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Home My WebLink AboutCarlyn Christianson - Form 460 - Termination Statement - 12-19-14Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200- 84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period Date of election If applicable: from October 19, 2014 (Month, Day, Year) through December 19, 2014 I November 4, 2014 Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 0 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part 5) O Sponsored ❑ General Purpose Committee (Also Comptete Part 6) Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Alw Complete Part r) 3. Committee Information I.D. NUMBER 1367453 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Carlyn Christianson for City Council 2014 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 4. Verification 2. Type of Statement: Date Stamp DEC 23 20111 COVER PAGE Page 1 of 7 For Official Use Only ❑ Preelection Statement ❑ Quarterly Statement Semi - annual Statement ❑ Special Odd -Year Report Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Jeri Carroll MAILING ADDRESS CITY STAIE ZIP CODE AREA CODErPPHONE 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@aft.net I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information under penalty of perjury under the laws of the State of California that the foregoing is true and correct. tea.- -- / I1 - l Executed on W By # Executed on � � / � � � O I By Date Signature of EX&GEW _ ❑fficehalder. CandeaGa_ Id in the attached schedules is true and complete. I certify Executed on g Date y Soia¢tre ofContnAing Omoarmier, -can adate. &M Measure Proponent Executed on By Data Signature of Coning Omcetwaer, Candidate, State Measure Proponent FPPC Forth 460 (January/05) FPPC Toll-Free Helpline: 6661ASK-FPPC (866/2753772) State of California Type or print in ink. COVER PAGE - PART 2 Recipient Committee Campaign Statement F CALIFORNIA 460 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, City of San Luis Obispo RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 1416 Morro St #16 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. COMMITTEENAME 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 COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Page 2 of 7 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JUR(SDICTION ❑ 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 ofiiceho /der(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 Attach continuation sheets If necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period CALIFORNIA Summary Page to whole dollars. I ' 1 from October 19, 2014 FORM Expenditures Made 6. Payments Made ........................ ............................... Schedule E, Line 4 $ through December 19, 2014 Page 3 of 7 SEE INSTRUCTIONS ON REVERSE 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ NAME OF FILER I.D. NUMBER Carlyn Christianson for City Council 2014 1367453 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHISPERIOD (FROM ATTACHED SCHEDULES) CALENDARYEAR TOTALTODATE Running fl in Both the State Primary and r General Elections 1. Monetary Contributions ............ ............................... schedule A, Line 3 $ 475.00 $ 13,755.00 1/1 through 6 /30 7/1 to Date 2. Loans Received ....................... ............................... Schedule e, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ................... "' " Add Lines 1 + 2 $ 475.00 $ 13,755.00 20. Contributions Received $ $ 4. Nonmoneta ry Contributions ., Schedule C, Line 3 ,00 100.23 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 475.00 $ 13,855.23 Made $ $ 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 F Line 3 10. Nonmonetary Adjustment ........... ............................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE . ............................... Add Lines 8 + 9 + 10 $ 4,690.42 $ 13,755.00 4,690.42 $ 13,755.00 4,690.42 $ 13,755.00 Current Cash Statement ....... Previous Summary Page, Line 16 $ 4,215.42 12. Beginning Cash Balance ................ 13. Cash Receipts ................... ............................... Column A, Line 3 above 475.00 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 15. Cash Payments ............. Column A, Line 8 above 4,690.42 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ .00 If this is a termination statement line 16 must be zero. 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 B above $ 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm /dd /yy) I $ 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule A Type or print in ink. SCHEDULE A Monetary Contributions Received Amounts may De rounaeo ry Statement covers period • ' to whole dollars. t from October 19, 2014 . December 19, 2014 4 7 EE INSTRUCTIONS ON REVERSE through pag of NAME OF FILER I.D. NUMBER Carlyn Christianson for City Council 2014 1367453 DATE 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 RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) SLO City Firefighter's Assoc.,2160 Santa i]IND 10/30/14 Barbara St. SLO, Ca 93401 [3Com 250.00 250.00 250.00 ❑ PTY ❑SCC Jennifer Rhynes, PO Box 878, Cayucos, Ca IaIND Retired 12/3/14 93430 []OTH 200.00 200.00 200.00 ! ❑ Pte, ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND [3Com ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 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 less 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.) ....................... TOTAL $ 450.00 25.00 475.00 '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 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) SCHEDULEB -PART1 Schedule B — Part 1 "- "' r ""' "' " "" Amounts may be rounded Statement covers period p Loans Received to whole dollars. October 19, 2014 CALIFORN from FORM December 19, 2014 5 7 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Carlyn Christianson for City Council 2014 1367453 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING BALANCE (b) AMOUNT (c) AMOUNT PAID laj OUTSTANDING BALANCEAT (6) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D.NUMBER) (IF BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOPERIOD HIS PAID THIS AMOUNT OF CONTRIBUTIONS NAMEOFBDUSI ESS)ER PERIOD THIS PERIOD` ! PERIOD LOAN TO DATE Carlyn Christianson City Council Member gPAID CALENDARYEAR 1450 Morro St #16 $ 162.38 .00 162.38 162.38 San Luis Obispo, Ca 93401 $ RATE $ $ ❑ FORGIVEN PER ELECTION" $ $ 162.38 $ $ 11/15/14 162.38 t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION`* RATE $ $ $ $ $ DATE DUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDARYEAR $ $ % S S ❑ FORGIVEN RATE PER ELECTION" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC I $ $ $ $ $ DATE DUE DATE INCURRED SUBTOTALS $ 162.38$ 162.38$ .00 $ Schedule B Summary 1. Loans received this period ..................................................................................... ............................... $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ......................................................... ............................... _ .............. $ (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. 162.38 162.38 ................ NET $ .00 (May be a negative number) (Enter (e) 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 (January /05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Cadyn Christianson for City Council 2014 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from October 19, 2014 through December 19, 2014 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 6 of 7 I.D. NUMBER 1367453 CbP campaign paraphernalia/misc. MBR member communications RAID 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 FIND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals W 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 Verdin* 3580 Sacramento Dr Ste 110 MAR San Luis Obispo Wells Fargo Visa PO Box 30086 Los Angeles, CA 90030 Sub Vendor Tolosa Press 242.50 615 Clarion Ct, Ste 2, SLO, CA 93401 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ........... ............................... DESCRIPTION OF PAYMENT SUBTOTAL$ I.......... $ 2. Unitemized payments made this period of under $100 ........................................................................................................... ............................... S 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column ( e).) ................................................ ............................... S 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ AMOUNT PAID 2,239.60 512.50 2,752.10 4,651.62 38.80 4,690.42 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule E CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Sub Vendor SCHEDULE E (CONY.) (Continuation Sheet) Type or print in ink Amounts may be rounded Statement covers period CALIFORNIA 460 Payments Made to whole dollars. from October 19, 2014 FORM Wells Fargo Visa 1 through December 19, 2014 7 7 SEE INSTRUCTIONS ON REVERSE Page of NAME OF FILER Sub Vendor I.D. NUMBER Carlyn Christianson for City Council 2014 Politicaldatainc 200.82 WEB 1367453 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CJvP 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 (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMMFEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Sub Vendor Politicaldata inc 270.00 WEB PO BOX 59570, Norwalk, CA 90652 Wells Fargo Visa 200.82 PO Box 10347 Des Moines IA 50306 Sub Vendor Politicaldatainc 200.82 WEB PO Box 595, Norwalk, CA80652 Verdin 3580 Sacramento Dr Ste 110 LIT 1,698.70 San Luis Obispo, CA 93401 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,899.52 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/2753772)