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HomeMy WebLinkAboutForm 460 - Greg Brockbank for City Council 2013 (2013-12-31)RecipientCommittee Campaign Statement CoverPage (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from 10/20/13 3. Committee Information I.D. NUMBER 1355049 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) BROCKBANK FOR CITY COUNCIL 2013 STREET ADDRESS (NO P.O.- BOX) 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 penalty of perjury under the laws of the State of California that the foregoing is true and correct. t Executed on 1/31/14 By Date Signature of Treasurer or Assistant Treasurer 1/31/14 yr Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 10/20/13 through 12/31/13 Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR TOTALTO DATE Running in Both the State -Primary and (FROM ATTACHED SCHEDULES) General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 12 $ ,025.00 $ 42yO63.18 31600.00 700.00 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2 $ 15,625.00 $ 49y663-18 20. Contributions Received $ $ 4. 'N'Onmonetary Contributions .................................... Schedule C, Line 3 547.80 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 15,625.00 $ 50,210.88 Made $ $ Expenditures Made1 Expenditure Limit Summary for State 6. Payments Made ....................................................... Schedule E, Line 4 $ 15yOl 7.74 $ 471771.73 Candidates 7. LoansMade............................................................. Schedule H, Line 3 1501774 471771.73 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ ,. $ (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 15,017.74 $ 47,771.73 $ $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 19284.19 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above 151625-00 amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 from Column B of your last reported in Column B. 15,017.74 report. Some amounts in 15. Cash Payments .................................................. Column A, Line 8 above Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1,891.45 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any. 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE GREG BROCKBANK OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Councilmember, City of San Rafael RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Rafael, CA 94901 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 I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 0 YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? F� YES NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 0101vi :1 :4 V.ATCI = wa 1-n 12 CALIFORNIA '0 FORM 4 b Page of it IC 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [:] SUPPORT F-JOPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT F� OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT F-1 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 Cnhnrli rin A Type or print in ink. SCHEDULE A Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period 1 10/20/13CALIFORNIA from FORM through 12/31/13 page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER 1355049 DATE AND ZIP 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 (E COMMITTEE, ALSO I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) WIND Chnrnn A P:^v ❑COM documentary filmmaker 100.00 10/22 ❑ OTH (self) San Rafael, CA 94901 E] PTY ❑ SCC ❑ IND S.F. Laborer's Local 261 ®COM 500.00 10/23 ❑ OTH �r rsz C,a CHO �scc ® IND Gary Tobin El COM publicist (self) 100.00 10!23 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC IND Gail Altschuler ElCOM physician (self) 50.00 150.00 10/25 400 Professional Ctr. Dr. ❑OTH Novato, CA 94947 ❑ PTY ❑ SCC ®IND Roberta Goldberg El COM retired 100.00 225.00 10/25 1- - - - - 0OTH San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL$ 850.00 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.) . `( 2`i0 IlU N 135.00 .......TOTAL $ 11,000.,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 Statement covers period • . CALIFNIA to whole dollars. 10/20/13 FORM ' from 12/31/13 through Page 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 Thnmac rlricrnll ❑COM retired 10/25 E] OTH 100.00 San Katael, cA 949U1 ❑ PTY ❑ ScC Janet Wiscombe ®IND ❑COM retired 10/25 35.00 135.00 - ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC Doug Jones ®IND [:]COM retired 10/25 100.00 ❑ OTH San Leandro, CA 94577 ❑ PTY ❑ SCC Doug Kerr VIIND ❑COM retired 10/25 2,000.00 2,199.00 ❑ OTH Larkspur, CA 94939 ❑ PTY ❑ScC No. Bay Labor Council Com. on Pol. Educ. ❑IND E]COM 10/25 (#744444) ❑ OTH 200.00 400.00 2525-A Cleveland Ave., Santa Rosa, CA 95403 ❑ PTY ❑ SCC SUBTOTAL$ 2435.00 *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 Statement covers period CALIFORNIA to whole dollars. 10/20/13 ' from 12/31/13 through Page of NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSENTERI.D.NUMBER) CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) IND Patty Bredt []COM Nurse 10/26 I ❑OTH Care Meridian 100.00 Fairfax, CA 94930 ❑ PTY ❑ SCC John Revnolds ®IND ❑COM retired 10/26 100.00 235.00 — — ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC Ed Vorous BIND ❑ COM Business Owner 10/26 ❑OTH Self (Dustbusterz) 200.00 950.00 San Rafael, CA 94901 ❑ PTY ❑ SCC Jeff Brusati ®IND El COM Business Owner 10/26 Self (T&B Sports) 250.00 San Rafael, CA 94903 ❑ PTY ❑ SCC Rona Schmidt ®IND ❑COM retired 10/26 100.00 200.00 ❑ OTH San NaTael, UA x4901 ❑ PTY ❑ SCC SUBTOTAL$ 750.00 *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 (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 10/20/13FORM • , from 12/31/13 through Page of NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSENTERI.D.NUMBER) CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) OIND Larry Rose ❑COM retired 10/26 E] OTH 25.00 150.00 Mill Valley, CA 94941 ❑ PTY ❑ SCC Bill Bernstein BIND [:]COM Attorney (self) Attorney 10/26 ❑ OTH San Francisco, CA 94111 ❑ PTY ❑ SCC ®IND retired 10/26 ❑ COM 50.00 125.00 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC Derek Knell V]IND EICOM Printer (self) 10/26 - 105.00 E] OTH Novato, CA 94949 ❑ PTY ❑ SCC Huqh Delehanty ®IND ❑COM Author (self) 10/27 100.00 200.00 ❑ OTH Mill Valley, CA 94941 ❑ PTY ❑ SCC SUBTOTAL$ 380.00 "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 Statement covers period to whole dollars. 10/20/13 �, ' from 12/31/13 7 ((' through Page of NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED IFCOMMIE,ALSENTERI.D.NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ❑ IND Gumbiner & Eskridge ❑COM 10/28 ® OTH 100.00 200.00 Walnut Creek, CA 94597 ❑ PTY ❑ SCC Tymber Cavasian V]IND ❑COM Property mgr. (self) 10/28 100.00 100.00 ...,.. E] OTH San Rafael, CA 94901 ❑ PTY ❑ ScC 10/28 Kay Karchevski VICOM E]CO50.00 retired 115.00 :_ ::::: _ _ E] OTH San Rafael, CA 94901 ❑ PTY ❑ ScC Martin J. Bennett ®IND ❑ COM college instructor (Santa 10/29 E] OTH Rosa J.C.) and union rep. 100.00 Sonoma, CA 95476 ❑ PTY (Unite Here) ❑ SCC Francis Greenburger ®IND ❑COM Real estate nvestor (self) 10/29 250.00 E] OTH Imcw I UI n, 1-41 - ❑ PTY ❑ SCC SUBTOTAL$ 600.00 a '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 (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. 10/20/13 • ' from _ 12/31/13 A through Page Of NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO ENTERI.D.NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) IND Jonathan Leone ICOM Attorney (self) 10/29 ❑ OTH 250.00 5ausaino, LH 94965 ❑ PTY ❑ SCC Mark Leno ®IND ❑COM California State Senator 10/30 250.00 ❑ OTH Sacramento, CA 95814 ❑ PTY ❑ ScC Ratty Wnnri ZIND ❑COM Clinical Social Worker 10/31 ❑ OTH (self ) 50.00 100.00 Novato, CA 94949 ❑ PTY ❑ SCC Pam Reaves ®IND ❑COM Therapist (self) 10/31 100.00 200.00 []OTH San Rafael, CA 94903 ❑ PTY ❑ SCC Marty Griffin ®IND ❑COM retired 10/31 200.00 ❑ OTH Belvedere, cA 94920 ❑ PTY ❑ SCC SUBTOTAL$ 850.00 *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 Statement covers period CALIFORNIA to whole dollars. 10/20/13 FO460 from " t Page (� of through 12/31/13 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 Nnna npnnis El COM retired 10/31 ❑ OTH 50.00 200.00 Mill Valley, CA 94941 ❑ PTY ❑ SCC Michael Allen ®IND ❑COM Board member 11/1 E] OTH California Unemployment 100.00 199.00 Santa Rosa, CA 95409 ❑ PTY Insurance Appeals Board ❑ SCC United Assn. of Journeymen & Apprentices of E] IND ®coM 11/4 the Plumbing & Pipe Fitting Industry Local 38 ❑ OTH 400.00 3473 Santa Rosa Ave., Santa Rosa, CA 95407 ❑ PTY ❑ SCC Helen Bacon ®IND El COM retired 11/4 50.00 300.00 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC Patrick Seidler ®IND ❑coM President 11/4 E] OTH WTB, Inc. 100.00 100.00 Nun vauey, L,F1 y4y4 I ❑ PTY ❑ SCC SUBTOTAL$ 700.00 *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 Statement covers period to whole dollars. CALIFORNIA ' 10/20/13 from • - through 12/31/13 Page of r ` NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITEE,ALSO ENTER I.D.NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Allan Blau ❑ COM retired 11/5 ❑ OTH 100.00 rvun v aucy, �_'M y -+U-+ I ❑ PTY ❑ SCC Ken Hobbs ®IND ❑ COM retired 11/6 25.00 175.00 ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ SCC 11/8 ®IND ❑ COM retired 100.00 225.00 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC IBEW--Int'I Brotherhood of Electrical Workers ❑IND COM 11/25 Local 551 (#1277746) E]oTH 500.00 ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ 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) Schedule Part I Loans Received Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 10/20/13 SCHEDULE B - PART 1 ❑ PAID CALENDAR YEAR ❑ FORGIVEN FATE PER ELECTION ** t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED (Total Column (b) plus unitemized loans of less than $100.) tContributor Codes IND - Individual 2. Loans paid or forgiven this period......................................................................................................... COM - Recipient Committee Notal Column (c) plus loans under $100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH - Other (e.g., business entity) PTY — Political Party 3. Net change this period. u�rac Line 2 from Line 1................................................................ � 31600.00 SCC - Small Contributor Col�mi#tee (May be a negative number) 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. FPPC Form 460 (January/05 FPPC Toll -Free helpline: 866/ASIC-FPPC (866/275-3772) 12131113 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER(a) OCCUPATION AND EMPLOYER OUTSTANDING BALANCE (b) AMOUNTOUTSTANDING (c) AMOUNT PAID (d) gALANCEAT (e) INTEREST V) ORIGINAL (g) CUMULATIVE OF LENDER (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE Greg Brockbank Attorney (self) ❑ PAID CALENDAR YEAR 35 St. Francis Lane Marin Law Center $ $ 71600.00 �,� $ $ 7,600.00 San Rafael, CA 94901 ❑ FORGIVEN RATE PER ELECTION** 41000.00 31600:00 $ $ $ t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCG DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN FATE PER ELECTION ** t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED (Total Column (b) plus unitemized loans of less than $100.) tContributor Codes IND - Individual 2. Loans paid or forgiven this period......................................................................................................... COM - Recipient Committee Notal Column (c) plus loans under $100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH - Other (e.g., business entity) PTY — Political Party 3. Net change this period. u�rac Line 2 from Line 1................................................................ � 31600.00 SCC - Small Contributor Col�mi#tee (May be a negative number) 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. FPPC Form 460 (January/05 FPPC Toll -Free helpline: 866/ASIC-FPPC (866/275-3772) Schedule D SCHEDULED Summery of Expenditures Type or print in ink. Statement covers period Supporting/OpposingOther Amounts may be rounded whole dt�lliaTS. � . to o from 101201 � +� Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE through 12131113 Page � of NAME OF FILER I.D. NUMBER GREG BROCKBANK 1 BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD OR COMMITTEE (JAN. 1 - DEC. 31) (IF REQUIRED) [1 Monetary Contribution [� Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution Nonmonetary Contribution (� Independent Support ❑ oppose Expenditure ® Monetary Contribution ® Nonmonetary Contribution 0 Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL Schedule D Summary 1. Itemized contributions and independent expenditures made this period. {Include all Schedule D subtotals.} ......................................................... . Unitemized contributions and independent expenditures made this period of under $100..................................................................................... 70.00 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2.Cho not enter on the Summar Page.) ............ TOTAL. 70.00 I=PPC Form 460 (January/05) FPPC Toll -Free Helpline.- 8£61AS1 -FPPC 866/275-3772) Schedule E Payments Made SEE 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 10/20/13 through 12/31/13 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment - Page of I.D.NUMBER CIDP 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 FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals M 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 l/\ EB 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 Dan Mullen 10 Altamira Ct., Nowt©, CA 94949 LIT 1279.42 Dan Mullen 10 Altamira Ct., Novato, CA 94949 LIT 259.67 Indie Politics 10 Altamira Ct., Novato, CA 94949 LIT 6652.68 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 8191.77 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ 14,904.11 2. Uniternized payments made this period of under $100 .......................................................................................................................................... $ 113.63 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 t 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ 15,017.74 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule E (Continuation Sheet) Payments Made SEE 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 10/20/13 . through 12/31/13 Pageuiuuuii iii 15- of I C I.D. NUMBER 1355049 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP 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 MB 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) Indie Politics 10 Altamira Ct., Novato, CA 94949 LIT 2650.00 Indie Politics 10 Altamira Ct., Novato, CA 94949 LIT 2118.42 Carpenters Local 35 lv PHO 150.00 < ,_3� Political Data, Inc. LIT 800.14 v;, Pat Johnstone 125 Redwood Road PHO 292.69 San Anselmo, CA 94960 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E Type or print in ink. (Continuation Sheet) Amounts may be rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME, OF FILER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 Statement covers period 10/20/13 ft roupY 12/31/13 Page of I.D. NUMBE■R 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 ND 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 Cardmember Service POB 790408 St. Louis, MO 63179 fundraiser venue, food for phone banks, and other misc. expenses 701.09 FITC For 460 (January/05) FP 'C Toll -Free Helpline: 866/ASK--PPC (866/275-3772)