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Home My WebLink AboutForm 460 - Gary Phillips for Mayor 2011 (2012-06-30) AmendmentRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from — 1-1-12 SEE INSTRUCTIONS ON REVERSE I through 6-30-12 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee (D State Candidate Election Committee C) Recall (Atso Complete Part 5) ❑ General Purpose Committee (:) Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO Gary Phillips for Mayor 2011 STREET ADDRESS (NO P.O. BOX) El Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Parr 6) Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 1) CUVER PAGE Date Stamp Date of election if applicable: Page — 1 of 4 (Month, Day, Year) For Official Use Only 11-8-11 2. Type of Statement: 0 Preelection Statement D Quarterly Statement El Semi-annual Statement 0 Special Odd -Year Report El Termination Statement F- Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 Amendment (Explain below) Amount of loan forgiven was overstated. I.D. NUMBER 1339680 Treasurer(s) NAME OF TREASURER Richard Kalish MAILING ADDRESS CITY STATE ZIP CODE AREA CODE,PHONE San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.Q. BOX CITY STATE ZIP CODE — AREA CODEIPHONE OPTIONAL. FAX 1 E-MAIL 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 CODEiPHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best 0 nowledge 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 anc orre Executed on January_, 2013 Date Executed on —January_ 2013 Dat Executed or, Executed on Date By By of Treasurer or rm FPPC Form 460 (januaryf05) FPPC Toll -Free Helpline: 866iASK-FPPC (8661275-3772) State of California Type or print in ink. COVER PAGE - PART 2 Recipient Committee CALIFORNIA Campaign Statement FORM Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Gary Phillips OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Mayor, City of San Rafael RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Rafael, CA 94903 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? [:] YES E, NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE — --- ------ ----- --- -- ----- - ------------- --- -- _ _ - ----- COMMI TITEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE-, ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO PC, BOX) Page 2 of 4 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION EISUPPORT I I [:j 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 officeholders) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD E] SUPPORT Ej OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD j SUPPORT [] OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD L7 SUPPORT `L_j OPPOSE Q-1 "I _ — Attach continuation sheets if necessary FPPC Form 460 (January,105) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Gary Phillips for Mayor 2011 Type or print in ink. SUMMARY PAGE Amounts may be rounded Statement to whole dollars. ent covers period CALIFORNIA from 1-1-12 FORM through 6-30-12 page 3 of Contributions Received To calculate Column B, add Column ATOTA(L .... Schedule E, Line 4 $ 7. Loans Made, ....... .......................... ....... ...... THIS PERIOD 8. SUBTOTALCASH PAYMENTS .. .... ... ................ Add Lines 6+7 $ i, -ROMATTACHED SCHEDULES) 1. Monetary Contributions ............ Schedule A. Line 3 $ 0 2. Loans Received ........... ....... .... _ ... ... ................ Schedule B, Line 3 -----15527 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I +2 0 4. Nonmonetary Contributions.. . ................................. Schedule C, Line 3 0 5. TOTAL CONTRIBUTIONS RECEIVED ... ...... ...... Add Lines 3 + 4 0 Expenditures Made To calculate Column B, add 6. Payments Made... ............. _ ................... .... Schedule E, Line 4 $ 7. Loans Made, ....... .......................... ....... ...... .... Schedule H, Line 3 8. SUBTOTALCASH PAYMENTS .. .... ... ................ Add Lines 6+7 $ 9. Accrued Expenses (Unpaid Bills) ........ _ ..... .............. Schedule F Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE . .... _ ..... .................. Add Lines 8 + 9 + to $ Current Cash Statement 12. Beginning Cash Balance . ....... ...... Previous Summary Page. Line !6 $ 13. Cash Receipts .. ..... ..... ........... ................. ...... Column A, Line 3 above 14. Miscellaneous Increases to Cash..... ....... _ ............. Schedule i, Line 4 15. Cash Payments. ....... _ ................. ... Column A. Line 8 above 16. ENDING CASH BALANCE ., _ . .... Add Lines 12 - 13 + 14, then subtract Line 15 $ Ifthis is a termination Statement Line 16 must be zero 17, LOAN GUARANTEES RECEIVED ........................... Schedule B Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ... _ .... __ ... ....... ...... ...... See instructions onre"e"-se 19 Outstanding Debts... ... ....... ........ Column B CALENDAR YEAR TOTALTOLATE $ 0 1073 $ 0 0 0 0 $ 0 $ 0 0 0 $ 1197 It - To calculate Column B, add 0 amounts in Column A to the 0 corresponding amounts - from Column B of your last 0 report. Some amounts in __ Column A may be negative 1197 figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only ca" over the amounts from Lines 2. 7, and 0 (if inv! -- 0 1073 I.D.NUMBER 11339680 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 711 to Date 20, Contributions Received $ 21. Expenditures Made $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* I If Subject to Volunta ry Expenditure Limit) Date of Election Total to Date (mm,'dd/yy) $ IAmounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Januaryi05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) ` Schedule B_Part I Loans Received / Type or print in ink. Amounts may oerounded mwhole dollars. Statement covers period from 1-1-12 SCHEDULE o - PART 1 SEE INSTRUCTIONS ON REVERSE tnrougn Page of— Gary Phillips for Mayor 2011 1339680 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING AMOUNT BALANCE A,Ou(c,)TPA,D OUTSTANDING I I INTEREST ORIGINAL CUMULATIVE ff COMWITTEE, ALSO ENTER J,D. NUMBER) IF SELF-EMPLOYED. ENTER RECEIVED THIS BEGINNING THIS j OR FORGIVEN BALANCEAT PAID THIS LOSE OF THIS AMOUNTOF CONTRIBUTIONS _NAM�OF6USINE5�) FERIQD I PERIOD THIS ERIOD* PERIOD LOAN TO DATE Gary Phillips Certified Public Acct PAID CALENDAR YEAR 1073 1 San Rafael, CA 94903 i $ PC RGIVEN PERELECTION** San Rafael, CA 94901 DATE DUE ETE INCURRED E! PAID CALENDAR YEAR tD IND EJCOM E OTH E] PTY E] DATE DUE DATE INCURRED I PAID CALENDAR YEAR E, FORGIVEN tEj IND Ej COM El OTH 0 PTY E. SCC DATE INCURRED DATE DUE 1 Schedule E5 Summary 1� Loans received this pehod—......... ------...... —...... —...... --' (Total Column (b)plus unhembedloans ofless than $1OOj 2. Loans paid orforgiven this period ..... —........... —.... ............................. ' (Total Column (c)plus loans under $1OOpaid orfoq]wen] (Include loans paid byethird party that are also itemized onSchedule Aj 3. Net change this period. (Subtract Line 2from Line 1j ..... -------' Enter the net here and onthe Summary Page, Column A.Line 2. $ 12527 --------� -12527 --- NET --� �tContributor CodesIND — IndividualCOM — Recipient Committee(other than PTY or SOO)OTH — Other (e.g., business entity)SCC — Small Contributor Committee FPPC Form ^60uanuaryma