HomeMy WebLinkAboutForm 460 - Andrew McCullough for City Council 2015 (2015-12-31)Recipient Committee COVER PAGEFtia
Campaign Statement D
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 9/20/15
through
12/31/15
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
O State Candidate Election Committee Committee
O Recall O Controlled
(Also Complete Part 5) O Sponsored
(Also Complete Parr 5)
❑ General Purpose Committee
O Sponsored ❑ Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee
O Political Party/Central Committee (Also Complete Part 7)
3. Committee Information
NAME IF NO
McCullough for City Council 2015
I.D. NUMBER
1339798
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael Ca 94901
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAILADDRESS
Date of election if applicable
(Month, Day, Year)
11/3/15
2. Type of Statement:
F E 8 -1 2016
CITY 4ERKSTrICE
❑
Preelection Statement
Semi-annual Statement
❑
Termination Statement
61
(Also file a Form 410 Termination)
❑
Amendment (Explain below)
1 of 3
Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
Treasurer(s)
NAME OF TREASURER
Andrew McCullough
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 CODEIPHONE
OPTIONAL: FAX/ E-MAILADDRESS
andrew—mccullough@yahoo.com
4. Verification
have used all reasonable diligence in preparing and reviewing this statement and to the be of my knowledge the information contained herein and in the attached schedules is true and complete.
certify under penalty of perjury under the laws of the State of California that the foregoing iue and correct.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
-------I— -- ----
2/1/16
01
Zy
Executed on
61
Y'4 /V
Date
Si nature of Tr — — —
g urer orAssistant Treasurer
Executed on
By
Dale
Signature of Controlling Officeholder, Candidate, Stale Measure Proponent or Responsible Officer of Sponsor
Executed on
By
Date
Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on
g y
Date
Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
-------I— -- ----
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Andrew McCullough
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE)
San Rafael City Councilmember
RESIDENTIAUBUSINESS ADDRESS (NO.AND STREET) 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.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
(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
COVER PAGE - PART 2
Page 2
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
of 3
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 Listnamesof
officeholder(s) or candidates) 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
Summa Pae to whole dollars. Statement covers period from Im g 9/20/150 • -
Expenditures Made
6. Payments Made................................................................
through
12/31/15
Page 3 of 3
SEE INSTRUCTIONS ON REVERSE
0
8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7 $
0
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line 3
0
NAME OF FILER
Schedule C, Line 3
0
11. TOTAL EXPENDITURES MADE ........................................
Add Lines 8 + 9 + 10 $
I.D. NUMBER
Andrew McCullough
1339798
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTALTHIS PERIOD
CALENDAR YEAR
Running in Both the State Primary
(FROM ATTACHED SCHEDULES)
TOTAL TO DATE
and
General Elections
0
0
1. Monetary Contributions...................................................
Schedule A, Line 3
$ $
0
0
1l1 through 6130 7/1 to Date
2. Loans Received................................................................
Schedule B, Line 3
0
0
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2
$ $
Received $ $
0
0
4. Nonmonetary Contributions ............................................
Schedule C, Line 3
21. Expenditures
0
0
Made $ $
5. TOTAL CONTRIBUTIONS RECEIVED....................................Add
Lines 3+4
$ $
Expenditures Made
6. Payments Made................................................................
Schedule E, Line 4 $
0
7. Loans Made.......................................................................
Schedule H. Line 3
0
8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7 $
0
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line 3
0
10. Nonmonetary Adjustment.........................................................
Schedule C, Line 3
0
11. TOTAL EXPENDITURES MADE ........................................
Add Lines 8 + 9 + 10 $
0
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 ►, Line 4
15. Cash Payments......................................................... Column A, Line 8 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 $
552.84
0
0-
0
552.84
0
0
0
$ 4,793.28
0
$ 4,793.28
0
I
$ 4,793.28
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)•
IExpenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made"
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
1 1 $
J $
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