HomeMy WebLinkAboutForm 465 - Police Association PAC (2011-09-24) Supporting Andrew McCulloughSupplemental Independent
Expenditure Report
(Government Code Section 84203.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded to
whole dollars.
❑ Amendment (Explain Below)
I.D. NUMBER (If recipient committee)
1. Committee/Filer Information 831553
San Rafael Police Association Political Action Committee
STREET ADDRESS (NO P.O. BOX)
1520 Fifth Avenue
CITY STATE ZIP CODE AREACODE/PHONE
San Rafael CA, 94901 (415) 485-3000
OPTIONAL: FAX/ E-MAIL ADDRESS
2. Flame of Candidate or Measure Supported or Opposed
Report covers period
from 0110112011
through 0912412011
Date of election If applicable:
(Month, Day, Year)
1110812011
Treasurer (If recipient committee)
NAME OF TREASURER
Mr. Scott Ingels
MAILING ADDRESS
1520 Fifth Avenue
SUPPLEMENTAL INDEPENDENT EXPENDITURE
Page 1 of___2
For Official Use Onlv
CITY STATE ZIP CODE AREACODE/PHONE
San Rafael CA, 94901 (415) 485-3000
OPTIONAL: FAX/E-MAIL ADDRESS
CHECK ONE
NAME OF CANDIDATE
Andrew McCullough
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
-1
(JAN. 1 DE 1
Freeman Public Affairs, Inc.
3,745.42
Mailer including production and postage
09/1212011
1405 Marcelina Avenue, Suite 111
in support of Andrew McCullough for Sa
PP g
8,894.09
Rafael City Council
Torrance, CA 90501
U.S. Postmaster
1,833.33
Postage for mailer in support of Andre
MEMO
09/1212011
1433 Marcelina Avenue
McCullough for San Rafael City Council
Subpayment made
through:
Freeman Public
Iffairs,
Torrance, CA 90501
Inc.
Freeman Public Affairs, Inc.
4,148.67
Mailer including production and postage
09/1212011
1405 Marcelina Avenue, Suite 111
in support of Andrew McCullough for San
8,894.09
Rafael City Council
Torrance, CA 90501
FPPC Form 465
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Supplemental Independent Type or print in ink.
NAME AND ADDRESS OF PAYEE
Expenditure Report Amounts may be rounded
p p
Report covers period
to whole dollars.
fro01/01/2011
m_
SEE INSTRUCTIONS ON REVERSE
through 09/24/2011
For use by an officeholder, candidate, or committee making independent expenditures totaling $500 or
Date of election if applicable:
more in a calendar year to support or oppose a single candidate or a single measure. This form must
be filed at the same times and places as the campaign statements flied by the candidate supported or
(Month, Day, Year)
opposed or by a committee primarily formed to support or oppose the measure. A separate form must
through:
be filed for each candidate or measure being supported or opposed. This form is filed in addition to
11/08/2011
any other required campaign statements.
Freeman Public
Inc.
IV Independent Expenditures Made Attach additional information on appropriately labeled continuation sheets.
Page 2 of--!-
For
f 3Far Official Use Only
CUMULATIVE TO DATE
CALENDAR VCAD
DATE
NAME AND ADDRESS OF PAYEE
UtSC:KIP I JUN Uh EXPENUI I UKE
AMOUNT
(JAN. 1 - DEC31)
09/12/2011
U.S. Postmaster
Postage for mailer in support of Andrew
2,100.00
1433 Marceline. Avenue
McCullough for San Rafael City Council
MEMO
Subpayment made
through:
Torrance, CA 90501
Freeman Public
Inc.
kffairs,
09/12/2011
Freeman Public Affairs, Inc.
Phone calls in support of Andrew
1,000.00
8,894.09
1405 Marceline. Avenue, Suite 111
McCullough for San Rafael City Council
Torrance, CA 90501
Supplemental Independent
Expenditure Report
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
San Rafael Police Association Political Action Committee
Type or print in ink. SUPPLEMENTAL INDEPENDENT EXPENDITURE
Amounts may be rounded Report covers period 1111111111111 CALIFORNIA A
to whole dollars.
01/01/2011 FORM
from -v65
through 09/24/2011 Page 3 -fi_
4. Summary
1. Total independent expenditures of $100 or more made this period. (Part 3.) ..... ........ ............................................. .............................. $
2. Total independent expenditures under $100 made this period. (Not itemized.) ...................... ....................... ............. ................ ... $
3. Total independent expenditures made this period (Add Lines 1 + 2.) . ........... ........... ..................................... ..... _ ................... TOTAL $
831553
8,894.09
0.00
8,894.09
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 Rafael City Clerk
ADDRESS (NO, AND STREET) ADDRESS (NO, AND STREET)
1400 5th Avenue
CITY STATE ZIP CODE
San Rafael, CA 94901
2) NAME OF FILING OFFICER
ADDRESS
(NO. AND STREET)
CITY STATE ZIP CODE
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 knowledge he information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the foregoing is true and corrVt. I
Executed on By
DATE
Executed on
DATE
Executed on
DATE
Executed on
DATE
FILER, TREASURER OR ASSISTANT TREASURER
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR
By
A:
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CAND0ATE, STATE MEASURE PROPONENT
FPPC Form 465
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
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