HomeMy WebLinkAboutForm 460- Andrew McCullough for City Council 2015 (2021-12-31)Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 7/1/21
through 12/31/21
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
Z Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
Q Recall
(Also Complete Part 5)
❑ General Purpose Committee
O Sponsored
O Small Contributor Committee
O Political Party/Central Committee
3. Committee Information
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO
McCullough for City Council 2015
❑ Primarily Formed Ballot Measure
Committee
O Controlled
O Sponsored
(Also Complete Part 6)
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
I.D. NUMBER
1339798
STREET ADDRESS (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
Ci'rV STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX/ E-MAIL ADDRESS
COVER PAGE
C
FED -1 2022 1 of 3
Date of election if appli t
(Month, Day, Year) For Official Use Only
C TY CLERK'S 0 FFIC E
2. Type of Statement:
J Preelection Statement ❑ Quarterly Statement
l� Semi-annual Statement ❑ Special Odd -Year Report
Termination Statement
(Also file a Form 410 Termination)
Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Andrew McCullough
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE%PHONE
San Rafael CA 94901
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIPCOOE AREA CODE/PHONE
OPTIONAL: FAX/ E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State sure 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 IFAPPLICABLE)
Former San Rafael City Councilmember
RESIDENTIAL/BUSINESS 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?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
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
COVER PAGE - PART 2
Page 2 of 3
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
OFFICE SOUGHT 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 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
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 7/1/21
SUMMARY PAGE
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
12/31/21
Page 3 of 3
SEE INSTRUCTIONS ON REVERSE
through
9
NAME OF FILER
I.D. NUMBER
Andrew McCullough
1339798
Contributions Received
Column A
TOTAL THIS PERIOD
Column B
Calendar Year Summary for Candidates
(FROM ATTACHED SCHEDULES)
CALENDARYEAR
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions................................................... Schedule A, Line 3
$
0
$ 0
0
0
1/1 through 6/30 7/1 to Date
2. Loans Received ................................. .. Schedule a, Line 3
0
0
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2
$
$
Received $ $
4. Nonmonetary Contributions ............................................ Schedule C, Line 3
0
0
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED ............................... Add Lines 3+4
$
0
$ 0
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made................................................................ Schedule E, Line 4
$
0
$ 0
Candidates
...........................................
7. Loans Made ........................... . Schedule H, Line 3
0
0
0
0
22. Cumulative Expenditures Made"
8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines s+7
$
$
(if Subject to Voluntary Expenditure Limit)
9. Accrued aid Expenses Un Bills ............ Schedule F, Line 3
P (Unpaid ) •••••••••••••••�••••••••••••••
0
0
Date of Election Total to Date
10. Nonmonetary Adjustment......................................................... Schedule C, Line 3
0
0
(mm/dd/yy)
11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10
$
0
$ 0
$
$
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16
$
2752.84
To calculate Column B,
13. Cash Receipts....................................................... Column A, Line 3 above
0
add amounts in Column
0
A to the corresponding
*Amounts in this section may be different from amountsamounts
14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4
from Column B
reported in Column B.
15. Cash Payments......................................................... Column A, Line 8 above
0
of your last report. Some
amounts in Column A may
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15
$
2752 84
be negative figures that
should be subtracted from
If this is a termination statement Line 16 must be zero.
previous period amounts. If
this is the first report being
17. LOAN GUARANTEES RECEIVED ................................ Schedule e, Part 2
$
0
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
Cash Equivalents and Outstanding Debts
2752.84
any).
18. Cash Equivalents ................................................ See instructions on reverse
$
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column a above
$
0
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov