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HomeMy WebLinkAboutForm 460- Greg Brockbank for City Council 2013 (2013-09-21)Date St6nip. CALIFORNIA -4-60 • FORM - II .i . of Statement covers period Date of election if applicable: • .Year)t r Official Use Only7/1/13 t 9/21113 11/5113 SEE INSTRUCTIONS ON REVERSE through 1. Ty __ p p e of Recipient Committee; All Committees - Complete Parts 1, 2, 3, and 4. 2. Type of Statement: • Officeholder, Candidate Controlled Committee E] Primarily Formed Ballot Measure Preelection Statement Quarter! Statement Q y State Candidate Election Committee Committee El Semi-annual Statement Special Odd -Year Report Recall 0 Controlled Termination Statement EJ Supplemental Preelection (Also Complete Part) 0 Sponsored (Also file a Farm 410 Termination) Statement - Attach Form 495 (Alsocomplete Part 6) E] Amendment (Explain below) General Purpose Committee Primarily Formed Candidate/ Sponsored Officeholder Committee Small Contributor Committee (Also Complete Part 7) Political Party/Central Committee Committee Information I.D. NUMBER 3. 1355949 Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Greg Brockbank SROCKBANK FOR CITY COUNCIL 2013 MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE San Rafael CA 94901 ( CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY San Rafael CA 94901 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CGDE AREA CODE/PHONE OPTIONAL- FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS ( ( 4. Verification 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 of perjury under the laws of the State of California that the foregoing is true and correct. penalty � u 9 126/ 13 B Y Executed on Date Signature of Treasurer or Assistant Treasurer 9/26/13 B Executed on Date € tore of Controlling llin Officeholder, C'andidate, State Measure Proponent rResponsible O� r # �r Executed on Date By ro oi amt Signature oyCon&ro in office-holder,C r 1bt rStateMeasureProponent Executed on By a t} 13Ed Measure Proponent Signatureof ConLr-. o in . 1dfCandidate, qdnt FPP Form 46 (January/05)Date 2) FPPC Toll -Free Helpline: /ASIS -ERC (8661275-3772) State of California Type or print in ink. COVER PAGE - PART 21 Recipient Committee CALIFORNIA Campaign Statement FORM 460 Cover Page — Part 2 Page Of 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE GREG BROCKBANK UMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION SUPPORT OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT N OPPOSE Councilmember, City of San Rafael RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, if any. San Rafael NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees Not Included in this Statement: List any committees OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 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 I.D.NUMBER CO , COMMITTEE? 7. Primarily Formed Candidate/Officeholder Committee List names of CONTROLLED NAME OF TREASURER officeholder(s) or candidate(s) for which this committee is primarily formed Kin Lj L 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 STREET ADDRESS tKin PC) RMO NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD E] SUPPORT [:] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [:] SUPPORT E]OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE C:OJIMITTEE ADDRESS . CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets if necessary FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of California Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. Statement covers period from 7/1/13 SEE INSTRUCTIONS ON REVERSE NAME OF FILER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 through 9/21/13 -AIV of Page --) I.D. NUMBER 1355049 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDAR YEAR Running in Both the State Primary and (FROMATTACHED SCHEDULES) TOTALTO DATE General Elections A, Line 3 $ 7704.00 $ 21 Y911.09 - ........................... 1. Monetary Contributions ................ Schedule 1/1 through 6/30 7/1 to Date 0.00 41000.00 2. Loans Received ...................................................... Schedule B, Line 3 7704.00 $ 251911.00 20. Contributions 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines I + 2 $ Received $ $ 0.00 547.80 4. Nonmonetary Contributions .................................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 7704.00 $ 22,458.80 Made $ $ Expenditures Made 11,473.61 $ 23,373.37 C. Payments Made ....................................................... Schedule E, Line 4 $ 7. Loans Made ............................................................. Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ................................... Add Lines 6 + 7 $ 111473.61 $ 23,373.37 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 $ 11,473.61 $ 23,373.37_ Current Cash Statement 61307.24 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 1 s 77704.00 3. Cash Receipts .......................... ........................ Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 - 15. Cash Payments ................................................... Column A, Line 8 above 11,473.61 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 2,537.63 If this is a termination statement, Line 16 must be zero. 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 $ Ta 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* (W Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) *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) e. - I- - -A ., w Tvoe or print in ink. SCHEDULE A VVI IGN Nva. /� Amounts may be rounded y Monetary Contributions Received to whole dollars. Statement covers period ' ' 7/1/13CALIFORNIA from • • RM Ef I z� 9/21113 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Kenneth King ❑COM Ships Clerk 40.00 40.00 40.00 7/4 ❑OTH PM.A San Rafael, CA 94913 ❑ PTY ❑ scc ®IND Patrick Seidler ❑COM Executive 100.00 100.00 100.00 7/19 ❑OTH WTB, Inc. Mill Valley, CA 94941 ❑ PTY ❑ scc ® IND Ma O'Mara ❑coM Ex. Cir. 100.00 100.00 100.0 7/19 ❑OTH Marin Link an a a , 1 ❑ PTY ❑scc IND Janet Allen ❑coM retired 300.00 300.00 300.00 7/30 ❑ OTH Kentfield, CA 94904 ❑ PTY ❑ SCC ®IND Stan Gold retired 50.00 150.00 150.00 7/22 acOOH Petaluma, CA 94952 ❑ PTY ❑scc SUBTOTAL $ 590.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. 6869.00 (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 $ 835.00 7704.00 *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/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded dollars. Statement covers period CALIFORNIA to whole 7/1/13 FORM' from 9/21/13 Page of through NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAMESTREET 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ❑ IND No. Bay Labor Council AFL-CIO COPE ®COM 200.00 200.00 200.00 7/26 E] OTH Santa Rosa, CA 95403 ❑ PTY ❑ SCC ®IND Hoang Duc ("Jimmy") Van E] COM 100.00 100.00 100.00 8/2 []OTH hair stylist -- self Lotus Y 967 Grand Ave., San Rafael, CA 94901 E] PTY Hair Salon) ❑ SCC Matt Brown ®IND [:]Com100.00 realtor 100.00 100.00 8/6 [:j OTH Meridian San Anselmo, CA 94979 ❑ PTY ❑SCC Bill Kier W] IND ❑COM Natural Resources 250.00 250.00 250.00 8/6 ❑ OTH Consultant San Rafael, CA 94901 ❑ PTY self (Kier Associates) ❑ SCC Ste hen Fein ®IND ❑COM retired 250.00 250.00 250.00 S/8 ❑ OTH Mill Valley, CA 94941 ❑ PTY ❑ SCC SUBTOTAL$ 900.00 *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/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Tvoeororintinink. SCHEDULEA (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers periodI CALIFORNIA to whole dollars. 7/1/13 FORM ' from through 9/21/13 jt Page of� NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE DEO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ECOMMITTEE,ALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED .D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) ® IND 8/8 ❑ COM retired 100.00 125.00 125.00 Omni ❑ OTH ❑ PTY ❑ SCC 8/10 Ka No LICH ®IND ❑❑ COM retired 100.00 150.00 150.00 OTH San Rafael, CA 94903 ❑ PTY ❑ SCC in rleider ®IND ❑COM cardiothoracic surgeon 100.00 300.00 300.00 8/10 ❑ OTH self Mill Valley, CA 94941 ❑ PTY ❑ SCC Ra Katz MINDD COM dentist 100.00 150.00 150.00 8/11 ❑OTH self Larkspur, CA 94939 ❑ PTY ❑ SCC 8/13 Ell n Obstler ®IND ❑COM retired 250.00 500.00 500.00 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL $ 650.00 "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/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Tvueororintinink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded to dollars. statement covers period CALIFORNIA 460 whole 7/1/13 . from through 9/21/13 Page of / NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE DEO FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO .D.N ENT(IF CODE * SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) IND ®❑COM Roberta Kemp retired 50.00 100.00 100.00 8/13 E] OTH an ae , 01 ❑PTY ❑ SCC ®IND videographer 100.00 150.00 150.00 8/15 10nOae, ooTH self (Legal Videos) 1 ❑ PTY ❑ SCC Keith & Gail Lester ®IND ❑COM retired 75.00 325.00 325.00 8/18 ❑ OTH an a ae , 01 ❑ PTY ❑ SCC Ed Vorous LZIND business owner 250.00 500.00 500.00 8/18 000H self (Dustbusterz) an a ae , 94901 ❑ PTY ❑ SCC Steve Silberstein VIIND ❑ COM retired 250.00 500.00 500.00 8/ 18 ❑ OTH Belvedere, CA 94920 ❑ PTY ❑ SCC SUBTOTAL$ 725.00 `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/ASK-FPPC (866/275-3772) Ri-hPd ule A (Continuation Sheet) Tvoe or print in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA 460 to whole dollars. 7/1/13 FORM from Page Y of through 9/21/13 I.D. NUMBER NAME OF FILER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Belle Cole ❑IND retired 300.00 600.00 600.00 8/18 DOTH San Rafael, CA 94901 ❑ PTY ❑ SCC _ ®IND teacher 250.00 250.00 250.00 8/18 Wiur"on,20 DOTH self ❑ PTY D SCC an ®IND ❑ COM property manager 1000.00 1000.00 1000.00 8/20 *ovato0,94947 DOTH self (Prospect []PTY Investments LLC) ❑ SCC Lori Grace ®IND L]CO teacher 250.00 500.00 500.00 8/21 self Tiburon, CA 94920 D PTY ❑ SCC Robert Herbst ®IND ❑ COM airport manager 250.00 250.00 250.00 8/22 DOTH an ort self SRafael Air ( Airport) San Rafael, CA 94903 ❑ 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 SUBTOTAL$ 2050.00 1 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. SCHEDULE A (CONT.) Amounts may be rounded Statement covers period---FCALIFORNIA to whole dollars.7/1/13 FORM t from "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/ASK-FPPC (866/275-3772) through 9/21/13 Page_ of I.D. NUMBER NAME OF FILER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Ed Vorous ❑COM business owner 250.00 750.00 750.00 9/6 E] OTH self (Dustbusterz) an a ae , ❑ PTY ❑ SCC Rico Hurvich ®IND O❑ CO retired 54.00 108.00 108.00 9/7 OTH Mill Valey, CA 94942 ❑ PTY ❑ SCC Bob Case Y ®IND ❑ COM retired 50.00 100.00 100.00 9/7 ❑ OTH Greenbrae, CA 94904 ❑ PTY ❑ SCC Larry Lar Rose ®IND ❑COM retired 50.00 175.00 175.00 9/7 ❑ OTH Mill Valley, CA 94941 ❑ PTY ❑ SCC Katie Crecelius ®IND EIC housing consultant 250.00 450.00 450.00 9/12 TH self Novto, CA 94948 ❑ PTY ❑ SCC SUBTOTAL $ 654.00 "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/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULEA (CONT.) Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 7/1/13 FORM from through 9/21/13 Page _JW of NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAMESTREET 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) IND 9/12 Frank Egger®❑IoM retired 100.00 100.00 100.00 E] OTH Fairfax, CA 94930 ❑ PTY ❑ SCC T mber Cavasian ®IND EICOM property manager 100.00 100.00 .100.00 9/13 L] OTH self San Rafael, CA 94901 ❑ PTY ❑ SCC Miriam Noiseux®IND ❑ IoM retired 100.00 100.00 100.00 9/ 13 ❑ OTH San Rafael, CA 94901 ❑ PTY [I SCC Ellen Karel W]IND retired 100.00 200.00 200.00 9/16 DOTH Corte Madera, CA 94925 ❑ PTY ❑ SCC Alfred & Ruth Heller ZIND ❑COM ind, investor 250.00 500.0 500.00 9/17 ❑ OTH self San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL $ 650.00 "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/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Twe or print in ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded to dollars. Statement covers period CALIFORNIA ' whole 7/1/13 FORM • from through 9/21/13 Pageof NAME OF FILER I.D. NUMBER GREG BROCKBANK / BR.00KBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR O CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO ENTER ID.NUMB CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) IND Margaret Kreutzkampf ICOM retired 100.00 100.00 100.00 9/19 ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC Andrea de la Fuente ®IND El COM Investment Banker 200.00 200.00 200.00 9/19 1 US Bancorp San Rafael, CA 94901 ❑ PTY ❑ SCC 9/20 ®IND ❑COM Ex. Dir. Agricultural Institute of 250.00 250.00 250.00 4ana*ae94901 E] OTH g ❑ PTY Marin ❑ ScC Ken King BIND Ships Clerk 100.00 40.00 140.00 9/20 ❑CO CITHSan PM.A Rafael, CA 94913 ❑ PTY ❑ ScC ❑ IND ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 650.00 ; `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/ASK-FPPC (8661275-3772) Schedule D SCHEDULED Summary of Expenditures Type or print in ink. Statement covers period Amounts may be rounded CALIFORNIA 460 Supporting/opposing Other to whole dollars. 7/1/13 O Candidates, Measures and Committees from 9/21/13 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER LD. NUMBER GREG BROCKBANK 1 BROCKBANK FOR CITY COUNCIL 2013 1355049 CUMULATIVE TO DATE PER ELECTION DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN. 1 DEC. - 31) (IF REQUIRED) OR COMMITTEE Democratic Central Committee of Marin Monetary sponsorship of fundraiser 7/25 Contribution 250.00 375.00 375.00 0 Nonmonetary Contribution E] Independent El Support ❑ oppose Expenditure Monetary Contribution © Nonmonetary Contribution Independent El Support oppose Expenditure El Monetary Contribution Nonmonetary Contribution Independent �] Support oppose Expenditure FPPC Form 460 (January/06) FPPC Toll -Free Helpline 866/ASK-FPPC (866/276-3772) I Schedule E Payments Made -;FF INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 Statement covers period from 7/1/13 through 9/21/13 Page lof ' t— I.D. NUMBER 1355049 E 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 AMOUNTPAID Indie Politics CNS 3100.00 Novato, CA 94949 Cherie Maria Alvarez SAL 1500.00 an a osa, 404 Strahm Communications remits 418.55 San Rafael, CA 94901 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 5018.55 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.) ............................. TOTAL $ 11, 382.97 90.64 11,473.61 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E (Continuation Sheet) Payments Made Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7/1/13 SCHEDULE E (CONT.) c. SEE INSTRUCTIONS ON REVERSE 9/21/13 through Page of I 1 NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 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 supportinglopposing 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 1 rr ramnainn Iitr ratllrP and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) City of San Rafael 1400 Fifth Ave. FIL 840.00 San Rafael, CA 94901 c. voter data ",Dala 1531.26 652 Cardmember Service food ($240.72) and chairs ($120) for campaign kickoff 616.16 63179-0408 Democratic Central Committee of Marin sponsorship of fundraiser � 250.00 San Rafael, CA 94903 Indie Politics lawn sign design and printing 3127.00 Novato, CA 94949 ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 6364.42 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule G Type or print in ink. AMOUNT PAID Pat Johnstone San Anselmo, CA 94960 LIT SCHEDULE G Indie Politics Novato, CA 94949 Statement covers period CALIFORN�IA 461(f 1 Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) to whole dollars. 7/1/13 from • through 9/21/13 Page L_ of SEE INSTRUCTIONS ON REVERSE T NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 NAME OF AGENT OR INDEPENDENT CONTRACTOR Pat Johnstone and Indie Politics 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 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 (internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Pat Johnstone San Anselmo, CA 94960 LIT 90.64 Indie Politics Novato, CA 94949 lawn sign design and printing 3127.00 Attach additional information on appropriately labeled continuation sheets. * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. TOTAL* $ 3217.64 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)