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HomeMy WebLinkAboutForm 410 - Kate Colin for San Rafael Mayor 2020; Termination (State)Statement of Organization Recipient Committee Statement Type I0 Initial Amendment 10 Termination -See Part ® Not yet qualified or ® Date qualification threshold met I Date qualification threshold met ®/��/ 01 _( 21 1 2020 1. Committee Information B.D. Number (if applicable) 1423740 NAME OF COMMITTEE Kate Colin for San Rafael Mayor 2020 STREET ADDRESS (NO P.O. BOX) 20 Galli Drive STE A CITY STATE ZIP CODE AREA CODE/PHONE Novato CA 94949-5731 (415)884-5500 FULL MAILING ADDRESS (IF DIFFERENT) PO Box 150817 San Rafael, CA94915-0817, CA 94949-5731 E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) katecolinsanrafael@gmail.com;nwarren@wepacca.com / (415)884-5501 COUNTY OF DOMICILE I JURISDICTION WHERE COMMITTEE 15 ACTIVE Marin County San Rafael Attach additional information on appropriately labeled continuation sheets. I have used all reasonable diligence in preparing this statement d -i penalty of perjury unde the Ows of the State of California t t e f Q � �4107�' Executed on By DAT Executed on By AT Date of termination 12 / 3-,/ 2022 Date Stamp .CEIVED AND Fol. c, office of the Secretary of of the State of California JAN 17 2023 %w oOtte(Uie aff t5 JAN 31 2023]1 2. Treasurer and Other Principal Office 1e 1 1 yLL^Ilei I V Vf 1 lull- NAME VL NAME OF TREASURER Kate Colin STREET ADDRESS (NO P.O. BOX) 20 Galli Drive STE A CITY STATE ZIP CODE AREA CODE/PHONE Novato CA 94949-5731 (415)205-3119 NAME OF ASSISTANT TREASURER, IF ANY Nancy L Warren STREET ADDRESS (NO P.O. BOX) 20 Galli Drive STE A CITY STATE ZIP CODE AREA CODE/PHONE Novato CA 94949 (415)884-5500 NAME OF PRINCIPAL OFFICER($) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIPCODE AREA CODE/PHONE best of my knowledge the information contained herein is true and complete. i certify under �g is true V_�eorct. ASSISTANTTREASVRER Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE nef%tle.com 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 Recipient Committee INSTRUCTIONS ON REVERSE Page 2 of 3 COMMITTEE NAME I.D. NUMBER Kate Colin for San Rafael Mayor 2020 1 1423740 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BANK ACCOUNT NUMBER Bank of San Francisco (415)744-6700 704022944 ADDRESS CITY STATE ZIP CODE 575 Market Street #900 San Francisco CA 94105 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. s 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 CHECK ONE Kate Colin Mayor San Rafael 2020 Nonpartisan X Partisan (list political party below) Nonpartisan Partisan (list political party below) Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(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) CHECK ONE T T OPPOSE OPPOSE 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 Kate Colin for San Rafael Mayor 2020 4. Type (Continued) General• 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 STREET ADDRESS NO. AND STREET CITY GROUP OR AFFILIATION OF SPONSOR Page 3 of 3 I.D. NUMBER STATE ZIP CODE AREA CODE/PHONE Smoli Contributor Date qualified 5. 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