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Home My WebLink AboutForm 460 Dariz 092718Recipient Committee IV= COVER PAGE Campaign Statement ��9V�C? �' . 1 Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from June 26, 2018 through September 22, 2018 1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. FO Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee InformationI I.D. NUMBER 1407272 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Mark Dariz Committee to Elect for Atascadero City Council 2018 STREET ADDRESS NO P.O. BOX CITY STATE ZIP CODE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ E-MAIL ADDRESS Date of election if applicable: (Month, Day, Year) Nov. 6, 2018 SEP 26 20181 Page CITY OF ATASI CITY CLERK'S Treasurer(s) NAME OF TREASURER Sue Dariz MAILING ADDRESS of 11 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report CITY STATE ZIP CODE AREA D PH N Atascadero CA 93422 NAME OF ASSISTANT TREASURER, IF ANY Ayd IN IRl111111ct*Y.9 CITY STATE ZIP CODE AREA CODE/PHONE 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 knowled the i certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct Executed on 9/25/18 By%�( Dale nate Executed on 9/25/18 A. - Date Si'of Controlling Officeholder, C or herein and in the attached schedules is true and complete. I or Executed on By Date Signature of Controlling Officeholder, Candidate.. State Measure Proponent Executed on By Date Signature of Controlling Officeholder. Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) ww"t fnnr ra onv I 2. Type of Statement: V Preelection Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Sue Dariz MAILING ADDRESS of 11 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report CITY STATE ZIP CODE AREA D PH N Atascadero CA 93422 NAME OF ASSISTANT TREASURER, IF ANY Ayd IN IRl111111ct*Y.9 CITY STATE ZIP CODE AREA CODE/PHONE 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 knowled the i certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct Executed on 9/25/18 By%�( Dale nate Executed on 9/25/18 A. - Date Si'of Controlling Officeholder, C or herein and in the attached schedules is true and complete. I or Executed on By Date Signature of Controlling Officeholder, Candidate.. State Measure Proponent Executed on By Date Signature of Controlling Officeholder. Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) ww"t fnnr ra onv Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Mark Dariz OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council, City of Atascadero CA 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 I I.D. NUMBER NAME OF TREASURER ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I I.D. NUMBER NAME OF TREASURER COMMITTEE ADDRESS STREETADDRESS (NO P.O. CONTROLLED COMMIT ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 11 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 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 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. from Statement covers period June 26, 2018 SUMMARY PAGE September 22 SEE INSTRUCTIONS ON REVERSE through , 2018 3 11 Page of NAME OF FILER I.D. NUMBER Sue Dariz 1407272 Contributions Received 1. Monetary Contributions................................................... Schedule A. Line 3 $ 2. Loans Received................................................................ Schedule 8, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3 + 4 $ Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 7,229 5,333.16 12,562.16 500 13,062.16 Expenditures Made 6. Payments Made................................................................ Schedule E. Line 4 $ 1,553.14 7. Loans Made....................................................................... Schedule H. Line 3 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ 1,553.14 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 500 11. TOTAL EXPENDITURES MADE ........................................ Add Lines s + 9 + 10 $ 2,053.14 Column B Calendar Year Summary for Candidates CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and 7,229 General Elections 1/1 through 6/30 7/1 to Date 1.553.14 $ 1,553.14 500 $ 2,053.14 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 0 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above 12,562.16 add amounts in Column A to the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 amounts from Column B 15. Cash Payments......................................................... Column A, Line s above 1,553.14 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 11,009.02 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ Schedule e, Part 2 $ filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column 8 above $ 5,333.16 20. Contributions Received $ $ . 21. Expenditures Made $ $ . 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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received io whole sonars. Statement covers period CALIFORNIA from June 26, 2018 , 6 0 - September 22, 2018 4 11 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Sue Dariz 1407272 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE. 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 6/29/18 Madalyn McDaniel ❑ COM Retired 200 200 200 ❑ OTH ❑ PTY ❑ SCC O IND 6/28/18 R Robert Jones ❑ COM Retired 500 500 500 ❑ OTH ❑ PTY ❑ SCC V IND 6/28/18 Albert Almodova ElcoM Store Manager 200 200 200 El OTH NAPA Auto Parts ❑ PTY ❑ SCC 9 IND 7/28/18 David Main ❑ COM Retired Architect 100 100 100 ❑ OTH ❑ PTY ❑ SCC Jimm uinone2: 9IND El COM Retired 8/1/18 100 100 100 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 1,100 Schedule A Summary 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.)....... $ 5,740 $ 1,489 TOTAL $ 7,229 `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) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) monetary contributions Received to whole dollars. Statement covers period from June 26, 2018 • ' through September 22, 2018 Page 5 of 11 NAME OF FILER I.D. NUMBER Sue Dariz 1407272 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF COMMITTEE. ALSO ENTER I.D. NUMBER) CONTRIBUTOR * IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) W IND Brian Atwell El COM Psych Tech 8/7/18 ❑ OTH County of San Luis 100 100 100 ❑ PTY Obispo ❑ SCC Mike Zappas la IND El COM Property Manager 7/26/18 250 250 250 ❑ OTH ❑ PTY ❑ SCC Roberta Fonzi ® IND El COM Realestate 8/19/18 250 250 250 ❑ OTH ❑ PTY ❑ SCC ❑ IND Lincoln Club of San Luis Obispo ❑ CoM 8/23/18 ❑ OTH 990 990 990 ❑ PTY P1 SCC David Marchell JO IND El COM Civil Engineer 8/25/18 El OTH OMNI Design GRoup 100 100 100 ❑ PTY ❑ SCC SUBTOTAL$ 1,690 `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) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA from June 26, 2018 FORM through September 22, 2018 Page 6 of 11 NAME OF FILER I.D. NUMBER Sue Dariz 1407272 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR COMMITTEE. ALSO ENTER 1. D. NUMBER) CONTRIBUTOR * IF AN INDIVIDUAL.. ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF CODE IIF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) L n Fowler ® IND 8/25/18 � CO 100 100 100 ❑ PTY ❑ SCC Ray Johnson ® IND Retired 8/24/18 ❑ COM 100 100 100 ❑ OTH ❑ PTY ❑ SCC Brent Win ett ® IND Businessman 9/6/18 ❑ COM 100 100 100 ❑ OTH ❑ PTY ❑ SCC Debbie Arnold 6a IND Self Employed Rancher 9/8/18 Ej COM 100 100 100 El OTH ❑ PTY ❑ SCC William Hatch IND Army, Retired 9/8/18 ❑ COM 100 100 100 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 500 *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) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA from June 26, 2018 FORM • through September 22, 2018 Page 7 of 11 NAME OF FILER I.D. NUMBER Sue Dariz 1407272 DATE RECEIVED FULL NAME, STREET 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Brian Sturtevant ® IND Maintenance Specialist 9/8/18 ❑ COM PG&E 100 100 100 ❑ OTH ❑ PTY ❑ SCC Vicky Morse ® IND Retired 9/8118 El COM 100 100 100 ❑ OTH ❑ PTY ❑ SCC Tom O'Malley ® IND Retired 9/8/18 ElCOM 250 250 250 ❑ OTH ❑ PTY ❑ SCC Harold bauer Q IND Retired 9/8/18 0 CO 100 100 100 ❑ PTY ❑ SCC Lee Moura JZ IND Retired 9/13/18 El COM 100 100 100 [-I OTH ❑ PTY ❑ SCC SUBTOTAL$ 650 *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) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) Monetary Gontrlibutions Received to whole dollars. Statement covers period from June 26, 2018 • - through September 22, 2018 page 8 of 11 NAME OF FILER I.D. NUMBER Sue Dariz 1407272 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR F COMMITTEE. ALSO CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Dennis Schmidt ® IND Surveyor 8/27/18 ❑ COM Granite Ridge 100 100 100 ❑ OTH ❑ PTY ❑ SCC HBACC ® IND 9/19/18 ❑ COM 100 100 100 ❑ OTH ❑ PTY ❑ SCC Lincoln Club of San Luis Obispo ® IND 9/16/18 El CO 1500 1500 1500 ❑ PTY ❑ SCC Al Price COM Retired 9/22/18 ❑2 100 100 100 El OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 1800 *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) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov A ...... ....1.. ... �... --..J...J SCHEDULE B - PART 1 scneauie b — Part 1 to who dollars. Statement covers period Loans Received from June 26, 2018 Page 9 of 11 SEE INSTRUCTIONS ON REVERSE through September 22, 2( NAME OF FILER I.D. NUMBER Sue Dariz 1407272 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING AMOUNT (c) AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL e CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN " BALANCE AT CLOSE OF THIS pglD THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE Mark Dariz Architect ❑ PAID CALENDAR YEAR OMNI Design Group $ g 5,333.16 % g 5.333.1 $ 5,333.16 ❑ FORGIVEN PER ELECTION' EEN $ 5,333.16 $ 5,333.16 $ $ $ TJZ IND [ICOM [_1 OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION`'' RATE T ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ g $ $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR $ $ % $ $ ❑ FORGIVEN PER ELECTION'* EEN t$ ❑ IND ❑COM El OTH ❑PTY ❑SCC $ $ $ $ DATE UE D DATE INCURRED SUBTOTALS $ 5,333.16 $ $ 5,333.16 $ 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 $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) .................................... Enter the net here and on the Summary Page, Column A, Line 2. 'Amounts forgiven or paid by another party also must be reported on Schedule A. "' If required. ..........................$ 5 13 33 16 ......................NET $ 5�33_1P (May be a negative number) (Enter (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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded .�_j F_ _ �_`�`� _a� SCHEDULE C Nonmonetary Contributions Received 0 " ""• Statement covers period from June 26, 2018 • Page 10 of 11 through September 22, 2Q� SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Sue Dariz 1407272 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) (IF REQUIRED) 2 IND 9/8/18 Tom O'Malle ❑ COM Retired Food and $ 500 $ 500 $ 500 ❑ OTH Beverage ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 500 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)... ................................................................................................................... $ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ..................................$ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.).....................TOTAL $ 500 500 *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) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. SCHEDULE E Statement covers period from June 26, 2018 through September 22, A I page 11 of 11 NAME OF FILER I.D. NUMBER Sue Dariz 11407272 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID ns Action Gra hics i LIT Check # 1201 $ 503.14 S.W. Martin & Associates WEB Check # 1202 $ 1,050 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ $ 1,553.14 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 6.)...... $ 1,553.14 1,553.-14 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov