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Home My WebLink AboutForm 460 - Maika Llorens Gulati for City Council 2020 (12-31-22)Recipient Committee Campaign Statement Cover Page Statement covers period from 07/01/2022 SEE INSTRUCTIONS ON REVERSE through 12/31/2022 1. Type of Recipient Committee: All Committees— Complete Parts 1, 2, 3, and 4. meTceholder, Candidate Controlled Committee ElPrimarily Formed Ballot Measure State Candidate Election Committee ommittee O Recall Controlled (Also ComplapPod ii) (((�� Sponsored (Also Complete Pad 6) ❑ eneral Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political Partylcentral Committee (Also Complete Part 7) 3. Committee Information I I.D; NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF Maika 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 COVER PAGE Date of election if applicable: LI LJ ELI —agE of 5 (Month, Day, Year) I I For Offt i 2 Use Only 11/03/2020 CITY CLERK'S FFICE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement m Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Maika Llorens Gulati MAILING ADDRESS CITY STATE ZIP CODE AREACODErRRONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILINGADDRESS CITY STATE ZIP CODE AREACODEIPHONE OPTIONAL: FAX/E-MAIL ADDRESS I have used all reasonable diligence in preparing and reviewing this statement and to the best Proponent Executed on By Date 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 Maika Llorens Gulati OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) 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 I.D. NUMBER NAME OF TREASURER ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? [-]YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (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 OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee t.ist names of oillcehotder(s) or candidaie(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 Summary Page Amounts may be rounded to whole dollars. Statement covers period from 07/01/2022 SUMMARY PAGE Expenditures Made 6. Payments Made................................................................ schedule E, Line 4 $ 12/31/2022 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 I.D. NUMBER Maika Ilorens Gulati for San Rafael City Council District 12020 1425910 A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDARYEAR Running in Both the State Primary and (FROM ATTACHED SCHEDULES) TOTAL TO DATE General Elections 1. Monetary Contributions................................................... schedule A, Line 3 $ 0.00 $ 0 1/1 through 6/30 7/1 to Date ..................................... 2. Loans Received ...................... ..... schedule A Line 3 0.00 0.00 0.00 0 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1+2 $ $ Received $ $ 4. Nonmonetary Contributions ............................................ schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 0.00 $ 0 Made $ $ Expenditures Made 6. Payments Made................................................................ schedule E, Line 4 $ 0 7. Loans Made ..................... :....... schedule H, Line 3 0.00 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 0 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+g+10 $ 0 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 189.70 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 8 above 0.00 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 189.70 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................. . .. Schedule APart e $ 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 8 above $ 0;00 0.00 $ 50 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 Subjectto Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) I I $ 1 1 $ 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 sonars. Statement covers period e from • Page 4 of 5 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Maika Llorens Gulati for San Rafael City Council District 12020 1425910 FULL NAME, STREETADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDARYEAR TO DATE RECEIVED (IF COMMITTEE,ALSO ENTER I.D. NUMBER) CODE (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) W W WJPPC.ca.gov E Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period from 07/01/2022 through 12/31/2022 Page 5 of 5 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Maika Ilorens 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 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) NAMEANDADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (I F COMM ITTEE, ALSO ENTER LD NUMBER) * 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.............................................................. ......................................................................... .,. $ 0.00 3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1 Column a ...... ...... $ 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 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov