HomeMy WebLinkAboutForm 465 - Police Association PAC (2011-10-22) Opposing Greg BrockbankSupplemental Independent
Expenditure Report
(Government Code Section 84203.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded to
whole dollars.
n Amendment (Explain Below)
1, D, NUMBER (if recipient committee)
1. Committee/Filer Information 831553
COMMITTEE/FILER'S NAME
San Rafael Police Association Political Action Committee
STREET ADDRESS (NO PO. BOX)
1520 Fifth Avenue
CITY STATE ZIP CODE AREACODF/PH7E
San Rafael CA, 94901 (415) 485-3000
OPTIONAL: FAX/ E-MAIL ADDRESS
2. Name of Candidate or Measure Surmorted or Opposed
Report covers period
from 01/01/2011
through 10/22/2011
Date of election if applicable:
(Month, Day, Year)
— 118/2011
Treasurer (if recipient committee)
NAME OF TREASURER
Mr. Scott Tngels
MAILING ADDRESS
1520 Fifth Avenue
SUPPLEMENTAL INDEPENDENT EXPENDITURE
Date Stamp IIIIIM �_.
Page 1 of ---.E
For Official Use Only
CITY STATE ZIP CODE AREACODE/PHONE
San Rafae-i CA, 94901 (415) 485-3000
OPTIONAL FAX/ E-MAIL ADDRESS
CHECK ONE
NAME OF CANDIDATE
Greg Brockbank
OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE
Mayor City of San Rafael, CA
SUPPORT
OPPOSE
X
NAME OF BALLOT MEASURE
BALLOT NOILETTER
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.
6,473.00
Mailer including production and postage
10/191/20-1-1140;
Marcelina Avenue, Suite 111
in opposition to Greg Brockbank for San
Rafael. Mayor
6,473.00
Torrance, CA 90501
U.S. Postmaster
3'1 0.00
Postage for mailer in opposition to
MEMO
101/19/2011
1433 Marcel"na Avenue
Greg Brockbank for San Rafae-, Mayor
Suhpa*,-,ent made
Freeman Fuhli'c
through:
lffas'rs'
Torrance, CA 90501
inc.
FPPC Form 465
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Supplemental Independent Type or print in ink.
Amounts may be rounded
Expenditure Report to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
San Rafael Police Association Political Action Committee
SUPPLEMENTAL INDEPENDENT EXPENDITURE
Report covers period CALIFORNIA 465
from 01/01/2011 FORM
through 10/22/20-11 Page — 2 of 2
I.D. NUMBER (If recipient corn.)
8 3 155 S 3
4. Summary
6,473.00
1. Total independent expenditures of $100 or more made this period. (Part 3.) .......... ............ __ .............. ........ _ ............... $
2. Total independent expenditures under $100 made this period. Not itemized.) ..... .......... _ ............. ............ ....... ............... $ 0.00
3. Total independent expenditures made this period (Add Lines 1 + 2.) .................. ......... ............ ____ ......... _ .... __ .............. TOTAL $ 6,473 .00
5. Filing Officers Enter the name and address of each filing officer with whom the filer's most recent campaign statements (Form 450, 460 or 461) have been filed.
1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER
San Ra�ael Citv Clerk
ADDRESS (NO. AND STREET)
1400 St, Avenue
CITY STATE ZIP CODE
San Pa- I ae 1, CA 94901
2) NAME OF FILING OFFICER
ADDRESS (NO. AND STREET)
STATE ZIP CODE
ADDRESS (NO, AND STREET)
CITY STATE ZIP CODE
4) NAME OF FILING OFFICER
ADDRESS (NO. AND STREET)
CITY STATE ZIP CODE
6. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my
penalty of perjury under the laws of the State of California that the foregoing is true and correct.
the information contained herein is true and complete. I certify under
Executed on
By
4 WLI ' I
DATE
SIGN/TURE OF fflLR`, 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
SIC -NATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
Executed on
By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. STATE MEASURE PROPONENT
FPPC Form 465
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)