HomeMy WebLinkAboutForm 460 - Andrew McCullough for City Council 2015 (2015-06-30)Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers periodI Date of election if applicable
from
1/1/2015 (Month, Day, Year)
through
6/30/2015
November 3, 2015
Recelyb
JUL 1 & 2015
Time:
City Clerk's oliice
COVER PAGE
Page 1 of-.. 6
For Official Use Only
1.
Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4.
® Officeholder, Candidate Controlled Committee _] Ballot Measure Committee
Q State Candidate Election Committee Q Primarily Formed
Q Recall Q ControlledTermination
(Also Complete Part 5) 0 Sponsored
(Also Complete rParted
❑ General Purpose Committee
Q Sponsored ❑ Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
Q Political Party/Central Committee (Also Complete Part 7)
2. Type of Statement:
® Preelection Statement
❑ Semi-annual Statement
❑ Statement
❑ Amendment (Explain below)
❑ Quarterly Statement
❑ Special Odd -Year Report
E] Supplemental Preelection
Statement - Attach Form 495
3.
Committee Information
I.D. NUMBER
1339798
Treasurer(s)
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
NAME OF TREASURER
McCullough for City Council 2015
Jeffrey Schoppert
MAILING ADDRESS
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
Andrew McCullough
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
MAILING ADDRESS
CITY STATE
ZIP CODE AREA CODE/PHONE
CITY STATE
ZIP CODE AREA CODE/PHONE
San Rafael CA
94901
OPTIONAL: FAX / E-MAIL ADDRESS
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 infor a on contained herein and in the
a ached schedules is true and complete. I
certify under penalty of perjury under the laws of the State of California that the foregoing is and rrect.
July (6 2015
Executed on
By
Date
Julyi(,,12015
Signature fTreasureror s tantTreasun.r
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 Me2sure Proponent
Executed on Date
By
der, Candidate, State Measure Proponent
Signature of Controlling Officeholder,
C Form 460 June/01
t )
FPPC Toll -Free Helpline: 866/ASK-FPPC
State of California
Type or print in ink.
COVER PAGE - PART 2
Recipient Committee
Campaign Statement
RNIA
CALIF
• 1
FORM�
Cover Page — Part 2
2 6
Page of
5. Officeholder or Candidate Controlled Committee
6. Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF BALLOT MEASURE
Andrew McCullough
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
BALLOT NO. OR LETTER
JURISDICTION
❑ SUPPORT
❑ OPPOSE
San Rafael City Councilmember
RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Identify the controlling officeholder, candidate,
or state measure proponent, if any.
San Rafael, CA, 94901
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
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
OFFICE SOUGHT OR HELD
DISTRICT NO. IF ANY
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME
I.D. NUMBER
7. Primarily Formed Committee List names of officeholder(s) or candidate(s) for
NAME OF TREASURER
CONTROLLED COMMITTEE?
which this committee is primarily formed.
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO PO. BOX)
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
COMMITTEENAME
ID NUMBER
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF TREASURER
CONTROLLED COMMITTEE?
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
SUPPORT
E] YES F-1NO❑
❑ OPPOSE
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 8661ASK-FPPC
State of California
Campaign Disclosure Statement
To calculate Column B, add
Type or print in ink.
0
SUMMARY PAGE
Summary Page
Amounts may be rounded
to dollars.
report. Some amounts in
Column A may be negative
Statement covers period
-
� NIA
figures that should be
subtracted from previous
whole
period amounts. If this is
the first report being filed
0
460 � '
any).
1/1/2015
•'
from
through
6/30/2015
page 3 of 6
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
McCullough for City Council 2015
1339798
Contributions Received
Column A
Column B
Calendar Year Summary for Candidates
To D
(FROM ATTACHED SCHEDULES)
TOTALTODATE
Running In Both the State Prima and
g Primary
General Elections
1. Monetary Contributions ...........................................
Schedule A, Line 3
$ 0 $
0
O
0
1/1 through 6/30 7/1 to Date
2. Loans Received......................................................
Schedule e, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 +2
$ 00 $
0
20. Contributions
Received $ $
4. Nonmonetary Contributions ....................................
Schedule C, Line 3
0
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ...........................
Add Lines 3 + 4
$ 0 $
0
Made $ - $
Expenditures Made
6. Payments Made .....................................
7. Loans Made ...........................................
8. SUBTOTAL CASH PAYMENTS ..............
9. Accrued Expenses (Unpaid Bills) .........
10. Nonmonetary Adjustment .....................
11. TOTAL EXPENDITURES MADE .............
............ Schedule E, Line 4 $
............ Schedule H, Line 3
................ Add Lines 6 + 7 $
................ Schedule F, Line 3
............... Schedule C, Line 3
............. Add Lines 8 + 9 + 10 $
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $
13. Cash Receipts ................................................... Column A, Line 3 above
14. Miscellaneous Increases to Cash ........................... schedule 1, Line 4
15. Cash Payments .................................................. Column A, Line a above
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $
if this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ........................................ See instructions on reverse $
19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $
2,907.60 $
0
2,907.60 $
750.00
0
3,657.60 $
2,907.60
0
2,907.60
750.00
0
3,657.60
10,346.12
To calculate Column B, add
0
amounts in Column A to the
corresponding amounts
from Column B of your last
0
2,907.60
report. Some amounts in
Column A may be negative
7,438.52
figures that should be
subtracted from previous
period amounts. If this is
the first report being filed
0
for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
750.00
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)
��_.. $
$
*Since January 1, 2001. Amounts in this section may be
different from amounts reported in Column B.
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
Schedule E Type or print in ink. Statement covers period
Payments Made Amounts may be rounded
y to whole dollars. from 1/1/2015
........_.
SEE INSTRUCTIONS ON REVERSE
through 6/30/2015 Page 4 of 6
NAME OF FILER I.D. NUMBER
McCullough for City Council 2015 1339798
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
FET
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
PMCohen Public Affairs
P.O. Box 150268
CNS
$2,000.00
San Rafael, CA 94915-0268
PMCohen Public Affairs
P.O. Box 150268 OFC $172.00
San Rafael, CA 94915-0268
four waters media, inc.
3093 Lassen St. LIT $235.60
West Sacramento, CA 95691
" Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2,407.60
Schedule E Summary
1. Payments made this period of $100 or more. Include all Schedule E subtotals. 2,907.60
2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 0
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)............................................................................... $ 0
4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 2,907.60
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
Schedule E Type or print in ink.
(Continuation Sheet) Amounts may be rounded
Payments Made to whole dollars.
Statement covers period
from .. 1/1/2015
SCHEDULE E (CONT.)
SEE INSTRUCTIONS ON REVERSE through 6/30/2015 Page 5 of 6
NAME OF FILER I.D. NUMBER
McCullough for City Council 2015 1339798
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CNP
campaign paraphernalialmisc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
NTfG
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
UT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 500.00
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
SCHEDULE F
Schedule F Type or print in ink.
Amounts may be rounded Statement covers period CALIFORNIA• '
Accrued Expenses (Unpaid Bills) to whole dollars. from 1/1/2015 • -
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
McCullough for City Council 2015
through 6/30/2015
Page 6 of 6
I.D. NUMBER
1339798
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
FIND
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)
* Payments that are contributions or independent expenditures must also be SUBTOTALS $
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.)......
0 $ 3,657.60 $ 2,907.60 $ 750.00
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.) ...
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.)..................................................................................................
................. INCURRED TOTALS $
............................ PAID TOTALS $
3,657.60
2,907.60
750.00
NET $ May be a negative number
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
a
b
c
d
NAME AND ADDRESS OF CREDITOR
CODE OR
OUTSTANDING
AMOUNT INCURRED
AMOUNT PAID
OUTSTANDING
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
DESCRIPTION OF PAYMENT
BALANCE BEGINNING
THIS PERIOD
THIS PERIOD
BALANCE AT CLOSE
OF THIS PERIOD
!ALSO REPORT ON E)
OF THIS PERIOD
PMCohen Public Affairs
P.O. Box 150268
CNS
0
2,672.00
2,172.00
500.00
San Rafael, CA 94915-0268
four waters media, inc.
3093 Lassen St.
CNS
0
985.60
735.60
250.00
West Sacramento, CA 95691
* Payments that are contributions or independent expenditures must also be SUBTOTALS $
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.)......
0 $ 3,657.60 $ 2,907.60 $ 750.00
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.) ...
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.)..................................................................................................
................. INCURRED TOTALS $
............................ PAID TOTALS $
3,657.60
2,907.60
750.00
NET $ May be a negative number
FPPC Form 460 (June/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC