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HomeMy WebLinkAboutForm 460 - Greg Brockbank for City Council 2013 (2014-06-30)Recipient Committee 'Campaign Statement CoverPage (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from 1/1/14 SEE INSTRUCTIONS ON REVERSE through 6/30/14 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee � Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) F-1 General Purpose Committee 0 Sponsored F-] Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information• , IIIIIIIIis]; I COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE, BROCKBANK FOR CITY COUNCIL 2013 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 OPTIONAL: FAX / E-MAIL ADDRESS P Date of election if applicable: age of (Month, Day, Year) For Official Use Only 1/5/13 2. Type of Statement: 0 Preelection Statement [� Quarterly Statement Semi-annual Statement M Special Odd -Year Report ❑ Termination Statement EJ Supplemental Preelection (Also file a Form 41© Termination) Statement - Attach Form 495 EJ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Greg Brockbank MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 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 foregoing is true and correct. P.11 P, 16 / ( z Executed on !1 1 / I - By I %, Date A Signatufr5of Treasurer or Assistant Treasurer . I TExecuted on -;n L I By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) State of California �- 'j ..,. CALIFORNIA FORM 460 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 RESIDENTIAUBUSINESS 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? Q YES ❑ NO 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? F] YES E] NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) Page 511of 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 N0. 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 ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT C] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT F] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD E] SUPPORT OPPOSE w� �a- c r ti.,vu� ter c, �.cyr .ac r nv vc Attach continuation sheets if necessary FPPC Form 460 January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Typo or -pfint In *10. CD Campaign Disclosure Statement Amounts mby be rounded S-Limmary Page tv whole dollars. 0 SEE INSTRUCTIONS ON REVERSE NAME OF FtLER GR EO B ROCKBANK / BROCKBAN K FOR C ITY COU NCI L 2013 Current Cash Statement 12. Beginning Cash Balance .............. PmiiausSmrr,-_WPaga, Line 16 $ 13. Cash Receipts ............................................. Cob=ALinq:7a1t" 14. Misc*llaneous Increases to Cash If Une 4 15- CaSh PgyMentS.........d ............ I ... I I.... I... I I ... I.... I... Cold =A, L�W 6 _ba 16. E?aNGCASHBALANCE ..... .... Add liftes 12 + 13 + Y4, ten subb"ad Lhie 15 $ ff this is a JenWhallon stafement, Une 16 must be zero, $ Cash 'a Eu lents nd Outstanding .debts eb. is. Cash ............. See fnsituaffans a? rwan* $ IS, Outstanding 1891AS 715.00 0 455.00 2151AS Statement covers period from 111114 iA14 ''ro Calculate Wumn B, add I amounF. in Column A to the correspond.ing arnaunts from Colwmn B of your last report. Some amourds in Column A may be rLegafftm figuires that should be subtracteU from preWous. period amovntsIf Ws is the first repGTt being fited for this calendar year, only carry over the amourts from Lines 2. 7,, and any). SUMMARY PAGE I.D. NUMBER A355049 General Elections 111 through W30 711 to Dafe 20. Contribullons Receivem:I 21, Expenditures Made 3 $ ExpendituTe Limit Summary for State Candidates 22. Cumulative Expenditures Made*. [IrSubjectto VolmHuy E.VeridWro UY01 Wte of Eiection Total to Date (mmld&W $ J $ 'Amounts in this see an may be dilWenf from amounts reported in Wurnn B_ F Form 460 (Jeri uary[05) FPPC Tog -Free Hlelplirw. 86&ASK-FPPC (866275-3772) Contributions- Received CallumnA HExpenditures Made ZALTH IS PERIOD 0FFMMArTA*U SCHMULM 6. Payments Made .................. ................. 4ri # rPl I 1 0 1 1. Monetary SdwUeAjine3 s$ $ Sch e &,da H, L;he 3 2. Loa" 8. SUBTOTAL GAS H PAYM ENT. 0 455.00 $ 3. SUBTOTAL CASH CONTRIBUTIONS ..................... a Adid Ufts I + 2 715.00$ W4, Nonmonetary Contributions.........%-., ........................ SC&M&d& C' Lihe 3 0 5. TOTAL DCS NTRIBUTlONS RECEIVED .......4................. -- AddLhes 3 + 4' 715.00 $ <1 Current Cash Statement 12. Beginning Cash Balance .............. PmiiausSmrr,-_WPaga, Line 16 $ 13. Cash Receipts ............................................. Cob=ALinq:7a1t" 14. Misc*llaneous Increases to Cash If Une 4 15- CaSh PgyMentS.........d ............ I ... I I.... I... I I ... I.... I... Cold =A, L�W 6 _ba 16. E?aNGCASHBALANCE ..... .... Add liftes 12 + 13 + Y4, ten subb"ad Lhie 15 $ ff this is a JenWhallon stafement, Une 16 must be zero, $ Cash 'a Eu lents nd Outstanding .debts eb. is. Cash ............. See fnsituaffans a? rwan* $ IS, Outstanding 1891AS 715.00 0 455.00 2151AS Statement covers period from 111114 iA14 ''ro Calculate Wumn B, add I amounF. in Column A to the correspond.ing arnaunts from Colwmn B of your last report. Some amourds in Column A may be rLegafftm figuires that should be subtracteU from preWous. period amovntsIf Ws is the first repGTt being fited for this calendar year, only carry over the amourts from Lines 2. 7,, and any). SUMMARY PAGE I.D. NUMBER A355049 General Elections 111 through W30 711 to Dafe 20. Contribullons Receivem:I 21, Expenditures Made 3 $ ExpendituTe Limit Summary for State Candidates 22. Cumulative Expenditures Made*. [IrSubjectto VolmHuy E.VeridWro UY01 Wte of Eiection Total to Date (mmld&W $ J $ 'Amounts in this see an may be dilWenf from amounts reported in Wurnn B_ F Form 460 (Jeri uary[05) FPPC Tog -Free Hlelplirw. 86&ASK-FPPC (866275-3772) HExpenditures Made 6. Payments Made .................. ................. 4ri # rPl I 1 0 1 3d?edW&5j Llne4 $ 455.0 -0 $ 7. Loans Made ft'.9 I # 111-4 1 1 1 -14 1 1 pft1 I ! 44 1 rq I 1 .4 a I um a I I a. I # 14-4 1 9 W-1 I I 1 44 9 ft" . . . . . . . Sch e &,da H, L;he 3 0 8. SUBTOTAL GAS H PAYM ENT. Add tine's 6 + 7 $ 455.00 $ 9. Accrued Expenses (Unpaid Bi115) SchedWe (7 line 3 0 10. N on m oneta ry Adjustment sch-e-cve C., b'AV 3 0 11. TOTAL EXPENDITURES MADE..: .............................. Add L�� 8 + 9 + f0 $ 455.00 Current Cash Statement 12. Beginning Cash Balance .............. PmiiausSmrr,-_WPaga, Line 16 $ 13. Cash Receipts ............................................. Cob=ALinq:7a1t" 14. Misc*llaneous Increases to Cash If Une 4 15- CaSh PgyMentS.........d ............ I ... I I.... I... I I ... I.... I... Cold =A, L�W 6 _ba 16. E?aNGCASHBALANCE ..... .... Add liftes 12 + 13 + Y4, ten subb"ad Lhie 15 $ ff this is a JenWhallon stafement, Une 16 must be zero, $ Cash 'a Eu lents nd Outstanding .debts eb. is. Cash ............. See fnsituaffans a? rwan* $ IS, Outstanding 1891AS 715.00 0 455.00 2151AS Statement covers period from 111114 iA14 ''ro Calculate Wumn B, add I amounF. in Column A to the correspond.ing arnaunts from Colwmn B of your last report. Some amourds in Column A may be rLegafftm figuires that should be subtracteU from preWous. period amovntsIf Ws is the first repGTt being fited for this calendar year, only carry over the amourts from Lines 2. 7,, and any). SUMMARY PAGE I.D. NUMBER A355049 General Elections 111 through W30 711 to Dafe 20. Contribullons Receivem:I 21, Expenditures Made 3 $ ExpendituTe Limit Summary for State Candidates 22. Cumulative Expenditures Made*. [IrSubjectto VolmHuy E.VeridWro UY01 Wte of Eiection Total to Date (mmld&W $ J $ 'Amounts in this see an may be dilWenf from amounts reported in Wurnn B_ F Form 460 (Jeri uary[05) FPPC Tog -Free Hlelplirw. 86&ASK-FPPC (866275-3772) ScheduleA loft Monetary uontributions Received Statement covers period CALIFORNIA 460 1/1/14 FORM from froff ----------- - ------------------------- ------- ------------------ - ------- I ------------ --------------------------- -------------------------- SUBTOTAL $ 450.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (include all Schedule A subtotals.) ........................................................................................................ $ 2. Amount received this period — uniternized 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.) ....................... TOTA L $ I MOT11 M11 • ••- • •ua COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC For 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) through 6/30/14 Page of SEE INSTRUCTIONS ON REVERSE 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 COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) VIIND 1 /2 Frank Solomon Jr. F_1COM self -- real estate 250-00 250.00 F-1 OTH investor/mgr. San Rafael, CA 94903 F-1 PTY F] SCC ®IND 1/5 Keith Melony F� COM retired 100.00 100.00 MOTH San Rafael, CA 94903 r-1 PTY F] SCC WIND 1 /9 Mary Jane Burke F-1 COM Marin Co, Supt. of Public 100.00 100.00 F-1 OTH Instruction Novato, CA 94947 [-] PTY F] SCC BIND F-1 COM F-1 OTH n PTY ❑ SCC RIND F-1 COM nOTH M PTY El SCC ----------- - ------------------------- ------- ------------------ - ------- I ------------ --------------------------- -------------------------- SUBTOTAL $ 450.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (include all Schedule A subtotals.) ........................................................................................................ $ 2. Amount received this period — uniternized 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.) ....................... TOTA L $ I MOT11 M11 • ••- • •ua COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC For 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E Payments Made NAME OF FILER Type or print in ink. Amounts may be rounded to whole dollars. GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 Statement covers period from 1/1/14 through 6/30/14 Page Of 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 SAL returned contributions campaign workers' salaries CTB contribution (explain nonmonetary)* OFC PET office expenses petition circulating TEL t.v. or cable airtime and production costs CVC FIL civic donations candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND VC fundraising events independent expenditure supporting/opposing others (explain)* POL P08 polling and survey research postage, delivery and messenger services TRS TSF staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT WEB voter registration information technology costs (internet, e-mail) LIT campaign literature and mailings PRT print ads NAME AND ADDRESS OF PAYEECODE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OR DESCRIPTION OF PAYMENT AMOUNT PAID Cardmember Service misc. election -night expenses 195.00 POB 790408 St. Louis, MO 63179 West End Cafe election night party 200-00 1131 - 4th St. San Rafael, CA 94901 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 395 Schedule E Summary 395.00 1. Itemized payments made this period. (include all Schedule E subtotals.) .............................................................................................................. $ 60.00 2. Uniternized payments made this period of under $100 .......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ 455.00 4. Total payments made this •period. •(Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-1=PPC (8661275-3772)