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Home My WebLink AboutForm 460 123110 Committee to Elect Chuck Ward 2010Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 10/17/2010 _ through 1 Type of Recipient Committee All Committees —Complete Parts 1 2, 3, and 4. ® Officeholder Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee O Recall Q Controlled (Also Complete Part 5) Q Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1331768 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Elect Chuck Ward for Council 2010 STREET AnnrtFSS (NO P 0 BOX) CITY STATE ZIP CODE AREA CODE/PHONE Atascadero CA 93422 805 MAILING ADDRESS (IF DIFFERENT) NO AND STREET OR PO BOX ZIP CODE PO Box 2711 Atascadero CA 93422 CITY STATE ZIP CODE AREA CODE/PHONE Atascadero CA 93423 same OPTIONAL. FAX / E-MAIL ADDRESS Date of election if applicable: (Month, Day Year) RECEIVED JAN -32011 COVER PAGE Page 1 of 9 ITY OF ATASCADERO For Official Use Only 11/2/2010 CITY CLERK'S OFFICE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ® Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER David Frayer MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE Atascadero CA 93422 805, _ NAME OF ASSISTANT TREASURER, IF ANY Chuck Ward MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE Atascadero CA 93422 805 OPTIONAL. FAX / E-MAIL ADDRESS 4 Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my kno d e the info under penalty of perjury under the laws of the State of California that the foregoi true an ect. Executed on By ' Signal Executed on �:7,f3� �d/0 By Date SqWtureofControlling Offioen5Tder,, Executed on Date Executed on Date herein and in the attached schedules is true and complete. I certify By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder Candidate, State Measure Proponent FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) State of California Type or print in ink. COVERPAGE PART2 Recipient Committee CALIFORNIA Campaign Statement FORM 4•1 Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Chuck Ward OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Seeking position City Council RESIDENTIAUBUSINESS 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 make expenditures on behalf of your candidacy COMMITTEE NAME LD NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO Page 2 of 9 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. COMMITTEE ADDRESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary 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 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) State of California Campaign Disclosure Statement Type or print in ink. SummaPaAmounts may be rounded Summary Page to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER CHUCK WARD SUMMARY PAGE Statement covers period CALIFORNIA�, from 10/17/2010 • 4s - /z 3�1.t�rc►/ through it Page 3 of 9 1.13 NUMBER 1331768 Contributions Received 3 645 Column A Column B Calendar Year Summary for Candidates 3 645 0 TOTALTHIS PERIOD (FROMATTACHED SCHEDULES) CALENDARYEAR TOTALTO DATE Running In Both the State g Primary and 1,039 $ 3,645 15 Cash Payments Column A, Line 8 above General Elections 1 Monetary Contributions Schedule A, Line 3 $ 669 $ 3,210 2. Loans Received Schedule B, Line 3 "600 0 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 $ 69 $ 3,210 20 Contributions 18. Cash Equivalents See instructions on reverse $ " Received $ $ 4 Nonmonetary Contributions Schedule C, Line 3 203 703 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 +4 $ 272 $ 3 913 Made $ $ Expenditures Made 6. Payments Made 7 Loans Made 8. SUBTOTALCASH PAYMENTS 9 Accrued Expenses (Unpaid Bills) 10 Nonmonetary Adjustment 11 TOTAL EXPENDITURES MADE Schedule E, Line 4 $ Schedule H, Line 3 Add Lines 6 + 7 $ Schedule F Line 3 Schedule C, Line 3 Add Lines 8 + 9 + 10 $ 836 $ 3 645 12. Beginning Cash Balance Previous Summary Page, Line 16 836 $ 3 645 0 0 203 1,039 $ 3,645 Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 $ 767 13 Cash Receipts Column A, Line 3above 69 14 Miscellaneous Increases to Cash Schedule 1, Line 4 15 Cash Payments Column A, Line 8 above 836 16 ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 0 If this is a termination statement, Line 16 must be zero. 17 LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ - Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ " 19 Outstanding Debts Add Line 2 +Line 9 in Column B above $ 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) Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-171313C (866/275-3772) ScheduleA Type or print in ink. SCHEDULE A Moneta Contributions Received Amounts may be rounded Monetary dollars.CALIFORNIA Statement covers period to whole Cri from 10/17/2010 _ / l2�3/ .7��j 4 9 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER CHUCK WARD 1331768 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND 8/4/2010 David Fraver ❑COM RETIRED 100 ❑ OTH Atascadero, CA 93422 ❑ PTY ❑ SCC ®IND 8/4/2010 Chuck Ward ❑COM RETIRED 100 ❑ OTH Atascadero CA 93422 ❑ PTY ❑ SCC ®IND 8/11 /2010 Richard Hathcock ❑COM RETIRED 500 [:]OTH Shell Beach, CA 93449 ❑ PTY ❑ SCC ®IND 10/20/2010 Jack Jones ❑COM RETIRED 200 400 ❑ OTH San Luis Obispo CA 93401 ❑ PTY ❑ SCC ®IND Jerry Clay ❑COM City Councilman 9/16/2010 ❑ OTH 100 Atascadero CA 93422 ❑ PTY ❑ SCC SUBTOTAL$ 200,.�z:,;,, 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 545 COM — Recipient Committee (other than PTY or SCC) 124 OTH — Other (e.g. business entity) PTY — Political Party SCC — Small Contributor Committee 669 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 10/17/2010 • 460 from 1 5 9 through Page of NAME OF FILER I.D. NUMBER CHUCK WARD 1331768 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Ted Jacobson ❑COM Meridan Insurance 100 9/20/2010 E] OTH Atascadero CA 93422 ❑ PTY ❑ SCC David Sanford ®IND ❑ COM Sanford Stone Co , Inc. 300 9/29/2010 ❑ OTH Atascadero, CA 93422 ❑ PTY ❑ SCC Andrew Peterson ®IND ❑ COM Self Writer 00 10/1/2010 ❑ OTH Bradley CA 9342(1 ❑ PTY ❑ SCC John Oberq V]COM IND Retired 100 10/1/2010 E]OTH Arroro Grande, CA 93420 ❑ PTY ❑ SCC Tim Haley BIND ❑ COM Retired 100 10/4/2010 ❑ OTH Atascadero CA 9342z ❑ PTY ❑ SCC SUBTOTAL a *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULEA (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. 10/17/2010 • • from 6 9 through Page of NAME OF FILER LD NUMBER CHUCK WARD 1331768 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR DEO CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (EFTAIF COMMITTEE, SANDZII.D.N CODE * (IFSELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND James Harrison ❑COM Retired 10/20/2010 E] OTH 245 245 Pismo Beach CH 93049 ❑ PTY ❑ SCC Committee to Elect Bob Kelley ❑IND ❑COM 10/26/2010 100 100 ®OTH Atascadero (,A 93422 ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 345 s '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) SCHEDULE B PART 1 v Schedule B — Part 1 Amounts may �be,rounded Statement coversperiod dollars. CALIFORNIA ' • Loans Received to whole 10/17/2010 FORM from 20`,/�0 7 9 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER CHUCK WARD 1331768 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING (b) AMOUNT (C) AMOUNT PAID OUTSTANDING (e) INTEREST ( ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAMEOFBUSINESS) PERIOD THIS PERIOD" PERIOD PERIOD LOAN TO DATE Barbara Ward RETIRED -PERIOD ® PAID CALENDARYEAR $165 $ 0 500 $ 500 $ ® FORGIVEN PER ELECTION— Atascadero, CA 93422 RATE $ 500 $ 0 $ 335 11/3/2010 $ 0 9/24/10 $ 500 DATE DUE DATE INCURRED tv IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR Chuck Ward RETIRED $ $ 0 100 $ 100 q $ Z FORGIVEN PER ELECTION"* Atascadero CA 93422 RATE $ 100 $ 0 $ 100 11/3/2010 $ 0 9/24/10 $ 100 DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PERELECTION`" RATE $ $ $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0 $ 600 $ 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 Page Column A, Line 2 'Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. NET $ -600 (May be a negative number) (tnter (e) on Schedule E, Line 3) tContributor 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule C Type or print in ink. .___.__._ ___ �_ ___._,_, SCHEDULE C Nonmonetary Contributions Received Mcclo o'ui wh lla UOrodollars. iuou Statement covers period CALIFO_ , 10/1712010 FORM from r .z / 10/a, 8 9 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER LD NUMBER CHUCK WARD 1331768 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF REQUIRED) (IF NAME OF BUSINESS) (JAN 1 DEC 31) ®IND David Frayer RETIRED CREATE 8/4/2010 �oOTMM WEBSITE 0 500 Atascadero CA 93422 E] PTY ❑ SCC ®IND 10/27/10 Jerry Clay ❑Com Cit Councilman Atascadero 203 203 ❑0TH News Ad Atascadero, CA 93422 ❑PTY ❑ SCC ❑IND ❑COM ❑OTH ❑ PTY [:]SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets SUBTOTAL $ 203 Schedule C Summary 1 Amount received this period —itemized nonmonetary contributions. 203 (include all Schedule C subtotals.) $ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 $ 0 3 Total nonmonetary contributions received this period. 203 (Add Lines 1 and 2. Enter here and on the Summary Page Column A, Lines 4 and 10) 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E Type or print in ink. Statement covers period SCH Payments Made Amounts may be rounded • - EDULEE to whole dollars. from 10/17/2010 • ' ' SEE INSTRUCTIONS ON REVERSE through 1 Page 9 of 9 NAME OF FILER LD NUMBER CHUCK WARD 1331768 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 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 PAYEE (IFCOMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Wilkins Printing Brochures and Cards 6405 EI Camino Real LIT 525 Atascadero CA 93422 All Signs Signs 2732 El Camino Real CMP 104 Atascadero CA 93422 Atascadero News Newspaper Advertising Atascadero CA 93422 PRT 612 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,241 Schedule E Summary 1 Itemized payments made this period. (Include all Schedule E subtotals.) $ 1,241 2. Unitemized payments made this period of under $100 �'�!'�!v'$ $ -405 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 $ 836 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)