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Home My WebLink About2018.09.27_Goldman_Jan_Form 460Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1/18 through 9/22/18 Date of election if applicable: (Month, Day, Year) Nov. 6, 2018 QED City of Morro Bay SEP 2 7 2018 Administration COVER PAGE Page For Official Use Only 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. EZ Officeholder, Candidate Controlled Committee O State Candidate Election Committee O Recall (Also Complete Pert 5) ❑ General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee ❑ Primarily Formed Ballot Measure Committee O Controlled O Sponsored (Also Complete Pert 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Pert 7) 2. Type of Statement: m Preelection Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) O Amendment (Explain below) ❑ Quarterly Statement ❑ Special Odd -Year Report 3. Committee Information I.D. NUMBER 1410216 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Jan Goldman for City Council a n 18 STREET ADDRESS NO P.O. BOX CITY STATE ZIP CODE Morro Bay CA 93442 AREA CODE/PHONE 805_ MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Treasurer(s) NAME OF TREASURER John Erwin MAILING ADDRESS CITY Morro Bay NAME OF ASSISTANT TREASURER, IF ANY STATE ZIP CODE CA 93442 AREA CODEIPHONE 701 MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / 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 Califomia that the foregoi 9/26/2018 Executed on Executed on Executed on Executed on Date Date 9/26/2018 Date Date By By By By ponsible 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 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE Janith Goldman OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council, 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 formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 0 YES flNO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE', 0 YES ENO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 CALIFORNJA 460 FORM NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION Li SUPPORT 0 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 List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD OFFICE SOUGHT OR HELD Attach continuation sheets if necessary 0 S• UPPORT 0 O• PPOSE • SUPPORT O OPPOSE 0 SUPPORT O OPPOSE 0 SUPPORT OPPOSE FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 'Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. NAME OF FILER Jan Goldman for City Council a o i g Contributions Received 1. Monetary Contributions 2. Loans Received 3. SUBTOTAL CASH CONTRIBUTIONS 4. Nonmonetary Contributions 5. TOTAL CONTRIBUTIONS RECEIVED Expenditures Made 6. Payments Made 7. Loans Made 8. SUBTOTAL CASH PAYMENTS Schedule Al Line 3 Schedule B, Line 3 Add Lines 1 + 2 Schedule C, Line 3 Add Lines 3 + 4 $ Schedule E, Line 4 $ Schedule H, Line 3 Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 10. Nonmonetary Adjustment Schedule C, Line 3 11. TOTAL EXPENDITURES MADE Current Cash Statement 12. Beginning Cash Balance 13. Cash Receipts 14. Miscellaneous Increases to Cash 15. Cash Payments 16. ENDING CASH BALANCE • Add Lines 8+9+10 $ Previous Summary Page, Line 16 Column Al 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 $ Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 0 0 Statement covers period from 7/1 /18 through 9/22/18 Column B CALENDAR YEAR TOTAL TO DATE 3 l33 0 VA; 0 ig? 1459 $ 1459 0 0 1459 $ 1459 0 0 0 0 1459 $ 1459 0 1459 ea* $ igt Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ 0 19. Outstanding Debts Add Line 2 + Line 9 in Column B above $ 0 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 Page 3 of 8 I.D. NUMBER 1410216 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 0 $ 0 0 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) 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 A Amounts may be rounded SCHEDULE A MonetaryContributions Received MI wnv�e aouars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1/18 CALIFORNIA FORM Page 460 through 9/22/18 4 of 8 NAME OF FILER Jan Goldman for City Council20)1 I.D. NUMBER 1410216 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 OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 9/19/2018iiiiiii Morro Bay, CA 93442 !A IND City of Morro Bay/Elected Official 199 199 ■ coM ■ OTH • PTY IN scc 9/19/2018 Lee Johnson orro ay, 3442 • IND CEO Accuair 500 500 ■ COM !A OTH • PTY ■ SCC 9/19/2018 Rick & Sharyn Young orro ay, 442 r IND Retired 100 100 IIcoM • OTH • PTY ■ Scc 9/19/2018 Suze Crowley Morro Bay, CA 93442 !I IND Personal Trainer Self Employed 100 100 ■ COM • OTH • PTY IN SCC 9/19/2018 Rich Buquet Morro Bay, CA 93442 !A IND Ritired 100 100 ■ coM ■ OTH • PTY ■ SCC SUBTOTAL$ 999 Schedule A Summary 1. Amount received this period — itemized monetary contributions. 2599 C (Include all Schedule A subtotals.) $ 2. Amount received this period — unitemized monetary contributions of less than $100 $ 534 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ 3233 *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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) nnonetary contributions Received townoledollars. Statement covers period from 7/1/18 CALIFORNIA 460 FORM through 9/22/18 Page 5 of 8 NAME OF FILER Jan Goldman for City Council .201 8 I.D. NUMBER 1410216 DATE RECEIVED FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEES ALSO ENTERI.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 9/19/2018 Laura Pick Morro Bay, CA 93442 !►� IND II COM ■ OTH ■ PTY • scc Ritired 200 200 9/19/2018 John & Irene Smith rro 442 IND ■ COM ■ OTH II PTY • scc Ritired 100 100 9/19/2018 Ric Deschler orro ay, 93442 +i IND • coM ■ OTH • PTY ■ scc Ritired 100 100 9/19/2018 Bruce Gibson for Supervisor #1279202 P,O.Box 1001 Morro Bay, CA 93443 • IND ■ COM ■ OTH p PTY • scc 200 200 9/19/2018 John & Trisch Garcia Morro Bay, CA 93442 ►i IND II COM IN OTH MI PTY • SCC Retired 100 100 SUBTOTAL $ 700 '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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) monetary contributions Received townoieuonars. Statement covers period from 7/1/2018 CA LIFO RN IA 460 FORM through 9/22/2018 Page 6 of 8 NAME OF FILER Jan Goldman for City Council ,2O ► 8 I.D. NUMBER 1410216 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 OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 9/19/2018 Julianna Larsen Morro Bay, CA 93442 �i IND ■ COM ■ OTH • PTY • scc Retired 100 100 9/19/2018 Judi Turner Carlsbad, CA 92011 ►1 IND II COM IN OTH • PTY IN scc Retired 100 100 9/19/2018 Glad s Bird orro ay, 93442 �I IND • COM ■ OTH • PTY • scc Retired 100 100 9/19/2018 Law Offices Jane Heath 1052 Main St. Ste A Morro Bay, CA 93442 ■ IND •of Gd OTH • coM • PTY • SCC Attorney Self-employed 100 100 9/19/2018 M r V n orro Bay, CA 93442 IF/ IND • COM III OTH • PTY • SCC Retired 100 100 SUBTOTAL $ 500 *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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period from 7/1/2018 CALIFORNIA 460 FORM through 9/22/2018 Page 7 of 8 NAME OF FILER Jan Goldman for City Council ?G / 8 I.D. NUMBER 1410216 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * !FAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OF SELF-EMPLOYED, ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 9/19/2018 Barbara Munoz Morro Bay, CA 93442 !►I IND ■ coM ■ OTH • PTY • scc Retired 100 100 9/19/2018 Ra McKelve Morro Bay, CA 93442 IND • COM ■ OTH • PTY • scc Retired 100 100 9/19/2018 Natalie Ramos Morro Bay, CA 93442 �I IND ■ COM ■ OTH ■ p-y ■ scc Retired 100 100 9/19/2018 Marie Allen Morro Bay, CA 93442 Q IND • COM ■ OTH ■ PTY ■ scc Retired 100 100 ■ IND ■ COM • OTH ■ PTY ■ SCC SUBTOTAL $ 400 *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 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jan Goldman for City Council 201g Amounts may be rounded to whole dollars. Statement covers period from 7/1/18 through 9/22/18 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP CNS CTB CVC FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB SCHEDULE E Page 8 of 8 radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID FIL Reimbursement of Filing and P.O. Box Fees 253 Jan Goldman Morro Bay, CA 93442 Hay Printing 3118G Main Street, Morro Bay, CA 93442 CMP Yard Signs and Envelopes 1090 ASAP Reprographics 495 Morro Bay Blvd., Morro Bay CA 93442 CMP Post Cards 116 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1459 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) $ 1459 2. Unitemized payments made this period of under $100 $ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ 1459 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov