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Home My WebLink AboutForm 460 - Andrew McCullough for City Council 2015 (2016-06-30)Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from ____ 1_1_1/_1_6 __ _ 6/30/16 through ________ _ 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. III Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also CompMI. PIWf 51 o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee 3. Committee Information o Primarily Formed Ballot Measure Committee o Controlled o Sponsored (Also Comptet. PIWf 51 o Primarily Formed Candidate/ Officeholder Committee (Also Compte" PIWf 7) NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) McCullough for City Council 2015 STREET ADDRESS (NO P.O. BOX) CITY San Rafael STATE CA ZIP CODE 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE OPTIONAL: FAX I E-MAil ADDRESS 4. Verification AREA CODElPHONE AREA CODElPHONE Date of election If ap"'I~~;tt~rp: (Month, Day, CLERK'S OFFICE 2. Type of Statement: o Preelection Statement I;zI Semi-annual Statement o Termination Statement (Also file a Form 410 Termination) o Amendment (Explain below) Treasurer(s) NAME OF TREASURER Andrew McCullough MAILING ADDRESS CITY San Rafael NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAl: FAX I E-MAil ADDRESS o Quarterly Statement o Special Odd-Year Report STATE ZIP CODE AREA CODElPHONE CA 94901 STATE ZIP CODE AREA CODElPHONE I have used all reasonable diligence in preparing and reviewing this statement and to the best my knowledge the information contained herein and in the attached schedules is true and complete . certify under penalty of pe~ury under the laws of the State of California that the foregoing is e and correct. Executed on 8/1/16 Date Executed on 8/1/16 Date Executed on Date Executed on Date By------~S~ig~na~tu=~~O~fc~o=n~t~illli~~~O~ffi .. ,c~eh=O~ld=e~~C~a=n~ .. ·d~at~e,~S~ta~te~M~e~as~u=~~P=ro~~~n~t--------- By----------~~~~~~~~~~~~~~~~n=~~----------Signature of Controlling Officeholder, Candidate . State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 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 IF APPLICABLE) 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? DYES D NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? DYES D NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE -PART 2 --"III!!!III!II!I!!RIIIJII 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION D SUPPORT D 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 List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD D SUPPORT D 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 Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER McCullough for City Council 2015 Contributions Received 1. Monetary Contributions ................................................... Schedule A, Une 3 2. Loans Received ................................................................ Schedule B, Une 3 $ 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Unes 1 + 2 $ 4. Nonmonetary Contributions............................................ Schedule C, Une 3 5. TOTAL CONTRI BUTIONS RECEIVED .................................... Add Unes 3 + 4 $ Expenditures Made 6. Payments Made................................................................ Schedule E, Une 4 $ 7. Loans Made....................................................................... Schedule H, Une 3 8. SUBTOTAL CASH PAyMENTS .......................................... Add Unes 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F. Une 3 10. Nonmonetary Adjustment... ...................................................... Schedule C, Une 3 11. TOTAL EXPENDITURES MADE. ....................................... Add Unes 8 + 9 + 10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Une 16 $ 13. Cash Receipts ........................................................... Column A. Une 3 above 14. Miscellaneous Increases to Cash .................................. Schedule I, Une4 15. Cash Payments ......................................................... Column A, Une 8 above 16. ENDING CASH BALANCE .................. Add Unes 12 + 13 + 14, then subtract Une 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEiVED ................................ ScheduleB, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Une 2 + Une 9 in Column B above $ Amounts may be rounded to whole dollars. ColumnA TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) o o o o o 2550 o 2550 o o 2550 5552.84 o o 2550 3002.84 o o o SUMMARY PAGE Statement covers period 1/1/16 from _________ _ CALIFORNIA 460 FORM 3 5 6/30/16 through ________ _ Page ___ of __ _ $ $ $ $ $ $ Column 8 CALENDAR YEAR TOTAL TO DATE o o o o o 2550 o 2550 o o 2550 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). 1.0. NUMBER 1339798 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 Received $ _____ _ $----- 21. Expenditures Made $ _____ _ $----- Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" (If Subject to Voluntary Expenditure Limit) Date of Election (mmldd/yy) ----1----1 __ Total to Date $----- $----- "Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3712) www.fppc.ca.gov Schedule D (Continuation Sheet) Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees NAME OF FILER McCullough for City Council 2015 DATE 4/29/16 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE Committee to Support San Rafael Libraries- Yes on Measure D liZ! Support o Oppose o Support o Oppose o Support o Oppose o Support o Oppose Amounts may be rounded to whole dollars. TYPE OF PAYMENT DESCRIPTION (IF REQUIRED) ~ Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure 0 Monetary Contribution 0 Nonmonetary Contribution 0 Independent Expenditure SUBTOTAL $ Statement covers period from ___ 1,;,;,1....;,1;",./1;",:6 __ _ through __ ..=;6/~3...:.0;",./1~6~_ SCHEDULE D (CONT.) CALIFORNIA 460 FORM Page __ 4_ of __ 5_ I.D. NUMBER 1339798 AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) 2500 2500 2500 2500 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER McCullough for City Council 2015 Amounts may be rounded to whole dollars. Statement covers period from ___ 1_1_1/_1_6 __ _ through __ 6_/_3_0/_1_6 __ SCHEDULE E CALIFORNIA 460 FORM Page _5 __ of_5 __ 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 CNS CTB CVC FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)· civic donations candidate filing/ballot fees fund raising events independent expenditure supporting/opposing others (explain)· legal defense campaign literature and mailings NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER 1.0. NUMBER) MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads CODE OR RAD radio airtime and production costs RFD retumed contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel,lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponso r VOT voter registration WEB information technology costs (internet, e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID Committee to Support San Rafael Libraries-Yes on Measure D Campaign contribution 1000 4th Street, Ste. 600 2500 San Rafael, CA 94901 FPPC# 1383895 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2500 Schedule E Summary 2500 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _ 50 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ _ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................. $ _____ _ 2550 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ _____ _ FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3172) www.fppc.ca.gov