HomeMy WebLinkAboutForm 410 - Kate Colin for San Rafael Mayor 2020 Amendment 2Statement of Organization
Recipient Committee
Statement Type ❑ Initial ® Amendment
Q Not yet qualified
or
Q Date qualification threshold met Date qualification threshold met
12 / 2 / 2019
1. Committee InformationI I.D. Number
(if applicable) 1423740
NAME OF COMMITTEE
KATE COLIN FOR SAN RAFAEL MAYOR 2020
STREET ADDRESS (NO P.O. BOX)
CITY STATF LIP CODE AREA CODE/PHONE
San Rafael CA 94901
FULL MAILING ADDRESS IIF DIFFERENT)
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL)
COUNTY OF DOMICILEJURISDICTION WHERE COMMITTEE IS ACTIVE
Marin City of San Rafael
Attach additional information on appropriately labeled continuation sheets.
fy;%,
11E
lTermination — See Part 5 r Official Use Only
IRD y
JAN 2 1 20
Date of termination
CITY CLERK'S OFFICE
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Richard Kalish
STREET ADDRESS (NO P.O. BOX)
CITY
San Rafael
STATE
CA
ZIP CODE
94903
AREACODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
C17Y
S1Aif
ZIP CODE
AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
Kate Colin
STREET ADDRESS (NO P.O. BOX)
CITY
San Rafael
STATE
CA
ZIP CODE
94901
AREACDDE/PHONE
3. Verification
I have used all reasonable diligence inpreparingthis ent and to the best of m knowledge the information contained herein is true and complete. I certiV un�4y��;.,:.
g y g p fy der
penalty of perjury under the laws of the State of C ifor ' at he fore oing is tru n orrect.
Executed on January2 i, 2020 By
DATE ) --
GATE
Executed on
DATE
Executed on
DATE
SIGNATURE OF CONTROLLING OFFICEIJOLDER, CANDIDATE, OR STATE MEASURE PROPONENI
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA'
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D. NUMBER
KATE COLIN FOR SAN RAFAEL MAYOR 2020 1423740
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION I AREA CODE/PHONE BANK ACCOUNT NUMBER
Bank of Marin 415-482-2265 12861671
ADDRESS CITY STATE ZIP CODE
1101 Fourth Street San Rafael CA 94901
4. Type of Committee Complete the applicable sections.
• List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and
district number, if any, and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable.
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECKONE
• Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(5) NAME OR MEA5URE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO.. CITY OR COUNTY. AS APPLICABLE)
SUPPn RT
Nonpartisan
Partisan
(list political party below)
Kate Colin
Mayor
2020
FV]
Nonpartisan
Partisan
(list political party below)
• Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(5) NAME OR MEA5URE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO.. CITY OR COUNTY. AS APPLICABLE)
FPPC Form 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SUPPn RT
OPPOSE
SUPPORTOPPOSE
FPPC Form 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME I I.D. NUMBER
KATE COLIN FOR SAN RAFAEL MAYOR 2020 1423740
4. Type of Committee (Continued)
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR
STREETADDRESS NO. AND STREET
CITY
GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE AREA CODE/PHONE
lTOUOL.q.1❑
Date qualified
S. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met.
• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in the future;
• This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations;
• This committee has no surplus funds; and
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
-- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519.
-- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov