRC candidate travel, lodging, and meals FND fundraising events POL pilling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supportinc?opposing others (explain)' POS p3,stage, delivery and messenger services TSF transfebetween committees of the same candidata/sponsor LEG legal defense PRO p-ofessional services (/,gal, accounting) VOT voter registration LIT campaign literature and mailings PRT pint ads WEB informa tion technology costs (internet, e-mail) NAME ANDADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID ff COMMiTTFE,ALSO ENTER I.O. NUMBS 1) FacebookI Promoting R.cebook posts M mlo Park, CA 94025 USPS POS Atascadero, CA 93422 Cornerstone Primingj LIT Novato, CA 94949 Ik * Payments that are ;ontributions or independent expenditures must also be summad2 ad on Schedule D. Schedule E 'summary $221.19 $756.80 $1,266.x,0 S1113TOTAL $ 2,244.59 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).)............................................................................ $ 2,611.63 190.45 4. Total payments made this perioJ. Add Lines 1, 2, and 3. Enter here and on the Surnmary Page, Column A, Line 6. .. TOTAL $ 2,802.08 FPPC Form 496 1 Feb/2019) FPPC Advice: advice@fppc.ca.gov (866,'275.3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTION:, ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Statement covers period 9/20/2020 from through 1 0 1 712020 SCHEDULE E (CONT.) Page � of LD. NUMBER Keen for Counc 12020 1428685 CODES: If ons of the followina codes accurately describes the payment, you mai enter the code. Otherwise, descrbe the payment. CMP campaign paraphernalialmisc, MBR nember communications RAD radia alirtime and production costs CNS campaign consultants MTG neetings and appear<nces RFD return:d contributions CTB contribution mxplain nonmonetary'' OFC )ffice expenses SAL campaign workers' salaries CVC civic donations PFT ietition circulating TEL t.v. or ;able airtime and proCuction costs FIL candidate ffli iglballot fees PHO )hone banks TRC candidate travel, lodging, and meals FND fundraising events POL lolling and survey res3arch TRS stafflsoouse travel, lodging, and meals IND independent expenditure supportinglopposing others (explain)` POS )ostage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO )rofessional services legal, accounting) VOT voter I egistration LIT campaign lite nature and mailings PRT xint ads WEB information technology cosh; (intemet, e-mail) NAME AND ADDRESS OF PAYE E (IFCOMMIT'£E,ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Ben Christian ,itascadero, CA 93422 PRO $250.00 The Artery Atascadero, CA 93442 FND $11-1.(4 " Payments that are contributions or independent expenditures must also be summar zed on Schedule D. SUBTOTAL $ 367.04 FPPC Form 49f Feb 2019 FPPC Advice: ad%,ice@fppe.ca.gov (866/275-3772) www,fppc.ca.gov