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HomeMy WebLinkAboutForm 460 Dariz 063019Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from Jan. 1, 2019 through June 30, 2019 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. [.� Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall O Controlled (Also Cmipiete Ped 5) O Sponsored (Also Comprate Pad 6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate! O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Cornpiete Pert 7) 3. Committee Information I.E. NUMBER 1407272 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Mark Darin Committee to Elect for Atascadero City Council 2018 Bax) CITY STATE ZIP CODE AREA CODElPHONE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE7PHONE OPTIONAL: FAX i E-MAIL ADDRESS COVER PAGE Date Stamp CALIFORNIA fieri+i,:,i46 • - Receptiori Date of election if applicable: Page 1 of 3 (Month, Day, Year) �UL 3 U 2019 For official Use only Nov. 6, 2018 City 0; atascalder : 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ® Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Sue Dariz MAIJNG ADDRESS CITY STATE ZIP CODE AREA DEMH NE Atascadero CA 93422 NAME OF ASSISTANT TREASURER. IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL FAX 1 E-MAIL ADDRESS 4. Verification 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 perjury under the laws of the State of California that the foregoing is true and correct. l� Executed on 7/30119 Dale Executed on 7/30/19 Date Executed on Date Executed on Dale By Signature of Clxdmlling Offtcehotder. Candidate. Slate Measure wopanenf By Signature of Controlling Officeholder. Candidate, Stale Measure Proponent FPPC Form 460 {Jan/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 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 [.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE'S ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P_0,BOX) CITY STATE ZIP CODE AREA GODFIPHONE COVER PAGE - PART 2 Page 2 of 3 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICThON ❑ SUPPORT ❑ OPPOSE Identity 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 officehoider(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 Summary Page err�w rarzai[.1:F3.rrra�ias�a Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers Pam A. - from Jan. 1, 2019 • - • through June 30, 2019 pop 3 of 3 NAME OF FILER I.D. NUMBER Sue Dariz 1407272 Contributions Received 1. Monetary Contributions................................................... Schedule A. Line 3 2. Loans Received................................................................ Schedule B. Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 4. Nonmonetary Contributions ............................................ Schedule Cr Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ......................._...... . Add Lines 3+4 Expenditures Made 6. Payments Made................................................................ schedule E, LIM4 7. Loans Made....................................................................... schedule H, Une 3 8. SUBTOTAL CASH PAYMENTS ................. _....................... Add Lines 6+7 9. Accrued Expenses (Unpaid Bills) ........ ... ............................. schedule F Linea 10. Nonmonetary Adjustment......................................................... schedule c, Line 3 11. TOTAL EXPENDITURES MADE ........................................ Add Lines a+g+ 10 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 13. Cash Receipts........................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 15. Cash Payments......................................................... Column A, Line 8above 16. ENDING CASH BALANCE .................. Add Liras12+13+f4,then subtract Lim 15 If this is a termination statement, Line 16 must be zero. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) $ 0 $ $ $ $ I $ 0 $ $ 888.70 1 $ -888.70 17. LOAN GUARANTEES RECEIVED ........ ___ ... _............ Schedule 8. Part 2 $ Cash Equivalents and Outstanding Debts 16. Cash Equivalents ................................................ See mstructrons on reverse $ 19. Outstanding Debts .............................. Add Line 2+ fine s in Column a above $ t u Column B CALENDAR YEAR TOTAL TO DATE Q U 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 tarty over the amounts from Lines 2, 7, and 9 (if any). 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 Made" (e Sunt to Voluntary Expenditure Limit) Date of Election Total to Date (mmtddlyy) F. '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