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Home My WebLink AboutForm 460 - Paramedic Services PAC (2014-12-31)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print In Ink. Statement covers period Date of election If applicable: from 7/1/14 (Month, Day, Year) 12/31/14 1. 7VPe of Recipient Committee: All Cormnittees - Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee N Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall (j) Controlled (A(-QDrr;p1e(eP&4&) 0 Sponsored ❑ General Purpose Committee (Aft Con#09 Part 6) 0 Sponsored ❑ Primarily Formed Candidate/ (:) Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Con#ere Pa1f;7 3, Committee Information I I.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee for Paramedic Services STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE San Rafael CA 94903 MAILING ADDRESS (IF DIFFERENT) NO. —AND STREET OR RD, BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX / E-MAIL ADDRESS N 2. Type of Statement: 0 Preelection statement F -A Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Greg Knell MAILING ADDRESS Same COVER PAGE Page — of — For Official Use Only El Quarterly Statement F71 Special Odd -Year Report El Supplemental Preelection Statement - Attach Form 495 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASUREATI-F—AUN-V MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I 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 I---v--'---IIS true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. rr O'Iffad by PUFfiller Executed on1/12/15 IV - - Dam By Signaun of Tranur6-wKwWamTramurer Executed on Date By Signigure ckilir, Owdidate, to mmsure Proponent or 9;�—=Sae Now of spw*a Executed on Dag By W—nime ofDftd�tokW, Canddate, StWe Measue propomrj Executed on Dais By SOMags OtZontrOkV —Oft didder, CWxJd3I% Stwe Mem" Pip ri FPPC Form 460 (January/05) FPPC Toil -Frey Helpline: 8661ASK-FPPC (866/275-3772) 1tetState of California Recipient Committee ' L or print in ink. COVER Campaign F!—!9 CoverPage '� 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure CommitteeNAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASU2E OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any committees not Included In this statement that arm controlled by you or arc primarily formed to receive contributions or make expenditures on behalf of your candidacy. .M NAME OF TREASURER ADDRESS STREET CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME r ❑ YES ❑ NO "MmlI I=tAuuhtti5 STREET ADDRESS (NO P.O. BOX) --- CITY STATE ZIP CODE AREA CODE/PHONE BALLOTNO,ORLETTER JURISDICTION ® SUPPORT ® OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of offkooholder(s) or candidates) for which this committee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [I 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 (January/os) FPPC Tall -Free Helpline: 866/ASK-FPPC (866/275 3772) State of California Campaign Disclosure Statement Type or print In ink. Summary Page Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAMt Ut- MLLH Statement covers period from - through Contributions Received ColumnA Column BTOTALTHIS PERIOD CALENDARYEAR (FROM ATTACHED SCHEDULES) TOTALTODATE 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 0 $ 0 2. Loans Received ...................................................... Schedule B, Line 3 0 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines 1+ 2 $ 0 $ 0 4. Nonmonetary Contributions .................................... Schedule C. Line 3 -0 0 5. TOTAL CONTRIBUTIONS RECEIVED .............. ............ Add Lines 3 + 4 $ 00 $ 6. Payments Made ....................................................... Schedule E Line 4 $ 00 7. Loans Made ............................................................. Schedule H, Line 3 00 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 0 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 00 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + to $ 0 Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 5,341.22 13. Cash Receipts ................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... schedule 1, Line 4 0.89 15. Cash Payments .................................................. Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ X342 11 ff this is a termination statement, Line 16 must be zero, 17. LOAN GUARANTEES RECEIVED ........................... Schedule A 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 $ $ 0 0 E $ 0 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). SUMMARYPAGE Page - of I.D. NUMBER Calendar Year Summary for Candidates Running In Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions 0 00 Received $ - $ 21, Expenditures Made $ 00 $ 0 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (ItSubimto vowntary Exwwtft" 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)