HomeMy WebLinkAboutForm 460 - Maika Llorens Gulati for City Council 2020 (2021-06-30)Recipient Committee t m COVER PAGE
Campaign StatementInp
• 1
Cover Page :411JE
SEE INSTRUCTtONS ON REVERSE
Statement covers period
from 01/01/2021
through 06/30/2021
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
m Qfiiceholder, Candidate Controlled Committee
El Primarily Formed Ballot Measure
V State Candidate Election Committee
O Recall
ommittee
Controlled
(Also Complete Part 5)
(((��� Sponsored
(Also Completo Pad 6)
❑gneral Purpose Committee
Sponsored
❑ Primarily Formed Candidate/
Small Contributor Committee
Officeholder Committee
Political Party/Central Committee
(Also Complete Pad 7)
3. Committee Information
I.D. NUMBER
1425910
Maila Llorens Gulati for San Rafael City Council District 12020
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
San Rafael CA 94901
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
Date of election if
(Month, Day,
AUG -2 2021 � -f5
I
Fir Official Use Only
11/03/2020 I ITY CLERK'S OFFICE
I
2. Type of Statement:
❑ Preelection Statement ❑ quarterly Statement
® Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Maila Llorens Galati
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
San Rafael CA 94901
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREACODEIPHONE
OPTIONAL: FAX/E-MAIL ADDRESS
I have used all reasonable diligence in preparing and reviewing this statement and to
attached schedules is true and complete. I
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Mailca Llorens Gulati
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE)
City Council Member City of San Rafael District 1
RESIDENTIAL/BUSINESS ADDRESS (NO.ANDSTREET) CITY STATE ZIP
San Rafael CA 94901
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.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
COMMITTEE NAME
I.D. NUMBER
NAME OF TREASURERI CONTROLLED COMMITTEE?
❑ YES ❑ NO
REET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
COVER PAGE - PART 2
Page 2 of 5
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION
❑ SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OR HELD
DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee Listnames of
officeholder(s) or candidate(s) for which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CAND.DATE
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 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement Amounts may be rounded
to whole dollars.
Summary Page
Statement covers period
from 01/01/2021
1Y11818LT3AW e[TW
Expenditures Made
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16
6. Payments Made................................................................
Schedule e, Line 4
06/30/2021
Page 3 of 5
SEE INSTRUCTIONS ON REVERSE
0.00
8. SUBTOTAL CASH PAYMENTS .......................................
Add Lines 6+7
through
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line 3
NAME OF FILER
10. Nonmonetary Adjustment.........................................................
Schedule C, Line 3
0.00
11. TOTAL EXPENDITURES MADE....................................Add
�.D. NUMBER
Mailca Ilorens Gulati for San Rafael City Council
District 12020
1425910
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTAL THIS PERIOD
CALENDAR YEAR
Running in Both the State Primary
(FROMATTACHED SCHEDULES)
TOTAL TO DATE
and
General Elections
1. Monetary Contributions...................................................
Schedule A, Line 3
$ 0.00
S 3339.87
0.00
0.00
1/1 through 6/30 7/1 to Date
2. Loans Received................................................................
Schedule B, Line 3
0.00
3339.87
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines I+2
$
$
Received $ $
4. Nonmonetary Contributions ............................................
Schedule C, Line 3
0.00
0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED................................Add
Lines 3+4
S 0.00
$ 3339.87
Made $ $
Expenditures Made
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16
6. Payments Made................................................................
Schedule e, Line 4
$ 0.00
7. Loans Made.......................................................................
Schedule H. Line 3
0.00
8. SUBTOTAL CASH PAYMENTS .......................................
Add Lines 6+7
$ 0.00
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line 3
0
10. Nonmonetary Adjustment.........................................................
Schedule C, Line 3
0.00
11. TOTAL EXPENDITURES MADE....................................Add
Lines 8+9+10
$ 0.00
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16
$ 239.70
13. Cash Receipts........................................................... Column A, Line 3 above
0.00
14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4
0.00
15. Cash Payments......................................................... Column A, Line a above
0.00
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15
$ 239.70
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $ 0_00
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ See instructions on reverse $ 0_00
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0_00
S 3174.47
0.00
$ 3174.47
0
0.00
$ 3,174.47
To calculate Column B,
add amounts in Column
Ato 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*
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A Amounts may be rounded SCHEDULE A
Monetary Contributions Received to whole dollars.
Statement covers period
CALIFORNIA ,
from 01/01/2021FORM'
through 06/30/2021
Page 4 of 5
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Maika Llorens Gulati for San Rafael City Council District 12020
1425910
FULL NAME, STREET ADDRESS AND ZIP CODE OF
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
RECEIVED
CONTRIBUTOR
CODE
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDARYEAR
TO DATE
(IF COMMITTEE,ALSO ENTER I.D. NUMBER)
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL $ 0
Schedule A Summary
1. 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 contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)
0.00
0.00
........TOTAL $ 0_00
'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 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule E Amounts may be rounded
Payments Made to whole dollars.
Statement covers period
from 01/01/2021
SCHEDULE E
SEE INSTRUCTIONS ON REVERSE through 06/30/2021 Page 5 of 5
NAME OF FILER I.D. NUMBER
Mailca Llorens Gulati for San Rafael City Council District 12020 1425910
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphemalia/misc.
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 filing/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
IND
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
WEB
information technology costs (Internet, e-mail)
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.)....................................................................................................
2. Unitemized payments made this period of under $100.................................................................................................................................
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)....................................................................
$ 0.00
$ 0.00
$ 0.00
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ 0.00
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov