HomeMy WebLinkAbout2020.08.20_Williams-Mahan_Form 460 Termination AmendRecipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
4.
Type of Recipient Committee: All Committees —Complete Parts 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
O Recall
(Also Complete Part 5)
feral Purpose Committee
Sponsored
Small Contributor Committee
Political Party/Central Committee
Committee Information
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO C
Williams Mahan For City Council 2020
Primarily Formed Ballot Measure
V Controlled
Sponsored
(Also Complete Part 6)
Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE /PHONE
Morro Bay CA 93442
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
P.O. BOX 1704
CITY STATE ZIP CODE AREA CODE/PHONE
Morro Bay CA 93443
OPTIONAL: FAX / E-MAIL ADDRESS
COVER PAGE
Type of Statement:
Preelection Statement e Quarterly Statement
Semi-annual Statement Special Odd -Year Report
Termination Statement
(Also file a Form 410 Termination)
m Amendment (Explain below)
Schedule E-Payments Made -Returned Contributions
Treasurers)
NAME OF TREASURER
Kristen Headland
MAILING ADDRESS
P.O. BOX 1704
CITY STATE ZIP CODE AREA CODE/PHONE
Morro Bay CA 93443
NAME OF ASSISTANT TREASURER, IF ANY
Barry Branin
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
Morro Bay CA 93442
OPTIONAL: FA
X / E-MAILADDRESS
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
certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
0 Z
, ()
Executed on Z_,Z� U By
Date
Executed on
f B ' ZU - 2� Za yX
Dale ' natu of Controlling Officeholder, Candidate, State Measure Proo nent or ResDons a Officer of Sponsor
Executed on
Date
Executed on
Date
ay Signature of Controlling Officeholder, Candidate, Slate Measure Proponent
By
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
Melanie Williams Mahan
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
City Council Member
RESIDENTIALIBUSINESS ADDRESS (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
NAME OF TREASURER
I.D. NUMBER
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME
OF TREASURER
CONTROLLED COMMITTEE?
ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
CK.��137 T c7�701211M
1
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I JURISDICTION
Page 2 of 5
❑ 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 L.isrnames of
officehoider(s) or candidate(*) 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
to whole dollars.
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Williams Mahan For City Council 2020
Contributions Received
1. Monetary Contributions................................................... schedule A, Line 3
2. Loans Received................................................................ Schedule e, Line 3
3, SUBTOTAL CASH CONTRIBUTIONS". too $St$ 0 $ISO Is *a &a Is Add Lines 1 + 2
4. Nonmonetary Contributions... a Schedule C. Line 3
5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4
Statement covers period
02/14/2020
from
06/29/2020
through
Column A Column B
TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTAL TO DATE
$ 1,100.00 $ 11100.00
0.00 0.00
$ 1,100.00 $ 11100000
0.00 0.00
$ 1,100.00 $ 11100.00
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).....................................9.... 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 ............................ Previous Summary Page, Line 16
13. Cash Receipts........................................................... column A. Line 3 above
14. Miscellaneous Increases to Cash... 0 1 a a 0 1 1 0 0 1 S a I a I 1 0 4 S 0 1 q V 4 0 9 a 0 0 S V Schedule i, Line 4
15. Cash Payments. ........................................................ column A. Line 8 above
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15
If
this is a termination statement, Line 16 must be zero.
1
,100.00
0.00
1,100000
0.00
0.00
1,100000
1 W100000
0.00
1 ,1 00000
$ 0.00
17. LOAN GUARANTEES RECEIVED ................................ schedule e, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents. ............................................... See instructions on reverse $
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column 8 above $
0.00
0.00
$ 1,100.00
0.00
$ 11100800
o.00
0.00
$ 11100800
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).
Page 3
I.D. NUMBER
1425213
SUMMARY PAGE
of 5
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
20. Contributions
Received Expenditures
Made
1/1 through 6/30 7/1 to Date
N/A
$
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.
1
FPPC Form 460 (!an/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A Amounts may be rounded
SCHEDULE A
Monetary Contributions Received to whole dollars.
Statement covers period
02/14/2020
,
from
06/29/2020
4 5
SEE INSTRUCTIONS ON REVERSE
through
Page of
NAME OF FILER
I.D. NUMBER
Williams Mahan For City Council 2020
FULL NAME, STREET ADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
CONTRIBUTOR
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
02/24/2020
Kristen Headland
®
IND
Retired
$100.00,
$100.00
❑
CoM
Morro Bay, CA., 93442
❑OTH
❑
PTY
❑
SCC
02/24/2020
Barry Branin
®
IND
Retired
$500.00
$500.00
❑
CoM
Morro Bay, CA., 93442
❑OTH
❑
PTY
❑
SCC
02/24/2020
Tom Rost
®IND
Retired
$500,00
$500000
❑COM
Topeka, KS, 66612-1608
❑
OTH
❑
PTY
SCC
❑
IND
❑
COM
❑
OTH
❑
PTY
❑
SCC
❑IND
❑ COM
❑ OTH
❑ PTY
SCC
SUBTOTAL$ 1,100.00
Schedule A Summary
1. Amount received this period Woodsitemized monetary contributions.
(Include all Schedule A subtotals.)..OWN ............ sea .. bass ads ... boo ............. boa .... ease . Possess ............ boa .......................$
1,100.00
0.00
2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$
3. Total monetary contributions received this period. 1,100.00
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $
*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 Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULEE
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Williams Mahan For City Council 2020
Amounts may be rounded
to whole dollars.
Statement covers period
02/24/2020
from
through 06/29/2020
"'" 46U
RM
D.NUMBER
1425213
CODES: If one %J 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
CTB contribution (explain nonmonetary) RFD returned contributions
OFC office expenses
CVC civic donations PET petition circulating
FIL candidate filing/ballot fees PHO phone banks
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
FIND fundraising events POL polling and survey research
ND independent expenditure supporting/opposing others (explain) TRS staff/spouse travel, lodging, and meals
IPOS 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)
9
p
NAME AND ADDRESS OF PAYEE
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Staples Office Supplies
OFC
Stationary, Envelopes, Planner, Binders
142.14
2950 Broad Street
San Luis Obispo, CA., 93401
Barry Branin
RFD
Returned Contribution
426.43
3290
Bay, CA., Morro Bay, CA
Tom Rost
RFD
Returned Contribution
426.43
827
KS., 6612-1608
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
Schedule E Summary
I.
SUBTOTAL $ 995.00
Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $
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 A, Line 6.)........................... TOTAL $
105.00
none
1,100.00
FPPC Form 460 (1an/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov