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Home My WebLink AboutForm 460 Dariz 123119Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from July 1, 2019 through Dec. 31, 2019 1. Type of Recipient Committee: All Committees—Complete Parts 1, 2, 3, and 4, V Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part S) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information COMMITTEE NAME ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Pmt 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Mo Complete Part 0 I.D. NUMBER 1407272 Mark Dariz Committee to Elect for Atascadero City Council 2018 Atascadero MAILING ADDRE! STATE ZIP CODE CA 93422 CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX 1 E-MAfL ADDRESS COVER PAGE Date Stamp !RECEIVED Date of election if applicable: Page 1 of 3 (Month, Day, Year) JAN 2020 For Official Use Only Nov. 6, 2018 CITY OF ATASCADER CITY CLERK'S OFFIC 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 MAILING ADDRESS Atascadero CA 93422 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX l E-MAILADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge thg informatlGA cotxained 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.. Executed on 130/2020 Date Executed on 1/30/2020 Date Executed on Executed on By or or By Signature of Confroiling Officeholder. Candidate, State Measure Proponent By Signature of Controlling DHiceholder, Candidate. State Measure Proponent FPPC Form 460 (Jan/2016} FPPC Advice: advice@fppc.ca.gov (866/275-3772) www fnnr ra anv 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 DISTRI T NUMBER IF APPLICABLE) City Council, City of Atascadero, CA RESIDENTIAUBUSINESSADDRESS (NO.AND STREET) CITY STATE ZIP w. Atascadero, CA 53422 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you o"rare primarily formed to receive contributions or make expenditures on behalf of your candidacy. r I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREACODEIPHONE COMMITTEE NAME NAME OF TREASURER STREETADDRESS (NO P.O. I.D. NUMBER ❑ YES ❑ NO COVER PAGE - PART 2 Page 4 of S. Primarily Formed Ballot Measure Committee BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholldey candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Llsrnames of officeholder(s) or candidate( ,) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT I ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELP ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT ❑ OPPOSE • I CITY STATE ZIP CODE ARI=A CODEIPHONE A;ch continuation sheets if necessary f i. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov t � f Campaign Disclosure Statement ,Summary Page ME OF FILER Sue Dariz Contributions Received 1. Monetary Contributions..................................................1 Schedule A, Line 3 2. Loans Received...............................................................� Schedule B, Linea 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines I+2 8. SUBTOTAL CASH PAYMENTS....................................I!.... ....nadide c, Line 3 5. TOTAL CONTRIBUTIONS RIBUTIONS RECEIVEDI .Add Lines 3 +q Expenditures Made e. Payments Made...............................................................1, schedule e, Line 4 7. Loans Made......................................................................1 Schedule H Line 3 8. SUBTOTAL CASH PAYMENTS....................................I!.... Add Lines 6+7 9. Accrued Expenses (Unpaid Bills) ...................................... :... Schedule 5 Linea 10. Nonmonetary Adjustment......................................................I', . schedule C, Line 3 11. TOTAL EXPENDITURES MADE .......................................... Add Lines 8 + 8 + fo Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, We 16 13. Cash Receipts........................................................... Column A, Line 3above 14. Miscellaneous Increases to Cash .................................. schedule L Line 4 15. Cash Payments......................................................... Column A, Line 8above 16. ENDING CASH BALANCE ..................Add Lines 12+ 13 + 14, then subtract Line 15 If this is a termination statement, tine 16 must be zero. 17. LOAN GUARANTEES Schedule B, Part 2 $ Amounts may be rounded to whole dollars. Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) 0 Column B CALENDARYEAR TOTALTO DATE 0 $ $ $ -888.70 -888.70 18. Cash Equivalents ................................................ see irlstmctionsonreverse $ 19. Outstanding Debts .............................. Add une 2+LineiBinColumn Babove $ 0 To calculate Column B, add amounts in Column A to the corresponding amounts from Column E of your last report. Sort amounts in Column Am be negative figures that should be subtracted fn previous period amount this is the first report be filed for this calendar ye only carry over the amo from Lines 2, 7, and 9 (i any). If nt covers period July 1, 2019 Dec. 31, 2019 iYrLrdJJ�1:��95�7� Wh Page 3 of 3 I.D. NUMBER 1407272 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6/30 711 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (If Sublect to voluntary Expenditure Umtt) Date of Election (mm/dd/yy) Total to Date � 1 $ $ Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2036) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppera.gov