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Home My WebLink AboutForm 460 - John Gamblin for City Council 2015 (2015-12-31) TerminationRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers periodDate of election if applicable: 7/1/2015 (Month. Day, Year) from SFE INSIRUC1IONS ON REVERSE I through 12/31/2015 1. Type of Recipient Committee: All Committees— Complete Parts 1, 2, 3, and 4. V1 Officeholder, Candidate Controlled Committee ❑ Ptimardy f=ormed Ballot Measure n Slate Candidate Election Committee Committee G Recall O Controlled fAfsn!:omp;c;c iiuf Gi 0 Sponsored tarso Corn;h'e;o Rw 6) [� General Purpose Committee C) Sponsored [-1 Primarily Formed Candidate/ C) Small Contributor Committee Officeholder Committee (3 Political Party/Central Commrltee 1%r1so C.on,p:c;%Par; 7) 3. Committee Information ID I'llifh,fnl=R _ 1378282 COMMITTEE NAME iOR CANDIDATE'S NAME IF: NO COMMI I iLL-I Garnblin for City Council 2015 S'IfiCC'I ADDRI:SS rNC) 1-'O BOX) CITY STAFF:: 'LIP CODL ARLA C01;LU11110NI_ San Rafael CA 94903 MAILING ADDRESS (it: DIFFERENT) NO AND STREET OR 110 ROX ;TAIL ARiA COOL PI IUNL West Sacramento CA CITY STAN- 711, CODE AREA CODE.T'110IJF Davis CA 95617 OPTIONAL FAX i E MAIL ADDRESS Date Stamp Received DEC 2 5 2315 Time: City C"eWs 2. Type of Statement: L.il:) C. Preelection Statement FI Serni-annual Slatement �f Tot minmon Statement (Also file a Form 410 Termination) Amendment (Explain below) Treasurer(s) COVER PAGE Page .. 1 of 7 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report I] .Supplemental Preelection Statement Attach Form 495 NAME Of TREASURI R John P. Fronefield fMn.ING, ADDRESS CITY ;TAIL III' CODE ARiA COOL PI IUNL West Sacramento CA 95691 NATAL Of- ASSISTANT rREANURLR, IF ANY John Gamblin MAILING AIJDR^SS CITY STAIE LIP CODF AREA C01)I_WIII-+NI San Rafael CA 94903 OPTIONAL FAX 1 E-IJAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the in opnation contained herein and in the attached schedules is true and complete I ceilify under penalty of perjury under the laws of the Slate of California that the foregoing Is true and correct. �! Ezecu:edon De_,.. Hy— DI-1-l AssrrTrrasu�r pna:u nr surer. sta Executed an '12-:6 2 J L By .. 3:yna:urad mtmV:nq' !x: Carr]L Ye Strc A!eawc F.vaonenlxRes - "eO.L:ardSa�nsor Executed on By Uai. S:gnallrn: ofCm'so"crx301:r..c,o1d[r G-xrr„IYe Slate 6:easure Pfnlxxlent Executed on By Dasa Si�nahre ct C nao::nx3 G rchdder (aM :ra:e S;a a r: easure Pr:gwen: F PPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) State of California Type or print in ink. COVER PAGE - PART 2 Recipient Committee CALIFORNIA Campaign Statement FORM '•1 Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE John Gamblin OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) San Rafael City Council RESIDE IJTIALIBUS114ESS ADDRESS (NO AND STREET) CITY STATE ZIP San Rafael, CA 94903 Related Committees Not Included in this Statement: Listany committees not included in this staternent that are controlled by you or are primarily formed to receive contributions or take expenditures on behalf of your candidacy. COMMITTEENAME I D NUMBER NAME OF TREASURER CONTROI LED COMMITTFE7 YLS ❑ tJ0 COMMIT I EE ADDRESS STREETADDRESS (NOPO BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEF_NAI.1E I D NUMBER NAME OF TREASURER CONTROLI ED COMMITTEE) [ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO PO BOXY IPage 2 of 7 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO OR LETTER I JURISDICTION I ❑SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER CANDIDATE OR PROPONENT OFFICE SOUGH- OR HELD I DISTRICT NO IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of oflicelrolder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑SUPPORT CI OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR FIELD CI SUPPORT CIOPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGIIT OR HELD ❑ SUPPORT ❑ OPPOSE `_" IT Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline- 866/ASK-FPPC (866/275-3772) Slate of California Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period- Summary Page to whole dollars- CALIFOI ' from 7/1/2015 O' SEE INSTRUCTIONS ON REVERSE NAME Of FILER Gamblin for City Council 2015 through 12/31/2015 Page 37 _. of ID NUMBER 1378282 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 613a 1 to Date 20 Conhibuhons Received S 21 ExpendiluleS Marie S 0 S 3,349.20 0 S 3,349.20 Expenditure Limit Summary for State Candidates 22, Cumulative Expenditures Made' (II Subject to Voluntary Expenditure Limit) Dale of L -lection Total to Date (nunldd/yy) / 1 $ / 1 $ 'Amounts in this section may be different from alllountS reported In COlumn B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Column A Column B Contributions Received TOLL If US PERICID CA[ ENDAR)TAR (rRo" ATTACH ID Sr- IiEDULES. fol AI.1 ODATE 1 Monetary Contributions Schedule A, Line 3 $ 3,349.20 $ 3,34920 2 Loans Received Schedule B, Line 3 — 0 0 3 SUBTOTAL CASH CONTRIBUTIONS Add Livres l -i 2 S 3,349.20 S 3,349 20 4 Nonmonetary Contributions Schedule C. Line 3 0 0 5 TOTAL CONTRIBUTIONS RECEIVED Add Lines 3+.1 $ 3,349.20 S 3,349.20 Expenditures Made 6 Payments Made Schedule E. Line •1 S 3,349.20 S 3,349.20 7 Loans Made Schedule H. Line 3 0 0 8 SUBTOTAL CASH PAYMENTS Add Lines 6+ 7 5 _ 3,349.20 S 3,349.20 9 Accrued Expenses (Unpaid Bills) Schedule F Line 3 0 0 10 Nonmonetary Adjustment Schedule C. Line 3 0 0 11 TOTAL EXPENDITURES MADE ....... Add Lines 0.t 9 t 10 S _ 3,349.20 S 3,34920 Current Cash Statement 12 Beginning Cash Balance Previous Summary Page. Line,16 $ 0 To calculate Colunut B add 13 Cash Receipts Colurnit A Line 3 above 3,349.20 amounts to Column A to the 0 corresponding amounts 14 Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B of your last 15 Cash Payments Column A Line 6 above 3,349.20 report Some amounts In Column A rnay be negative 16 ENDING CASH BALANCE Add l.mes 12 t 13 t 14 then sublract Line 15 $ 0 figures tha' should be subtracted from previous /f this is a termination staternent, Line 16 must be zero period amounts If this Is the first report being filed 17 LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ 0 for this calendar year, only carry over the amounts from Lines 2. 7. and g (if Cash Equivalents and Outstanding Debts 18 Cash Equivalents ... ... See instnichons on reverse $ 0 any) 19 Outstanding Debts ....... .. Add Line 2 4 Line 9 rn Column B above $ 0 ID NUMBER 1378282 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 613a 1 to Date 20 Conhibuhons Received S 21 ExpendiluleS Marie S 0 S 3,349.20 0 S 3,349.20 Expenditure Limit Summary for State Candidates 22, Cumulative Expenditures Made' (II Subject to Voluntary Expenditure Limit) Dale of L -lection Total to Date (nunldd/yy) / 1 $ / 1 $ 'Amounts in this section may be different from alllountS reported In COlumn B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Gamblin for City Council 2015 Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE A Statement covers period from 7/1/2015 12/31/2015 4 7 through Page _..�...... _.__ of DATE FULL NAME STREET ADDRESS AND ZIP CODE OF COIJTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS RECC VCD flr[cictrrnt! - AIS; Schedule B - Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Gamblin for City Council 2015 FULL NAME STREET ADDRESS AND ZIP CODE OFLENDER W COHMHILE, A1 5C: ENT kH 10 nUMVIL.il John Gamblin San Rafael, CA 94903 t(.A IND 1_I COM — 0TH ❑ PTY n SCC Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7/1/2015 through 12/31/2015 IF AN INDIVIDUAL. ENTER OCCUPATIONANDEMPLOYER nraeLr-Ere, Loren rrira hr,!neorou uN[seI OUTSTANDING BALANCE BEGINNING THIS pFRiOR— AMOUNT RECEIVED THIS PERIOD AMOUNTPAID OR FORGIVEN THIS PERIOD" OUTSTANDING BALANCEAT CLQSE OF 'fLIIS _ p -RI D - INTEREST' PAID THIS PERIOD Banking Ir) '� P41D S 750.80 S 0 0 ; 1`01iGVEN CONTRIBUTIONS Wells Fargo TO DATE FAT= s 4000.00 S 0 ; 4000.00 $ 3,249.20Ej S PAIS INCURNEI:r CALENDAR'iFAR 5 5 _._. rAID t] FORGIVFFI rte."` Schedule B Summary 5 5 S DAIC DUE 11 Pa! s s [� FORGNT,14 s s DATE DUE S SCHEDULE B - PART 1 5 7 Page of I.D NUMBER 1378282 Ir) 19) ORIGI14AL CUMULATIVE AMOUNTOF CONTRIBUTIONS LOAN TO DATE CAi.ENDAR YEAR s 4000.00 4,000.00 PERELECTION.. 7/3/15 S 4,000.00 PAIS INCURNEI:r CALENDAR'iFAR 5 5 "ER ELCCTIUN" CALENDAR YEAR gnlE PLR ELEC; I ION" s s DATE Ii: C! ERRED SUBTOTALS $ 4,000.00 $ 4,000.00 $ 0 $ 0 aieild� E, Lnie 31 1- Loans received this period .. $ 4,000.00 (Total Column (b) plus unitemized loans of less than $100 ) 2. Loans paid or forgiven this period .--........ $ 4,000.00 (Total Column (c) plus loans under $100 paid or forgiven ) (Include loans paid by a third party that are also Itemized on Schedule A.) 3. Net change this period. Subtract Line 2 from Line 1. -------- NET $ 0 Enter the net here and on the Summary Page, Column A, Line 2 (baybeanepam:emim°`r) 'Amounts forgiven or paid by another party also must be reported on Schedule A " If required - lGontrlbutor Codes IND Individual COM— Recipient Commitee (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 (8661275-3772) ',LAME AND ADDRESS OF PAYEE _ r40.1.TT EF rd'li1r LATER ie N111.!BF.R) John Fronefield West Sacramento, CA 95691 CODE UR DESCRIPTION OF PAYMENT " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 1 Itemized payments made this period. (Include all Schedule E subtotals-) ....... ................................................................................................. $ 2 Unitemized payments made this period of under $100 .... ............................................................................................................................. $ 3 Total Interest paid this period on loans (Enter amount from Schedule B, Part 1, Column(e).)............................ ................................................... S 4 Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ AMOUNT PAID 600.00 2.090.00 300.00 2,990.00 3,290.00 59.20 0 3.349.20 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Gamblin for City Council 2015 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 7/1/2015 through 12131/2015 SCHEDULE E (CONT) Page _7 of 7 IU NUMBER 1378282 CODES: If one of the following codes accurately describes the payment, you may enter the code Otherwise, describe the payment. CMP campaign paraphernalialmisc MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions C76 contribution (explain nonmonetary)' CFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t v. or cable airtime and production costs FIL candidate flinglbaliot fees R-10 phone banks TRC candidate travel, lodging, and meats FND fundraising events POI. polling and survey research TRS staff/spouse travel Indging and meals IND independent expenditure supporting/opposing others (explain)' POS postage delivery and messenger services TSF transfer between committees of the same candidate/sponsoi LEG legal defense PRO professional services (legal, accounting) V01 voter registration LIT campaign literature and mailings FRT print ads WEB information technology costs (Internet a-rnail) ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 300.00 FPPC Form 460 (January/05) FPPC Tall -Free Helpline: 866/ASK-FPPC (8661275-3772)