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HomeMy WebLinkAboutForm 460 Mattson 123121Recipient Committee COVER PAGE Campaign Statement Cover Page ' Statement covers period from 7/1/2021 SEE INSTRUCTIONS ON REVERSE I through 12/31/2021 I. Type of Recipient Committee: All Commkires—Complete Parts 1, 2, 3, and 4. Z QTk holder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure U State Candidate Election Committee O Recall mmittes Controlled (AIN CompgtaPatt5) Sponsored {Also COM#6to Part 6) ❑ eneral Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political Parry/Central Committee (Afeo Coq*le PM r) 3. Committee Information I.D NUMBER 1431600 Nic Mattson for Atascadero City Council 2020 STREET ADDRESS (NO P.O. BOX) CITY STATE ZJP CODE AREA CODEIPHONE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREAC OEIPHONE OPTIONAL: FAX IE -MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the bestaf my certify under penalty of perjury under the laws of the State of California that the foregoing is tree and Executed on 04/15/2022 B Date y Execvied on 04/15/2022 Date Executed on Date Executed on Hy Bate of election If applicable: (Month, Day, Year) 11/03/2020 :I, 0 2022 OF ATASCADERO CLERK'S OFFICE 2. Type of Statement: ❑ Preelection Statement G% Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER MAILING ADDRESS Page of For Official Use ❑ Quarterly Statement ❑ Special Odd -Year Report CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL FAX I E-MAIL ADDRESS the information contained herein and in the attached schedules is true and complete. I By Signature of controlling Ofteholder, Canddate, State Measure Proponeq By Signature of Controlling 011lcehoMar, Candidate, State Measure Proponar4 FPPC Form 460 ()an/2016)) 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 NIC MATTSON OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL MEMBER, CITY OF ATASCADERO RESIDENTIALIBUSINESSADDRESS (NO.ANDSTREET) CITY STATE ZIP ATASCAD15 CA 93422 Related Committees Not Included in this Statement: List anycommlttees not Included In this statement that are controlled by you or are primarily formed to receive contrfbutfons or make expenditures on behalf of your candidacy. COMMITTEE NAME I I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page of $. 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 t SUUUH I UK HELL) DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Lfst names of offfceholdbr(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 ❑ OPPOSF NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Aftach 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 Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers period s . Summary Page 1/1/2021 e • ' • 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 Contributions Received Column A TOTALTHISPERIOD Column B Calendar Year Summary for Candidates (PROMATTACHED9CHEWLES) CALENOAH YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Linea $ 0 $ 949 0 950 1A tivough 6/30 7n to Date 2. Loans Received _ ................. .................................... ......... Schedule B, Linea 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add unes7.2 $ 0 $ 1899 20. Contributions Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, LIM3 0 759.37 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ....... ... ..... _............ Wdunes3«a $ 0 $ 2658.37 Made $ $_ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ Schedule E, Line a $ 0 $ 1402.91 Candidates 7. Loans Made....................................................................... Schedule H, Line 3 0 0 B. SUBTOTAL CASH PAYMENTS Add Unes6«7 $ 0 $ 1402.91 22. Cumulative Expenditures Made'(Itsublaa ....................................... to voluntary EExe,"Ituro UWo 9. Accrued Expenses (Unpaid BIIIS ................Schedule F, Line 3 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment ............ ................ _........... .Schedule C, Llm3 0 759.37 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE .................... _......... Add Lines 8«9«10 $ 0 $ 2162.28—J $ _� 1 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous summery Page. Line 16 $ 46.E To calculate Column B, 13. Cash Receipts ....................................... _.................. Column A, Line 3 above add amounts in Column 14. Miscellaneous Increases to Cash .............................. _.. Schedule i, Linea Ato the corresponding amounts from Column B 'Amourds in this section may be different from amounts reported in Column B. 15. Cash Payments......................................................... Cdumn A, One 8show of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add tinea 12 « 13 « 10, men subfred Line 15 $ `�•� be negative figures that shouId be subtracted from If this is a termination statement, Lim16 must be zero. i prevous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ schedule e, Ped 2 $ 0 filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 0 any). 18. Cash Equivalents ................................................ see Instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2« One 9 In Column B above $ 950 FPPC Form 460()an/2016)) FPPC Advice: advice@fppc.w.gov (866/27537721 wmnNJpPc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers parlod from 1/1/2021 SEE INSTRUCTIONS ON REVERSE through 6/30/2021 page of NAME OF FILER I.D. NUMBER NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1431600 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIOU70R CONTRIBUTOR CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER LD. NUMBER} ff SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) m IND 10/06/2020 ROBERT DAVIS ❑COM OWNER, APS AUTO 250 250 (G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTY ❑ SCC 10/1/2020 ROLFE NELSON OcoM RETIRED 100 100(G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTY ❑ SCC Il iND 10/9/2020 ROLFE NELSON ❑COM RETIRED 250 250 (G20) ❑ OTH ATASCADERO, CA 93422 ❑ PTY ❑ SCC m IND 10116/2020 RON KRALL ❑ COM GENERAL MANAGER 250 250 (G20) ❑ OTH MID -STATE SOLID TEMPLETON, CA 93465 ❑ PTY WASTE ❑ SCC []IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 0 Schedule A Summary Amount received this period — itemized monetary contributions. ".._.L ado al. CrhadUle 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 SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FP PC Advice: advice@fppc.ca.gov (866/275-3772) wwwjppc.ca.gov Amnunts may ha rounelnrl SCHEDULE B - PART 1 C e U e is »r Part i to whole dollars. Statement covers period Loans Received + _ I • ' from 1/1/2021 Page of SEE INSTRUCTIONS ON REVERSE through 613012021 NAME OF FILER I 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 (IF COMMITTFF,A(_so FNTERI.D. NUMBER) {IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN THISPERIOD. BALANCE AT CLOSE OF THIS PAID THIS PERIOD AMOUNT OF LOAN CONTRIBUTIONS TO DATE NAME OF 9USlNEBB) PERIOD PERIOD [] PAID CALENDAR Y R HAYLEY MATTSON STARS MEDIA $ 0 $ 950 % 950 s //13 CO-FOUNDER, NDER, RATE ATASCADERO, CA 93422 PRESIDENT, COO ❑ FORGIVEN PER ELECFIOi s 950 ; 0 5 0 s 10116/20a s tZ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED PAID CALFNDAR YEAR $ S % S $ © FORGIVEN PER ELECTION- RATE t❑ IND ❑ COM ❑ 0TH © PTY © SCC S $ $ I 3 $ DATE DUE DATE fNCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION` RATE s s ; $ $ -. �.�.��� DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH El ❑SCC j SUBTOTALS $ 0 $ 0 $ 0 $ 0 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.) ................................ Enter the net here and on the Summary gage, Column A, Line 2. "Amounts forgiven Or paid by another party also must be reported on Schedule A. If required. .................................... $ ...............................$ 0 ........................NET $ (May be a negeow number) (Enter (a) on Schedule E, Line 3) tContributor Codes IND—Ii COM — Recipient Committee (other than PTI' or SCG) OTH —Other (e.g., business entity) PT`( — PolitiCal Pa<<y SCC—Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advlce@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded Statement covers to whole dollars. Payments Made from 1/1/2021 ON REVERSE I through 6/30/2021 I Page of NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 1 1431600 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign parephernalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetaryr 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 supporting/opposing 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 (internet, e-mail) Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 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).)............................................................................. $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line S.) ........................... TOTAL $ FPPC Form 460 ()an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made Amounts may be rounded to whole dollars. from "Mont covers 1/1/2021 SCHEDULEE(CONT) SEE INSTRUCTIONS ON REVERSE I through 6/30/2021 page of NIC MATTSON FOR ATASCADERO CITY COUNCIL 2020 I 1431600 CODES: If one of the following codes accurately describes the payment, you may enter the Code. Otherwise, describe the payment. CMP campaign paraphemale/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' salades 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 supporting/opposing 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 (internet, e-mail) ' Payments that are contributions or Independent expenditures meet also be summarized on Schedule D. SUBTOTAL $ FPPC Form 460 tan 2016 FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov NAME AND ADDRESS OF CREDITOR (IF COMMITTEE,A ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (e) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD N) AMOUNT INCURRED THIS PERIOD (o) AMOUNT PAID THIS PERIOD (u.sO REPORT ON E) SCHEDULE Schedule F Amounts may be rounded Accrued Ex Expenses (Unpaid Bills Pe � P ) to whole dollar. 6lebmeM cover Period e , g ' - from ln/2o21 . through 6/30/2021 SEE INSTRUCTIONS ON REVERSE 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 parphemalialmisa MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetaryp OFC office expenses SAL campaign workere'solaries CVC civic donations PET petition circulating TEL tv. or cable airtime and production costs FIL candidate ffling/balbl fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS doff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing 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 (Internet e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE,A ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT (e) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD N) AMOUNT INCURRED THIS PERIOD (o) AMOUNT PAID THIS PERIOD (u.sO REPORT ON E) (d) OUTSTANDING BALANCEATCLOSE OF THIS PERIOD Payments that ere contlfautlona or independent expendPoses must also be SUBTOTALS $ $ = 0 $ summarized on Schedule D. Schedule F Summary 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.)...... 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.)........ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.).............................................................................................................................. .....INCURRED TOTALS $ ................ PAID TOTALS $ ........................... NET $ May be a nega" number FPPC Form 460 (Jan/2016)) FPPC Advice: advicetyfppc.ca.gov (666/275.3772) www.fppc.ca.gov