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Home My WebLink AboutForm 460 - Gary Phillips for Mayor 2011 (2011-10-22)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink, Date Stamp Statement covers period Date of election if applicable: from 9-25-11 (Month, Day, Year) through 10-22-11 1. Type of Recipient Committee: All committees — Complete Parts 1, 2.3, and 4, Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Pad 6) ❑ General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate) Q Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER . ,.,, 1— S NAME IF NO COMMITTEE) Gary Phillips for Mayor 2011 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) NO, AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEWHONE OPTIONAL: FAX ! E-MAIL ADDRESS 2. Type of Statement: t.; ® Preelection Statement ❑ Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE Page 1 of 16 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Richard Kalish MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CiTY STATE ZIP CODE AREA CODElPtiONE OPTIONAL: FAX' E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and co7ad�—'c Executed on October -4, 2011 By •'r"'j� Date S tureof asureror Assista,°rt Treasurer October 011 Executed or, By Date Signa, tC . trctnq Of etv rrd te. State Measr;re Proponent or Resporsi6te Otfiter of Sponsor Executed on By DaE Signature ofGontrntrng Order, Candidate, State Measure F: 000 -em Executed on By DateSigna.u-raofGontraKngcYfii<eirr�;,Carrite, StageMeasu,�P,-o,+recS FPPC Form 460 (JanuarylOrS) FPPC Toll -Free Helpfine: 866/ASK-FPPC (8661276-3772) State of California Recipient Committee Campaign Statement Cover Page -- Part 2 S. Officeholder or Candidate Controlled Committee Type or print in ink. 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 San Rafael, CA 94903 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. I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO ADDRESS STREET ADDRESS (NO P.O. BOX) CiTY STATE ZIP CODE AREA CODEIPHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVERPAGE-PART2 Page 2 of 16 BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Liatnames of offrceholderlsj or candidates) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (January106) FPPC Toll -Free Helpline: 666tASK-FPPC (86612764772) State of California Campaign Disclosure Statement Type or print In ink. SUMMARYPAGE Summary Page Amounts may be rounded to whole dears. II Statement covers period I 1 1 I' OR , 601 ? - from 9-25-11 , through 10-22-11 Page 3 of 16 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2011 1339680 Contributions Received ColumnA Column B Calendar Year Summary for Candidates TOTALTHISPER100 (FROMATTACHED SCHEDULES) CALENDARYEAR TOT&TO GATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A, Line $ 16236 $ 50455 0 15,000 111 through 6130 711 to Date 2. Loans Received...................................................... schedule s, Lina 3 3. SUBTOTALCASH CONTRIBUTIONS .............. ........... Add Lines f + 2 $ 16236 $ 6 455 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... scheauleGwe3 4249 6901 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 +4 $ 20485 $ 72356 Made $ $ Expenditures Made 6. Payments Made ........................... 7. Loans Made ................................. 8. SUBTOTALCASH PAYMENTS .... 9. Accrued Expenses (Unpaid Bilis) 10. Nonmonetary Adjustment ........... 11. TOTAL EXPENDITURES MADE... ....................... I... Schedule E, Line 4 $ ..................... Schedule H, Line 3 Add Lines 6 + 7 $ ............................... Schedule F Line 3 ............................ Schedule C. Line 3 ...... ....... ............... 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. Miscellaneous Increases to Cash ........................... schedule 1, Line 4 15. Cash Payments .................................................. Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B. Parte $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add L'ne 2 +Line 9 in Column B above $ 15945 $ 0 15945 $ 0 4249 20197 $ 15948 49216 0 49216 0 6901 56117 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made` Or subject to Voluntary Expenditure Limit) Date of Election Total to Date (mmfdd/yy) $ $ Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A Type or print in ink, SCHEDULE A Amounts may be rounded 1 --_ Moneta Contributions Received Statement covers period Monetary to whale dollars. O , from 9/25/11 � . i . page 4 of 16 SEE INSTRUCTIONS ON REVERSE through 10/22/11 NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2011 1339680 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER {IF SELF-EMPLOYED. ENTER NAME RECEIVED THIS PERIOD CALENDAR YEAR TO DATE (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) ®IND 9/26/11 Albert t3oro ❑COM Mayor 100 100 ICA 0Pn of San Rafael San Rafael, 94901 City ❑ SCC ®IND 9/26/11❑OTH Michael Craford ❑COM Owner 100 100 ( CBenefits San Rafael, CA 94901 []PTY Coonsulnsul ting F1 SCC ®IND 9/26!11 Carl Huber [3Com Officer 100 100 on []OTti San Rafael Police Dept � e a uma, CA 94955 F1 PTY ❑SCC Foreman & Brasso ❑ IND ❑COM 9126/ 11®OTH 100 100 4J San Francisco, CA 94133 ❑ PTY ❑ SCC Ghilotti Bros G'IND ❑COM j 9/26/11 ®OTH 499 749 (1 San atae), C 94901 ❑ PTY ❑ scc SUBTOTAL$ 899 i Schedule A Summary Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ........................................................................................$ ................ 2. Amount received this period — unitemized monetary contributions of less than $100 ........................:.... $ 3. Total monetary cos .tributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ 14,699 1,537 16,236 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCG — Small Cor".butor Committee FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. SCHEDULE A (CONT) Amounts may be rounded Statement covers period ORNIA to whole dollars. , CALIF from 9/25/11 FORM 460 through 10/22/11 Page 5 of 16 NAME OF FILER - I.D. NUMBER Gary Phillips for Mayor 2011 1339680 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMM[TTFE, ALSO ENTER I.D.NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS : CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Golden Restoration and Construction, Inc. ❑IND EICOM T 9/26/11 W] OTH 100 100 Novato, CA 94949 El PTY Ej SCC 9/26/11 Heidi Kuhn IND r—ZICOM Executive Director DOTH Mines to Vines I00 100 San Rafael,=CA94,901 D PTY El SCC 9/26/11 Joe Ayoob IND EIOCOM Retired UOTH 100 350 SanEl Rafael, CA 94903 PTY [I SCC Marge Bartolini OIND MCOM Retired 9/26/11 DOTH 150 400 Novato, CA 9494" [1 PTY 0 sCC 9/26/11 William McDevitt, Jr F�IND ICOM President D OTH McDevitt Construction 100 100 Petalumn, IM4 D PTY *Contributor Codes IND—individual COM—Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee SUBTOTAL$ 550 FPPC Form 460 (January/05) FPPC Tell -Free Helptine: 8661ASK-FPPC (8661276-3772) Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded ma—tement-covem period CALIFORNIA to whole dollars. 9125/11 FORM 460 from 10/22/11 6 16 through Page of NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2011 1 339680 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.O. NUMBER) CODE (IF SELF -EMPLOYEE), ENTER NAME PERIOD (JAN, 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) VC 9/26/11 Leo Isotalo E]COM Retired 100 100 E] OTH San Rafael, 'W01 El PTY MSCC Randy Coleman ®IND 000M Retired 100 100 9/26/11 EOTH SFart TRNT5317, L-AV4901 El PTY ❑ SCC Jerry Tallman ZIND ®COM Printer 150 150 9127/11 []OTH Minuteman Press San Rafael, CA 9490 1 [] PTY I ❑SCC Jordan Leland VIND EICOM Retired 100 100 9/28/11 [:] OTH El PTY FJSCC Charles G man JZINDM OCO Self employed investor 100 100 9128/11 Ej OTH an Rafael, CA 94903 [] PTY Ej SCC SUBTOTALS 550 `Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other business entity) PTY — Political Party SOO — Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statementcovers period CALIFORNIA to whole dollars. g/25111 FORM 460 from page 7 of 16 through 10/22/11 NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2011 1339680 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR T ADDRESS S ND ZI1.o. ODNUME O CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF SAENTER CODE * (IF SELF•EMPLOYEo.ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Leo Isotalo OCpM Retired 1013111 ❑ OTH ` 300 400 San a ae , 901 ❑ PTY Raymond Frost ®CND ❑COM CFO 10/3/11 ZCTM DOTH Self em to ed P Y 300 300 San TaTae r 03 ❑ PTY ❑SCC 10/5/11 Stuart Lum 0 oM Banking Edgewood Properties 100 100 DOTH San Hatael, CA 01 ❑ PTY ❑SCC Gary Mizono ®coM Physician 10!5!11 nOTH Kaiser Permanente 300 300 anClscO, 4116 ❑ PTY ❑ SCC I WIND Donald Dickey ❑CDM Retired 1016111 100 100 ❑ oTH � f afael, CA n PTY I ❑SCC I j SUBTOTALS 1,100�,� 777 '`Contributor Codes IND - Individuai COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Ccntributor Committee FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 666/ASK-FPPC (666!276-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print In ink. SCHEDULE A (CONT) Amounts may be rounded -Statement covers period townowsonars. Ifrom 9/25/11 - 16111 through 10/22/11 page 8 of 16 17NUMB NAME OF FILER E8FR Gary Phillips for Mayor 2011 1339680 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMM[TtEE, ALSOENTER 1.1). NUMWR) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TODATE RECEIVED CODE (IF SELF-EMPLOYED, ENTrRIAME I PERIOD (JAN. I - DEC. 31) (IF REQUIRED) oF BUStNESSj Tirrell Graham IZIND Elcom Retired 1016/11 nOTH 100 100 T'jFu-ro_n-CXTZ20 r] PTY F1 sce 10/7/11 Barbara Pahre WINi ®IND E)COM Retired 100 100 DOTH JJ E] PTY El SCC 10/7/11FICOM Bruce Ferry ®IND CPA 500 500 W I LINININSENOM F1 OTH DZH Phillips PTY ❑ SCC CA Real Estate PAC (#890106) DIND 10/7/11 L6 COM j1,500 1,500 '90020 DOTH El PTY SCC L 10/7/11 rShip Council PAC (#1246290) E] IND 000M _.N� Tan 'Rafael, nOTH 1,000 1,000 CA 94901 E] PTY EISCC_ SUBMTAL$ 3,200 *Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e-;;., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline; 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded statement covers period_�_ to whole dollars. ! 9/25/11 FOCALIFORNIA RM 46 from0 through 110/22/11 - P-9. of 16 NAME OFFILER LD. NUMBER Gary Phillips for Mayor 2011 1339680 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR B IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED OF COMMITTEE, ALSO ENTER I.C. NUMBER) CODE (IF SEUFEMPLOYEID, ENTER NAME PERIOD (JAN. I - DEC. 31) (IF REQUIRED) OF BUSINESS) WIND Phillip Ferris ncom Owner 10/7/11 E]OTH Oakland Packing & 100 100 ffawnmXns—eTmo, =4 7960 El PTY Supply i E]SCC Maggicira & Ghilotfi DIND E]COM 10/13/11 250 250 VICITH San Rafael, 94901 I n PTY nsco - - Gary Epperly WIND E]COM Retired 10/13/11 200 200 nOTH 903 0 Pry EjSCC Dan Dimitratos ®IND INDRetired r1cOom Retired 10/14/11 100 100 E] TH MRWOer, CA 949 F1 PTY Rich Ej SCC WIND E]COM Attorney �Seolfrernployed 250 10/15/11 250 nOTH mploye 07Valley, CA 940M [-I PTY 11 E] SCC SUBTOTAL$ goo `Contributor Codes IND - individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY- Political Party SCC - Small Contributor Committee FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print In Ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded F-S-t-atement covers period to whole dollars. CALIFORNIA 9/25/11 FORM 460 from through 10/22/11 Page 10 of 16 NAME OFFILER I.D. NUMBER Gary Phillips for Mayor 2011 11339680 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTORCONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME RECEIVED THIS PERIOD CALENDAR YEAR (JAN, I - DEC. 31) TO DATE (IF REQUIRED) Or BUSINESS) Maynard Willms VIINDM FICO Retired 10/15111 nOTH 150 1 400 San RaTael, UA 4903 ❑ PTY ❑SCC Price Automotive It, LLC nIND EICOM 10/17/11 5,000 5,000 WIDTH San -R-afael, CA 1 E] PTY E] $cc Earl Farnsworth Express []IND 10/17111 r DCOM 200 200 'an Rafael, CAMMr V)OTH Ej PTY E) SCC William McDevitt, Jr MIND EICOM President 10/18111 [70TH McDevitt Construction 300 300 Petaluma, 54 PTY ❑$cc Law Office of Perry Litchfield E]IND 10121111O I loomim E3COM 1,500 2,500 VOTH 1VRWaTa'e1,TA 94901 El PTY []SCC SUBTOTAL$ 7,150 *Contributor Codes IND -Individual COM- Recipient Committee (other than PTY or SCC) OTH - Other (e,,,., business entity) PTY - Political Party SCC - Small Contributor Committee FP PC Form 460 (January/06) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661276-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Gary Phillips for Mayor 2011 Type or print in ink. Amounts may oe rounded to whole dollars. Statement covers p from 9/25/11 through 10122/11 SCHEDULE Page 11 of 16 1339680 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR F AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE 11 OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITrEE, ALSO ENTER I.C. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. I - DEC. 31) (IF REQUIRED) OFBUSiNESS) _ ❑INDE]COM 10/22/11 Samuelson Schafer '1OTH 250 250 K-e-niffield, CA 94914 E] PTY E]SCC Daniel Hanlon W1 IND DCOM Refired 10122/11 100 100 []OTH Novato,�CA ;4947 ri PTY []SCC R IND [JCOM FIOTH E] PTY nSCG E]IND ncom nOTH n PTY nscC LJIND E]OTH El PTY EISCC SUBTOTAL$ 350 *Contributor Codes IND—individual COM— Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (January/06) FPPC Toll -Free Helplins: 866/ASK-FPPC (866!276-3772) Schedule B — Part 1 Loans Received Type or print in ink. SCHEDULES-PART1 Amounts may be rounded Statement covers period CALIFORNIA to whole dollars.9_25_11 g , from • ( 10-22-11 12 16 through SEE INSTRUCTIONS ON REVERSE Page of NAME OF FILER I I.D. NUMBER Gary Phillips for Mayor 2011 1339680 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING: AMOUNT Icl AMOUNT PAID OUTSTANDING el INTEREST r ORIGINAL g► CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN ggLgNCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS Or COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER NAMEOF BUSINESS) BEGINNING THIS PERIOD , THIS PERIOD PERIOD_ PERIOD LOAN TO DATE _ ❑PAID CALENDAR YEAR Gary Phillips Certified Public Acct. $ 0 15,000 0 15,000 % $ 15,000 18 Eida Drive I DZH Phillips $ % $ ❑ FORGIVEN PERELECTION" San Rafael, CA 94903 999 Fifth Ave, #320 RATE San Rafael, CA 94901 E 15,000 $ 0 i $ 0 $ 0 6/30/11 E DATE DUE DATE INCURRED t® IND [ICOM ❑ OTH El PTY ❑ SCC ❑ PAID 1 CALENDAR YEAR iC]FORGIVEN RATE PER ELECTION *' 1 E E $ E I E t❑ IND F1COM f-.]OTH F1PTY ❑ SCC DATE DUE DATE INCURRED � ❑ PAID CALENDAR YEAR $ E % I $ $ j L'1 FORGIVEN 1 t RATE PER ELECTION"" E E E $ i$ DATEDUE t❑ IND El COM ❑ OTH ❑ PTY F1 SCC DATE INCURRED SUBTOTALS $ $ $ $ Schedule B Summary (tmer te} on Schedde E, Line 3) 1. Loans received this period......................................................................................................... .......... $ 0 (Total Column (b) plus unitemized loans of less than $100.) tcontributor Codes IND— Individual 2. Loans paid or forgiven this period......................................................................................................... $ 0 COM—Recipient Committee (Total Column (c) plus loans under $100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH — Other (e.g., business entity) PTY — Political Party 0 SCC—Small Contributor Committee 3. Net change this period. (Subtract Line 2 from Line i.) ....................................................... NET $ ;May beareQalivenu>nbef, Enter the net here and on the Summary Page, Column A, Line 2. "Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. FPPC Fort 460 (January106) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/2784772) Schedule C Type or print in ink. SCHEDULE C amounts may be rounded _ statement coverspenoarvvnmoneta ryGontriputionsReceived to whole dollars. • from 9-25-11 FORM i! I through 10-22-11 Page 13 of 16 SEE INSTRUCTIONS ON REVERSE - -- NAME OF FILER ------- - --- - -- — -- - - I.D. NUMBER Gary Phillips for Mayor 2011 1339680 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF ANINDIVIDUAL,ENTER OCCUPATION AND EMPLOYER AMOUNT/ DESCRIPTION OF FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR CODE * (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SEtFE SUSINr ENTER BUSINESS) GOODS OR SERVICES ! VALUE CALENDAR YEAR (JAN 1 -DEC 31) (IF REQUIRED) OF NAME Of 9-26-11 []IND 11 Davide 0� Restaurant use 2188 2188 San Ra O N and related ae , CA 94901 services OSCC t0 4-11 Marin Resources E]IND i Campaign Signs 1740 5637 San Rafael, 01 E]PT ❑ SCC Cal -Pox, Inc. Communications 9-26-11 co Services 142 , 642 i San �j OTH a ❑PTY ❑SCC Forest Investment Group, Inc. []IND Printing 10-21-11 []COM 150 150 Novato, CA 914TI" FIPTY EISCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 4220 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)..................................................................................................................... $ 2. Amount received this period — unitemized nonmonetary contributions of less than $100 .................................... $ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10) ...................... TOTAL $ 4220 29 4249 *Contributor Codes IND -individual COM - Recipient Committee (other than PTY or SCC) OTH - Other (e.g., business entity) PTY - Political Party SCC - Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (5661275-3772) Schedule E Type or print in Ink. Statement covers perio I meets Made e . ~ Pa Amounts may be rounded CALIF Y to whole dollars. ; 9-25-11 • from through 10-22-11 FP -19-1 14 of 16 SEE INSTRUCTIONS ON REVERSE g NAME OF FILER 1.D. NUMBER Gary Phillips for Mayor 2011 1339680 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MOR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PEr petition circulating TEL f.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POI- polling and survey research TRS staff/spouse travel, lodging, and meals IMD independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTERI.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT j AMOUNTPAID Barbara S uires SAL 960 reenbrae, CA 94904 Tom Oblitz Food for event 234 n afael, CA 4915 SC Desi LIT � 1863 anta Rosa, CA 95401 * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3057 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .......................... ............................................ $ 15708 2. Unitemized payments made this period of under $100 ..................................... ..... $ 237 3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column (e).) ............................................... $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) _ ..... _ .... ....... _ ..... TOTAL $ 15945 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 86WASK-FPPC (8661275-3772) Schedule E (Continuation Sheet) Payments Made Type or print In Ink. Amounts may be rounded to whole dollars. Statement covers period from 9-25-11 through SEE INSTRUCTIONS ON REVERSE NAME OF FILER Gary Phillips for Mayor 2011 10-22-11 SCHEDULE E (CONT.) FORM 4 60 15 16 Page Of - I.D. NUMBER 1339680 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVIP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CT13 contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meats FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meats W Independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads UVEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Kreativz WEB 2100 Larl(SPUT, L;1 David Ha don FND 1100 n Rafael, CA 94901 Big Cat Advertising Campaign materials, brochures and Photography, CNS campaign literature, flowers 3518 Novato, CA 94949 Ad-Vantgage Marketing, Inc. I I I 119111101111111ft LIT 5779 I'Fralro=saA 95401 Mountain View Vintners FND 154 Nova o, 948 *Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 12651 FPPC Form 460 (Januarylos) FPPC Toll -Free Helpline: 8681ASK-FPPC (8661275-3772) Schedule G Type or print in ink. Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) towholedoilars. Statement covers p from 9-25-11 through 10-22-11 {Pa16 of 16 SEE INSTRUCTIONS ON REVERSE I Page NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2011 1339680 NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphernalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate ffling/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals ND independent expenditure supportfnglopposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration fIT campaign literature and mailings PRT print ads WEB information technology costs (Internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Stuart Lirette ovato, CA 94949 CODE OR DESCRIPTION OF PAYMENT LIT Photography AMOUNT PAID 1223 750 Attach additional information on appropriately labeled continuation sheets. TOTAL` $ 1973 * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Form 460 (January/o5) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)