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Home My WebLink About2018.10.19_Goldman_Jan_Form 460Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 9f2G/18 4/A3//8 10/257168't%4/$ through Date of election if applicable: (Month, Day, Year) Nov. 6, 2018 Date Stamp RECEIVED City of Morro Bay OCT 19 2018 City Clerk COVER PAGE CALIFORNIA 460 FORM Page 1 of 8 For Official Use Only 1. Type of Recipient Committee: AN Committees —Complete Parts 1, 2, 3, and 4. [✓� 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 ❑ Primarily Formed Ballot Measure Committee O Controlled O Sponsored (Also Complete Porte) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Pert 7) 2. Type of Statement: O Preelection Statement ❑ Semi-annual Statement O Termination Statement (Also file a Form 410 Termination) O Amendment (Explain below) 0 Quarterly Statement ❑ Special Odd -Year Report 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Jan Goldman for City Council 2018 I.D. NUMBER 1410216 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 STATE ZIP CODE CA 93442 AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY 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 foregoing is true a Executed on Executed on Executed on Executed on Date 1-9/261201-8 / o// /2.eV 8 Date 18126T201B /0//9/26rr Date Date By By By By Signature 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? ❑ YES ❑ NO 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? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION El 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 List names 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 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT 0 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 Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jan Goldman 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 Add Lines 3 + 4 $ Expenditures Made 6. Payments Made Schedule E, Line 4 $ 7. Loans Made Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) Schedule € 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 Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) AO in Y. -1-372 198 /07 0-4570-r $ from Statement covers period 9126118 T•134, icv 46125t1-8- Mg through % e Column B CALENDAR YEAR Qts TOTAL TO DATE -46$5• 91° . 198 4303 41703" 2361 $ 3820 0 $ 2361 330 198 $ 2889 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 1674(yi 7,2\ t3 0 2361 / es; -685 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 $ $ 3820 330 198 $ 4348 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 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ 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 (866/2751-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A MonetaryContributions Received I.v WI'u.e aouars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 8`�7.23 CALIFORNIA 460 FORM /ol/�fy / through 10/25/18 //6 Page 4 of 8 NAME OF FILER Jan Goldman for City Council 2018 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) 9/26/18 Robert H land orro ay, 3442 i• IND Retired 100 100 ■ COM • OTH • PTY ■ SCC 9/26/18 Marc Shouse Morro Bay, CA 93442 !I IND Retired 100 100 ■ COM • OTH • PTY • scc 9/26/18Mil Morro Bay, CA 93442 r IND Retired 100 100 • COM ■ OTH ■ PTY ■ scc 9/26/18 John Heading Morro Bay, CA 93442 Elected Official/City of Morro Bay 200 200 !I IND • coM • OTH • PTY • SCC 10/8/2018 Jeremiah O'Brien Morro Bay, CA 93442 !A IND Fisherman 100 100 ■ COM • OTH • PTY • scc SUBTOTAL $ 600 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) $ 2. Amount received this period — unitemized monetary contributions of Tess 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.) g00 672 1 It7. TOTAL $ 432 *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.) MonetaryContributions Received to whole dollars. Statement covers period from 8. /3//bJ CALIFORNIA FORM 460 loft / 74 Page 5 of 8 through 9 tte- NAME OF FILER Jan Goldman for City Council 2018 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) 10/7/2018am. Morro Bay, CA 93442 M IND ■ COM II OTH • PTY ■ scc Retired 100 100 10/12/2018 Judith Resnick Morro Bay, CA 93442 ®IND ■ COM ❑ OTH • PTY • scc Retired 100 100 • IND • COM • OTH • PTY ■ SCC • IND • COM • OTH • PTY • SCC • IND • COM ■ OTH • PTY • SCC SUBTOTAL$ 200 *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 C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jan Goldman for City Council 2018 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * 11 IND COM OTH PTY S CC IND COM OTH PTY S CC IND COM OTH PTY SCC IND COM OTH PTY S CC Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Attach additional information on appropriately labeled continuation sheets. from through DESCRIPTION OF GOODS OR SERVICES SUBTOTAL $ Statement covers period gity/ y t 10/25/18 1/4, Page SCHEDULE C CALIFORNIA 460 FORM AMOUNT/ FAIR MARKET VALUE i 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 Paget Column A, Lines 4 and 10.) TOTAL $ 198 198 6 I.D. NUMBER 1410216 CUMULATIVE TO DATE CALENDAR YEAR (JAN1- DEC 31) of 8 PER ELECTION TO DATE (IF REQUIRED) *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 1 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772j www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jan Goldman for City Council 2018 Amounts may be rounded to whole dollars. from through Statement covers period -9/2etta 4AS" / 04a /8 SCHEDULE E CALIFORNIA 460 FORM 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 NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER 1 D. NUMBER) ASAP Reprographics MBR MTG OFC P ET P HO P OL P OS P RO P RT 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 CODE CMP RAD RFD SAL TEL TRC TRS TSF VOT WEB Page 7 I D NUMBER 1410216 of 8 radio airtime and production costs returned contributions campaign workers' salaries U. 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 (Internet, e-mail) OR DESCRIPTION OF PAYMENT Post Cards and Mailings AMOUNT PAID 2360.71 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2360,71 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) $ 2361 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).) $ 4. Total payments made this period. (Add Lines 1, 2, and 3 Enter here and on the Summary Page, Column Al Line 6.) TOTAL $ 2361 FPPC Form 460 pan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE F Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jan Goldman for City Council 2018 CODES: If one of the following codes accurately describes the 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 NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) MBR MTG OFC PET P HO POL POS P RO P RT Amounts may be rounded to whole dollars. payment, you may enter the code. 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 CODE OR DESCRIPTION OF PAYMENT Statement covers period from 4/43 401254844A through Otherwise, RAD RFD SAL TEL TRC TRS TSF VOT WEB (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD CALIFORNIA 460 FORM t Page 8 I.Q. NUMBER 1410216 of 8 describe the payment. radio airtime and production costs returned contributions campaign workers' salaries U. 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 (Internet, e-mail) (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD New Times 1010 Marsh St. San Luis Obispo, CA 93401 ASAP Reprographics * Payments that are contributions or independent expenditures must also be summarized on Schedule D. New Paper Advertising Campaign Mailing SUBTOTALS $ 0 0 o$ 330.00 2360.71 2690.71 $ 0 2360.71 2360.71 $ Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 330 0 0 2691 PAID TOTALS $ 2361 on the Summary Page, Column Al Line 9.) NET $ 330 May be a negative number FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov