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Home My WebLink AboutForm 460 - Firefighters' Association PAC (2018-06-30) AmendmentRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from ___ J_a_n_1_,_2_0_1_8 __ June 30, 2018 through ________ _ 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) li2l General Purpose Committee ® Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information D Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Patt 6) D Primarily Formed Candidate/ Officeholder Committee /Also Complete Part 7) I.D. NUMBER 891308 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) SAN RAFAEL FIREFIGHTERS POLITICAL AWARNESS COMMITTEE STREET ADDRESS (NO P.O. BOX) CITY SAN RAFAEL STATE ZIP CODE CA 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY SAN RAFAEL OPTIONAL: FAX/ E-MAIL ADDRESS 4. Verification STATE CA ZIP CODE 94912 AREA CODE/PHONE AREA CODE/PHONE Date of election if applicable: (Month, Day, Year) 2. Type of Statement: D Preelection Statement li2! Semi-annual Statement D Termination Statement (Also file a Form 41 O Termination) ~ Amendment (Explain below) D Quarterly Statement D Special Odd-Year Report Amended to include responsible officer of sponsor signature. Treasurer(s) NAME OF TREASURER ANDREW ROGERSON MAILING ADDRESS CITY ROHNERT PARK NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX/ E-MAIL ADDRESS STATE ZIP CODE CA 94928 STATE ZIP CODE AREA CODE/PHONE AREA CODE/PHONE 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. certify under penalty of pe ·ury un r the laws of the State of California that the foregoing is true a rrect. -, Executed on --+---+:•'"a.,..te _____ _ Executed on _ _.7<-+-/_,3:a_,;;,o-+.,/.;;,UJ;...=a.. .... l ... 8'......_ __ _ I #Date Executed on _____ _, 0 ,,..a.,..te _____ _ Executed on ____________ _ Date BY-------------------------------Signature of Controlling Officeholder, Cand idate, Stale Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca,gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. SAN RAFAEL FIREFIGHTERS POLITICAL AWARNESS COMMITTEE Contributions Received Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 1. Monetary Contributions................................................... Schedule A, Une 3 $ 0 2. Loans Received................................................................ Schedule B, Line 3 0 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ 0 4. Nonmonetary Contributions............................................ Schedule c, Line 3 0 5. TOTAL CONTRIBUTIONS RECEIVED ................................... .Add Lines 3 + 4 $ 0 Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 500 7. Loans Made....................................................................... Schedule H, Line 3 0 8 . SUBTOTAL CASH PAYMENTS.......................................... Add Lines 6 + 7 $ 500 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F. Line 3 0 10. Nonmonetary Adjustment.. ....................................................... Schedule c, Line 3 0 11 . TOTAL EXPENDITURES MADE. ....................................... Add Lines 8 + g + 10 $ 500 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 86,420.78 13. Cash Receipts ........................................................... Column A, Line 3 above 0 14. Miscellaneous Increases to Cash.................................. Schedule I, Line 4 8.55 15. Cash Payments ......................................................... Column A, Line 8 above 500.00 16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtract Line 15 $ 85,929.33 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED................................ Schedule a, Part 2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents................................................ See instructions on reverse $ 0 19. Outstanding Debts.............................. Add Line 2 + Line 9 in Column B above $ 0 SUMMARY PAGE Statement covers period CALIFORNIA 460 FORM from ___ J_a_n_1_, _20_18 __ _ 2 6 June 30, 2018 through _______ _ Page ___ of __ _ $ $ $ Column B CALENDAR YEAR TOTAL TO DATE 0 0 0 0 0 $ 500 0 $ 500 0 0 $ 500 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if 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 $ ____ _ $ ____ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* Ill Subject to Voluntary Expendllure Llmll) Date of Election (mm/dd/yy) __j__j __ __J__J __ Total to Date $ ___ _ $ ___ _ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Monetary Contributions Received Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER SAN RAFAEL FIREFIGHTERS POLITICAL AWARNESS COMMITTEE DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D . NUMBER) CODE * •IND •COM DOTH •PTY •sec •IND •COM 00TH •PTY •sec •IND •COM 00TH •PTY •sec •IND •COM DOTH OPTY •sec •IND •COM 00TH OPTY •sec Schedule A Summary IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) SUBTOTAL$ SCHEDULE A Statement covers period CALIFORNIA 460 FORM from ___ J_a_n_1_,_2_0_1_8 __ through __ J_u_n_e_3_0_,_2_0_1_8_ Page _3 __ of __ 6 __ AMOUNT RECEIVED THIS PERIOD I.D. NUMBER 891308 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes IND -Individual 1. Amount received this period -itemized monetary contributions. (Include all Schedule A subtotals.) ......................................................................................................... $ ______ o COM -Recipient Committee {other than PTY or SCC) 0TH -Other (e.g ., business entity) PTY -Political Party 2. Amount received this period -unitemized monetary contributions of less than $100 ........................... $ _______ o 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 sec -Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. SAN RAFAEL FIREFIGHTERS POLITICAL AWARNESS COMMITTEE DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE D Support D Oppose D Support D Oppose D Support D Oppose Schedule D Summary TYPE OF PAYMENT • Monetary Contribution • Non monetary Contribution • Independent Expenditure • Monetary Contribution • Nonmonetary Contribution • Independent Expenditure • Monetary Contribution • Non monetary Contribution • Independent Expenditure DESCRIPTION (IF REQUIRED) SUBTOTAL$ Statement covers period from __ J_a_n_1~,_2_0_18 __ through June 30, 2018 SCHEDULED CALIFORNIA 460 FORM Page __ 4_ of __ 6_ I.D. NUMBER 891308 AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN .1-DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ....................................................... $ _____ ~0~ 2. Unitemized contributions and independent expenditures made this period of under $100 .................................................................................... $ ____ .....:0~ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL .. $ ____ .....:0~ FPPC Form 460 (Jan/2016} FPPC Advice: advlce@fppc.ca.gov (866/275-3772} www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. SAN RAFAEL FIREFIGHTERS POLITICAL AWARNESS COMMITTEE Statement covers period from __ J_a_n_1_,_2_0_1_8 __ through June 30, 2018 SCHEDULE E CALIFORNIA 460 FORM Page_5 __ of_G __ I.D .NUMBER 891308 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP CNS CTB eve FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings NAME AND ADDRESS OF PAYEE (IF COMMITTEE . ALSO ENTER 1.0 . NUMBER ) MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads CODE OR RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID SECRETARY OF STATE 1500 11TH ST SACRAMENTO CA 95814 ANNUAL FEE, PLUS LATE FEE OFC $200 SAN RAFAEL ELKS LODGE 1312 MISSION AVE SAN RAFAEL CA 94901 RENTAL OF ELKS LODGE FOR CITY COUNCIL MTG RALLY $300 * Payments that are contributions or independent expenditures must also be summarized on Schedule D . SUBTOTAL$ 500 Schedule E Summary 500 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _ 0 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ _ O 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................. $ _____ _ 500 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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER SAN RAFAEL FIREFIGHTERS POLITICAL AWARNESS COMMITTEE DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER 1.0 . NUMBER) Amounts may be rounded to whole dollars. Statement covers period from __ J_a_n_1_, _2_0_1 _8 __ through June 30, 2018 DESCRIPTION OF RECEIPT BANK OF AMERICA 1000 4TH ST SAN RAFAEL CA 94901 INTREST EARNED 6/30/2018 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ Schedule I Summary 1. Itemized increases to cash this period ............................................................................................................................ $ _____ 8_._55_ 2. Unitemized increases to cash of under $100 this period ................................................................................................. $ ______ O_ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ ______ O_ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ............................................................................................................................. TOTAL $ _____ 8 ._5_5 SCHEDULE I CALIFORNIA 460 FORM Page _6_ of_6_ LO .NUMBER 891308 AMOUNT OF INCREASE TO CASH $8.55 8.55 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov