HomeMy WebLinkAboutForm 460 - Firefighters' Association PAC (2015-06-30)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
fro
Type or print in ink.
Statement covers period
m
1/1/2015
through 6/30/2015
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
Q Recall
(Also Complete Part 5)
® General Purpose Committee
® Sponsored
Q Small Contributor Committee
Q Political Party/Central Committee
❑ Ballot Measure Committee
0 Primarily Formed
Q Controlled
0 Sponsored
(Also Complete Part 6r
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Compete Part 7)
3. Committee InformationI.D. NUMBER
891308
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 DIFFERENT) NO. AND STREET OR P.O. BOX
CITY
STATE
ZIP CODE
AREA CODE/PHONE
San Rafael
Ca
94912
OPTIONAL: FAX / E-MAIL ADDRESS
Date Stamp
Date of election if applicable:
(Month, Day, Year) JUL 16 2015
2.
"Office
t. 1Prk's
Type of Statement: City of San KaidP
❑ Preelection Statement
® Semi-annual Statement
❑ Termination Statement
❑ Amendment (Explain below)
COVERPAGE
Page _.L_ of_
For Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
Treasurer(s)
NAME OF TREASURER
Andrew D. Rogerson
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
Rohnert Park Ca 94928
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
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 foregoinq.;"rue and correct.
Executed on 7/15/2015
Date
Executed an
Executed on
Date
By
By
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on 460 BY
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
State of California
Campaign Disclosure Statement
Type or print in ink.
SUMMARY PAGE
Statement covers period
-
Amounts may be rounded
Summary Page to whole dollars.
1/1/2015460FORM
from
through
6/30/2015
Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D NUMBER
San Rafael Firefighters Political Awareness Committee
891308
Column
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTALTHISPER'OD
CALENDAR YEAR
Running in Both the State Primary and
iFROM ATTACHED SCHEDULES]
TOTAL TO DATE
General Elections
1. Monetary Contributions ........................................... Schedule A, Line 3
$
0
$ 0
0
0
1/1 through 6130 7/1 to Date
2. Loans Received.,.................................................... Schedule B,Line 3
3. SUBTOTAL CASH CONTRIBUTIONS ............... Add Lines 1 +2
$
0
0
$ ---
20. Contributions.........
Received $ $
4. Nonmonetary Contributions .................................... Schedule C, Line 3
0
0
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ...... ••• ••....... Add Lines 3+4
$
0
$ 0
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made ....................................................... Schedule e, Line 4
$
0
$
Candidates
7. Loans Made............................................................. Schedule H, Line 3
0
0
0
0
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7
$
$
(if Subjectto Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ••••••••••••••••••••••••��••••• Schedule FLine 3
0
0
Date of Election Total to Date
10. Nonmonetary Adjustment .......................................... Schedule C, Line
0
0
(mm/dd/yy)
11. TOTAL EXPENDITURES MADE ................................ Add Lines 6 + s + 10
$
0
$ 0
$
If $
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16
$
87,576
To calculate Column B, add
$
13. Cash Receipts ................................ !.................. Column A, Line 3 above
0
amounts in Column A to the
5
corresponding amounts
14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4
from Column B of your last
$
15. Cash Payments ....................... Column A, Line 6 above
0
report. Some amounts in
Column A may be negative
J $
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15
$
87581
,
figures that should be
9
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
$
0
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
*Since January 1, 2001. Amounts in this section may be
different from amounts reported in Column B.
Cash Equivalents and Outstanding Debts
any).
18. Cash Equivalents ........................................ See instructions on reverse
$
0
19. Outstanding Debts ......................... Add Line 2 + Line s in Column B above
$
0
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
Schedule A Type or print in ink. SCHEDULE A
Moneta Contributions Received Amounts may be rounded
to dollars.
Statement covers period
CALIFORNIAA60
whole
from 1/1/2015
FORM
Page 2
through 6/30/2015
SEE INSTRUCTIONS ON REVERSE
of
NAME OF FILER
I.D. NUMBER
San Rafael Firefighters Political Awareness Committee
891308
DATE
A
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
(ET
COMMITTEE ALSO ENTER I.D. NUMBER)
CODE *
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 -DEC. 31)
(IF REQUIRED)
OF BUSINESS)
❑IND
❑ COM
❑ OTH
❑ PTY
El SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
[:]IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
[]IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL$
Schedule A Summary
1. Amount received this period — contributions of $100 or more.
(Include all Schedule A subtotals.)...................................................
2. Amount received this period — unitemized 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 $
'Contributor Codes
IND— Individual
0 COM — Recipient Committee
(other than PTY or SCC)
0 OTH — Other
PTY— Political Party
SCC—Small Contributor Committee
0
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
Crharlr Ila I
SCHFnIII F I
Miscellaneous Increases to Cash Amounts may be rounded
to whole dollars.
SEE INSTRUCTIONS ON REVERSE
Statement covers period
1/1/2015
from
through 6/30/2015
_
• " I ,
page of
___x__
NAME OF FILER
San Rafael Firefighters Political Awareness Committee
I.D. NUMBER
891308
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCEAMOUNT
(IF COMMITTEE ALSO ENTER D NUMBER)
DESCRIPTION OF RECEIPT
OF
INCREASE TO CASH
06/30/2015
Bank Of America
1000 4th St San Rafael Ca. 94901
Intrest Earned
$5
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 5
Schedule I Summary
1. Increases to cash of $100 or more this period...........................................................................................
2. Unitemized increases to cash under $100 this period...............................................................................
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) .................
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
SummaryPage, Line 14.)...........................................................................................................................
.............. $ 5
.............. $ 0
.............. $ 0
TOTAL $ 5
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC