HomeMy WebLinkAboutForm 410 - Police Association PAC Amend 01-25-22Statement of Organization
Recipient Committee
Statement Type In Initial
Amendment ILJ Termination —See
(� Not yet qualified
or
0 Date qualification threshold met Date qualification threshold met Date of termination
JA\N 31 219-22
TY CLERK'S OFFI
For Official Use Only
/ / 1 01 / 01 /_.L9 8 3 / /
1. Committee Information I.D. Number 2. Treasurer and Other Principal Officers
(if applicable) 831553
NAME OF COMMITTEE NAME OF TREASURER
San Rafael Police Association Political Action Committee Cynthia Morgan
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael CA 94901 (
FULL MAILING ADDRESS (IF DIFFERENT)
San Rafael, CA 94915-1557
E-MAIL ADDRESS (REQUIRED) / FAX {OPTIONAL)
COUNTY OF DOMICILE
Marin County, CA
JURISDICTION WHERE COMMITTEE IS ACTIVE
San Rafael
CA
94901
(
NAME OF ASSISTANT TREASURER, IF ANY
Stacy E. Owens
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
Oakland
CA
94607
(
NAME OF PRINCIPAL OFFICER(S)
Lynn E. Murphy,_Vice President
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
San Rafael CA 94901 (
3. Verification
I have used all reasonable diligence in preparing this
PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
ON REVERSE
I CALIFI&RIA
FORM 410
Page 2 of 4
COMMITTEE NAME
I.D. NUMBER
831553
San Rafael Police Association Political Action Committee
2a. Additional Officers I Assistant Treasurers
NAME
NAME
Carl A. Huber, President
MAILING ADDRESS
MAILING ADDRESS
_
CITY STATE ZIP CODE
AREA CODE/PHONE
CITY
STATE
ZIP CODE AREA CODEIPHONE
San Rafael CA 94901
(
NAME
NAME
MAILING ADDRESS
MAILING ADDRESS
CITY STATE ZIP CODE
AREA CODE/PHONE
CITY
STATE
ZIP CODE AREA CODE/PHONE
NAME
NAME
MAILING ADDRESS
MAILING ADDRESS
C17Y STATE ZIP CODE
AREACODEPHONE
CI -Y
STATE
ZIP CODE AREA CODE/PHONE
NAME
NAME
MAILING ADDRESS
MAILING ADDRESS
CITY STATE ZIP CODE
AREA CODE/PHONE
CITY
STATE
ZIP CODE AREA CODE/PHONE
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
San Rafael Police Association Political Action Committee
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Union Bank
ADDRESS
AREA CODE/PHONE
(
CITY
BANK ACCOUNT NUMBER
STATE ZIP CODE
San Rafael CA 94901
4. iy0e dWC0ittee Complete the applicable seasons. -mr
I.D. NUMBER
-aory 3 of 4
831553
• List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and
district number, if any, and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable.
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
(INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURES) FULLTITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
T OPPOSE
OFPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
San Rafael Police Association Political Action Committee
4. Type
(Continued)
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑x CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Page 4 of 4
I.D. NUMBER
To make political contributions to support and oppose candidates and issues of interest to the San Rafael Police Association..
SponsoredList additional sponsors on an attachment.
NAME OF SPONSOR
San Rafael Police Association
STREET ADDRESS NO. AND STREET
Union
CITY
San Rafael
GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE ANNA LUVWVeVMC
CA 94901 (
Small Contributor Committee
Date qualified
5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met:
This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in the future;
• This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations;
• This committee has no surplus funds; and
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519.
-- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov