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Home My WebLink AboutCarlyn Christianson - Form 460 - Termination Statement - 07-01-2013Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200 - 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from _ 06/02/2013 through 06/30/2013 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee Q State Candidate Election Committee O Primarily Formed Q Recall Q Controlled (Also Complete Part 5) 0 Sponsored ❑ General Purpose Committee (Also Complete Parf6) Q Sponsored Q Small Contributor Committee Q Political Party /Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1355988 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Carlyn Christianson for City Council 2013 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE San Luis Obispo CA 93401 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS carlynpc @gmail.com Date Stamp RECEIVED Date of election if applicable: (Month, Day, Year) 11 JUL 0.12013 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my kn+ certify under penalty of perjury under the laws of the State of California that the foregoing I true and r � Executed on �f -!- /" By Data Executed on TTr � 0 By SrgnahueofConlm I Dale 06/18/2013 2. Type of Statement: ❑ Preelection Statement +.[ Semi - annual Statement I Termination Statement ❑ Amendment (Explain below) COVER PAGE 1 of 9 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Jeri F Carroll MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE San Luis Obispo CA 93401 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS jeri_Carroll @att.net contained herein artd in the attached schedules is true and complete. I Executed on By Date Signature ofConVolling Officeholder, Candidate, State Measure Proponent Executed on By FPPC Form 460 June/01 Dale Signature of Controlling Officeholder, Candidate, Stale Measure Proponent t ) FPPC Toll-Free Helpline: 868 1ASK•FPPC State of California Recipient Committee Type or print in ink. COVER PAGE - PART 2 Campaign Statement F CALIFORNIA 4 • 1 Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Carlyn Christianson OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council, San Luis Obispo RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Luis Obispo Ca 93401 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 ID 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) Page 2 of 9 6. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO OR LETTER JURISDICTION ® 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 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 ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE �I IT OIMIC ur t.vUC MRCM UVUC1rr1U1VC Attach continuation sheets if necessary FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Carlyn Christianson for City Council 2013 Type or print in ink. Amounts may be rounded to whole dollars. SUMMARY PAGE Statement covers period from 06/02/2013 through 06/30/2013 Page 3 of 9 Contributions Received Column A Column B 6. Payments Made ............ ............................... Schedule E, Line 4 $ TOTALTHISPERIOD CALENDARYEAR 7. Loans Made .......................................... _ ............. .... Schedule H, Line 3 (FROM ATTACHED SCHEDULES) TOTALTODATE 1. Monetary Contributions ............ ............................... Schedule A, Line $ 3,044.00 $ 19,758.99 2. Loans Received ....................... ............................... schedule B, Line 3 46 (303.46) 456. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 2,740.54 $ 20,215.53 4. Nonmonetary Contributions ..... ............................... Schedule C, Line 3 400.00 720.00 5. TOTAL CONTRIBUTIONS RECEIVED ...•... ..• .................AddLines3 +4 $ 3,140.54 $ 20,935.53 Expenditures Made 6. Payments Made ............ ............................... Schedule E, Line 4 $ 4,529.82 $ 20 215.53 7. Loans Made .......................................... _ ............. .... Schedule H, Line 3 .00 .00 8. SUBTOTAL CASH PAYMENTS ................. __.............. Add Lines 6 +7 $ 4,529.82 $ 20,215.53 9. Accrued Expenses (Unpaid BIIIS ....... Schedule F, Line 3 .00 .00 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 .00 .00 11. TOTAL EXPENDITURES MADE ........................ ....AddLinesa +9 +10 $ 4,529.82 $ 20,215.53 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 ........................... Schedule 1, Line 4 $ 1,789.28 2,740.54 . 00 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last 15. Cash Payments ................... ............................... Column A, Line 6 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 4,529.82 •00 report. Some amounts in Column A may be negative figures that should be If this is a termination statement, Line 16 must be zero. subtracted from previous period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ __ _.. for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Cash Equivalents and Outstanding Debts 18. Cash Equivalents ......... ............................... See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ . __ ..... _ I.D. NUMBER 1355988 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6/30 7/1 to Date 20. Contributions Received $ 21. Expenditures Made $ $ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (It Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) _-J 1 $ *Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule A Type or print in ink. SCHEDULE A Monetary ontributions Received Amounts may be rounded Statement covers period ry ec to dollars. CALIFORNIA A whole • t from 06/02/2013 FORM through 06/30/2013 Page 4 of 9 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Carlyn Christianson for City Council 2013 1355988 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED ( IFCOMMITTEE ,ALSOENTERI.D.NUMBER) CODE* (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC (SEE ATTACHED CONTINUATION SHEET) ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ I I Schedule A Summary 1. Amount received this period — contributions of $100 or more. (Include all Schedule A subtotals.) ......................................................................... ............................... $ 2. Amount received this period — unitemized contributions of less than $ 100 ......................... I................... $ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ 2,520.00 524.00 3,044.00 "Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY— Political Party SCC — Small Contributor Committee FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule A (Continuation Sheet) Statement covers period California Form 460 Monetary Contribution Received from 06/02/13 Page 5 of 9 Name of Filer: Carlyn Christianson for through 06/30/13 I.D. Number 1355988 City Council 2013 Date Name and Address Code Occupation Employer Period YTD Election 4 -Jun Mila Vujovich -La Barre, San Luis Obispo CA 93405 IND R 100 100 100 4 -Jun Helen Schneider, Santa Barbara Ca 93121 IND Mayor Santa Barbara 100 100 100 4 -Jun Bob Nichols, San Luis Obispo CA 93401 IND Professor Allan Hancock College 200 200 200 6 -Jun Laura Ward, San Luis Obispo Ca 93401 IND Wine Broker Self Employed 80 200 200 6 -Jun Cambria Democratic Club of the North Coast, Cambria CA 93428 PTY PTY 200 200 200 6 -Jun Cheryl Conway, 110 Ca ucos CA 93430 IND Homemaker Self Employed 200 200 ^'10 6 -Jun .James Conway, 110 Chaney Ave Cayucos Ca 93430 IND Professor Cal Poly 200 200 ,0 6 -Jun IBEW Local San Luis Obispo CA 93401 PTY - PTY 200 200 200 6 -Jun .Jeri Carroll, SLO, CA 93401 IND IR 100 200 200 6 -Jun 'Tanya Kiani, Morro Bay, CA 93442 IND University Administrator Cal Poly 100 200 200 7 -Jun Richard & Carol Mortensen, San Luis Obis o CA 83401 IND R Artist 90 140 140 7 -Jun Ron Tilley, San Luis Obispo, CA 93401 IND Vice President Hospice of San Luis Obis o 50 100 100 7 -Jun ,Anne Cruikshanks, San Luis Obispo CA IND R 150 150 150 7 -Jun Gary Grossman, Pismo Beach CA 93449 IND Contractor Coastal Community Builders 200 200 200 19 -Jun Mary Matakovich, Avila Beach, CA 93424 IND IR 50 149i 149 19 -Jun Ellen Sheffer, San Luis Obispo Ca 93405 IND R 100 100 100 19 -Jun Dawn Legg, San Luis Obispo, Ca 93401 IND asst project mgr First Solar 100 200 200 21 -Jun Andrew & Laurie Mangano, San Luis Obispo, CA 93401 IND Developer/Housewife Self Employed 300 399' 399 2520 6 (1 � edue& 2 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER r..nrlvn r..hristinnsnn fnr r.ifv r..nllnr it 7(113 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Carlyn Christianson San Luis Obispo, CA 93401 t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC to whole dollars. from 06/02/2013 through 06/30/2013 IF AN INDIVIDUAL, ENTER tai OUTSTANDING lo) AMOUNT (c) AMOUNT PAID la) OUTSTANDING (e) INTEREST OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN BALANCEAT PAID THIS (IF SELF - EMPLOYED, ENTER BEGINNING THIS PERIOD TO DATE CLOSE OF THIS CALENDARYEAR NAME OF BUSINESS) P ERIOD $ THIS PERIOD" PERIOD PERIOD Medical Practice ® PAID DATE INCURRED Administrator, CALENDARYEAR $ 303.46 $ 456.54 0 % ❑ FORGIVEN Anesthesiology Medical DATE INCURRED RATE Associates $ PER ELECTION"* DATE INCURRED $ 760.00 $ $ none $ DATE DUE ❑ PAID ❑ FORGIVEN RATE DATE DUE SUBTOTALS $ ❑ PAID $ $ % ❑ FORGIVEN RATE DATE DUE $ 303.46 $ 456.54 $ Schedule B Summary 1. Loans received this period $ 0 (Total Column (b) plus unitemized loans less than $100.) 2. Loans paid or forgiven this period ......................... 303.46 (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. Subtract Line 2 from Line 1. NET $ (303.46) Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number) Contributor Codes ND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY— Political Party SCC —Small Contributor Committe (Enter (e) on Schedule E, Line 3) SCHEDULE B - PART 1 6 9 Page of I.D. NUMBER 1355988 9 ORIGINAL CUMULATIVE AMOUNTOF CONTRIBUTIONS LOAN TO DATE CALENDARYEAR 760.00 $ $ PER ELECTION** 02/25/2013 $ DATE INCURRED CALENDARYEAR PER ELECTION"" DATE INCURRED CALENDARYEAR $ $ PER ELECTION"* DATE INCURRED *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Carlyn Christianson for City Council 2013 Type or print in ink. Amounts may be rounded to whole dollars. ........... Statement covers period from .._ 06/02/2013 - through 06/30/2013 Plag e 7 I.D. NUMBER 1355988 of 9 C DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTIO N OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) (IF REQUIRED) MIND 06/11/13 Mary Verdin ❑COM Marketing Design 200.00 200.00 ❑❑PTY Verdin* Copywriting and g San Luis Obispo, CA 93401 Marketing printing ❑SCC coordination 0 Wine 200.00 200.00 200.00 6/27/13 Daniel Ward MIND ❑ COM Machinist ❑OTH P.G. & E San Luis Obispo, CA 93401 El PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 400.001 i Schedule C Summary 1. Amount received this period — nonmonetary contributions of $100 or more. (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 Page, Column A, Lines 4 and 10.) ...................... TOTAL $ 400.00 *Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule E Payments Made Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 06/02/2013 SCHEDULE E NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Verdin* Des Moines IA 50306 -0347 Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary AMOUNT PAID 3,066.72 100.00 165.00 SUBTOTAL$ 3,331.72 1. Payments made this period of $100 or more. (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 $ 4,529.82 0 0 4,529.82 FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC Schedule E Type or print in ink. (Continuation Sheet) Amounts may be rounded Payments Made to whole dollars. Statement covers period from 06/02/2013 SCHEDULE E (CONT.) SEE INSTRUCTIONS ON REVERSE through 06/30/2013 — Page g of g NAME OF FILER I.D. NUMBER Carlyn Christianson for City Council 2013 1355988 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia /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 PEf 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 (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Sub Vendor Political Data Inc tio6. LIT Norwalk CA 90652 p Wells Fargo Visa Des Moines IA 50306 -0347 1,198.10 D TEL Sub Vendor Stones' Phones it 7 Q- 34 Rancho Mirage, CA 92270 p ............... _.. Sub Vendor Novo Restaurant _...._... _ 7� & ?� MTG I San Luis Obispo, CA 93401 p *Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,198.10 FPPC Form 460 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC