HomeMy WebLinkAboutForm 460 - Maika Llorens Gulati for City Council 2024 (2024-06-30)Recipient Committee to m COVER PAGE
Campaign Statement111n
• 1
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 01/01/2024
through 06/30/2024
1. Type of Recipient Committee: All Committees – Complete Parts 1, 2, 3, and 4.
Z Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
O Recall
(Also Complete Pad 5)
General Purpose Committee
O Sponsored
O Small Contributor Committee
O Political Party/Central Committee
❑ Primarily Formed Ballot Measure
Committee
O Controlled
O Sponsored
(Also Complete Part 6)
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Pad 7)
3. Committee Information I.D. NUMBER
1468005
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Maika Llorens Gulati for San Rafael City Council District 12024
STREETADDRESS (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 CODE/PHONE
OPTIONAL: FAX/ E-MAIL ADDRESS
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/ E-MAILADDRESS
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 correct.Digitally signed by Maika rlurens
Maika Llorens Gulati Gulati
Executed on 06/30/2024 By Date: 2024 08 02 10:10:36-07'00'
Date SM Lieftnipr'["&—% TfAas.rer
06/30/2024 Gulati Date: 2024 08 02 10:11:31
Executed on By -07'00•
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, Stale Measure Proponent
Executed on By
Dale Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
......... 4— __ _
U U
AUG - 2 20 Page' Lf of 5
Date of election if applicable:
(Month, Day, Year)
I For Oficial Use only
CITY CLERK'S 0 TICE
11/05/2024
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
MAILINGADDRESS
CITY
STATE ZIP CODE AREA CODE/PHONE
San Rafael
CA 94901
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/ E-MAILADDRESS
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 correct.Digitally signed by Maika rlurens
Maika Llorens Gulati Gulati
Executed on 06/30/2024 By Date: 2024 08 02 10:10:36-07'00'
Date SM Lieftnipr'["&—% TfAas.rer
06/30/2024 Gulati Date: 2024 08 02 10:11:31
Executed on By -07'00•
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, Stale Measure Proponent
Executed on By
Dale Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
......... 4— __ _
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.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 STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME
NAME OF TREASURER
I.D. NUMBER
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/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
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee Listnamesof
officeholder(s) or 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
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
Summary Page to whole dollars.
Statement covers period
from 01/01/2024
SUMMARY PAGE
SEE INSTRUCTIONS ON REVERSE
through
06/30/2024
Page 3 of 5
NAME OF FILER
7. Loans Made ................. .......................
Schedule H, Line 3
0.00
0.00
I.D. NUMBER
Maika Llorens Gulati for San Rafael City Council District 12024
$ 0
$ 0.00
9. Accrued Expenses (Unpaid Bills) ..........................................
1468005
Contributions Received
0.00
Column A
TOTAL PERIOD
Column B
0.00
Calendar Year Summary for Candidates
11. TOTAL EXPENDITURES MADE ...................................
Add Lines 8+9+10
THIS
(FROM ATTACHED SCHEDULES)
CALENDAR YEAR
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions...................................................
Schedule A, Line 3
$ 189.70
$ 0
0.00
0.00
1/1 through 6/30 7/1 to Date
2. Loans Received................................................................
Schedule e, Line 3
189.70
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
$ 189.70
$ 0
Made $ $
Expenditures Made
6. Payments Made................................................................
Schedule E, Line 4
$ 0
$ 0.00
7. Loans Made ................. .......................
Schedule H, Line 3
0.00
0.00
8. SUBTOTAL CASH PAYMENTS .......................................
Add Lines 6+7
$ 0
$ 0.00
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line 3
0
0.00
10. Nonmonetary Adjustment.........................................................
Schedule C, Line 3
0.00
0.00
11. TOTAL EXPENDITURES MADE ...................................
Add Lines 8+9+10
$ 0
$ 0.00
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 0.00
13. Cash Receipts ... Column A, Line 3 above 189.70
14. Miscellaneous Increases to Cash .................................. Schedule I, Line 4 0.00
15. Cash Payments......................................................... Column A, Line 8 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, Parte $ 0.00 I
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
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 LO W"Ole U011arb.
Statement covers period
CALIFORNIA
'
from 01/01/2024
FORM
SEE INSTRUCTIONS ON REVERSE
through 06/30/2024
Page 4 of 5
I.D. NUMBER
NAME OF FILER
Maika Llorens Gulati for San Rafael City Council District 12024
1468005
FULL NAME, STREET ADDRESS AND ZIP CODE OF
IFAN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
DATE
CONTRIBUTOR
RECEIVED
CONTRIBUTOR
CODE
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
(IF SELF-EMPLOYED, ENTER NAME
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
❑ IND
06/30/2024
Maika Llorens Gulati for San Rafael City Council
m COM
189.70
District 12020 - Committee 1425910 (closing)
❑ OTH
San Rafael, CA 94901
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
— —
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
SUBTOTAL $ 189.70
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 contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)
189.70
.............. $
$ 0.00
TOTAL $ 189.70
'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)
......... C--- __ __..
Schedule E Amounts may be rounded to whole dollars. SCHEDULE E
from Statement covers periodFPage
� _ � ,
Payments Made 01/01/2024 • - � �
SEE INSTRUCTIONS ON REVERSE
through 06/30/2024 5 of 5
NAME OF FILER I.D. NUMBER
Maika Llorens Gulati for San Rafael City Council District 12024 1468005
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalia/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 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 ENTER ID. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
.
FIL
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.).....................................................................
2. Unitemized payments made this period of under $100..................................................................................................
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).).....................................
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)
SUBTOTAL$
............ $
0.00
$ 0.00
TOTAL $ 0
FPPC Form 460 (1an/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov