HomeMy WebLinkAboutForm 465 - Police Association PAC (2011-10-22) Supporting Connolly, DamonSupplemental Independent Type or print in ink. —
Amounts maybe rounded to Report covers period
Expenditure Report
whole dollars.
(Government Code Section 84203.5) 1 from 09J25/2011
SEE INSTRUCTIONS ON REVERSE I through 10/22/2011
❑ AfTletldfTt@nt (Explain Below) g
I.D. NUMBER (If recipient committee)
1. Committee/Filer Information 831553
COMMITTEE/FILER'S NAME
San Rafael Police Association Political Action Committee
STREET ADDRESS (NO P.O. BOX)
1520 Fifth Avenue
CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael CA, 94901 (415) 485-3000
OPTIONAL: FAX/E-MAIL ADDRESS
2. Name of Candidate or Measure Supported or Opposed
Date of election if applicable:
(Month, Day, Year)
11/08/2011
SUPPLEMENTAL IN
Date Stamp
EXPENDITURE
Page 1 of___L_
For Official Use Only
Treasurer (Ifrecipientcommittee)
NAME OF TREASURER
Mr. Scott Ingels
MAILING ADDRESS
1520 Fifth Avenue
CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael CA, 94901 (415) 485-3000
OPTIONAL: FAX/ E-MAIL ADDRESS
CHECK ONE
NAME OF CANDIDATE
Damon Connolly
OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE
City Council Member City of San Rafael, CA
SUPPORT
X
OPPOSE
NAME OF BALLOT MEASURE
BALLOT NOJLETTER
JURISDICTION
SUPPORT
OPPOSE
3. Independent Expenditures Made Attach additional information on appropriately labeled continuation sheets.
CUMULATIVE TO DATE
DATE
NAME AND ADDRESS OF PAYEE
DESCRIPTION OF EXPENDITURE
AMOUNT
JAN_ 1 DEC� 31
Freeman Public Affairs, Inc.
4,648.67
Mailer including production and postage
10/17/2011
1405 Marcelina Avenue, Suite Ill
in support of Damon Connolly for San
13,642.76
Rafael City Council
Torrance, CA 90501
U.S. Postmaster
2,100.00
Postage for mailer in support of Damon
MEMO
10%17/2011
1433 Marcelina Avenue
Connolly for San Rafael City Council
Subpayment made
through:
Freeman Public
Affairs,
Torrance, CA 90501
Inc.
FPPC Form 465
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)
Supplemental Independent �p o,v�tmm�
-- Amounts may uorounded
Expenditure Report to whole dollars.
SEE INSTRUCTIONS owREVERSE
NAME OF FILER
San Rafael Police Associat"on Po'.itical Aczion Committee
SUPPLEMENTAL INDEPENDENT EXPENDITURE
Report covers n^uCALIFORNIA 465
from 09/25/2011 FORM
through 10/22/2011 Page 2 of 2
LID, NUMBER (If recipient com.)
831553
4. Summary 4,648 .67
1. Total independent expenditures of$1OOormore made this period. (Part 3j ...... ----........ ----....... --............ —......... $
2. Total independent expenditures under $100 made this period. (Not itemized.) ---------------------------$ ».«»
3. Total independent expenditures made this period (Add Lines 1 +2j ------------------------------TOTAL $ 4'648,6'
5. Filing OfficerS Enter the name and address ofeach filing officer with whom the filer's most recent campaign statements (Form 450, 460m461)/ave been filed.
1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER
San Rafael c_Jzy czsru
ADDRESS (NO. AND STREET) ADDRESS (NO� AND STREET)
1400 5r' Avenue
CITY STATE ZIP CODE CITY STATE ZIP CODE
San maxael, na 94901
2) NAME OF FILING OFFICER
ADDRESS (NO. AND STREET)
4) NAME OF FILING OFFICER
ADDRESS (NO. AND STREET)
STATE ZIP CODE CITY
STATE ZIP CODE
6. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the bestof my knowleogetbe information contained herein is true and complete. | certify under
penalty of perjury under the laws of the State of California that the foregoing is true d
FPPC Form 465
Executed on
By
TFJ TREASURER OR ASSISTANT TREASURER
Executed on
By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR
Executed on
By
DATE
~IC -"^."°,", CONTROLLING OFFICEHOLDER, ~~,=~`.,,~~~MEASURE PROPONENT
Executed on
By
DATE
SIGNAT_RE O� CONTROLLING OFFICEHOLDER, CANDIDATE. STATE MEASURE PROPONENT
FPPC Form 465