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HomeMy WebLinkAboutForm 460 Mattson 063021 AmendmentRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 1/1/2021 through 6/30/2021 1. Type of Recipient Committee: All Committees - complete Parts 1, z, 3, and 4. mJ ceholder, Candidate Controlled Committee (Slate Candidate Election Committee 0 Recall {APoo cmvwo Port 5) ❑ eneral Purpose Committee Sponsored Small Contributor Committee Political Party/Central Committee 3. Committee Information Nic Mattson for Atascadero City Council 2020 ❑ Primarily Formed Ballot Measure mmittee Controlled Sponsored (iso Cp+06 Porn ®) ❑ Primarily Formed Candidate/ Officeholder Committee (Aran 0-000 PoR 7) I.D. NUMBER 1431600 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Atascadero CA 93422 MAILINO ADDRESS iIF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAXIE-MAILADDRESS Date of election If applicable: (Month, Day, Year) 11/03/2020 COVER PAGE Date Stamp CALIFORNIA RECEIVE ' Page of SEP 2 J ff,, 2021 For Official Use Only CITY OF ATASCADE CITY CLERK'S OFF] 2. Type of Statement: ❑ Preelection Statement m Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Temtination) m Amendment (Explain below) Wrong summary parte included. Treasurer(s) NAME OF TREASURER MAILING ADDRESS ❑ Quarterly Statement ❑ Special Odd -Year Report CITY STATE ZIP CODE AREACODElPH NE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACOOEIPHONE OPTIONAL: FAX 1 E-MAIL ADDRESS I have used all reasonable diligence in preparing and reviewing this statement and to the st of my n dge the i at n contained herein and in the attached schedules is true and complete. i certify under penalty of perjury under the taws of the State of California that the foregoing s true and Executedon 7/21/2020 8V y re of Tr—m—sure—r « Want I rmsurer Executed on 7/21/2020 B ate SWwWre re Pmpanent or Responsbe 0111cer Sponsor Executed on By nature of Controling Officehokler, Candidane. StMe Mamure Pmpwent Executed on Data BySignature ur ContruMV 00kehDkIer, CandkWa, Siste Massum Pmponwd FPPC form 460 (Jan/2016)) FPPC Advice: acivice@fppr—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 NIC MATTSON OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL MEMBER, CITY OF ATASCADERO RES IDENTIALIBUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP ATASCADh 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 OF TREASURER I.D. NUMBER ❑ YES ❑ NO ADDRESS (NO P.O. BUX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME NAME OF ADDRESS STREET I.D. NUMBER ❑ YES ❑ NO CITY STATE ZIP CODE AREACODEIPHONE pap of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO, OR LETTER JURISDICTION ❑ 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 ofNceholdWs) or candidates) 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/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc-ca.gov Campaign Disclosure Statement Summary Page NAME OF FILER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 Contributions Received 1. Monetary Contributions................................................... sdedu/e A, Line 3 $ 2. Loans Received................................................................ srheduie s, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ................... _._...... Add Lines 1.2 $ 4. Nonmonetary contributions. ........................................... schedule c, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ... _.._................... Add Linea 3+4 $ Expenditures Made 6. Payments Made..................... _......................................... Schedule E, tyre 4 $ 7. Loans Made....................................................................... scnedua rL 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 Lures 6. 9-io $ Amounts may be rounded to whole dollars. statement rovers period from 1/1/2021 Current Cash Statement 12. Beginning Cash Balance ............................ previous summery Page, Line is $ 46.09 13. Cash Receipts........................................................... Column A. Line 3 above 14. Miscellaneous Increases to Cash .................... _............ schedule I, Line 4 15. Cash Payments......................................................... Column A, Line a above 16. ENDING CASH BALANCE Add Lens 12 4 13 * 14, then subtract Line 15 $ 46.09 If this is a termination statement, Lim 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ schedule e, Part 2 $ 0 18. Cash Equity 19. Outstanding ............. S" hr/ucllms on reverse $ 0 AddLha2a Lhaah Cohmrnaabove $ 950 Column B CALENDAR YEAR TOTAL TO DATE $ 949 950 $ 1899 759.37 $ 2658.37 $ 1402.91 0 $ 1402.91 0 759.37 $ 2162.28 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). 6/30/2021 1 Page of 1 1431600 Calendar Year Summary 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 Mads• IN subiect to WWNary ExpeMaum Limit) Date of Election Total to Date (mnddd/yy) P, 'Amounts in this section may be different from amounts Feported in Column B. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers from 1/1/2021 SCHEDULE A SUBTOTAL; 0 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 $ 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCG — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advlce@fppc.ca.gov IS"/275-3772) www.fppc.ca.gov through 6/30/2021 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 FULL NAME, STREET ADDRESS AND ZIP CODE OF [FAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE PF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ® IND 10/06/2020 ROBERT DAMS ❑ COM OWNER, APS AUTO 250 250 (G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTX ❑ SCC ® IND 10/1/2020 ROLFE NELSON ❑COM RETIRED 100 100 G20 ( ) ❑ OTH ATASCADERO, CA 93422 PTX ❑ SCC ® IND 10/9/2020 ROLFE NELSON ❑ COM RETIRED 250 250 (G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTX ❑ SCC ® IND 10/16/2020 RON KRALL ❑ COM GENERAL MANAGER 250 250 (G20) ❑ OTH MID -STATE SOLID TEMPLETON, CA 93465 ❑ PTX WASTE ❑ SCC ❑ IND ❑ COM ❑ OT H ❑ PTY SUBTOTAL; 0 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 $ 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCG — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advlce@fppc.ca.gov IS"/275-3772) www.fppc.ca.gov SCHEDULE 8 - PART 1 Schedule B — Part 1 to whole dollars. statement covers period Loans Received from 1/1/2021 CALIFORNIA FORM 460 through 6/30/2021 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMWTTEE, ALSO ENTER I.D. NUMBER) (1F SELF-EMPLOYED. ENTER BEGINNING THIS PERIOD THISPERIOD. CLOPERIOD HIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD ❑ PAID CALENDAR Y AR HAYLEY MATTSON 13 STARS MEDIA $ 0 950 950 $ s : CO-FOUNDER, RATe ❑ FORGIVEN PER ELECTIOrf+ ATASCADERO, CA 93422 PRESIDENT, COO s 950 s 0 s 0 s 10/16/206 s 10 IND [j COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED DATE DUE PpED CALENDAR YEAR $ s % $ s Q FORGIVEN PER ELECTION` RATE t ❑ IND ❑COM ❑ OTH El Q SCC S : i i $ DATE DUE DATE INCURRED ❑ PA3D CALENDAR YEAR s s % s s PER ELECTnON`+ ❑ FORGIVEN RATE s s = s s DATE DUE DATE INCURRED # ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0 $ 0 $ 0 $ 0 1 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 party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.).............................................................. NET $ 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 0 0 (May be a nega"a number) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCG) OTH — Other (e.g., business entity) PTY— Political Party SCC — Small Contributor Committee FPPC Form 460 (1an/2016)) FPPC Advice: adviceMpc.ca.gov ($66/275-3772) www.fppc.ca.gov Schedule E Payments Made Amounts may be rounded to whole dollars. covers from 1/1/2021 SEE INSTRUCTIONS ON REVERSE through 6/30/2021 Pa of � NAME OF FILER I.D. NUMBER NIC MATPSON FOR ATASCADERO CITY COUNCIL 2020 1431600 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 tv. 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 supportinglopposing 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 a -mail) Paymerds that we contributions or independent expenditures must also be summarized on Schedule O. SUBTOTAL $ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E 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.) ........................... TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) ww%vJppc.ca.gov SCHEDULE E (CONT.) Schedule E Amounts may be rounded Statement covers period (Continuation Sheet) to whole dollars. 1/1/2021 .• ' •' Payments Made from SEE INSTRUCTIONS ON REVERSE through 6/30/2021 Page of NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 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 supportirg/opposing others (explain)' POS postage, delivery and messenger services TSF transfer between cammMees of the same candidata/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT pdrd ads WEB infonnabon technology costs (internet, e-mail) ` Payments that are contirbutions or Independent expenditures must also be summamed on Schedule D. SUBTOTAL $ FPPC Form 460 Jan 2016 FPPC Advice: advice@fppc.w.gov (866/275-3772) www.fppc.ra.gov SCHEDULEF Schedule F Amounts may be rounded (a) OUTSTANDING BALANCEBEGINNING OFTHI OF THIS PERIOD Statement covers period (a) AMOUNT PAID THIS PERIOD luso REPORr ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD to whole dollars. I 1 Accrued Expenses (Unpaid Bills) 1/1/2021 e from through 6/30/2021 Page � SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign pamphemalia/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 FIND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supportinglopposing others (explainr 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 (Internet, e-mail) NAME AND ADDRESS OF CREDITOR IIF COMMITTEE,AlBO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCEBEGINNING OFTHI OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (a) AMOUNT PAID THIS PERIOD luso REPORr ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD Palrnxardstlutars m)trbutiom or Intlsperdent Bxpandawes mud also be SUBTOTALS $ f $ 0 Z surtarrrhstl on Schedule D. 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 $ 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 $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)........................................................................_......................................................................................................... NET $ May be a nsaMNs numOer FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/2753772) www.fpPc.ca.BoV