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HomeMy WebLinkAboutForm 465 - Police Association PAC (Colin)Supplemental Independent Expenditure Report (Government Code Section 84203.5) SEE INSTRUCTIONS ON REVERSE STREET ADDRESS (NO P.O. BOX) 1520 Fifth Avenue Type or print in ink. Amounts may be rounded to whole dollars. n Amendment (Explain Below) I.D. NUMBER (If recipient committee) 831553 CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 (415) 485-3000 Report covers period from 10/20/2013 through 12/31/2013 Date of election if applicable: (Month, Day, Year) 11/05/2013 Treasurer (if recipient committee) Sate Stamp CALIFORNIA FORM 46:mm) NAME OF TREASURER Ms. Beth Minka MAILING ADDRESS 1520 Fifth Avenue CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA, 94901 (415) 485-3000 OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS 2. Name of Candidate or Measure Supported or Opposed CHECK ONE NAME OF CANDIDATE OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE SUPPORT OPPOSE Kate Colin City Council Member City of San Rafael, CA X NAME OF BALLOT MEASURE BALLOT NO./LETTER JURISDICTION SUPPORT OPPOSE I MMMMOO 3. Independent Expenditures Made Attach additional information on appropriately labeled continuation sheets. CUMULATIVE TO DATE DESCRIPTION OF EXPENDITURE AMOUNT CALENDAR YEAR DATE NAME AND ADDRESS OF PAYEE (JAN. 1 - DEC. 31) --- Freeman Public Affairs, Inc. 5,870.50 Mailer including production and postage 10/25/2013 1405 Marcelina Avenue, Suite 111 in support of Kate Colin for City 10,759.50 Council. Torrance, CA 90501 u.S. Postmaster 2,900-00 Postage for mailer in support of Kate MEMO Colin for San Rafael City Council Subpayment made through: 10/25/2013 1433 Marceline Avenue Freeman Public ffairs, Inc. Torrance, CA 90501 1 FPPC Form 465 (June/09) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) SUPPLEMENTAL INDEPENDENT EXPENDITURE Type or print in ink. —gasigza Supplemental Independent Amounts may be rounded Report covers period Expenditure Report to whole dollars. from 10/20/2013 through 12/31/2013 Page 2 Of 2 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER (If recipient com.) NAME OF FILER831553 San Rafael Police Association Political Action committee ....J 4. Summary $ 5,870.50 1. Total independent expenditures of $100 or more made this period. (Part 3.) ........................................................................................... $ 0.00 2. Total independent expenditures under $100 made this period. (Not itemized.) ........................................................................................ 5,870.50 3. Total independent expenditures made this period (Add Lines I + 2.) .......................................................................................... TOTAL $ --- 5. Filing __ OfficerS Enter the name and address of each filing officer with whom the filer's most recent campaign statements (Form 450, 460 or 461) have been filed. 1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER San Rafael City Clerk ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET) 1400 5th Avenue CITY STATE ZIP CODE CITY STATE ZIP CODE San Rafael, CA 94901 2) NAME OF FILING OFFICER 4) NAME OF FILING OFFICER ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET) CITY STATE ZIP CODE CITY STATE ZIP CODE 6. Verification closed in this statement were not "made at the behest of the candidate or committee that benefitted from the expenditure(s) I certify that the "independent expenditure(s)" "disclosed Section 82031 and FPPC Regulation 18225.7. 1 have used all reasonable diligence in preparing and reviewing this as those terms are defined in Government Code corn lets. 1 certify under, penalty of perjury under the laws of the State of California that statement and to the best of my knowledge the information contained herein is true a the foregoing is true and correct. Executed on 1 22 By 0- T EA_ OR ASSISTANT TREASURER DAT9 Executed onA;,o tv By I DATEf SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR Executed on DATE Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT 0 SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENI FPPC Form 465 (June/09) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)