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Home My WebLink AboutForm 460 - Firefighters' Association PAC (2014-12-31)Recipient Committee Campaign Statement CoverPage (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period Date of election if applicable: from 07/01/2014 (Month, Day, Year) SEE INSTRUCTIONS ON REVERSE thr.,gh 12/31/2014 1. Type of Recipient Committee: All Committees— Complete Parts 1,2,3,and4. El Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) W1 General Purpose Committee (R) Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee Ballot Measure Committee 0 Primarily Formed 0 Controlled 0 Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) San Rafael Firefighters Political Awareness Committee STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael Ca 94901 MAILING ADDRESS IF DIFF" COVED PAGE M -."A?'111114'2'� KM M JAN 3 0 2015 P0 .......... ", . .. .. ..... ............ ...... . .... : For Official Use Only ;ty Clerws office ,ty of San Rafael 2, Type of Statement: ❑ Preelection Statement Semi-annual Statement E] Termination Statement 0 Amendment (Explain below) NAME OF TREASURER Andrew D. Rogerson MAILING ADDRESS E] Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 CITY STATE ZIP CODE AREA CODE/PHONE Rohnert Park Ca 94928 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP GODS AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE San Rafael Ca 94912 OPTIONAL: FAX t 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 penalty of perjury under the laws of the State of California that the foregoing is true and carrec 0 By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor By Signature of Controlling Officehokier, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State, Measure Proponent - FPIPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC State of California 01/22/2015 Executed on Date Executed on Date Executed on Date Executed on Date 0 By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor By Signature of Controlling Officehokier, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State, Measure Proponent - FPIPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC State of California Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. SEE INSTRUCTIONS omREVERSE NAME orFILER San Rafael Firefighters Political Awareness Committee Statement covers period 07/01/2014 from K through 13/31/20 Contributions Received * Column Column 7. LoonaMeda--------------------� Schedule H, Line (mm/dd/yy) rmxmmpERmo oALsND^vEAn & SUBTOTAL CASH PAYMENTS .----------_� Auwcm* s+r $ (FROM ATTACHED SCHEDULES) TOTALmDATE 1. KXonetoryContribuUono--'--------- av»'m/m»'Lin*a $ O * 1'218 2. LoonsReoeived------------------ SchauuleB,Line x D O 1 SUBTOTAL CASH CONTRIBUTIONS ..... Add Lines I+c $ O $ 1.216 4. NonmonetaryConUibuUonn----—------- Schedule C, Line O O 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 + 4 $ ---o $ 1,216 8. Payments Made ....... .—....... --...... ---...... —' ocho»uloE, Line * 550 $ 2'321 7. LoonaMeda--------------------� Schedule H, Line (mm/dd/yy) D O & SUBTOTAL CASH PAYMENTS .----------_� Auwcm* s+r $ 550 $ 2.321 9� Accrued Expenses (Unpaid Bills) —............... --.—avmedumF,uno O O 1O,Nonmoneto[yAdjustment .... ---- ..... ........ ---- Schedule C,Line a � U O 1tTOTAL EXPENDITURES MADE ............ ...... _..... _»dxLines o+o+m * 550 $ 2.321 Current Cash Statement 1Z Beginning Cash Balance ....... ---- ...... Previous Summary Page, Line 16 $ 88,117 lu calculate Column B, add 14. Miscellaneous Increases to Cash ................. Schedule /, Line 4 9 corresponding amounts from Column B of your last 15. Cash Payments ............. ... Column A, Line 8 above 550 report. Some amounts in — Column A may be negative 16. ENDING CASH BAL-ANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 87,576 figures that should be ff this is a termination statement, Line 16 must be zero, subtracted from previous period amounts. If this is the first report being filed 17� LOAN GUARANTEES RECEIVED.... ........ ..... Schedule B, Part 2 $ 0 for this calendar year, only carry over the amounts Cash Equivalents and Outstanding Debts from Lines 2, 7, and 9 (if 18, Cash Equivalents ....... ...... -- .... See instructions on reverse $ 0 any). I.D. NUMBER 891308 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $_____-__'_ $ 21, Expenditures | Made $________. $ 1; Candidates 22. Cumulative Expenditures Mmur (if Subject to Voluntary e,penun.wLimit) Date nfElection Total toDate (mm/dd/yy) $�� $________ $______-__ $_________ � $________ | �inoeJmnuory 1, 2001. Amounts inthis section may ue FPPC Form 460 (June/01) Schedule A Type orprint in ink. A�mvmtsmay myroundedto whole dollars. Monetary Contributions Received SEE INSTRUCTIONS owREVERSE San Rafael Firefighters Political Awareness Committee DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER CONTRIBUTOR RECEIVED (IF COMW FTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) EJIND El COM E] OTH PTY SCC El IND E_J COM OTH PTY El SCC COM OTH PTY SCC El COM El OTH PTY SCC DIND OCOM E] OTH El PTY El SCC Statement covers period 07/01/2014 '41 from through 12/31/2014 of 8913 8 AMOUNT ULATIVE TO DATE PER ELECTION RECEIVED THIS LENDAR YEAR TO DATE SUBTOTAL$ Schedule A Summary 1.Amount received this period - contributions of$1O0ormore. (include all Schedule Asubtote|oj.... ..-........ -..... ...... ~.---_................. ____ ...... --'$ » 2.Amount received this period -unibamizedcontributions cJless than $1QQ---.._-.......... .----� u 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ O Contributor Codes IND -individual FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule E Type m,print in ink. Made Amounts may be rounded Statement~covers—~~''~~ Payments to mmm|e 6oQame. | 07/01/2014 SEE INSTRUCTIONS owREVERSE NAME upFILER San Rafael Firefighters Political Awareness Committee CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. � G P�n_�__ I.D. NUMBER 891308 QvIP mampaignperaphemana/nisn. MBR member communications pmo radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions cna contribution (explain nonmonetary)° OFCoffice axnnnaem SAL campaign workers' salariesCVC civic donations PB' petition circulating TeL Lv, or cable airtime and production costs nIL canuiuete§Ung/benot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events PUL polling and survey research TRS utaffiepouaatravm|. |odging, and meals IND independent expenditure supporting/opposing others (explain)* POS postoge, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense pnD professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (intemet.emaiV NAME AND ADDRESS OF PAYEE (IF COML1rTTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Marin For 911 Yes On "A" 116 Alexander Ave Larkspur Ca. 94939 Contribution in support of "A" FPPC# 1369822 CTB $500 Secretary of State Annual Campaign Committee Fee 1500 11 th Street Room 495 Sacramento, Ca. 95814 $50 * Payments that are contributions orindependent expenditures must also besummarized omSchedule D. SWBTOTAL$ 550 1,Payments made this period of$1OOurmore, (Include all Schedule Enubbzbalsj—~--.......... —...... ----------~-----~----�550 2.Undemizedpayments made this period of under $1OD—... ___ ...... ------.~------------~-------~----~.---_.' O 3.Total interest paid this period onloans. (Enter amount from Schedule B.Part 1.Column (e)l~----~----~----~—....... ---~--'$ O 4. Total payments made this period. (Add Lines 1.2.and 3.Enter here and onthe Summary Page, Column A\Line 6j ..... --.... .—........ TOTAL $ 55O Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS owREVERSE NAME opFILER San Rafael Firefighters Political Awareness Committee FULL NAME AND ADDRESS OF SOURCE RECEIVED (IF COMMITTEE, ALSO ENTER J.D, NUMBER) DATE Bank of America 1000 4th St San Rafael Ca. 94901 Attach additional information onappropriately labeled continuation sheets. Statement covers period from O7A]1/2814 12/3i/2O14 tbmuQb DESCRIPTION opRECEIPT Interest Earned 1.Increases to cash of $10Oor more this period. .... .... ..... ......... ~_---....... —....... ...... --.~~----.--.—� 2.Undemizedincreases tocash under $1QOthis period. ----.—~---.---.—...... ....... ----------'� 3. Total of all interest received this period on loans made to others. (Schedule H. Column (e).) ---.-----$ 4. Total miscellaneous increases hocash this period. (Add Linen 1. 2, and 3. Enter here and on the 8 G ��____�__ m.wuMasR 891308 11 0 FPpC Form 4en(Junm01) FPP2 Tn|Wrce NdpQmm: 866Q\SK-FPPC