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Home My WebLink AboutHarmon, Heidi - Form 460 - 07-01-16 to 09-24-16Recipient Committee Date Stam COVER PAGE Campaign Statement p ' " Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1/2016 through . 9/24/2016 1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. FO Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I D. NUMBER 1388334 ;OMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Heidi Harmon for Mayor 2016 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 I E-MAIL ADDRESS HeidiisMighty@gmail.com 4. Verification Date of election if applicable:i RECEI (Month, Day, Year) i SEP 2 9 2016 11/8/2016 SLO CITY CLE 2. Type of Statement: 50 Preelection Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) �MgI of1.9-- I For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Kathie Walker MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE San Luis Obispo CA 93405 ( NAME OF ASSISTANT TREASURER, IF ANY Heidi Harmon MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE San Luis Obispo CA 93401 ( OPTIONAL: FAX/ 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 parju under the laws of the State of California that the foregoing or Resvbnsibie Offerer o[ Soansor Executed on Date Executed on Date By By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Heidi Harmon OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Mayor of the City of San Luis Obispo RESIDENTIAL/BUSINESS ADDRP.::S (NO. AND STREET) COT, S ;A T F 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 NAME OF TREASURER COMMITTEE ADDRESS I.D. NUMBER k— —1 COVER PAGE - PART 2 Page Z of iq 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTERj 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 )NTROLLED COMMFrrEE7 7. Primarily Formed CandidatelCfficeholder Committee Listnames of officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ YES F1 NO CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME i I.D. NUMBER NAME OF TREASURER ADDRESS (NO P.O. ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE 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 ❑ SUPPORT ❑ OPPOSE ❑ SUPPORT ❑ OPPOSE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE 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 Amounts may be rounded to whole dollars. Statement covers period from 7/1/2016 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE through 9/24/2016 Page J of J� NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 Contributions Received Expenditure Limit Summary for State Column A Column B Calendar Year Summary for Candidates 0.00 13. Cash Receipts .. Column A, Line 3 above TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and 1,539.57 0.00 15. Cash Payments......................................................... Column A, Line 8 above _ 58.68 General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 712.00 $ 11, $ 11,712.00 2. Loans Received ............................... .....................:::...:.:..._..... Schedule 8, Line 3 1,000.00 1,000.00 1/1 through 6130 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS...... ........................ Add Lines 1 +2 12,712.00 $ $ 12,712.00 20. Contributions Received $ $ 4. Nonmonetary Contributions... ............. -- ................ Schedule c, Line 3 58.68 58.68 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 $ 12,770.68 $ 12,770.68 Made $ $ Expenditures Made 6. Payments Made... ................... - .. .... . Schedule E, Line 4 $ 3,515.35 7. Loans Made....................................................................... Schedule H. Line 3 0.00 8. SUBTOTAL CASH PAYMENTS... ....................................... Add Lines 6+7 $ 3,515.35 9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 1,539.57 10. Nonmonetary Adjustment ................. .......... Schedule C, Line 3 58.68 11. TOTAL EXPENDITURES MADE ...... ....... :.......................... Add Lines 8 + 9 + 10 $ 5,113.60 Current Cash Statement Expenditure Limit Summary for State $ 3,515.35 12. Beginning Cash Balance........ . ................... Previous Summary Page, Line 16 $ 0.00 13. Cash Receipts .. Column A, Line 3 above 3515.35 $ , 11,712.00 14. Miscellaneous Increases to Cash ............................... Schedule 1, Line 4 1,539.57 0.00 15. Cash Payments......................................................... Column A, Line 8 above _ 58.68 3,515.35 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 8,196.65 If this is a termination statement, Line 16 must be zero. add amounts in Column 17. LOAN GUARANTEES RECEIVED ................................ Schedule e, Part 2 $ 0.00 Cash Equivalents and Outstanding Debts reported in Column B. of your last report. Some 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ G�0.00 7 �� Expenditure Limit Summary for State $ 3,515.35 Candidates 0.00 3515.35 $ , 22• Cumulative Expenditures Made' (If Subject to Voluntary Expenditure Limit) 1,539.57 Date of Election Total to Date _ 58.68 (mm/dd/yy) �� $ $ 5.113.60 To calculate Column B, add amounts in Column A to the corresponding 'Amounts in this section may be different from amounts amounts from Column B reported in 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). 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 to whole dollars. Statement covers period Monetary Contributions Received P CALIF.-N-IA � , • from . 7/1/2016 • SEE INSTRUCTIONS ON REVERSE through 9/24/2016 Page 4` .. of., NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL. ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED I OF CONTRIBUTOR (IF OCCUPATION AN EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER I D NUMBER) OCCUPATION ANDEMPLOYER NAME PERIOD (JAN. 1 - DEC 31) (IF REQUIRED) ESS) James Lopes � IND 9/22/2016 El COM Retired 290 290 290 San Luis Obispo, CA 93401 El 0TH ❑PTY ❑ SCC Julie Towery m IND 8/16/2016 ❑ COM Retired 200 200 200 San Luis Obispo, CA 93405 ❑ OTH ❑ PTY ❑ SCC Mal Towery LZ IND _ 8/16/2016 ❑ COM Retired 200 200 200 San Luis Obispo, CA 93405 ❑ OTH ❑ PTY ❑ SCC, Mark Henry W1 IND Retired 9/5/2016 ElcoM 300 300 300 San Luis Obispo, CA 93401 ❑ OTH ❑ PTY _.._. _ ❑ SCC John Connor JZI IND 9/9/2016 El Com Hotelier, Petit Soleil 300 300 300 San Luis Obispo, CA 93401 ❑ OTH ❑ PTY ❑ scc SUBTOTAL $ 2-90 Schedule A Summary 1. Amount received this period — itemized monetary contributions. �_ (Include all Schedule A subtotals.)...............................................................................................$ 10, 1-EIA l r- iii-0" * r2L-1 2. Amount received this period — unitemized monetary contributions of4&ss4han--$300 ...........................$ ? 3. Total monetary contributions received this period. r (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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Schedule A (Continuation Sheet) Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period from 7/1/2016 SCHEDULE A (CONT.) `Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) 0TH — 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 through 9/24/2016 Page 5 of A9— NAME OF ^I.. --R - I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 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 AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Lanyce Mills 0IND Retired 9/14/2016 ❑ COM 300 300 300 San Luis Obispo, CA 93405 ❑ OTH ❑ PTY ❑ SCC Linda White BIND Retired RN and Real 8/30/2016 ❑ CoM Estate Broker 300 300 300 San Luis Obispo, CA 93405 ❑ OTH ❑ PTY - ❑ SCC J2 IND ... Retired - Karen Butzbach 9/10/2016 ❑ CoM 300 300 300 Los Molinos, CA 96055 ❑ OTH ❑ PTY ❑ SCC Thomas Butzbach IND Retired 9/10/2016 ❑ coM 300 300 300 Los Molinos, CA 96055 ❑ OTH ❑ PTY ❑ SCC John Connerley 0 IND Self Employed, 9/7/2016 ❑ Co Musician 100 100 100 Arroyo Grande, CA 93420 El ❑ SCC SUBTOTAL$ 1,300 `Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) 0TH — 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 Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA (CONT.) Monetary GontributionS Keceived to wnoie oouars• Statement covers period _ J • from .. 7/1/2016 r - through 9/24/2016 page— of NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER)CODE CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Jonathan Tasini la IND Organizational Strategist, 8/15/2016 ❑ CoM Economic Future Group 300 300 300 New York NY 10033 ❑ OTH ❑ PTY ❑ SCC Scott Secrest 0 IND Advisor, 9/17/2016 ElcoM Natural Investments, Inc. 100 100 100 Arroyo Grande, CA 93420 ❑ OTH ❑ PTY ❑ SCC Thomas Rippner 0IND Retired 9/10/2016 ❑ coM 300 300 300 San Luis Obispo, CA 93401 ❑ OTH ❑ PTY ❑ SCC 100 100 9/7/2016 Camille Small El IND Retired 100 San Luis Obispo, CA 93405 Elco ❑ PTY ❑ scc Joyce Tseng 0 IND Stay-at-home Mom 9/1/2016 ❑❑co (Unemployed) 300 300 300 San Luis Obispo, CA 93401 ❑ PTY ❑ SCC SUBTOTAL$ 1,100 `Contributor Codes IND – Individual COM – Recipient Committee (other than PTY or SCC) UH – 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) Monetary Contributions Received Heidi Harmon for Mayor 2016 Amounts may be rounded to whole dollars. Statement covers peri from _7/1/2016 I i through 9/24/2016 SCHEDULE A (CONT.) Page — of 1388334 ULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR I CONTRIBU *ORI OCIF AN INDIVIDUAL, ENTERCUPATION sUPATION AND SNM RLO MER I REC ER OD HIS I AMOUNT CU( AN. 1D DECEAR (IF ROEDATE QU RED) RECEIVED (IF COMMITTEE, ALSO ENTER I,D. NUMBER) j CODE OF PTY ❑ SCC Kristin Hazard OIND lCheif Executive Officer, 9/23/2016 El CO Wildnote, 300 300 300 San Luis Obispo, CA 93405 ❑ PTY ' Suntoucher, LLC ❑ SCC SUBTOTAL $ 925 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) UH — 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 (CONT.) monetary C:OntrinutionS Kecelved to wnoie aouars• Statement covers period , from 7/1/2016 FORM 60 Page 8 of ...— through 9/24/2016 NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1,0- NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Robert and Gail Davis i 0IND Retired 8/14/2016 ❑ COM 100 1 100 100 Morro Bay, CA 93442 El OTH ❑ PTY ❑ SCC Thomas Dunne ` 0IND Labor Representative, 9/22/2016 El California Nurses Assoc. 100 100 100 Santa Maria, CA 93458 ❑ OTH ❑ PTY ❑ SCC Terry Elfrink and Vicky McPartland 10 IND Retired 9/23/2016 0 CO 300 300 300 Templeton, CA 93465 ❑ PTY ❑ SCC Pete Evans 0IND Retired 9/9/2016 ❑ COM 200 200 200 San Luis Obispo, CA 93401 ❑ OTH ❑ PTY ❑ SCC 9/12/2016 Erika Feresten Los Angeles, CA 90067 O IND ❑ COM ❑ OTH Leadership Coach, Emerge California 300 300 300 ❑ PTY ❑ SCC SUBTOTAL $ 1,000 *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 ConinDutions Keceivea xo wnoie aonars• Statement covers period from 7/ 1 /2016 • - through 9/24/2016 Page of NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 DATE j FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED - (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME RECEIVED THIS CALENDAR YEAR TO DATE OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Cody King JO IND Teacher, 9/24/2016 ❑ COM Lucia Mar Unified School 200 200 200 Ni omo, CA 93444 P ❑ OTH ❑ PTY District ❑ SCC Adam Kirchner RIND Fishing Guide, 9/8/2016 ElcoM Natural Progressions 200 200 200 Los Osos, CA 93402 ❑CITH ❑ PTY ❑scc Linda Pax j 01ND Retired 9/8/2016 ❑ CoM 300 300 300 San Luis Obispo, CA 93401 ❑ OTH ❑ PTY ❑ SCC Susie Lamb -Buckman IND Retired 9/8/2016 ❑ coM 100 100 100 Laguna Woods, CA 92367 ❑ oTH ❑ PTY ❑ SCC Paul Ogren OIND Retired 9/14/2016 ❑❑ CO 300 300 300 San Luis Obispo, CA 93405 ❑ PTY ❑ scc SUBTOTAL $ 1,100 "Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) UH — 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 ContrIDuilonS Keceived to wnoie sonars. Statement covers period O' j • from 7/1/2016 - page —LLL of through 9/24/2016 _ NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER)CODE * (IF SELF-EMPLOYED, ENTER NAME RECEIVED THIS PERIOD CALENDAR YEAR (JAN. 1 - DEC. 31) TO DATE (IF REQUIRED) OF BUSINESS) Margaret Crockett la IND Retired 8/30/2016 ❑ COM 300 300 300 San Luis Obispo, CA 93405 ❑ OTH ❑ PTY j ❑ SCC Gail Johnson 0IND Business Owner, 9/2/2016 El COTH Johnson's Framing 100 100 100 San Luis Obispo, CA 93401 Gallery ❑ PTY ❑ SCC Phil Hurst 0IND Business Owner, 9/22/2016 ❑ COM Live Local Apparel 300 300 300 San Luis Obispo, CA 93405 ❑ OTH ❑ PTY ❑ SCC Regina Hurley IND Program Coordinator, 9/23/2016 El CO Americorps 100 100 100 Beaverton, OR 97003 ❑ PTY ❑ SCC Integrity San Luis Obispo, ID#1364687 ❑ IND 8/10/2016 p COM 300 300 300 San Luis Obispo, CA 93401 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 1,100 '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 periatE CALIFORNIA • 0 460from 7/1/2016 • - through 9/24/2016Page —LL --of NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR COMMITTEE, ALSO ENTER W. NUMBER) CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Marilyn Mazess IND J❑ Retired 8/15/2016 COM 300 300 300 j Montecito, CA 93108 El OTH ❑ PTY I` ❑ SCC Quinn Brady 0 IND o @V 8/20/2016 El COM 200 200 200 Los Osos, CA 93402 ❑ OTH ! ! [I PTY ❑ SCC Samsom Blackwell 0IND Director, Talent 9/18/2016 ❑❑ o°H Acquisition 100 100 100 San Luis Obispo, CA 93401 Cal Poly State University F] PT, ❑ SCC Chemist, Karl Wright IND 9/22/2016 El ooH California Fine Wine 200 200 200 San Luis Obispo, CA 93405 El PTY ❑ SCC Joseph Meza OIND Engineer, 8/31/2016 El COM San Disk 200 200 200 Aliso Viejo, CA 92656 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 1,000 `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) Monetary Contributions Received NAME OF FILER. Heidi Harmon for Mayor 20167/1/2016 Amounts may be rounded to whole dollars. DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTORIFAN INDIVIDUAL, ENTER RECEIVED (IF COMMITTEE, ALSO ENTER I D NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) "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 Statement covers peri from 7/1/2016 through _ ... 9/24/2016 SCHEDULE A (CONT.) Page 12, of I f`7 1388334 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 300 1 300 100 1 100 300 ! 300 100 1 100 300 1 300 SUBTOTAL$ 1,100 two 100 300 100 300 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Susan Robinson OIND Retired 9/9/2016 ❑ COM Paso Robles, CA 93446 ❑ OTH ❑ PTY ...... ......... ❑ SCC j Ron Tilley JO IND Retired 9/9/2016 ❑ COM j San Luis Obispo, CA 93401 ❑ OTH ❑ PTY ❑ SCC Savannah Cooper JO IND Retired 8/23/2016 ❑ COM Grover Beach, CA 93433 ❑ OTH ❑ PTY ❑ SCC 1 Stephanie Allen IND ll 1 Retired 9/5/2016 ❑ COM Cayucos, CA 93430 ❑ OTH ❑ PTY ❑ SCC Larry Brooks OIND Business Owner, 9/9/2016 ❑❑ CO L.M. Brooks San Luis Obispo, CA 93401 ❑ PTY ❑ ScC "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 Statement covers peri from 7/1/2016 through _ ... 9/24/2016 SCHEDULE A (CONT.) Page 12, of I f`7 1388334 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 300 1 300 100 1 100 300 ! 300 100 1 100 300 1 300 SUBTOTAL$ 1,100 two 100 300 100 300 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 CALIFORNIA .1 from 7/1/2016 FORM Page of j"a— through 9/24/2016 NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR COMMITTEE, ALSO ENTER I.D. NUMBER)CODE CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Sherri Stoddard 01ND Registered Nurse, 8/18/2016 ❑ Co Sierra Vista Regional 70 70 70 ❑ Los Osos, CA 93402 El PTY Medical Center ❑ SCC Tod Sargus 0IND Self employed, 9/18/2016 El Com Property manager 60 60 60 San Luis Obispo, CA 93401 ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 130 '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 B - PART 1 Schedule B — Part 1 to whole dollars. Statement coversperiod Loans Received 7/1/2016 � from through 9/24/2016 Page Pa � SEE INSTRUCTIONS ON REVERSE 9 9 of NAME OF FILER I D. NUMBER Heidi Harmon for Mayor 2016 1388334 FULL NAME, STREET ADDRESS AND ZIP CODE IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER la OUTSTANDING (b) AMOUNT (c) AMOUNT PAID OUTSTANDING a INTEREST () ORIGINAL is CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD" PERIOD PERIOD LOAN TO DATE Heidi Harmon Office Manager, ❑ PAID CALENDAR YEAR L. M. Brooks Consulting $ $ 1,000 0 1.000 $ San Luis Obispo, CA 93401 % $ FORGIVEN E] FORGIVEN PER ELECTION*" $ 0 1,000 $ 1/15/2017 $ 8/12/2016 $ t la IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID DATE DUE CALENDAR YEAR FORGIVEN El FORGIVEN PER ELECTION `* DATE DUE t ❑ IND ❑ COM ❑ OTH [:1 PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION'* RATE t ❑ IND ElCOM [IOTH E]PTY E]SCC j $ $ $ $ I$ DATE DUE DATE INCURRED SUBTOTALS $ 1,000$ $ $ Schedule B Summary 1. Loans received this period....................................................................................................................$ 1 nnn (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period............................._....,..................................$ - n (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.) ................. Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. ........................ NET $ 1 ,nnn (May be a negative number) tt;rrter ted on Schedule E, Line 3) tContributor 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 Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER µ Heidi Harmon for Mayor 2016 DATE FULL NAME, STREET ADDRESS AND RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER 1 D. NUMBER) Amounts may be rounded to whole dollars. Statement covers period from ..... 7/1/2016 through CONTRIBUTOR I IF AN INDIVIDUAL, ENTER_ DESCRIPTION OF CODE * OCCUPATION AND EMPLOYR GOODS OR SERVICES (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. 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 Page, Column A, Lines 4 and 10.) . AMA /'IA4 AMOUNT/ FAIR MARKET VALUE .- 58.68 SCHEDULE C �- Page � of I LL__ LD NUMBER 1388334 CUMULATIVE TO DATE PER ELECTIONCALENDAR YEAR TO DATE (JAN 1 - DEC 31) (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 FPPC Form 460 (1an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Heidi Harmon for Mayor 2016 Amounts may be rounded to whole dollars. Statement covers period from 7/1/2016 through 9/24/2016 SCHEDULE E Page of ! sZ LD NUMBER 1388334 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 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 (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I D NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID City of San Luis Obispo Ballot statement 990 Palm Street FIL 660.00 San Luis Obispo, CA 93401 ASAP Reprographics Post cards 3121 S. Higuera Street LIT 91.80 San Luis Obispo, CA 93401 ASAP Reprographics 3121 S. Higuera Street LIT 518.64 San Luis Obispo, CA 93401 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,270.44 Schedule E Summary 1. 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.) .................... 3,515.35 (included above) ................ $ 0 TOTAL $ 3,515.35 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made Amounts may be rounded to whole dollars. Statement covers pe from 7/1/2016 SCHEDULE E (CONT.) 9/24/2016 � �% SEE INSTRUCTIONS ON REVERSE through � g Page —Ll— of NAME OF FILER I.D. NUMBER Heidi Harmon for Mayor 2016 1388334 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 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 (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Signs.com (888)222-4929 Yard signs CMP 859.93 StickerGiant.com (866)774-7900 Stickers CMP 228.69 UPS Store 1241 Johnson Avenue POS 64.44 San Luis Obispo, CA 93401 FedEx Copies 1127 Chorro Street OFC 28.08 San Luis Obispo, CA 93401 Custom Ink Shirts 2910 District Avenue Fairfax, VA 22031 CMP 292.60 * Payments that are contributions or independent expenditures must also be summarized on Schedule D_ SUBTOTAL $ 1,473.74 FPPC Form 460 (Jan/2016) FPpr ArlvirP- ndvirPna fnnc.ca.eov 1866/275-37721 Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE Heidi Harmon for Mayor 2016 Amounts may be rounded to whole dollars. Statement covers period from 7/1/2016 SCHEDULE E (CONT.) through 9/24/2016 g Page J%__ ofJ9__ ID. NUMBER 1388334 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 FIL civic donations candidate filing/ballot fees PET petition circulating TEL t.v. or cable airtime and production costs FND fundraising events PHO phone banks TRC candidate travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)` POL POS polling and survey research postage, delivery and messenger services TRS TSF staff/spouse travel, lodging, and meals 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) ASAP Reprographics 3121 S. Higuera Street San Luis Obispo, CA 93401 Stripe.com 185 Berry Street #550 San Francisco, CA 94107 Square.com 1455 Market Street #600 San Francisco, CA 94103 CODE OR DESCRIPTION OF PAYMENT LIT Payment processing WEB WEB * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Payment processing AMOUNT PAID 518.64 239.74 12.79 SUBTOTAL $ 771.17 FPPC Form 460 (Jan/2016) FPpr 4dvirp. advirp(a)fnnr ra.anv fR6t;/775-,37771 Schedule F Accrued Expenses (Unpaid Bills) SEE INSIRUCTIONSON REVERSE NAME OF FILER Heidi Harmon for Mayor 2016 Amounts may be rounded to whole dollars. Statement covers period from 7/1/2016 through 9/24/2016 SCHEDULEF Page —1 , i of I.D. NUMBER 1388334 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 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 (internet, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I,D, NUMBER) Quinn Brady 1359 10th Street Los Osos, CA 93402 (reimburse: ColorCraft Printing, Atascadero, CA) Kathie Walker 1269 Fredericks Street San Luis Obispo, CA 93405 (remiburse: Costco, San Luis Obispo, CA) Kumani, Inc. 1334 Galleon Way #A San Luis Obispo, CA 93405 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD LIT 0.00 237.19 0.00 237.19 FND 0.00 215.48 ; 0.00 215.48 WEB 0.00 j 1,000.00 i 0.00 I 1,000.00 SUBTOTALS $ 0.00 $ 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.) ........................ 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.)... 1,452.67 $ 0.00 ................INCURRED TOTALS $ ................ I......... PAID TOTALS $ $ 1,452.67 1,539.57 =1 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) ........................ NET $ 1,539.57 May be a negative number FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772)