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HomeMy WebLinkAbout2019.04.02_Addis_Dawn_Form 460 AmendmentRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from Oct 21, 2018 through Dec 31, 2018 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. M Officeholder, Candidate Controlled Committee O State Candidate Election Committee O Recall (Also Complete Part 5) ❑ General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee 0 Primarily Formed Ballot Measure Committee O Controlled O Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Pad 7) Date of election if applicable: (Month, Day, Year) 11/6/2018 Date Stamp RECEIVED City of Morro Bay APR 0 2 2019 Administration Page COVER PAGE of 5 For Official Use Only 2. Type of Statement: ❑ Preelection Statement O Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) M Amendment (Explain below) Misunderstanding of reporting requirements for non -monetary ❑ Quarterly Statement ❑ Special Odd -Year Report contribution among multi candidates at same event 3. Committee Information I.D. NUMBER 1406734 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Dawn Addis City Council 2018 STREET ADDRESS (NO P.O. BOX) 1...1 I Y Morro Bay STATE ZIP CODE CA 93442 AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification Treasurer(s) NAME OF TREASURER Gail Bunting MAILING ADDRESS Morro Bay STATE ZIP CODE CA 93442 NAME OF ASSISTANT TREASURER, IF ANY AREA CODE/PHONE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 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 correc j- -ii )— 't% Executed on - 1 Date Executed on Executed on Executed on Date Date Date By By — By By ible Officer of Sponsor Signature of Controlling Officeholder, Candidate, State Measure Proponent Signature of Controlling Officeholder, Candidate, State 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 Dawn Addis for City Council 2018 OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPI_CABLE) City Council Member - Morro Bay, CA RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Morro Bay CA 93442 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily fonned 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 STREET ADDRESS (NO P.O. BOX) CITY STATE Z P CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER VAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZJP CODE AREA CODE/PHONE 6„ Formed Ballot Measure Committee NAME OF' BALLOT MEASURE COVER PAGE - PART - BALLOT NO, OR LETTIER JURJSDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling ofiiceholcierr, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OF: HELD DISTRICT NO. IF ANY 7. IPt1malrily Fowled Candidate/Officeholder Committee Listnames of officehiolder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER 0It CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT • OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT • OPPOSE NAME OF OFFICEHOLDER 01 CANDIDATE OFFICE SOUGHT OR HELD • SUPPORT • OPPOSE NAME OF OFFICEHOLDER 0 2 CANDIDATE OFFICE SOUGHT OR HELD• SUPPOR- • OPPOSE kitsch continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice(afppc.ca,.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Dawn Addis for City Council 2018 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 C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED AddLines3+4 $ Expenditures Made 6. Payments Made 7. Loans Made Schedule E, Line 4 Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS AddLines6+7 9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 10. Nonmonetary Adjustment Schedule C, Line 3 11. TOTAL EXPENDITURES MADE Add Lines 8 +9 + 10 $ Current Cash Statement 12. Beginning Cash Balance 13. Cash Receipts 14. Miscellaneous Increases to Cash 15. Cash Payments 16. ENDING CASH BALANCE Previous Summary Page, Line 16 Column A, Line 3 above Schedule 1, Line 4 Column A, Line 8 above Add Lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 3,356.00 0 Statement covers period from Oct 21, 2018 through Dec 31, 2018 Column B CALENDAR YEAR TOTAL TO DATE $ 18,409.00 0 3,356.00 $ 18,409.00 5,655.30 6,482.30 8,795.48 $ 24,891.30 7,011.64 0 $ 7,011.64 $ 0 5,655.30 12,666.94 $ $ 6,406.99 3,356.00 0 7,011.64 $ 2,751.35 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 $ 15,661.65 0 151661,65 0 6,482.30 22,143.95 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). SUMMARY PAGE I.D. NUMBER 1406734 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contributions Received $ 21. Expenditures Made $ 1/1 through 6/30 7/1 to Date $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/ddlyy) Total to Date *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 C Amounts may beiron rodeo] • SCHEDULE C N imonet l y ContributionsReceived SEE INSTRUCTIONS ON REVERSE Statement covers period t om Oct 21, 2018 e r � k r jyr M i r y 4 ,, r Dec31,2018 through ", 5 gage ®$ VAME OF FILER Dawn Addis City Council I.D. NUMBER 1,1.06734 DATE RECEIVED FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR. (IF COMMITTEE, ALSO ENTER I.D.NUMEER) CIONTRIi3UTOl : CODE IF �d t IPIDIVC)UAL, ENTER OGCI IPAl'ICiJ ARID I( EN1ER I'R (II`SELF-GMPLO'iGC},ENTER NAME DI- UUSINESS) o DESCRIPTION OF GOODS OR SER'dICES AMOUNT/ FA R MARKET VALUE CUMULATIVE DATE CALENDAR (JAN 1 - TO YEAR DEC 31) PER ELECTION TO DATE (IF REQUIRED) 10/31/208 Dawn Beattie Morro Bay, CA 93442 •„d IND ` 1CC)1VI _] Ci I1-1 _] P1 y _] •SL;C hlone Office supplies,etc 314.00 45E1.00 11 /11 /2018 April Elliott: PO Box 835 Morro Bay CA 93443 -d11P')D -] COM , _] OTI-I i _] PTY _] SCC April Elliott Designs Graphic Design 125.48 125.48 11/18/2018 Joe B.rney Morro Bay CA 93442 2IND : 11C0'1 ! D aril -] s(:c .Joe Birnev Designs Graphic Design 1,000.00 1,00.00 11/7/2018 Travis Ford Morro Bay 93442 -, INC I]Co 4 ! ❑ OTI-1 ❑Pus' ❑ Si.:11 Rock l-Iarpor Marketing Website 4,000.00 4,030.00 ___________________________ Attach additional information on appropriately labeled cl'')ntinuation sls-lemetSUBTOTAL 1' 5,439.48 Schedule C Summary 1. Amount received this period — itemized nonmonetary Ioontrl'Juiiorl3. (Include all Schedule C subtotals.) 2. Amount received this period — unitemized ncrirnorlotary cot ilr'iceutions of 3. -Total nonmonetary contributions received this pencil: (Add Lines 1 and 2. Enter here and on the Surnrna -y j?age; Column A, L less than $100 irle 4 vim 10.) 5,655.30 0.00 TOTAL $ 5,655.30 "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/20:16) FPPC Advice: advke.@FPpc.ca.gov (866/275-3772) www.fppc.c.a.gov Schedule C Amounts may be rounded SCHEDULE C Nonmonetary Contributions Received LJW111e"""d'b SEE INSTRUCTIONS ON REVERSE Statement from from through covers period 21, 2018 CALIFORNIA FORM': Page — __-' of 5 Dec 31, 2018 NAME OF FILER Dawn Addis for City Council 2018 I.D. NUMBER 1406734 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME QF BUSINESS) DESCRIPTION OF GOODS OR SERVICES AMOUNT/ FAIR MARKET VALUE CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 - DEC 31) PER ELECTION TO DATE (IF REQUIRED) 10/28/2018 Helios Dayspring San Luis Obispo, CA 93405, Owner/CEO Natural Healing Center. Fundraiser Event Cost (Food & Drink) 215.82 215.82 t►/ IND • COM ❑ OTH • PTY • SCC April Elliott PO Box 835 Morro Bay CA 93443 • IND ■ COM • OTH El PTY • SCC Joe Birnev Morro Bay CA 93442 ❑ IND • COM • OTH ❑ PTY ❑ SCC Travis Ford Morro Bay 93442 ■ IND ❑ COM ❑ OTH • PTY • SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 215,82 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.) 5,655.30 0.00 TOTAL $ 5,655.30 *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