HomeMy WebLinkAbout2022.01.18_CAL_Form 460Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Type of Recipient Committee: All Comtnittees —Complete Parts 1, 2i 3, and a.
Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
0 Recall
(Also Complete Part 5)
feral Purpose Committee
Sponsored
Small Contributor Committee
Political Party/Central Committee
Committee Information
COMMITTEE NAME (OR CANDIDATE'S N
Citizens For Affordable Living
STREET ADDRESS (NO P.O. BOX)
Primarily Formed Ballot Measure
Committee
Controlled
Sponsored
(Also Complete Pert 6)
Primarily Formed Candidate/
Officeholder Committee
(Also Complete Pad 7)
CITY STATE ZIP CODE AREA CODE/PHONE
Morro
CA 93442
NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODEIPHONE
OPTIONAL: FAX I E-MAIL ADDRESS
4. Verification
COVER PAGE
Type of Statement:
iJ Preelection Statement ❑ Quarterly Statement
m Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
Also file a Form 410 Termination)
m Amendment (Explain below)
Change CAL bank account to Pacific Premier Bank, P.O. Box 25171,
anta Hna, uH aziaa-
Treasurers)
NAME OF TREASURER
Kristen Headland
MAILINGADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
Morro Bay CA 93442
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX I 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 correct.
Executed ony — j Z' 0 By
Date na Treasurer or Assistant Treasurer
Executed on v / �� ZV 2 � By
Date ftnatu n ro ing O , Candidate, State Measure Proponent or Responsible Officer of Sponsor 02
Executed on
Date
Executed on
Date
By
Signature of Controlling Officeholder, Candidate, Slate Measure Proponent
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01 /2021
SUMMARY PAGE
SEE INSTRUCTIONS ON REVERSE through 12/31/2021 Page 2 of 3
NAME OF FILER I.D. NUMBER
Citizen For Affordable Living 1396018
Contributions Received Column A Column B Calendar Year Summary for Candidates
TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and
General Elections
1. Monetary Contributions................................................... schedule A, Line 3 $ 0. $ 648.38
1/1 through 6/30 7/1 to Date
2. Loans Received. schedule a, Line 3 0. 0.
0 64838 20. Contributions 0 0
3. SUBTOTAL CASH CONTRIBUTIONS, N 6 W 1 6 4 1 1 a 6 1 a 6 1 F a 4 1 6 V a V 6 1 * Add Lines 1 +2 $ $ Received $ $
4. Nonmonetary Contributions ............................................ schedule C, Line 3 0' 0' 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED, ...............................Add Lines 3+4 $ 0. $ 648.38 Made $ 0. $0.
Expenditures Made Expenditure Limit Summary for State
6. Payments Made,..... 0 a t 6 # k 0 t 6 1 a a A 0 a 6 1 4 a a 4 6 1 t 6 1 1 A 0 $ . 4 4 1 1 0 t & a t b & a a a 6 a & A 1 4 6 . a 4 t I I schedule E, Line 4 $ 50.00 $ 50.00 Candidates
7. Loans Made......... 6 9 . 0 0 0 r I A 4 V W a 1 4 4 W 6 1 1 t 6 a a a . 0 . 6 V 6 6 V 4 4 6 * 9 0 . 1 4 a t 6 4 1 6 1 4 W 6 1 4 W . q 0 t 0 0 Schedule H, Line 3 0. ON
8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 50,00 $ 50.00
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 0' 0' Date of Election Total to Date
10. Nonmonetary Adjustment.. Schedule C. Line 3 0. 0. (mm/dd/yy)
11. TOTAL EXPENDITURES MADE. . 6 6 1 4 4 1 4 6 6 6 4 4 6 0 4 4 4 1 1 4 1 4 b 0 0 1 1 1 1 1 1 6 1 Add Lines 6+9+ to $ 50.00 $ 50.00 l so.
Current Cash Statement so.
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 648.38
To calculate Column B,
13. Cash Receipts........................................................... column A, Line 3 above 0• add amounts in Column
ON A to the corresponding *Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash .................................. schedule t, Line 4amounts from Column B reported in Column B.
15. Cash Payments......................................................... Column A, Line 6 above 50.00 of your last report. Some
amounts in Column A may
16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 598.38 be negative figures that
should be subtracted from
If this is a termination statement, Line 16 must be zero. previous period amounts, If
this is the first report being
17. LOAN GUARANTEES RECEIVED ................................ schedule e, Part 2 $ 0, filed for this calendar year,
only carry over the amounts
Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if
18. Cash Equivalents. . 1 0 0 9 0 1 a 1 $ F 14 0 V 4 4 10 V a 1 4 1 a 1 0 . 0 9 0 0 1 V . W 4 N 0 0 W , 0 4 , 4 , See instructions on reverse $
0. any)'
19. Outstanding Debts. . 6 t a 1 0 6 1 1 a 4 . 4 0 . 4 0 V . I a 0 0 a 0 P 0 0 P Add Line 2 + Line 9 in Column a above $ 0' FPPC Form 460 (1an/2016))
FPPC Advice: advice@fppc.ca.gov (866/275=3772)
www,fppc.ca.gov
Schedule ER
Payments Made
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2021
SCHEDULE E
SEE INSTRUCTIONS ON REVERSE
through 12/31/2021 3
Page of 3
NAME OF FILER I.D. NUMBER
Citizens For Affordable Living 1396018
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
FILM 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
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ ON
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $
2. Unitemized payments made this period of under$100.......................................................................................................................................... $
o.
50.00
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e)) ............................................................................. $ 04
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 50.00
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/2753772)
—� www.fppc.ca.gov