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Home My WebLink AboutForm 460 - Gary Phillips for Mayor 2015 (2016-12-31)Recipient Committee Campaign Statement Cover Page Type or print in ink. (Government Code Sections 84200-84216 .5) Statement covers period from ___ 7_'_1_'2_0_1_6 __ SEE INSTRUCTIONS ON REVERSE through __ 1_2_'3_1_'2_0_1_6 __ 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. IKJ Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also Complele Part 5) o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee 3. Committee Information o Ballot Measure Committee o Primarily Formed o Controlled o Sponsored (Also Complete Part 6) o Primarily Formed Candidatel Officeholder Committee (Also Complele Part 7) I.D. NUMBER 1376443 NAME (OR CANDI IF NO COMMIITEE) Gary Phillips for Mayor 2015 STREET ADDRESS (NO P.O. BOX) CITY San Rafael STATE CA ZIP CODE 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE OPTIONAL : FAX / E-MAIL ADDRESS 4. Verification AREA CODE/PHONE ( AREA CODE/PHONE I have used all reasonable diligence in preparing and reviewing this statement and to the bes certify under penalty of perjury under the laws of the State of California that the foregoing s Executed on January 26, 2017 By Date Executed on January_, 2017 By Date Executed on By Date Execuled on By Date Date of election if (Month, Day, 2. Type of Statement: 0 Preelection Statement IKJ Semi-annual Statement 0 Termination Statement 0 Amendment (Explain below) Treasurer(s) NAME OF TREASURER Richard Kalish MAILING ADDRESS CITY San Rafael NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX / E-MAIL ADDRESS rkalish@kalishnexon.com 2 6 2017 of __ _ 0 0 0 STAT E CA STATE Quarterly Statement Special Odd-Year Report Supplemental Preelection Statement -Attach Form 495 ZIP COD E 94901 ZIP CODE AREA CODE/PHONE ( AREA CODE/PHONE Signature ofConlroUing Officeholder. CandIdate , State Measure Proponent FPPC Form 460 (June/01) FPPC TolI·Free Hetpline: 866/ASK-FPPC State of California Type or print in ink. COVER PAGE -PART 2 Recipient Committee Campaign Statement 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 RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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. COMMITIEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES 0 NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES 0 NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE --- 6. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION o SUPPORT o 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 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 o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE Attach continuation sheets if necessary FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK·FPPC State of California Type or print in ink. SUMMARY PAGE Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE NAME OF FILER Gary Phillips for Mayor 2015 Contributions Received ColumnA TOTAL THIS PERIOO (FROM ATIACHEO SCHEDULES) 1. Monetary Contributions ....... ........ ................ ........ .... Schedule A, Line 3 S 0 2. Loans Received ...................................................... Schedule B, Line 3 0 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 0 4 . Nonmonetary Contributions .............. ...................... Schedule C, Line 3 0 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 0 Expenditures Made 6 . Payments Made ....................................................... Schedule E. Line 4 $ 1150 7 . Loans Made ............ ................................... .............. Schedule H. Line 3 o 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 S 1150 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F. Line 3 o 10 . Nonmonetary Adjustment .......................................... Schedule C, Line 3 o 11 . TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 1150 Current Cash Statement 12 . Beginning Cash Balance ....................... Previous SummaI}' Page, Line 16 S 8425 13 . Cash Receipts ................................................... Column A, Line 3 above o 14 . Miscellaneous Increases to Cash ........................... Schedule I, Line 4 o 15 . Cash Payments .................................................. Column A. Line 8 above 1150 16 . ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then sub/ractLlne 15 $ 7275 If this is a termmation statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B. Part 2 $ o Cash Equivalents and Outstanding Debts 18 . Cash Equivalents ........................................ See instructions on reverse $ o 19 . Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ o from ___ 7_1_1/_2_0_16 __ _ through ColumnB CALENOAR YEAR TOTAL TO OATE $ 0 0 $ 0 0 $ 0 $ 2200 o $ 2200 o o $ 2200 To calculate Column B. add amounts in Column A to the corresponding amounts from Column B of your la st report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year. only carry over the amounts from Lines 2, 7, and 9 (if any). 12/31/2016 Page __ 3 __ of __ 4 __ 1.0 . NUMBER 1376443 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20 . Contributions Received $ _____ _ $ ____ _ 21 . Expenditures Made $ _____ _ $ ____ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" (If Subj ect to Voluntary Expenditure Urnlt) Date of Election Total to Date (mm/dd/yy) -----.1-----.1 __ $ -----.1-----.1 __ $ -----.1-----.1 __ $ -----.1-----.1 __ $ -----.1-----.1 __ $ -----.1-----.1 __ $ 'Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC ScheduleE Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Gary Phillips for Mayor 2015 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from ___ 7_/1_/2_0_1_6 __ _ h h 12/31/2016 t roug _______ _ SCHEDUlEE CALIFORNIA 460 FORM Page __ 4_ of __ 4 _ I.D . NUMBER 1376443 CODES: If one of the following codes accurately describes the payment, you may enter the code . Otherwise, describe the payment. CtvP campaign paraphernal ia/misc . CNS campa ign consultants cm contribution (explain nonmonetary), eve civic donations FIL candidate fil ing/ballot fees FND fundraising events I/'ID independent expenditure supporting/opposing others (explain)- lEG legal defense LIT campaign literature and mailings NAME AND ADDRESS OF PAYEE (IF COMMITTEE. AL SO EI<TER I.D. NUMBER) MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHD phone banks POL polling and survey research POS postage , delivery and messenger services PRO professional services (legal , accounting) PRT print ads CODE OR RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs me candidate travel. lodging, and meals ms staff/spouse travel, lodging , and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet , e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID San Rafael Fire Department Foundation Support of Foundation 1400 Fifth Avenue C-VU 1000 San Rafael, CA 94901 Canal Alliance 91 Larkspur Street CVC 100 San Rafael, CA 94901 = * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1100 Schedule E Summary 1100 1. Payments made this period of $1 00 or more. (Include all Schedule E subtotals.) .................................................................................................. $ _____ _ 50 2. Unitemized payments made th is period of under $1 00 .......................................................................................................................................... $ ______ _ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ _____ _ 1150 4. Total payments made this period . (Add Lines 1, 2, and 3. Enter here and on the Summary Page , Column A, Line 6.) ............................. TOTAL $ _____ _ FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC