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HomeMy WebLinkAbout2022.04.08_Addis_Dawn_Form 460 (termination)Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 01 /01 /2022 through 03/22/2022 1. Type of Recipient Committee: All Committees —Complete Parts 1, z, 3, ana a. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee 0 Recall O Controlled (Also Complete Parts) O Sponsored (Also Complete Pert 6) ❑ General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee 3. Committee Information Friends of Dawn Addis City Council 2022 ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1406734 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAILADDRESS daddis@ morrobayca.gov 4. Verification COVER PAGE Date Stamp CALIFORNIA 4611 RECEIVED • City of Morro Bay Date of election if applicable: Page 1 of 6 (Month, Day, Year) APR 0 8 2022 For Official Use Only IAdministration I 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement El Semi-annual Statement El Special Odd -Year Report la Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurers) NAME OF TREASURER Barbara Spagnola MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE Palm Desert CA 92211 ( NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAXlE-MAILADDRESS 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 alb correct. _ �� d Executed Executed Executed on Date Executed on Date By Signature of Controlling Officeholder, Candidate, Stale Measure Proponent FPPC Farm 460 (Jan/2016) Clear Cover Pg1 Print Form FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fnnr.ra_pnv Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Dawn Addis OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member, City of Morro Bay, CA RESIDENTIAL/BUSINESSADDRESS (NO.ANDSTREET) 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 formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER Dawn Addis for Assembly 2022 1442437 NAME OF TREASURER CONTROLLED COMMITTEE? Marissa Russell 0 YES ❑ NO COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX) 5445 Madison Ave CITY STATE ZIP CODE AREA CODE/PHONE Sacramento COMMITTEE NAME NAME OF TREASURER COMMITTEE ADDRESS CA 95841 (916) 348-9100 I.D. NUMBER CONTROLLED COMMITTEE? STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Clear Cover Pg2 Print Form 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT N0. OR LETTER I JURISDICTION COVER PAGE - PART 2 Page 2 of 6 ❑ 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 CandidatelOfficeholder Committee List names of officeho/der(s) or candidates) 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. Statement covers period from 01 /01 /2022 SEE INSTRUCTIONS ON REVERSE through 03/22/2022 NAME OF FILER Friends of Dawn Addis City Council 2022 Contributions Received 1. Monetary Contributions................................................... scneduleA, Linea 2. Loans Received... schedule B. Line 3 3. SUBTOTAL CASH CONTRIBUTIONS.... I 1 004 1 944 Ltd' 6646 6*1&1 Add Lines 1 +2 4. Nonmonetary Contributions,. 9 1 1 4 1 0 0 0 1 * I & 9 1 0 & 1 0 1 6 4 1 1 W A 0 1 & I N A 1 4 1 1 1 A I Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3 + 4 Expenditures IlAade 6. Payments Made... 6 A I A I I h D I 1 0 0 & 0 0 4 9 1 1 4 0 D I t 1 0 4 6 6 A I 1 4 b I & a Schedule E, Line 4 70 Loans Made...... I a 1 1 4 a a a a a . ...................................................... schedule!) Line 3 8. SUBTOTAL CASH PAYMENTS, . 0 1 0 P 1 9 A I * 4 1 1 0 0 4 4 1 1 0 W 1 9 * I 1 6 * 4 1 0 1 1 A & 1 4 t I I * Add Lines 6 + 7 0 9. Accrued Expenses (Unpaid Bills) .......................................... schedule 1; Line 3 10. Nonmonetary Adjustment, 1 4 1 1 4 1 4 1 4 4 1 4 1 0 A 4 1 4 * I I I I I I I I I 1 1 4 1 6 1 4 1 1 4 1 1 1 1 1 1 , , 1 4 1 1 4 1 , * I I schedule Co Line 3 11. TOTAL EXPENDITURES MADE'..,....",',,, . . I I I I I I . I. I.I........... Add Lines 8 + 9 + 10 $ Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) Column B CALENDAR YEAR TOTAL TO DATE 0 568.57 $ 00 57 568. .0o .00 568,57 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 558.57 13, Cash Receipts........................................................... Column A, Line 3 above 10.00 14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 .00 15. Cash Payments......................................................... Column A, Line 8above 568.57 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ .00 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED. ............................... Schedule e, Part $ 00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents, ..............................................6 See instructions on reverse $ .00 19. Outstanding Debts .............................. Add Line 2 + Line sin Column a above $ .00 0 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some an in Column A may be negative figures that should be subtracted from previ this ous period amounts. If 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 Page 3 of 6 I.D. NUMBER 1406734 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 $ 10.00 $ xpen21 M de ditures $ 568,57 $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit} Date of Election (mm/dd/yy) l� Total to Date *Amounts in this section may be different from amounts reported in Column B. 0 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SC f}edu'a A Amounts may be rounded SCHEDULE A One rY Contributions @C�'IV@d to whole dollars. Statement covers period ® o 01 /01 /2022 . from ® 03/22/2022 4 6 through page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Friends of Dawn Addis City Council 2022 1406734 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER MOUNT CUMULATIVE TO DATE PER ELECTION 7RECEiVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME ERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 1. 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.)......................TOTAL $ 10 10 *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 (1an/2016) FPPC Adviee: advice@fppc.ca.gov {866/275-3772) www.fpPC.ca.gov Schedule SCHEDULE D Summary Of Expenditures Amounts may be rounded Statement covers period ' " Supporting/Opposing ®that to whole dollars. • 01 /01 /2022 0 Candidates, Measures and Committees from 03/22/2022 5 6 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Friends of Dawn Addis City Council 2022 1406734 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION CUMULATIVE TO DATE AMOUNT THIS CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OR COMMITTEE Monetary 01 /28/2022 Shatter PAC Contribution $ 358.87 $ 358.87 Committee ID # 1439036 ❑ Nonmonetary Contribution ❑ Independent Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 358.87 Schedule ®Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.)....................................................... $ 358.87 2. Unitemized contributions and independent expenditures made this period of under$100.................................... Iota $ 4.70 3. Total contributions and independent expenditures made this period. ( Add Lines 1 and 2. Do not enter on the Summary Page.) ......... . TOTAL.. $ 363.57 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/2753772) wwwJppc.ca.gov SCHEDULE E • • I • SEE ON REVERSE OF FILER Friends of Dawn Addis City Council 2022 Amounts may be rounded to whole dollars. Statement covers period from 01 /01 /2022 through 03/22/2022 ( Page 6 of 6 1406734 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 CA Secretary of State 1500 11th Street, Room 495 FIL $ 200.00 Sacramento, CA 95814 Shatter PAC (Committee ID # 1439036) 5445 Madison Ave CTB $ 358.87 Sacramento, CA 95841 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 558.87 Schedule E Summary 558.87 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ ..................A 9.70 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).)............................................................................. $ .00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 568.57 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov