The URL can be used to link to this page

Home My WebLink AboutForm 460 - Maika Llorens Gulati for City Council 2024; terminationRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 09/23/2024 through 10/04/2024 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Pad 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 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 STREET ADDRESS (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 AREA CODE/PHONE San Rafael CA 94901 OPTIONAL: FAX/E-MAIL ADDRESS COVER PAGE Date of election if ap r Page 1 of � (Month, Day, Ye '" _ 024 For Official Use Only 11/05/2024 1CLERK'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 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-MAIL ADDRESS 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 Digitally signed by certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Maika Llorens Maika Llorens Gu latl Gulati Date: 2024.10.04 Executed on By - - 10/04/2024 10:17:01-07'00' Digitally signed by m- Date Signature of Treasurer or Assistant Treasurer Ma 10/04/2024 Gulati Dateern : 2024.70.04 7 0., 7.33-07'00' Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date 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 COVER PAGE - PART 2 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 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 I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 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 Page 2 of 7 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 Listnames of 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 Summary Page 0W. - � , � � from 09/23/2024 - SEE INSTRUCTIONS ON REVERSE through 10/04/2024 Page 3 of 7 NAME OF FILER I.D. NUMBER Maika Llorens Gulati for San Rafael City Council District 12024 1468005 Contributions Received Column A TOTAL Column B Calendar Year Summary for Candidates THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ 0.00 $ 189.70 0.00 1,000.00 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule e, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ 0.00 $ 1,189.70 20. Contributions Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 0.00 $ 1,189.70 Made $ $ Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 0.00 $ 450.00 7. Loans Made....................................................................... Schedule H, Line 3 739.70 739.70 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 0 $ 0.00 9. Accrued Un Bill Expenses aid s p (Unpaid �.......................................... 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 $ 739.70 $ 1,189.70 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 739.70 To calculate Column B, 13. Cash Receipts........................................................... Column A, Line 3 above 0.00 add amounts in Column 0.00 A to the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule /, Line 4 amounts from Column B 15. Cash Payments......................................................... Column A, Line 8 above 739.70 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 0.00 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ Schedule e, Part 2 $ 0.00 filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0.00 any). 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column 8 above $ 0.00 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) I/ $ "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 Statement covers period CALIFORNIA ' from 09/23/2024 FORM SEE INSTRUCTIONS ON REVERSE through 10/04/2024 page 4 of 7 NAME OF FILER I.D. NUMBER Maika Llorens Gulati for San Rafael City Council District 12024 1468005 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR 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 ❑ COM 0.00 ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 0.00 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 $ 000 TOTAL $ 000 *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 Amounts may be rounded SCHEDULE B - PART 1 ceue — Part to whole dollars Statement covers period . Loans Received A •) from 09/23/2024 0 - SEE INSTRUCTIONS ON REVERSE through 10/04/2024 page 5 of 7 NAME OF FILER I.D. NUMBER Maika Llorens Gulati for San Rafael City Council District 12024 1468005 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER a OUTSTANDING ) AMOUNT c AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL g CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS PERIOD THIS PERIOD • CLOSE OF THIS PERIOD LOAN TO DATE NAME OF BUSINESS) PERIOD PERIOD Z PAID CALENDAR YEAR Maika Llorens Gulati Council member $ 739.70 $ 0.00 0 i $ 1,000 $ 1,000 164 Du Bois Street, San Rafael, CA 94901 RATE ❑ FORGIVEN PER ELECTION 0.00 $ 0.00 $ $ $ $ t Z IND ❑ COM ❑ OTH ❑ PTY ❑SCC DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION - RATE ❑ IND ❑ COM ❑ OTH ❑PTY ❑SCC 'El $ $ $ $ $ DATE DUE DATE INCURRED ❑ PAID CALENDARYEAR ❑ FORGIVEN PER ELECTION" RATE DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 0.00 $ 739.70 $ 0.00 $ 0 Schedule B Summary 1. Loans received this period....................................................................................................................$ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.).............................................................. NET $ Enter the net here and on the Summary Page, Column A, Line 2. 'Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. 1,000.00 739.70 0.00 (May be a negative number) (Enter (e) on Schedule E, Line 3) tContributor 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 Payments Made SEE INSTRUCTIONS ON REVERSE F FILER Maika Llorens Gulati for San Rafael City Council District 12024 Amounts may be rounded to whole dollars. covers period from 09/23/2024 through 10/04/2024 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE E Page 6 of I.D. NUMBER 1468005 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 I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * 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 0 00 0.00 ................................. $ .................... TOTAL $ 0.00 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEF Schedule F Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 09/23/2024 through 10/04/2024 Page 7 of 7 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 RAID 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) (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING AMOUNT INCURRED THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD 0.00 0.00 0.00 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ $ 0.00 $ 0.00 $ 0.00 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ...... 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.).............. INCURRED TOTALS $ PAID TOTALS $ 1 �� 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 0.00 onthe Summary Page, Column A, Line 9.)................................................................................................................................................................................... NET $ May be a negative number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov