HomeMy WebLinkAboutForm 410- Andrew McCullough for City Council 2015; TerminationStatement of Organization
Recipient Committee
Statement Type El Initial ❑ Amendment
Q Not yet qualified
or
O Date qualification threshold met Date qualification threshold met
• • I.D. Number 1339798
p Fod
® Termination — See Part 5
NOV 2 6 202
Date of termination
I it 10 ?*
CLERK'S 0_ FICE
For Official Use Only
NAME OF COMMITTEE
NAME OF TREASURER
Andrew McCullough
McCullough for City Council 2015
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
San Rafael
CA
94901
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
San Rafael CA 94901
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE
AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. i cernry unaer
penalty of perjury under the laws of the State
OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
DATE
Executed on
By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: adviceMpoc.ca.eov (8661275-3772)
www.fppc.ca.gov
Statement of Organization • - '
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
I.D. NUMBER
COMMITTEE NAME
McCullough for City Council 2015 1339798
All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Bank of Marin
ADDRESS
1101 Fourth Street
AREA CODE/PHONE BANK ACCOUNT NUMBER
415/485-2265
CITY STATE ZIP CODE
San Rafael CA 94901
Controlled Committee I
• 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.
• 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
niANA❑ n[ rANMnATF/nFFICFHnI nFR/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan
Partisan
(list political party below)
Andrew McCullough
San Rafael City Council
2015
Dem
Nonpartisan
Partisan
(list political party below)
Primarily Formed Committee 0 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
[onnir n[Tu[ n[[IrFHnI nFR'C NAMF (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPPORT
OPPOSE
SUPPORT
OPPOSE
FPPC Form 410 (August/2018)
FPPC 4dvice:-advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee Mae'
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME 4D. NUMBER
McCullough for City Council 2015 1339798
General Purpose Committee 0 Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
F DESCRIPTION OF ACTIVITY
Sponsored Committee I List additional sponsors on an attachment.
NAME OF SPONSOR
STREET ADDRESS NO. AND STREET
Small Contributor Committee
Date
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
This committee has ceased to receive contributions and make expenditures;
STATE ZIP CODE AREA CODh/PHUNh
• 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@fPDc.ca.eov (866/275-3772)
www.fppc.ca.gov
