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Form 460 - Greg Brockbank for City Council 2013 (2013-06-30) Amendment
Im Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) 0 Type or print in ink. Statement covers period from 1/1/13 SEE INSTRUCTIONS ON REVERSE I through 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee Q Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) E] General Purpose Committee 0 Sponsored � Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 30 Committee Information I.D. NUMBER 1 1355049 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) BROCKBANK STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE San Rafael CA 94 903 AREA CODE/PHONE ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA ss • • OPTIONAL: FAX / E-MAIL ADDRESS ( I Date of election If applicable: (Month, Day, Year) 1/5/13 IN Date Stamp _?t Page 1 Of 3 1 @i13 For Official Use Only n 4' 2. Type of Statement: Preelection Statement Quarterly Statement Semi-annual Statement Special Odd -Year Report El Termination Statement F-1 Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Greg Brockbank MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94903 ( NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I 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. 7/31/1 3 Executed ©n By Date Signature of Treasurer or Assistant Treasurer 7/31/13 Executed on DateBy Signature of Contro, #ing 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 Ofteholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Expenditures Made Disclosure Statement Campaignmen Type or print in Ink. SUMMARY PAGE Summary Page Amounts may be rounded to whole dollars. Statement cover's period A 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 11,899.76 from 1/1/13 SEE INSTRUCTIONS ON REVERSE 6/30/13 Page of tl t�oh NAME OF FILER A I.D.NUMBER GREG BROCKBANK i BROCKBANK FOR CITY,COUNCIL 2013 Current Cash Statement 1355049 Contributions Received Column A Column B Calendar Year Summary for Candidates amounts in Column A to the TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTO DATE Running in Both the State Primary and 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 from Column B of your last General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 149207.00 $ 2. Loans Received ...................................................... Schedule B, Line 3 4tOOO.00 $ 61307.24 111 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2 $ 18j207.00 $ subtracted from previous 20. Contributions 4. Nonmonetary Contributions .................................... Schedule C, Line 3 547.80 Received $ $ $ for this calendar year, only 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 18,754.80 $ Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 11,899.76 $ 7. Loans Made ............................................................. Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 11,899.76 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 10. Nonrnonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + lo $ 11,899.76 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 0.00 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above 18,207.00 amounts in Column A to the corresponding amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 from Column B of your last 15. Cash Payments............................................... ... Column A, Line 8 above 11 ,899.76 report. Some amounts in Column A may be negative 16. ENDING CASH BALAdKICE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 61307.24 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 $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (tr Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) J $ $ *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) S. Officeholder or Candidate Controlled Committee is Type or print in ink. 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 94903 Related Committees Not Included in this Statement: Listany 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? YES E] NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE -PART 2 "'13 Page of 6. Primarily Formed Ballet Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION Q SUPPORT OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD 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 SOUGHTOR HELDI I �II ■ SUPPORT i! ■ !..! NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHTOR HELD SUPPORT i! FJOPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHTOR HELD SUPPORT i! ® !ii! NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD OPPOSE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free helpline: 866 ASK-FPPC (866/275-3772) State of California Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 Campaign Disclosure Statement Type or print in Ink. 7. Loans Made .............................................................. Schedule H, Line 3 SUMMARY PAGE Summary Page Amounts may be rounded to whole dollars. Statement covers period $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 1/1/13 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 from $ 11899.76 $ Current Cash Statement 6/30/13 through Page of C) SEE INSTRUCTIONS ON REVERSE $ 0.00 To calculate Column 13, add 13. Cash Receipts ................................................... Column A, Line 3 above NAME OF FILER amounts in Column A to the I.D. NUMBER corresponding amounts GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 MLM 13550T%OAG 11,899.76 report. Some amounts in Column A may be negative Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDARYEAR DATE Running in Both the State Primary and period amounts. If this is (FROM ATTACHED SCHEDULES) TOTALTO General Elections 1. Monetary Contributions ............................................ Schedule A, Line 3 14 207 $ ,.00 $ for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts q I 49000.00 18. Cash Equivalents ........................................ See instructions on reverse 1/1 through 6130 7/1 to Date 2. Loans Received ...................... ................................ Schedule B, Line 3 $ 3. SUBTOTAL CASH CONTRIBUTIONS......................... Add Lines 1 + 2 $ 18,207.00 $ 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 547.80 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 18,754.80 $ Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 1,899.76 $ 7. Loans Made .............................................................. Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 11,899.76 $ 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 $ 11899.76 $ Current Cash Statement 12. Beginning Cash Balance....................... Previous Summary Page; Line 16 $ 0.00 To calculate Column 13, add 13. Cash Receipts ................................................... Column A, Line 3 above 18,207.00 amounts in Column A to the corresponding amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 from Column B of your last 15. Cash Payments.................................................. Column A, Line 8 above 11,899.76 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 61307.24 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 q any). 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (K 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) 1FPPC Toll -Free Helpline: 866/ASK-FPLC (866/275-3772) 0' .9 Schedule A Type or print in Ink. Amounts may be rounded Monetary Contributions Received to whole dollars. SEE INSTRUCTIONS ON.,REVERSE Statement covers period from 1/1/13 through 6/30/13 SCHEDULEA 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 (IF COMMITTEEALSO ENTER I.D. NUMBER) , CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) VIIND 2/28 Jeff Kroot ❑Com Architect (self) $100 MOTH San Anselmo, CA 94960 [:] PTY (� SCC ® IND 2/28 Francis W. Parnell & Diana D. Parnell F�Com Physicians (self) $100 ❑OTH Ross, CA 94957 © PTY RSCC WIND 2/28 Deb Hubsmith F�Com Manager $35 ❑OTH Marin Co. Bicycle Fairfax, CA 94978 El PTY Coalition RSCC WJIND 3/1 Shahla Davoudi F� Com Property investor/mgr. $100 BOTH (self) San Rafael, CA 94901 [:] PTY FISCC Clark Hinderleider WIND F�COIVI ❑ r_1 OTH (self) Mill Valley, CA 94941 F�PTY 0SCC SUBTOTAL$ 435 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 .................... I ......... $ 1,353 3. Total monetary contributions received this period. 141207 (Add Lines I and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................... TOTAL $ F PC orm 46 ( anuary/05) FPPC Toll -Free Helpfine: 866/ASK-FPPC (866/275-3772) *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 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (!F COMMITTEE, ALSO ENTER I.D. NUMBER) CQNTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Z IND Ed Boyce ❑GOM retired 3/1 ❑ OTH $200 San Rafael, CA 94901 ❑ PTY ❑ SCG Ellen Obstler ®IND ❑COM retired 3/2 ❑ OTH $250 San Rafael, GA 94901 PTY ❑ ScC 312 Helen Bacon WIND FICOM retired $250 r-1 OTH San Rafael, CA 94901 0 PTY ❑ SCC Prank Solomon WIND n GCM real estate investor 3/3 ❑ OTH self (self) $100 San Rafael, CA 94903 ❑ PTY F1SCC Ed Vorous ®IND ICOM Dustbusterz self { 3/5 ❑ OTH 300 San Rafael, GA 94901 ® PTY Scc r *Contributor Codes DIndividual Recipient (other than PTY or # • PTY — Political Party SCC — Small Contributor J SUBTOTAL$ 1100 FITC Form 460 (Januar /06 FPPC Tail -Free Helpline: 866/ASK-FPP►C (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts maybe rounded to whole dollars. Statement covers period from 1/1/13 through 6/30/13 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) OIND Keith & Gail Lester r-1 COM retired 3/5 F-1OTH $100 San Rafael, CA 94901 r-1 PTY r] SCC Linda Remy VIIND ❑F1COM researcher 3/5 rjOTH UCSF $100 Mill Valley, CA 94941 FJPTY ❑ SCC Ken Hobbs IND FICOM retired 3/5 FJOTH $100 San Rafael, CA 94903 n PTY F1SCC Faye & Lou Hinze L?j IND FICOM retired 3/6 94925 FJPTY Q SCC Katherine Crecelius Z IND ©COM housing consultant (self) 3/8 E] OTH $200 Novato, CA 94948 EIPTY [] ScC *Contributor Codes IND — Individual Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL$ 600 FPPC Form 460 (January/05) FPPC'Toll-Free Helpline: 866/ASK-FPPC (866/276-3772) : �� -F � i[ as tllll Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 1/1/13 FORM 460; from through 6/30/13 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 (IF COMMITTEEALSO ENTER I.D. NUMBER) , CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) WIND Douglas Kerr FICOM ❑ ❑OTH Larkspur, CA 94939 n PTY F-1 SCC Raymond Katz ®IND ncom dentist (self) $50 3/9 FJOTH Larkspur, CA 94939 n PTY r❑jSCC David Coury ®IND ❑ncom retired $250 3/9 nOTH San Rafael, CA 94901 n PTY F-1 SCC Bill Carney & Tamra Peters L61ND FICOM consultants (self) 3/12 F-1 OTH $250 San Rafael, CA 94901 F-1 PTY LSCC 3/13 Vicki Sievers ZIND ncom retired $100 nOTH San Rafael, CA 94901 n PTY EISCC IND - Individual Recipient Committee V_4 (other than PTY or SCC) OTH - Other (eg., business entity) Political Party S-C,C,,-- rit it i 'Lee SUBTOTAL $ 749 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) Schedule A (Continuation Sheet) Monetary Contributions Receiveif 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 1/1/13 through 6/30/13 0 SCHEDULE A (CONT.) Page of I.D. NUMBER 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. I DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Jeff Brusati ICOM sports store owner 3/15 PinewoodF-1 OTH (self -- T&B Sports) $100 San Rafael, CA 94903 El PTY n SCC Stan Gold ®IND MCOM retired 3/16 ] OTH $100 Petaluma, CA 94952 0 PTY ©SCC Denise Lucy VIIND ncom Professor. 3/18 QOTH Dominican University of $100 San Rafael, CA 94901 F1 PTY Calif. M SCC Judy Schriebman Z IND F -ICOM ❑ MOTH $50 San Rafael, CA 94903 F-1 PTY M SCC Roger E. Roberts OIND F�Com retired 3/20 F-1 OTH $150 San Rafael, CA 94901 F-1 PTY El SCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (eg., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL;;l 500 FPPC Form 460 (January/06) FPPC Toll -Free Helpline- 866/ASK-FPPC (866/276-3772) Schedule A (Continuation Sheet) Type or print in ink. Monetary Contributions Received Amounts maybe rounded Statement covers period _12SMIM a A to whole dollars. 1/1/13 from 6/3 through 30/1 Page of 00 NAME OF FILER I.D. NUMBER GREG BROCKBANK BROCKBANK FOR CITY COUNCIL 2013 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEEALSO ENTER I.D.MBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION � TO DATE RECEIVED , . CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Gail Theller ncom Executive Director 3/21 F� OTH Community Action Marin $100 Novato, CA 94949 r-1 PTY r-jSCC Nona Dennis ZIND ncom retired 3/25 r -10TH $7'5 Mill Valley, CA 94941 F1 PTY F-1 SCC Alfred Heller ®IND ncom ind. investor (self) 3/26 FICITH $250 San Rafael, CA 94903 0 PTY EISCC Lee Dornanico VIIND ®COM CEO 3/27 F-10TH Marin General Hospital $100 Mill Valley, CA 94941 F-1 PTY F-1 SCC Elaine Brockbank ZIND F-1COM retired 3/31 F�OTH $100 Kentfield, CA 94904 D PTY I I El ScC IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (eg., business entity) PTY — Political Party SCC — Small Contributor Committee SUBO TTAL$ 625 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2764772) Schedule A (Continuation Sheet) r-, Type or print in Ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period�i to whole dollars. 1/1/13 CALIFORNIA 460 from FO RM through 6/30/13 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. I - DEC. 31) (IF REQUIRED) OF BUSINESS) JZ IND Carol Misseldine RCOM consultant (self) 4/23 Ej OTH $100 Novato, CA 94949 n PTY F1 SCC Peter G. Joseph V]IND Ficom retired 5/9 DOTH $100 San Anselmo, CA 94960 El PTY n SCC John Reynolds ®SND FICOM retired 5/9 n OTH $100 San Rafael, CA 94901 F] PTY F] SCC Jonathan Frieman ®IND ncom football coach 5/9 F-1 OTH $250 San Rafael, CA 94901 n PTY [-jSCC Belle Cole L61ND EICOM retired 5/9 Q OTH $300 San Rafael, CA 94901 F-1 PTY I I 0SCC IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL$ 850 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. 1/1/13 FORM 460 from Page of -30 through 6/30/13 NAME OF FILER I.D. NUMBER GREG BROCKBANK BROCKBANK FOR CITY COUNCIL 2013 11355049 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) ® IND Roberta Goldberg F_1COM ❑ F-1 OTH $125 San Rafael, CA 94901 n PTY RSCC Janet Wiscombe & Ed I Lai VIIND FJCOM retired 5/9 nOTH $100 San Rafael, CA 94903 0 PTY nSCC Keith & Gail Lester VIIND F1COM retired 5/9 F-1 OTH $100 .; { San Rafael, CA 94901 F-1 PTY RSCC Raymond Katz OIND FICOM dentist (self) 43 5/15 E]OTH $50 Larkspur, CA 94939 F1 PTY [-]SCC Steve Shaiken OIND F-1com attorney (self) 5/1 6 F� OTH $100 Fairfax, CA 94930 [:] PTY I I EISCC t Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL$ 475 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) 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 COMMITTEEALSO ENTER I.D. NUMBER) , CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ® IND Robert Spofford FICOM retired 5/19 F] OTH $250 San Rafael, CA 94901 n PTY r] SCC Steve Silberstein W] IND ©COM retired $250 5/20 r] OTH Belvedere, CA 94920 n PTY F] SCC 5/20 Diana Conti W] IND r1COM Ex. Dir. $150 r-1 OTH PARCA Mill Valley, CA 94941 n PTY rjSCC Kevin Gladstone IND ncom Usher $100 5/21 nOTH Century Theaters San Rafael, CA 94901 El PTY F-1 SCC Mary Gidley VI IND ncom retired 5/21 F-1 OTH $50 San Rafael, CA 94901 El PTY EISCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL$ 800 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF, CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Statement covers period CALIFORNIA (IF SELF-EMPLOYED, ENTER NAME PERIOD to whole dollars. (IF REQUIRED) 1/1 /13 FORM 460 OF BUSINESS) from JZ IND through 6/30/13 Page of NAME OF FILER I.D. NUMBER Wade Holland GREG BROCKBANK 1 BROCKBANK FOR CITY COUNCIL 2013 retired 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) JZ IND Wade Holland FICOM retired $100 5/21 Fj OTH Inverness, CA 94937 F] PTY rl SCC Building Trades Council(#900667) Fj IND VICOM $150 5/21 F-1 OTH San Rafael, CA 94903 F1 PTY RSCC Paul & Rembert Kingsley Vj IND FICOM retired $100 5/21 r-1 OTH Ross, CA 94957 F-1 PTY ❑ SCC 5/21 Roger E. Roberts V1 IND CI COM retired $100 $250 F-1 OTH San Rafael, CA 94901 n PTY SCC 5/23 Keith & Gail LesterIND F-1COM retired $50 $250 F�OTH San Rafael, CA 94901 El PTY El SGC *Contributor ..- >r — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (eg., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL;O 500 FPPC For 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Type or print in ink. R N rM FA 101 W., - A 0 Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 1/1/13 FORM 460' from through 6/30/13 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 (IF COMMITrEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. I - DEC. 31) (IF REQUIRED) OF BUSINESS) OIND Deborah Hubsmith Mcom ❑ FJOTH Marin Co. Bicycle $100 $135' Fairfax, CA 94978 ❑ PTY Coalition ❑SCC Gumbiner & Eskridge F] IND ncom 5/23 VIOTH $100 Walnut Creek, CA 94597 ❑ PTY ❑ SCC 5/23 Dave Coury VIIND ❑ncom retired $250 $500 nOTH San Rafael, CA 94901 [:] PTY r-1 SCC 5/25 Ellen S. Karel OIND [:]Com retired $100 [:]OTH Corte Madera, CA 94925 n PTY r-1 SCC Clark Hinderleider ®IND FlCOM ❑ ROTH (self) $100 $200 Mill Valley, CA 94941 [:] PTY I I El SCC IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party 77 77 - SUBTOTAL$ 650 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER Schedule A (Continuation Sheet) Type or print In ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded , I.D. . (IF COMMITTEEALSO ENTER 1DNUMBER) Statement covers period CALIFORNIA (IF SELF-EMPLOYED, ENTER NAME PERIOD to whole dollars. (IF REQUIRED) 1/1/13 FORM 460 OF BUSINESS) from IND through 6/30/ 13 Page of NAME OF FILER t I.D. NUMBER Don Miller GREG BROCKBANK BROCKBANK FOR CITY COUNCIL 2013 retired 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 , I.D. . (IF COMMITTEEALSO ENTER 1DNUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) IND 5/27 Don Miller 17160M ❑ 17-1 OTH Tiburon, CA 94920 El PTY 0 SCC Dietrich Stroeh ® IND FICOM ❑ 94949 n PTY n SCC 6/1F1COM Angelo Douvos OIND retired $50 $100 E] OTH San Rafael, CA r-1 PTY n SCC Mark Leno for Senate 2012(#1293202) F] IND VCOM $250 6/6 nOTH Encenitas, CA 92024 r-1 PTY nscC George John OIND ncom Attorney (self) $250 6/7 n OTH San Rafael, CA 94901 E] PTY El SCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business ent ity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL $ 800 FPPC Form 460 (January/06) FPPC Toll -Free Helpline; 866/ASK-FPPC (866/276-3772) DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. I - DEC. 31) (IF REQUIRED) OF BUSINESS) William Sims IND f-1com retired 6/8 r] PTY Cl ScC Bill Daniels n IND 6/10 ncom 0TH V1 $500 Novato, CA 94949 El PTY F-1 SCC 6/11 Ed Boyce IND ®IND retired retired $50 $250 FJOTH San Rafael, CA 94901 r-1 PTY Q SCC Jeff Levin OIND FICOM ❑ BOTH $100 Marin City, CA 94960 ❑ PTY SCC Rona Schmidt L6 IND ncom retired 6/11 r-JOTH $100 San Rafael, CA 94901 F-1 PTY I I 0SCC *Contributor Codes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Commi'Xee SUBTOTAL$ 850 FPPC Forrn 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) 0' Schedule A (Continuation Sheet) Monetary Contributions Received 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 1/1/13 through 6/30/13 SCHEDULE A (CONT.) Page of I.D. NUMBER 1355049 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) IND Denise Athas Ficom realtor (self) 6/12 FJOTH $100 Novato, CA 94947 171 PTY F1 SCC Pamela Reaves VIIND ncom therapist (self) 6/12 f -I OTH $100 San Rafael, CA 94903 n PTY ri SCC Rick Fraites ®IND F1COMF1 supervisorial aide 6/13 OTH County of Marin $100 Novato, CA 94947 F71 PTY F] SCC Joel Kirsch OIND ncom Director 6/15 [:]OTH American Sports Institute $100 Mill Valley, CA 94941 F-1 PTY Ej SCC Keith Meloney VI IND F-1 COM retired 6/17 r-1 OTH $100 San Rafael, CA 94903 PTY SCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) 11 OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee .. �7 SUBTOTAL$ 500 F1PPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2764772) ME Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period from 1/1/13 SCHEDULE A (CONT) *Contributor Codes Individual Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) through 6/30/13 1 _7 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 (IF COMMITTEEALSO ENTER I.D. NUMBER) , CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Jack Gibson W3IND FICOM Attorney (self) $1 00 6/18 r-JOTH San Anselmo, CA 94960 r_1 PTY F-1 SCC Amy Likover WIND FICOM retired $100 5/20 DOTH San Rafael, CA 94901 F-1 PTY nscC Jim Draper VIIND FICOM video director (self) $100 6/19 94901 n PTY FISCC Peter Lacques VIIND ncom Attorney (self) $100 6/19 nOTH Fairfax, CA 94930 © PTY FISCC 6/21 Doug Kerr ZIND ncom retired $100 $199 nOTH Larkspur, CA 94939 El PTY [:]SCC SUBTOTAL $ 500 *Contributor Codes Individual Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink. Monetary Contributions Received Amounts may be rounded Statement covers period —josorm 0 to whole dollars. 1/1/13 A 0 a A from 0 Ma through 6/30/13 Page age 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) VIIND Lawrence Baskin MCOM Attorney (self) 6/21 r-1 OTH $150 San Rafael, CA 94901 0 PTY F71 SCC Joe Walsh ®IND RCOM retired 6/21 r-1 OTH $100 Lagunitas, CA 94938 n PTY 0 SCC Ralph McLeran VIIND r-icom realtor (self) 6/21 r-1 OTH $250 Kentfield, CA 94904 r-1 PTY F71 SCC David Glick ®SND r1com therapist (self) 6/22 QOTH $125 Fairfax, CA 94930 F-1 PTY OSCC Esther Wanning Z IND r-icom therapist (self) 6/23 r-1 OTH $500 San Rafael, CA 94901 F-1 PTY I El SCC IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) Political Party SCC - Small Contributor Committee SUBTOTAL$ 1125 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule (Continuatio6 Monetary Contributions Received NAME OF . GREG :' :' BROCKBANK FOR CITY COUNCIL! Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 1/1/13 through 6/30/13 Page of I.D. NUMBER 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) ®IND John & Berneice Moore IOM retired , 6123 ❑ OTH $100 Ban Rafael, CA 94901 [:] PTY OscC 6123 Jahn Reynolds W]IND 0 coM retired $35 $135 ❑ OTH San Rafael, CA 94901 p PTY ❑ scc Judy Schriebman ® IND 0 coM homeopath (self) $50 $100 6123 ❑ OTH San Rafael, CA 94903 r-1 PTY 0 scc Steve Burdo ]IND COM consultant $100 6/23❑ ❑ OTH Kathleen Russell & San Anselmo, CA 94960 ❑ PTY Associates 0 scc 6123 Faye Hinze VIIND 0 COM retired $35 $135 FJOTH Corte Madera, CA 94925 n PTY El scc Codes IND — Individual Recipient (otherPTY or SCC) OTH — Other l • business PTY — Political Party SCC — Small i Contributor Committee j SUBTOTAL$ 320 FPPG Form 460(January/06) FPPC Toll -Free Helpline. 866/ASK-FPPG (866/276-3772) Schedule A (Continuation Sheet) C� C Type or print in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 1/1/13 FORM 4 60 from 6/30/13 through Page Of NAME OF FILER I.D. NUMBER GREG BROCKBANK 1 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) ®IND 6/23 Elaine Brockbank RCOM retired $230 $330 R OTH Kentfield, CA 94904 r-1 PTY n SCC 6/23 Nona Dennis JZ IND [:]Com retired $25 $100 F-1 OTH Mill Valley, CA 94941 R PTY r-1 SCC 6/23 Jack Beggs WIND F] COM retired $20 $110 ❑ OTH San Rafael, CA 94903 R PTY n SCC Hugh/Delehanty/ & Barbara Graham OIND ❑FICOM author (self) $100 6/23 MOTH Mill Valley, CA 94941 R PTY F-1 SCC Richard Benson OIND mcom Assessor/Recorder/Clerk 6/23 [] OTH County of Marin $100 Novato, CA 94947 r-1 PTY I El SCC IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business enti PTY — Political Party Rrr- — Rttall Cottributor C•ittirtiXel SUBTOTAL $ 475 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) 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 COMMITTEEALSO ENTER ID. NUMBER) , . CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ZIND 6/23 Ken Hobbs ncom retired $50 $100 r-1 OTH San Rafael, CA 94903 r-1 PTY E1SCC Aref Ahmadia dba West End Cafe ®IND [_]COM owner $150 6/23 F-1 OTH West End Cafe and San Rafael, CA 94901 n PTY Catering n SCC 6/25 Frank Solomon VIIND FlCOM real estate investor $400 $500 OTH (self) San Rafael, CA 94903 PTY F-1 SCC Dolores Heeb ®IND r-1 Com retired $100 6/26 F-1 OTH San Rafael, CA 94901 R PTY F-1 SCC Woody Rowland Z IND EICOM attorney (self) 6/26 F-1 OTH $100 San Rafael, CA 94901 0 PTY EISCC *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (eg., business entity) PTY — Political Party I SCC — Small Contributor Committee SUBTOTAL$ 800 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) 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) W] IND Marjorie Goodman [-] com Leg. liaison 6/26 F1 OTH Hanson Bridgett $100 Novato, CA 94949 F] PTY F-1 SCC Carolyn Lenert W]IND ncom realtor (self) $100 6/28 OTH San Rafael, CA 94903 Q PTY ❑ScC Mary Gidley ®IND EICOM ❑ r_1 OTH San Rafael, CA 94901 El PTY SCC F1 IND [:]Com E]OTH n PTY SCC F] IND EI COM n OTH F] PTY El SCC *Contributor Codes Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other •(e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTALS 300 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) Tion® j%r nrinf in ink SCHEDULE B - PART I Schedule B — PartAmounts may I myrow %we rougebe % am rounded vxvff�ft Statement covers period Loans Received to whole dollars. 1/1/13 � ! from 6/30/13 Page SEE INSTRUCTIONS ON REVERSE through 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 OCCUPATION AND EMPLOYER (a) OUTSTANDING BALANCE (b) AMOUNT W AMOUNT PAID OUTSTANDING BALANCEAT (e) INTEREST M ORIGINAL (9) 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* PEBI PERIOD LOAN TMJ DATE Greg Brockbank attorney (self - Marin [� PAID CALENDAR YEAR Law Center) $ $ 4,000 % $ 4,000 $ San Rafael, CA 94901 ❑ FORGIVEN RATE PER ELECTION" 41000 $ $ $ DATE DUE t[Z IND F] COM ❑ OTH F] PTY F1 SCC DATE INCURRED E] PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION DATE DUE tO IND Ej COM Ej OTH 0 PTY El SCC, DATE INCURRED ❑ PAID CALENDAR YEAR E] FORGIVEN RATE PER ELECTION DATE DUE t7 IND F1 COM D OTH [I PTY 0 SCC DATE INCURRED SUBTOTALS 41000$ 4,000 (Enter (e) on Schedule B Summary S&edule E, Line 3) 1. Loans received this period ..................................................................................................................... (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ......................................................................................................... $ (Total Column (c) plus loans under $100 paid or forgiven.) (include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............... _ .............................................. NET $ 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. =I tContributor Codes 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 C Type or print in ink. Amounts may be rounded Nonmonetary Contributions Received to whole dollars. Statement covers period from 1/1/13 0 SCHEDULEC SEE INSTRUCTIONS ON REVERSE through 6/30/13 Page of I NAME OF FILER I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION DATE RECEIVED ZIP CODE OF CONTRIBUTOR CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR TO DATE (IF REQUIRED) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) Schedule C Summanj 1. Amount received this period — itemized nonmonetary contributions. IND -incuvicivai (include all Schedule C subtotals.) ..................................................................................................................... $ 547.80 COM - Recipient Committee (other than PTY or SCC) 2. Amount received this period — uniternized nonmonetary contributions of less than $100 .................................... $ OTH - Other (e.g., business entity) PTY - Political Party 3. Total nonmonetary contributions received this period. 547.80 SCC - Small Contributor Committee m (Add Lines I and 2. Enter here and on the Summary Page, Colun A, Lines 4 and 10.) ...................... TOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) FPPC Form 460 (January/05 FPPC Toll -Free Helpline: 8661ASK•FPPC (866/275-3772) DCCM (Democratic Central Committee of Monetary sponsorship of fundraiser Schedule D 1/26 Marin) Contribution SCHEDULED Summary of Expenditures Type or print In ink. Statement covers period Supporting/Opposing°tiler Amounts may be rounded dollars. to whole 1/1/13 from Contribution Candidates, Measures and Committees through 5/30/13 Pae of SEE INSTRUCTIONS ON REVERSE NAME OF FILER ❑ Support ❑ Oppose I.D. NUMBER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 1355049 3/7 DATE NAME OF CANDIDATE OFFICE AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE. CALENDAR YEAR PER ELECTION TO DATE Committee) MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) C] Nonmonetary OR COMMITTEE Contribution FPPC Form 460 (January/05 FPPC Toll -Free Helpline: 8661ASK•FPPC (866/275-3772) DCCM (Democratic Central Committee of Monetary sponsorship of fundraiser 1/26 Marin) Contribution $125 (� Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure 3/7 MWPAC( Marin Women's Political action Monetary Contribution sponsorship of fundraiser Committee) $125 C] Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure 5/4 Cardmember Service (for Friends of Judy EZ Monetary sponsorship of fundraiser Arnold) Contribution $250 ❑ Nonmonetary Contribution ❑ Independent Support ❑ Oppose Expenditure SUBTOTAL $500 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) .......... $ 500 200 2. Unitemized contributions and independent expenditures made this period of under $100..................................................................................... . Total contributions and independent expenditures made this period. Add Lines 1 and 2. Cho not enter on the Summary Page.) TOTAL $ 700 p p p ( � 0 ) .,.......... FPPC Form 460 (January/05 FPPC Toll -Free Helpline: 8661ASK•FPPC (866/275-3772) Schedule E 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 1/1/13 through 6/30/13 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page _2`1 of I.D.NUMBER 1355049 A 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 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 UVEB 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 Green Dog Campaigns CNS $3,000-00 DCCIVI sponsorship of fundraiser $ 125-00 Strahm Communications remits and stationery envelopes $638.32 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3763.32 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ 11,550.12 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ 349.64 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 $ 11,899.76 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) 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 from 1/1/13 through 6/30/13 I.D. NUMBER 1355049 E (COUT.) CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW 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 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 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 MWPAC sponsorship of fundraiser $125.00 Indie Politics CNS $2,400.00 Cardmember Service postage, campaign meeting meals, sponsorship of POS fundraiser $488-38 Cherie Maria Alvarez SAL $1,000.00 Timodesigrfs PRO $150.00 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4163.38 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) rt Schedule E Type or print in ink. (Continuation Sheet) Amounts may be rounded to whole dollars. Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER GREG BROCKBANK / BROCKBANK FOR CITY COUNCIL 2013 Statement covers period from 1/1/13 through 6/30/13 Page. 11 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. IVIBR 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 PFK) 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 1 r1r ramnaian 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 Indie Politics POL and kickoff invites $3623.42 will 11� iq� il� i pi FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-1=PPC (866/276-3772) NAME OF AGENT OR INDEPENDENT CONTRACTOR 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 a - 0 -- - I - I airtime and production costs in campaign 'consultants IVITG meetings and appearances RFD CALIFORNIA 460 contribution (explain nonmonetary)* OFC office expenses SAL FORM CVC civic donations PET petition circulating TEL Page. Of candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND NAME OF FILER POL polling and survey research I.D. NUMBER staff/spouse travel, lodging, and meals GREG BROCKBANK BROCKBANK FOR CITY COUNCIL 2013 independent expenditure supporting/opposing others (explain)* POS 11 1355049 TSF NAME OF AGENT OR INDEPENDENT CONTRACTOR 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 IVITG 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) * 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 Indie Politics POS (and kickoff invites) $3623.42 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ $3623.42 * Do riot transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460 (January/05) independent contractor as reported on Schedule E. FPPC Toll -Free Helpline: 866/ASK-1~PPC (866/276-3772)