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Home My WebLink AboutForm 460 - Maika Llorens Gulati for City Council 2020 (2022-06-30)Recipient Committee Campaign Statement Cover Page Statement covers period from 01/01/2022 SEE INSTRUCTIONS ON REVERSE I through 06/30/2022 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. m eceholder, Candidate Controlled Committee ElPrimarily Formed Ballot Measure V State Candidate Election Committee ommittee O Recall Contro4led (Also Complete Ped S) (((�� Sponsored (Also Complete Pert 6) ❑ Purpose Committee gneral Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political Party/Central Committee (Also Complete Pert 7) 3. Committee Information I.D. NUMBER Maika 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 AREACODEIPHONE OPTIONAL: FAX IE -MAIL ADDRESS E[� COVER PAGE WEI M 2 in— Date of election if applica A i� t of 5 (Month, Day, Year)ill r r 4 2822 1 1 L__,,fFtf Official Use Only 11/03/2020 1JITY CLERK'S OFFICE 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 Maika Llorens Gulati MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE 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 Executed on 06/30/2022 Data Executed on 06/30/2022 Date Executed on Date By By By Ignstwa of CarardFlng D me der. Candidaea. 5!818 Measure Proponent Executed on By Dere Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwwJppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Maika Llorens Gulati OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member City of San Rafael District 1 RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) 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) C.TY STATE ZIPCOAE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) COVER PAGE - PART 2 Page 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTERI JURISDICTION I ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee 1lstnamesof officeholde4sj at candidate(s) 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 CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets ifnecessary 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 SUMMARY PAGE Summa Pae to whole dollars. Statement covers period 9 . ry g 01/01/2022 S- a 1 from Expenditures Made 12. Beginning Cash Balance ........................ . Previous Summary Page, Line 16 6. Payments Made................................................................ through 06/30/2022 Page 3 of 5 SEE INSTRUCTIONS ON REVERSE 0.00 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 9 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 I.D. NUMBER Maika Llorens Gulati for San Rafael City Council District 12020 1425910 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDARYEAR Running in Both the State Primary (FROM ATTACHED SCHEDULES) TOTAL TO DATE and General Elections 1. Monetary Contributions................................................... Schedule A, Linea $ 0.00 $ 0 0.00 0.00 1/1 through 6/30 7/1 to Date 2. Loans Received........................................................... schedule B, Line 3 0.00 0 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ................................Add Lines 3+4 $ 0.00 $ 0 Made $ $ Expenditures Made 12. Beginning Cash Balance ........................ . Previous Summary Page, Line 16 6. Payments Made................................................................ schedule E, Line 4 $ 50 7. Loans Made....................................................................... schedule H, Line 3 0.00 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 50 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 6+9+10 $ 50 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 I, Line 4 0.00 15. Cash Payments........................................................ Column A, Line 6 above 0.00 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 189.70 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 $ 50 0.00 $ 50 0 0.00 $ 50 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" (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 io wnoie sonars. Statement covers period X610 , WA from 01/01/2022 • ' through 06/30/2022 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 CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDARYEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER 10. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ IND ❑ COM ❑ OTH ❑ PTY Cl 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 Amount received this period — itemized monetary contributions. 0.00 (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.)...... . $ 00_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 TOTAL $ 0.00 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 from 01/01/2022 SEE INSTRUCTIONS ON REVERSE through 06/30/2022 page 5 of 5 NAME OF FILER I.D. NUMBER Maika 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 CMP campaign paraphemalia/misc. MBR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)* OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads Otherwise, describe the payment. RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT FIL Filing fee AMOUNT PAID Secretary of State, Sacramento, CA 95814 50.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 50.00 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),) ............... 50.00 $ 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 $ 50.00 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov