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Home My WebLink AboutForm 460 - Gary Phillips for Mayor 2011 (2012-12-31)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 7-1-12 through 12-31-12 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. (� Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee d Recall O Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored 0 Small Contributor Committee O Political Party/Central Committee 3. Committee Information NAME (OR CANDIDATE'S Gary Phillips for Mayor 2011 STREET ADDRESS (NO P.O. BOX) Date Stamp Date of election if applicable: (Month, Day, Year) 11-8-11 1 2. Type of Statement: ❑ Preelection Statement ❑ Semi-annual Statement ® Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE Page 1 of 5 For Official Use Only E❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement -Attach Form 495 ❑ Primarily Formed Candidate/ STATE Officeholder Committee AREA CODE/PHONE (Also Complete Part 7) CA 94901 I.D. NUMBER 1339680 Treasurer(s) COMMITTEE) 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.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX J 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 1 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 corfect. Executed on January_, 2013 Date Executed on January_, 2013 Date Executed on Executed on DarhD By By By Signature of Gexrtrafiutg Office , Gantkdee, Stats Measure Proponent By Svgnature afCon Of'�.e .Candidate. Stale Measure Proponent FPPC Farm 460 (January/05) FPPC Toil -Free Helpline: 8661ASK-FPPC (866t275-3772) State of California Recipient Committee Type or print in ink. COVERPAGE-PART2 Campaign Statement CALIFORNIA FORM 460 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 ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME — - - -- LD. NUMBER ` NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) Page Z of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION I ❑ 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 offtceholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Statement covers period CALIFORNIA A 60 Amounts may be rounded Summary Page to whole dollars. 7-1-12 FORM from through 12-31-12 Page 3 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D.NUMBER Gary Phillips for Mayor 2011 1339680 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHISPERIOD CALENDAR YEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTALTO DATE General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 0 $ 0 2. Loans Received ...................... ............ ............... - Schedule B, Line 3 -1073 0 111 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS Add Line + 2 s 1 $ -1073 $ 0 20. Contributions .............. .......... Received $ - $ 4. Nonmonetary Contributions .................................... Schedule C, cines 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED . ......... ...... -- ...... Add Lines 3 + 4 $ -1073 $ 0 Made $ - $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made....................................................... Schedule E, Line 4 $ 124 $ 124 Candidates 7. Loans Made............................................................. Schedule H, Line 3 0 0 124 124 22. Cumulative Expenditures Made* & SUBTOTALCASH PAYMENTS .................................... Add Lines 6 +7 $ $ IN Subject to Voluntary Expenditure Limit) 9, Accrued Expenses (Unpaid Bills) ............................... schedule F Line 3 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment .................... ..... Schedule C, Line 3 0 0 (mmfdd/yy) 11. TOTAL EXPENDITURES MADE ................. Add Lines 8 + 9 + 10 $ 124 $ 124 $ $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 1197 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above -1073 amounts in Column A to the 14, Miscellaneous Increases to Cash........................... Schedule 1, Line 4 0 corresponding amounts from Column B of your last *Amounts in this section may be different from amounts reported in Column B. 15. Cash Payments.................................................. Column A, Line 8 above 124 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 0 figures that should be subtracted from previous If this is a tennination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED ............. schedule 8, Part 2 $ 0 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 $ 0 19. Outstanding Debts........ ... -- .......... Add Line 2 + Line 9 in Column B above $ 0 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275�3772) SCHEDULE B - PART 1 Ypc .. F.. Schedule —Part 1 .n• ... ... n. Amounts may be rounded Statement covers period CALIFORNIA 011 Loans Received to Whole dollars. 7-1-12 FORM • from 12-31-12 4 5 through Page of 3EE INSTRUCTIONS ON REVERSE DAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2011 1339680 a (b) (c) (d) (e) to (9) FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING BALANCE AT INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS 1F COMMITTEE, ALSO ENTERID NUMBER) IE SELF-EMPLOYED. ENTER NAMEMPLOYE .EN BEGINNING THIS PERIOD PERIOD THIS PERIOD' PERI D PERIOD LOAN TO DATE ® PAID CALENDAR YEAR Gary Phillips Certified Public Acct DZH Phillips $ 1073 $ 0 0 % $ 15000 $ 1 Q FORGIVEN PER ELECTION"` San Rafael, CA 94903RATE San Rafael, CA 94901 1073 $ 0 $ Paid $ 0 6-30-11 $ $ DATE DUE _ DATE INCURRED t W IND ❑ COM [] OTH 0 PTY ❑ SCC PAID CALENDAR YEAR $ $ % $ $ FORGIVEN PER ELECTION `* it RATE ( I$ $ $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM❑ OTH PTY ❑ SCC ❑ PAID CALENDARYEAR I FORGIVEN RATE 1 PER ELECTION"* $ $ $ $ $ t[--, INDL! COM ❑ OTH ❑ PTY [] SCC DATE DUE GATE INCURRED SUBTOTALS $ 0$ 1073 $ 0 $ 0 (Enter (e) on Schedule B Summary SchedtdeE,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.) 0 1073 3. Net change this period. Subtract Line 2 from Line 1. NET $ -1073 Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative rwmbeQ *Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. tContributor Codes IND — 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 (8881275-3772) Schedule E Payments Made _FF INSTRUCTIONS ON REVERSE Gary Phillips for Mayor 2011 Type or print mink. Amounts may unrounded to whole dollars. Statement covers period from 7-1-12 12'3142 5 S Page ofI.D. NUMBER1339680 CODES: Kone of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. cmIP campuignnamnxomuxmmisc. wmx member communications RAD radio airtime and production costs cwn campaign oonovm,ma Mna meetings and appearances RFD returned contributions CTB, contribution (explain nvnmnnomw)^ OFC ^moc expenses SAL campaign workers' salaries ovo civic donations PET petition circulating TeL tx o,cable airtime and production costs pn candidate m/,wmoomfeen PHO vxo,= uuoxo TRC candidate travel, lodging, and meals pwo /u^o,u/omuevovm FnL polling and survey research TRS staff/spouse travel, lodging, and meals W independent expenditure uvppom^n*pous/nn vmem (explain)* poo pnntaso` delivery and messenger services TSF tm^w,r between committees of the opmo candidate/sponsor LEG legal defense pno professional oowioom (|onul, uumvnuno) voT voter registration LIT campaign literature and mailings pnr print ads vmEB information technology costs (imemet.o+mon) NAME AND ADDRESS orPAYEE (IF COMMIT -TEE ALSO ENTER 1.0, NUMBER) Rio Cat Advertising Novato, CA 94949 cooE on DESCRIPTION cFPAYMENT Internet URL and related services AMOUNT PAID 124 ^ Payments that are contributions u,independent expenditures must also be summarized vnSchedule D. SUBTOTAL$ 124 Schedule Summary 124 1. Itemized payments made this period. (include all Schedule Emubtota|aj......................... ......... ................ ......... ......................................... $ 2.Unbem�edpayma�mmmdethispehudofundar$1OO----------------------------------------------� ~ � . 3. Tb��li�enaatpau1this per�donkmne.0Enba amount hnmSchedule B.Pa�1.Cok/mn�)j--------------------------� 4.Total payments made this period. (Add Lines 1.2.and 3.Enter here and onthe Summary Page, Column A.Line Gj.... -------'TOTAL $ 124 FPPC Form 460