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Home My WebLink AboutForm 410 - Robert Sandoval for City Council 2026Statement of Organization Recipient Committee Statement Type ® Initial ❑ Amendment Q5 Not yet qualified or Q Date qualification threshold met Date qualification threshold met _ _ I.D. Number NAME OF COMMITTEE Robert Sandoval for San Rafael City Council 2026 STREET ADDRESS (NO P.O BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 FULL MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS OF COMMITTEE (REQUIRED) / FAX (OPTIONAL) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Marin I San Rafael City Council ❑ Termination — See Part 5 Date of termination NAME OF TREASURER Linda Cieslak Sandoval Date Stamp ECEIV I r n t _ ,� 2025 A PP - 2 ^n. STREET ADDRESS (NO P.O. BOX) EMAIL ADDRESS OF TREASURER (REQUIRED) NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) EMAIL ADDRESS OF ASSISTANT TREASURER (REQUIRED) NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY San Rafael CITY CITY For Official Use Only STATE ZIP CODE CA 94901 AREA CODE/PHONE STATE ZIP CODE AREA CODE/PHONE STATE ZIP CODE EMAIL ADDRESS OF PRINCIPAL OFFICER(S) (REQUIRED) AREA CODE/PHONE Attach additional information on appropriately labeled continuation sheets. 3. Verification 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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. DigitLnda Cieslak 4/1/2025 Linda Cieslak Sandoval Datea1ly 20250401signed by19115:25-0700'andoval Executed on By DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER 4/1/2025 Robert Sandoval Digitally signed by Robert Sandoval Executed on By Date: 202504.0119:10:52-07'00' DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (October/2023) FPPC Advice: advice@fpoc.ca.eov (866/275-3772) www.fooc.ca.sov Statement of Organization CALIFORNIA Recipient Committee Ptplf „ INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Robert Sandoval for San Rafael City Council 2026 All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records. NAME OF FINANCIAL INSTITUTION AND PERSON(S) AUTHORIZED TO OBTAIN BANK RECORDS r4l ODE/PHONE BANK ACCOUNT NUMBER Bank of Marin 485-2276 12858318 ADDRESS OF FINANCIAL INSTITUTION CITY STATE ZIP CODE 1101 Fourth Street San Rafael CA 94901 • 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 NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION ... --. Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULLTITLE (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 SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (October/2023) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Nonpartisan Partisan (list political party below) Robert Sandoval Councilmember, San Rafael City Council, Dis. 3 2026 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) FULLTITLE (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 SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (October/2023) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Page 3 I.D. NUMBER General Purpose Committee 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 Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE ❑ Date qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent certify that all of the following conditions have been met: . This committee has ceased to receive contributions and make expenditures; I • 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 (October/2023) FPPC Advice: advice@fppc.ca.eov (866/275-3772) WWw.fppc.ca.RoV