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HomeMy WebLinkAboutForm 460 Dariz 123119 AmendmentRecipient Committee Campaign Statement Cover Page Statement covers period from July 1, 2019 SEE INSTRUCTIONS ON REVERSEthrough December 31, 2019 1. Type of recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. [J Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 51 0 Sponsored {Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee Also Complete, Part 7) 3. Committee Informationf I.D. NUMBER 1407272 COMMITTEE NAME (OR CANDIDATE'S NAME IF Mark Dariz Committee to Elect for Atascadero City Council 2018 CITY STATE ZIP CODE AREA CODEPHONE Atascadero CA 93422 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA COOEJPHONE OPTIONAL: FAX I E-MAIL ADDRESS Date of election if applicable: (Month, Day, Year) Nov. 6, 2018 Date Stamp RECEIVED ALW i.. 4 2020 TY OF ATASCADERO 2. Type of Statement: ❑ Preelection Statement Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) Amendment (Explain below) COVER PAGE CALIFORNIA • FORM Page 1 of 3 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Sue Dariz MAILING ADDRESS CITY STATE ZIP CODE AREA CODEMHONE Atascadero CA 93422 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE 71P CODE AREA CODEIPHONE 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 ipfbrmation certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 7/27/20 Date Executed on 7/207/20 Date Executed an Date Executed on Date By _' _. , / or By aluL ct By herein and in the attached schedules is true and complete. I OF By Signature of Controlling Omcehalder, Candidate, State Measure Proponent FPPC Form 460 (!an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www fnnr ra onu 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 RESIDE NTIAUBUSINESSADDRESS (NO.ANDSTREET) 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? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.D. 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 AREA CODEIPHONE COVER PAGE - PART 2 Page 2 of 3 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 Listnames 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 July 1, 2019 Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 0 $ 0 Dec. 31, 2019 3 3 SEE INSTRUCTIONS ON REVERSE 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lifts 6+7 $ $ 9. Accrued Expenses (Unpaid Bills) .......... ........................... through Page of Schedule C, Line 3 NAME OF FILER 11. TOTAL EXPENDITURES MADE ............... ......................... Add Lines 8+9+16 $ $ I.D. NUMBER Sue Danz amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12+ 13 + 14, then subtract Line 15 $ 1407272 Contributions Received TOTAL A THIS PERIOD Column B Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) CALENDARYEAR TOTAL TO DATE Running in Both the State Primary and this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ schedule S. Pan 2 $ General Elections filed for this calendar year, D 0 Cash Equivalents and Outstanding Debts 1. Monetary Contributions................................................... schedule A, Line 3 $ $ any). 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column B above $ 111 through 6/30 7/1 to Date 2. Loans Received................................................................ schedule B, Line 3 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ $ Received $ $ 4. Nonmonetary Contributions... ......................................... schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ...... -............. --- .... .... Add Lines 3+4 $ $ Made $ $ Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 0 $ 0 7. Loans Made....................................................................... schedule H,, Line 3 13. Cash Receipts........................................................... Column A Line 3 above 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lifts 6+7 $ $ 9. Accrued Expenses (Unpaid Bills) .......... ........................... ..... schedule F Linea 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ............... ......................... Add Lines 8+9+16 $ $ 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 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 a above of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12+ 13 + 14, then subtract Line 15 $ 0 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 S. Pan 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 B above $ 0 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made` (n Subject b, voxunterr EapendWre Ltmtt) Date of Election Total to Date (mm/dd/yy) —I $ 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/27S-3772) www.fppc.ca.gov