HomeMy WebLinkAboutForm 460 - Damon Connolly for City Council 2015 (2014-06-12) TerminationRecipient Committee
Campaign Statement
CoverPage
(Government Code Sections 84200-84216.5)
Type or print in ink.
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Damon Connolly for City Council 2015
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE
AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
Date of election if applicabi
(Month, Day, Year) I
Date Stamp
Page of
For Official Use Only
2. Type of Statement:
F� Preelection Statement E] Quarterly Statement
2 Semi-annual Statement � Special Odd -Year Report
J0 Termination Statement F -I Supplemental Preelection
(Also file a Form 410 Termination) Statement - Attach Form 495
E] Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Gary Anspach
MAILING 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 CODE/PHONE
OPTIONAL: FAX / 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 i rmation contained herein and in the attached schedules is true and complete. I certify
under penalty of perjury un r e laws the State of California that the foregoing is true and correct.
Executed on By
Da Signa AoTre urero0AsS*-1'Pt*t as er
a 07 1 L
Executed on By
CrAte Signature of Controlling Offic6holder, Candidate, State Measure Proponent or Rtnsible Officer of Sponsor
Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Pn3ponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/AS1 -FPPC (866/275-3772)
State of California
• a s
• a�♦
CALIFORNIA
FORS 46AU
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Damon M. Connolly
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
San Rafael City Council
RESIDENTIAL/BUSINESS 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 F-1 NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CGDE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
YES NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
Primarily6. Formed Ballot Measure Committee
NAME OF BALLOT •
BALLOT NO. OR LETTER JURISDICTION F� 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 Farmed Candidate/Officeholder Committee List names of
officeholder(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
E] OPPOSE
ul l y Z> Ixr c Ir c... ut- Attach continuation sheets if necessary
FPPC Form 60 (January/05
FPPC Toll-FreeHelpline: 866/ASI1 -FPPC (8661275-3772)
State of California
A**&
t;ampaign Disclosure Statement
Summary Page
Type or print in ink.
Amounts may be rounded
to whole dollars.
Statement covers period
01/01/2014
from
through
06/12/2014
Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D.NUMBER
Damon M. Connolly
1299779
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTALTHISPERIOD
CALENDARYEAR
Running in Both the State Primary and
(FROM ATTACHED SCHEDULES)
TOTAL TO DATE
General Elections
1. Monetary Contributions ........................................... Schedule A, Line 3
$
12 6.00
$ 126.00
0.00
0.00
1/1 through 6/30 7/1 to Date
2. Loans Received...................................................... Schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS......................... Add Lines I + 2
$
126.00
$ 126.00
20. Contributions
Received $ $
4. Nonmonetary Contributions .................................... Schedule C, Line 3
0.00
0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED .......................... Add Lines 3 + 4
$
126.00
$ 126.00
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made ....................................................... Schedule E, Line 4
$
130.00
$ 130.00
Candidates
7. Loans Made ............................................................. Schedule H, Line 3
0.00
0.00
130.00
130.00
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 +7
$
$
(if Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3
0.00
0.00
Date of Election Total to Date
10. Nonmonetary Adjustment .......................................... Schedule Cr Line 3
0.00
0.00
(mm/dd/yy)
11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10
$
130.00
$ 130.00
$
$
Current Cash Statement
12. Beginning Cash Balance....................... Previous Summary Page, Line 16
$
4.00
To calculate Column B, add
13. Cash Receipts................................................... Column A, Line 3 above
126-00
amounts in Column A to the
0.00
corresponding amounts
*Amounts in this section may be different from amounts
14. Miscellaneous Increases to Cash ........................... Schedule /, Line 4
from Column B of your last
reported in Column B.
15. Cash Payments.................................................. Column A, Line 8 above
130.00
report. Some amounts in
Column A may be negative
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15
$
0-00
figures that should be
subtracted from previous
If this is a termination statement, Line 16 must be zero.
period amounts. If this is
the first report being filed
17. LOAN GUARANTEES RECEIVED........................... Schedule B, Part 2
$
0.00
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ........................................ See instructions on reverse
$
0.00
any.
19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above
$
0.00
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule A Type or print in ink. SCHEDULE A
Monetary Contributions Received Amounts may be rounded Statement covers period
to whole dollars. CALIFORNIA
01/01/2014 4bo;�
from FORM
SEE INSTRUCTIONS ON REVERSE through 06/12/2014 Page of
NAME OF FILER I.D. NUMBER
Damon M. Connolly 1299779
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT
RECEIVED THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. I DEC. 31)
(IF REQUIRED)
OF BUSINESS)
IND
RCOM
R OTH
[:] PTY
RSCC
R IND
[:] Com
ROTH
E] PTY
RSCC
RIND
EICOM
[:] OTH
R PTY
RSCC
RIND
RCOM
E] OTH
E] PTY
El SCC
E:] IND
DCOM
ROTH
Ej PTY
SCC
. . . . . . .... ....
SUBTOTAL $
Schedule A Summary
1. Amount received this period — itemized monetary contributions. 0.00
(include all Schedule A subtotals.) .......................................... ............................................................. $
2. Amount received this period — uniternized monetary contributions of less than $100 ............................. $
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $
126.00
EM
*Contributor Codes
Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
Political Party
SCC — Small Contributor Committee
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline.- 866/ASK-FPPC (866/275-3772)
Schedule E
Payments Made
NAME OF FILER
Damon M. Connolly
Type or print in ink.
Amounts may be rounded
to whole dollars.
jq��11 11 1111 � 1
IN I
MOTO =-I
MEW
Statement covers period
from 01/01/2014
through 06/12/2014
. III -•
I.D.NUMBER
1299779
CIVP
campaign paraphernalia/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)*
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing/ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
independent expenditure supporting/opposing others (explain)`
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
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.) .............................................................................................................. $ 0.00
2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ 130-00
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ 0.00
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ..................... ....... TOTAL $ 130.00
FPPC Form 460 (January/05)
FPPC ToH-Free Helpline: 866/ASK-FPPC (866/275-3772)