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Home My WebLink AboutForm 460 - Firefighters' Association PAC (2018-06-30)Recipient Committee Campaign Statement Cover Page .-------------·ooo Statement covers period Date of election if applicable: Jan 1, 2018 (Month , Day, Year) from _________ _ SEE INSTRUCTIONS ON REVERSE 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 Parl 5) ~ 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 (Al so Complete Parl 6) D Primarily Formed Candidate/ Officeholder Committee (Also Complete Parl 7J 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 STATE ZIP CODE SAN RAFAEL 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 2. Type of Statement: D Preelection Statement ~ Semi-annual Statement D Termination Statement (Also file a Form 410 Termination) D Amendment (Explain below) Treasurer(s) NAME OF TREASURER ANDREW ROGERSON ROHNERT PARK NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX/ E-MAIL ADDRESS D Quarterly Statement D Special Odd-Year Report STATE ZIP CODE CA 94928 STATE ZIP CODE 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 ;ietry 1nder the laws of the State of California that the for~~2 Executed on -'i _ '2-0 I'S? BY----------=----.---·---.,......,-,--,.,,-----------Date Sig re o Urer or Assistant Treasurer ---=· Executed on ------• ... a-te ______ _ Executed on------...-------Date Executed on------,,--------Date By-..,,S,,...lg-na..,.tu-,e-o..,.f""Co-n..-tro""'ll,-lng-O""ffi"'"c-eh,...o""ld..,.er...,,C,..a-nd"'"ld..-a,-te""',s,...ta..,.te""'M..,..e-as-u-re""P,..ro-po-n-en..,.t-or""R'""e-sp-on_s.,,.lb,-le""o""ffi-ce-r""of""S_po_n_so-,- BY-------,,S.,...ig-na-tu_re_0"'"1c,..o_n.,...tr0""lli,...ng-O"'ffi ... ,c....,eh-o'"'lde-~""'c,....a-nd.,,.id.,...at,...e,""s'""ta-te...,M.,...e-as-u-re""'P..,.ro-po-n-en..,.t------ By-------,,S-,g-na-tu-re-0"'"1c,..o-n,-tro""lli,...ng...,O"'ffi,..,c....,eh-o'"'lde-~""'c,....a-nd.,,.id,-at,...e,""s'""m-te...,M.,...e-as-u-re""'P,...ro-po-n-en..,.t------ 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 a, 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, Une 3 0 11. TOTAL EXPENDITURES MADE. ....................................... Add Lines B + 9 + 10 $ 500 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 86,420.78 13. Cash Receipts ........................................................... Column A. Une 3 above 0 14 . Miscellaneous Increases to Cash.................................. Schedule I, Line 4 8.55 15. Cash Payments......................................................... Column A, Une B 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 8, 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 Jan 1, 2018 from ________ _ CALIFORNIA 460 FORM 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 111 through 6130 711 lo Date 20. Contributions Received $ ____ _ $ ____ _ 21. Expenditures Made $ ____ _ $ ____ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) ___}___} __ ___}___} __ 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 DOTH OPTY •sec •IND •COM DOTH •PTY •sec •IND •COM DOTH OPTY •sec •IND •COM DOTH 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 _a __ through __ J_u_n_e_3_0_,_2_0_1_8_ Page _3 __ of __ 6 _ AMOUNT RECEIVED THIS PERIOD 1.0. 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 0 Oppose D Support D Oppose Schedule D Summary TYPE OF PAYMENT • Monetary Contribution • Nonmonetary Contribution • Independent Expenditure • Monetary Contribution • Nonmonetary Contribution • Independent Expenditure • Monetary Contribution • Non monetary Contribution • Independent Expenditure DESCRIPTION (IF REQUIRED) SUBTOTAL$ Statement covers period from ___ Ja_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.) ....................................................... $ _____ _,O:,_ 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: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) 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 _J_u_n_e_3_0_, _2_0_1_8_ SCHEDULE E (CONT.) CALIFORNIA 460 FORM Page _5 __ ot _6 __ 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 member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT 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 VDT 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 SAN RAFAEL ELKS LODGE 1312 MISSION AVE SAN RAFAEL CA 94901 MTG * Payments that are contributions or independent expenditures must also be summarized on Schedule D. $200 RENTAL OF ELKS LODGE FOR CITY COUNCIL RALLY $300 SUBTOTAL$ 500 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 _B __ through June 30, 2018 DESCRIPTION OF RECEIPT BANK OF AMERICA 1000 4TH ST SAN RAFAEL CA 94901 INTREST EARNED 6/30/2018 SCHEDULE I CALIFORNIA 460 FORM Page _6_ of_6_ I.D. NUMBER 891308 AMOUNT OF INCREASE TO CASH $8.55 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL$ 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 $ _____ B_.5_5_ FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov