HomeMy WebLinkAboutForm 460 - Andrew McCullough for City Council 2015 (2017-06-30)Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from _____ 1_1_1/_1_7 __ _
6/30/17 ~rough ________________ __
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4.
III Officeholder. Candidate Controlled Committee o Primarily Formed Ballot Measure
Committee o State Candidate Election Committee o Recall
(Also Complete PIIIt S)
o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee
3. Committee Information
o Controlled o Sponsored
(Aiso Complete Plitt 6)
o Primarily Formed Candidate/
Officeholder Committee
(Aiso Complete Plitt 7)
IF NO COMMITIEE)
McCullough for City Council 2015
STREET AODRESS (NO P.O. BOX)
CITY
San Rafael
STATE ZIP CODE
CA 94901
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE
OPTIONAL: FAX J E-MAILAODRESS
4. Verification
AREA CODEIPHONE
AREA CODE/PHONE
JUl 3 1 2017
Date of election if applic:cjt,le:
(Month, Day, Year)
2. Type of Statement:
o Preelection Statement
Ql Semi-annual Statement
o Termination Statement
(Also file a Form 410 Termination)
o Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Andrew McCullough
MAILING ADDRESS
CITY
San Rafael
NAME OF ASSISTANT TREASURER. IF ANY
MAILING ADDRESS
CITY
OPTIONAL: FAX I E-MAIL ADDRESS
o Quarterly Statement o Special Odd-Year Report
STATE ZIP CODE
CA 94901
STATE ZIP CODE
AREA CODE/PHONE
AREA CODE/PHONE
I have used all reasonable diligence in preparing and reviewing this statement and to the best a my knowledge the information contained herein and in the attached schedules is true and complete.
certify under penalty of perjury under the laws of the State of California that the foregoing is;l( and correct. ,/"'---J
Executed on ______ 7_1""2".8,..../1_7 ____ _
Dale
Executed on 7/28/17
Dale
Executed on
Dale
Execuled on
Dale
V~ (/
By _______ ~~ __ ~~~~~~~~~~~~~~~~------Signalure of Conlrolhng OfficehOlder. Candidate . Slale Measure Proponent
By------~S~lg=n~al~ure~o~t~Co=n~lro~lh~ng~OWfft~ICe~hO~ld~.~~~Ca=n~did~a~te'.S~ta~~~M~c~Ds~ur~en.Pro~p=o~ne~nl~-----
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page -Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Andrew McCullough
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
San Rafael City Councilmember
RESIDENTIAUBUSINESS ADDRESS (NO . AND STREET) CITY STATE ZIP
San Rafael CA 94901
Related Committees Not Included in this Statement: Listanycommittees
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 1.0 . NUMBER
NAME OF TREASURER CONTROLLED COMMITIEE?
D YES o NO
COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITIEE NAME 1.0 . NUMBER
NAME OF TREASURER CONTROLLED COMMITIEE?
DYES ONO
COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE -PART 2
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETIER 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 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 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 (Jan/2016)
FPPC Advice: advice@fppc.ca,gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
S'EE INSTRUCTIONS ON REVERSE
NAME OF FILER
Andrew McCullough
Contributions Received
1. Monetary Contributions ................................................... Schedule A, Line 3
2. Loans Received ................................................................ Schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 ... 2
4. Nonmonetary Contributions............................................ Schedule C, Line 3
$
$
5 . TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3'" 4 $
Expenditures Made
6. Payments Made................................................................ Schedule E, Lme 4 $
7. Loans Made................................................. ...................... Schedule H, Line 3
8. SUBTOTAL CASH PAyMENTS .......................................... Add Lines 6'" 7 $
9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F. Line 3
10. Nonmonetary Adjustment... ...................................................... Schedule C, Line 3
11. TOTAL EXPENDITURES MAD E. ....................................... Add Lines 8'" 9'" 10 $
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $
13. Cash Receipts ........................................................... Column A, Line 3 above
14. M iscellaneous Increases to Cash .................................. Schedule I, Line 4
15. Cash Payments ......................................................... Column A, Line B above
16. ENDING CASH BAlANCE .................. Add Lines 12'" 13'" 14, then subtract Lme 15 $
If this is a tennination statement, Une 16 must be zero.
17. LOAN GUARANTEES RECEiVED ................................ Schedule B , Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ See instructions on reverse $
19. Outstand i ng Debts .............................. Add Lme 2 ... Lme 9 m Column B above $
Amounts may be rounded
to whole dollars.
ColumnA
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
o
a
a
o
o
o
o
a
o
o
o
2952
a
o
o
2952
a
o
a
SUMMARY PAGE
Statement covers period CALIFORNIA 460
FORM from ____ 1_1_1/_1_7 __ _
3 3 6/30/17 through ________ _ Page ___ of __ _
$
$
$
$
$
s
Column B
CALENDAR YEAR
TOTAL TO DATE
To calculate Column B.
add amounts in Column
o
o
o
o
o
o
a
o
o
o
o
A to the corresponding
amounts from Column B
of your last report. Some
amounts in Column A may
be negative figures Ihat
should be subtracted from
previous period amounts. If
th is is the first report being
filed for this calendar year,
only carry over the amounts
from Unes 2, 7, and 9 (if
any).
1.0. NUMBER
1339798
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
111 through 6/30 711 to Date
20. Contributions
Received $ ____ _ $-----
21. Expenditures
Made $ ____ _ $-----
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made·
(Ir Subject to Voluntary Expendltu", Umi!)
Date of Election
(mm/ddlyy)
Total to Date
$-----
$-----
-Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3172)
www.fppc.ca.gov
