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Home My WebLink AboutForm 460 - Maika Llorens Gulati for City Council 2020 (06-30-21)Recipient Committee t m COVER PAGE Campaign StatementInp • 1 Cover Page :411JE SEE INSTRUCTtONS ON REVERSE Statement covers period from 01/01/2021 through 06/30/2021 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. m Qfiiceholder, Candidate Controlled Committee El Primarily Formed Ballot Measure V State Candidate Election Committee O Recall ommittee Controlled (Also Complete Part 5) (((�� Sponsored (Also Completo Pad 6) ❑gneral Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political Party/Central Committee (Also Complete Pad 7) 3. Committee Information I.D. NUMBER 1425910 Maila Llorens Gulati for San Rafael City Council District 12020 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification Date of election if (Month, Day, AUG -2 2021 � -f5 I Fir Official Use Only 11/03/2020 I ITY CLERK'S OFFICE I 2. Type of Statement: ❑ Preelection Statement ❑ quarterly Statement ® Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Maila Llorens Galati MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODEIPHONE OPTIONAL: FAX/E-MAIL ADDRESS I have used all reasonable diligence in preparing and reviewing this statement and to attached schedules is true and complete. I By Signature of Controlling Officeholder, Candidate, State Measure Proponent By 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 Mailca Llorens Gulati OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE) City Council Member City of San Rafael District 1 RESIDENTIAL/BUSINESS ADDRESS (NO.ANDSTREET) 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 COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO REET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Listnames of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CAND.DATE 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 to whole dollars. Summary Page Statement covers period from 01/01/2021 1Y11818LT3AW e[TW Expenditures Made 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 6. Payments Made................................................................ Schedule e, Line 4 06/30/2021 Page 3 of 5 SEE INSTRUCTIONS ON REVERSE 0.00 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 through 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 NAME OF FILER 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0.00 11. TOTAL EXPENDITURES MADE....................................Add �.D. NUMBER Mailca Ilorens Gulati for San Rafael City Council District 12020 1425910 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR Running in Both the State Primary (FROMATTACHED SCHEDULES) TOTAL TO DATE and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ 0.00 S 3339.87 0.00 0.00 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule B, Line 3 0.00 3339.87 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines I+2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 S 0.00 $ 3339.87 Made $ $ Expenditures Made 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 6. Payments Made................................................................ Schedule e, Line 4 $ 0.00 7. Loans Made....................................................................... Schedule H. Line 3 0.00 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 0.00 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0.00 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 0.00 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 239.70 13. Cash Receipts........................................................... Column A, Line 3 above 0.00 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 0.00 15. Cash Payments......................................................... Column A, Line a above 0.00 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 239.70 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $ 0_00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0_00 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0_00 S 3174.47 0.00 $ 3174.47 0 0.00 $ 3,174.47 To calculate Column B, add amounts in Column Ato 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure 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 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA , from 01/01/2021FORM' through 06/30/2021 Page 4 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Maika Llorens Gulati for San Rafael City Council District 12020 1425910 FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR RECEIVED CONTRIBUTOR CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDARYEAR TO DATE (IF COMMITTEE,ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 0 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.)........................................................................................ 2. Amount received this period — unitemized monetary contributions of less than $100 .......... 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) 0.00 0.00 ........TOTAL $ 0_00 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC -• Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded Payments Made to whole dollars. Statement covers period from 01/01/2021 SCHEDULE E SEE INSTRUCTIONS ON REVERSE through 06/30/2021 Page 5 of 5 NAME OF FILER I.D. NUMBER Mailca Llorens Gulati for San Rafael City Council District 12020 1425910 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs 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 candidatelsponsor 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) " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).................................................................................................... 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).).................................................................... $ 0.00 $ 0.00 $ 0.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ 0.00 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov