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Committee Info rmation I.G. NUMBER
1,154041
COMMITTEE NAME (OR CANDIDATE'S NAME' IF NO COMMITTEE)
STACIE DAVIS FOR ENCINITAS CITY COUNCIL DISTRICT 4
STREETADDRESS (N0 P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
ENCINITAS CA 92024
MAILING ADDRESS (IF DIFFERENT) NO. ANEJ STREET OR P.O. BO>;
CITY STATE ZIPCODE AREA(:ODE/PHONE
OPTIONAL: FAX/E-M_MLADDRESS
Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from SEPT 25,2022
through OCT 22, 2022
1. Type of Recipient Committee: All Committees— Complete Parts 1, 2, 3, and 4.
[� Officeholder, Candidate Controlled Committee ❑ Primarily Formed Bal of Measure
State Candicate Election Committee Committee
0 Recall 0 Controlled
(Also Complete Pan 5) 0 Sponsored
(i Ise Complete Part 6)
[] General Purpos(: Committee
Q Sponsored El rimarily Formed Candidate/
(off Small Contributor Committee Officeholder Committ e
Political Part//Central Committee (7 lso Complete Part 7)
3.
Date Stamp
CITY Or Ericifi I"f
CITY CLUM
Date of election if applicable:
(Month, Dast, Year) 2022 OCT 27 PM 4;
NOV 8, 2022
2. Type of Statement:
m Preelecl ion Statement
❑ Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendnent (Explain below)
COVER PAGE
Page 1 _ of 6
i (�orF OfiOfiicial Use Only
m Quarterly Statement
❑ Special Odd -Year Report
Treasurer(()
NAME OF TREASURER
STACIE DAVIS
MAILING ADDR=SS
STATE .'_IP CODE 4REA CODE/PHONE
ENCINITASi CA 92024
NAME OF ASSISTANT TREASURER, W ANY
ELI STERN
MAILING ADDR =SS
CITY STATE .'_IPCODE %REACODE/PHONE
ENCNINITAS CA 92024
OPTIONAL: FA:(/ E-MAILADDRESS
_ STACIEDAVIS@ 4ENCINITAS. CC M
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my k owledge the info r tion contained herein and in the attached schedules is true and complete. I
(:ertify under penalty of perjury under the laws of the State of California that the foregoing is true ar)d C rreet.
G CT 26,2022
n Executed o_
Dale Ey ,Sig{ta/I of Tye surer Jlistant Treaswat
Executed on CCT26,2022
Date E
y Slgnature_o!.�Z'nlr bng Officeholder, CandidaV3,%5kffe Weagbre Proponel for Responsible Offmer of Sponsor
Executed on _
Dale Ey Signature of Controlling Offi-holder. Candidate. Stale Measure Proponent
Executed on _ Ey
Date Signature of Controlling OKa:holder, Candidate, Slate Pleasure 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
STACIE DAVIS
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
ENCINITAS CITY COUNCIL DISTRICT 4
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
ENCINITAS CA 92024
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.
MMI I I LE NAME I I.D. NUMBER
NAME OF TREASURER I CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE - PART 2
Page 2 of 6
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I JURISDICTION
El SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE
UK HtLU
DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee Listnames 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
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
Summary Page to whole dollars.
Statement covers period
from SEPT 25,2022
SUMMARY PAGE
SEE INSTRUCTIONS ON REVERSE through OCT 22,2022 Page 3 of 6
NAME OF FILER
I.D. NUMBER
STACIE DAVIS FOR ENCINITAS CITY COUNCIL DISTRICT 4 1454041
Contributions Received
Column A
Column B
Calendar Year Summary for Candidates
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
CALENDAR YEAR
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions...................................................
Schedule A, Line 3
$
239.00
$
1,339.00
2. Loans Received ................................................................
Schedule B, Line 3
5,000.00
1/1 through 6/30 7/1 to Date
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines 1 +2
$
239.00
$
6,339.00
20. Contributions
Received $ $
4. Nonmonetary Contributions ............................................
schedule C, Line 3
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED................................Add
Lines 3+4
$
239.00
$
6,339.00
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made................................................................
ScheduleE, Line
$
2,984.00
$
3,750.00
Candidates
7. Loans Made.......................................................................
Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS .......................................
Add Lines s+7
$
Z 984 00
$
3,750.00
22• Cumulative Expenditures Made*
(if Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule /, Line 3
Date of Election Total to Date
10. Nonmonetary Adjustment.........................................................
Schedule C, Line 3
(mm/dd/yy)
11. TOTAL EXPENDITURES MADE ....................................
Add Lines 6+9+10
$
2,984.00
$
3,750.00
_ J- J $
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
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.
$ 5,334.00
239.00
2,984.00
$ 2,589.00
17. LOAN GUARANTEES RECEIVED ................................ Schedule B, 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
$ 5,000.00
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).
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (1an/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
Monetary Contributions Received
statement covers period
from SEPT 25, 2022
CALIFORNIA
FORM
SEE INSTRUCTIONS ON REVERSE
through OCT 22, 2022
Page 4 of 6
NAME OF FILER
I.D. NUMBER
STACIE DAVIS FOR ENCINITAS CITY COUNCIL DISTRICT 4
1454041
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
CONTRIBUTOR
CODE
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OF BUSINESS)
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
10-18-2022
DEBORAH SMITH
IND
RETIRED
100.00
❑ COM
❑ OTH
LAKESIDE, CA 92040
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL $ 100.00
Schedule A Summary
Amount received this period — itemized monetary contributions. 100.00
(Include all Schedule A subtotals.).........................................................................................................$
2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$
139.00
3. Total monetary contributions received this period. 239.00
(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 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
o r'A—" A
Amounts may be rounded
SCHEDULE B - PART 1
vv,r rcuurC v — rar L I to whole dollars.
Statement covers period
Loans Received
from SEPT 25, 2022
0-
SEE INSTRUCTIONS ON REVERSE
through OCT 22, 2022
page 5 of 6
NAME OF FILER
I.D. NUMBER
STACIE DAVIS
1454041
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
a
OUTSTANDING
(
AMOUNT
c
AMOUNT PAID
OUTSTANDING
e
INTEREST
ORIGINAL
g
CUMULATIVE
OF LENDER
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF-EMPLOYED, ENTER
BALANCE
BEGINNING THIS
RECEIVED THIS
PERIOD
OR FORGIVEN
THISPERIOD-
BALANCE AT
CLOSE OF THIS
PAID THIS
PERIOD
AMOUNT OF
LOAN
CONTRIBUTIONS
NAME OF BUSINESS)
PERIOD
PERIOD
TO DATE
STACIE DAVIS
BUSINESS OWNER
El PAID
CALENDAR YEAR
1711
BY STACIE
$
$
'�
$ 5,00 000.
2022
❑ FORGIVEN
$
PER ELECTION
ENCINITAS, CA. 92024
RATE
$ 5,000.00
$
$
11-7-2022
$
$
IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
DATE DUE
DATE INCURRED
PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION-
RATE
t ❑ IND El COM ❑ OTH ❑ PTY El SCC
$
$
$
$
$
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
❑ FORGIVEN
PER ELECTION"
RATE
t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
S
$
S
$
$
DATE DUE
DATE INCURRED
SUBTOTALS $ 5,000.00 $ $ $
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.).............................................................. NET $
Enter the net here and on the Summary Page, Column A, Line 2.
(May be a negative number)
"Amounts forgiven or paid by another party also must be reported on Schedule A.
** If required.
(enter (e) on scneouie E, Line a)
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 E
Payments Made
SEE INSTRUCTIONS ON REVERSE
STACIE DAVIS FOR ENCINITAS CIT COUNCIL DISTRICT 4
Amounts may be rounded
to whole dollars.
Statement covers period
from SEPT 25,2022
through OCT 22,2022
SCHEDULE E
Page 6 of 5
I.D. NUMBER
1454041
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 ON THE CHEAP
CMP
YARD SIGNS
313.00
11525 A STONEHOLLOW DR. STE 100
AUSTIN, TX. 78758
VISTA PRINT
LIT
MAILER POST CARDS
951.00
275 WTMAN ST.
WALTHAM, MA. 02451
US POSTAL SERVICE ENCINITAS
POS
POSTAGE FOR POST CARDS
1,281.00
1150 GAREDEN VIEW RD.
ENCINITAS, CA. 92024
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,545.00
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 2,545.00
2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 439.00
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 $ 2,984.00
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov