No preview available
HomeMy WebLinkAboutForm 465 - Police Association PAC (2011-10-22) Supporting Connolly, DamonSupplemental Independent Type or print in ink. — Amounts maybe rounded to Report covers period Expenditure Report whole dollars. (Government Code Section 84203.5) 1 from 09J25/2011 SEE INSTRUCTIONS ON REVERSE I through 10/22/2011 ❑ AfTletldfTt@nt (Explain Below) g I.D. NUMBER (If recipient committee) 1. Committee/Filer Information 831553 COMMITTEE/FILER'S NAME San Rafael Police Association Political Action Committee STREET ADDRESS (NO P.O. BOX) 1520 Fifth Avenue CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA, 94901 (415) 485-3000 OPTIONAL: FAX/E-MAIL ADDRESS 2. Name of Candidate or Measure Supported or Opposed Date of election if applicable: (Month, Day, Year) 11/08/2011 SUPPLEMENTAL IN Date Stamp EXPENDITURE Page 1 of___L_ For Official Use Only Treasurer (Ifrecipientcommittee) NAME OF TREASURER Mr. Scott Ingels MAILING ADDRESS 1520 Fifth Avenue CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA, 94901 (415) 485-3000 OPTIONAL: FAX/ E-MAIL ADDRESS CHECK ONE NAME OF CANDIDATE Damon Connolly OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE City Council Member City of San Rafael, CA SUPPORT X OPPOSE NAME OF BALLOT MEASURE BALLOT NOJLETTER JURISDICTION SUPPORT OPPOSE 3. Independent Expenditures Made Attach additional information on appropriately labeled continuation sheets. CUMULATIVE TO DATE DATE NAME AND ADDRESS OF PAYEE DESCRIPTION OF EXPENDITURE AMOUNT JAN_ 1 DEC� 31 Freeman Public Affairs, Inc. 4,648.67 Mailer including production and postage 10/17/2011 1405 Marcelina Avenue, Suite Ill in support of Damon Connolly for San 13,642.76 Rafael City Council Torrance, CA 90501 U.S. Postmaster 2,100.00 Postage for mailer in support of Damon MEMO 10%17/2011 1433 Marcelina Avenue Connolly for San Rafael City Council Subpayment made through: Freeman Public Affairs, Torrance, CA 90501 Inc. FPPC Form 465 FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Supplemental Independent �p o,v�tmm� -- Amounts may uorounded Expenditure Report to whole dollars. SEE INSTRUCTIONS owREVERSE NAME OF FILER San Rafael Police Associat"on Po'.itical Aczion Committee SUPPLEMENTAL INDEPENDENT EXPENDITURE Report covers n^uCALIFORNIA 465 from 09/25/2011 FORM through 10/22/2011 Page 2 of 2 LID, NUMBER (If recipient com.) 831553 4. Summary 4,648 .67 1. Total independent expenditures of$1OOormore made this period. (Part 3j ...... ----........ ----....... --............ —......... $ 2. Total independent expenditures under $100 made this period. (Not itemized.) ---------------------------$ ».«» 3. Total independent expenditures made this period (Add Lines 1 +2j ------------------------------TOTAL $ 4'648,6' 5. Filing OfficerS Enter the name and address ofeach filing officer with whom the filer's most recent campaign statements (Form 450, 460m461)/ave been filed. 1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER San Rafael c_Jzy czsru ADDRESS (NO. AND STREET) ADDRESS (NO� AND STREET) 1400 5r' Avenue CITY STATE ZIP CODE CITY STATE ZIP CODE San maxael, na 94901 2) NAME OF FILING OFFICER ADDRESS (NO. AND STREET) 4) NAME OF FILING OFFICER ADDRESS (NO. AND STREET) STATE ZIP CODE CITY STATE ZIP CODE 6. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the bestof my knowleogetbe information contained herein is true and complete. | certify under penalty of perjury under the laws of the State of California that the foregoing is true d FPPC Form 465 Executed on By TFJ TREASURER OR ASSISTANT TREASURER Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR Executed on By DATE ~IC -"^."°,", CONTROLLING OFFICEHOLDER, ~~,=~`.,,~~~MEASURE PROPONENT Executed on By DATE SIGNAT_RE O� CONTROLLING OFFICEHOLDER, CANDIDATE. STATE MEASURE PROPONENT FPPC Form 465