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HomeMy WebLinkAboutForm 460 - Andrew McCullough for City Council 2015 (2016-12-31)Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from _____ 7_/1_'_16 __ _ 12/31/16 through ________ _ 1. Type of Recipient Committee: All Committees-Complete Parts 1, 2, 3, and 4. 3. I!ll Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Abo Complel. Petl SJ o General Purpose Committee o Sponsored o Small Contributor Committee o Political Party/Central Committee McCullough for City Council 2015 STREET ADDRESS (NO P.O. BOX) CITY San Rafael STATE CA o Primarily Formed Ballot Measure Committee o Controlled o Sponsored (A"" C<lmpkl. Petl6) o Primarily Formed Candidatel Officeholder Committee (Abo Complol. Petl7) AREA CODEIPHONE ZIP CODE 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification Date of election if ap (Month, Day, Year) 2. Type of Statement: o Preelection Statement ~ Semi-annual Statement o Termination Statement DateSlamp JAN 3 0 20 17 CLERK'S OFFI E o Quarterly Statement o Special Odd-Year Report (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 STATE ZIP CODE CA 94901 STATE ZIP CODE AREA CODE/PHONE AREA CODE/PHONE I have used all reasonable diligence in preparing and reviewing this statement and to the best of 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 Ihe foregoing is e nd correct. ,?£,t:~ Executed on 1/29/17 Date Executed on Date Executed on Dale Executed on Dale By By By By Signature of Treasurer or Assistant Treasurer Signature of ConlrcUlng Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Signa lure of Controlling Officeholder, Candidate, Stale Measure Proponent Signaturo of Controlling Officeholder, Candidate, State Measure Proponenl 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 STREED CITY STATE ZIP San Rafael CA 94901 Related Committees Not Included in this Statement: Listanycommlttees 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. COMMITIEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITIEE? DYES ONO COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITIEE NAME 1.0. NUMBER NAME OF TREASURER CONTROLLED COMMITIEE? DYES o NO COMMITIEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE -PART 2 .... ~"" 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETIER JURISDICTION o SUPPORT o 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 offlceholder(s) or candidate(s) for which thIs committee ;s prlmarffy formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD o SUPPORT o 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 Andrew McCullough Contributions Received 1. Monetary Contributions ................................................... Schedule A, Line 3 2. Loans Rece ived ................................................................ Schedule B, Line 3 $ 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ 4. Nonmonetary Contributions............................................ Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $ Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 S 7. Loans Made ....................................................................... Schedule H, Line 3 8. SUBTOTAL CASH PAyMENTS .......................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F. Line 3 10. Nonmonetary AdjustmenL ...................................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE. ....................................... Add Lines 8 + 9 + 10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Lme 16 $ 13 . Cash Receipts ................................................. .... ...... Column A, Lme 3 above 14. Miscellaneous Increases to Cash .................................. Schedule I, Line 4 15. Cash Payments ......................................................... Column A, Line 8 above 16 . ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtracl Line 15 S If this is a termination statement, Une 16 must be zero . 17. LOAN GUARANTEES RECEiVED ................................ ScheduleB. Part 2 S Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See inslructlons on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ Amounts may be rounded to whole dollars. ColumnA TOTAl THIS PERIOD (FROM ATIACHEO SCHEDULES) o o o o a 50 a o o o 50 3002.84 a o 50 2952.84 a o o SUMMARY PAGE Statement covers period CALIFORNIA 460 FORM from ____ 7_'_1'_1_6 __ _ h h 12'31/16 t roug ___________ _ Page __ 3 __ of __ 4_ $ $ $ $ $ s Column B CALENDAR YEAR TOTAL TO DATE o o o a o 2600 a 2600 o o 2600 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 previou's 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" (II Subject 10 Voluntary Expenditure limit) Date of Election (mm/dd/yy) Total to Date $_---- $----- "Amounts in th is section may be different from amounts reported in Column B. FPPC Form 460 (Jan/20I6) FPPC Advice: advice@fppc.ca,gov (866/275-3772) www.fppc.cil.gov SCHEDULE E Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period from __ ---.:..7.:..../1:.:./~16=__ __ CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE through __ 1..::;2--,/3--,1--,/1--,6~_ Page_4 __ of _4 __ NAME OF FILER I.D. NUMBER Andrew McCullough 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 cos Is 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 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 COMMtnEE. ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAlD Secretary of State FIL 50 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS 50 Schedule E Summary 50 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _ o 2. Un itemized payments made this period of under $1 00 .................................................................................................................. " ...................... $ _____ _ o 3. Total interest paid this period on loans. (Enter amount from Schedule B. Part 1. Column (e}.} ............................................................................. $ _____ _ 50 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 (Jao/2016) FPPC Advice: advice@fppc.ca.gov (866/27S-3772) www.fppc.ca.gov