HomeMy WebLinkAboutForm 410 - Kate Colin for San Rafael Mayor 2024; AmendmentDocuSign Envelope ID: 2E9D437C-9053-400E-B5FB-3EOABF3E9765
Statement of Organization
Recipient Committee
Statement Type ❑ Initial ® Amendment
0 Not yet qualified
or
0 Date qualification threshold met Date qualification threshold met
01 / 11 / 2023
14- nfo Committee, trmatiain I.D. Number
(if applicable) 1457593
NAME OF COMMITTEE
Kate Colin for San Rafael Mayor 2024
❑ Termination —See
Date of terminatio
2 Tre a ure
NAME OF TREASURER
STREET ADDRESS (NO P.O. BOX)
C/
STATE ZIP CODE AREA CODE/PHONE
Oakland CA 94607 (415)
MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
sowens@seowenscompany.
OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Alameda County San Rafael
Kate Colin
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ti 'v t 2 11,
For Official Use Only
STREET ADDRESS (NO P.O. BOX)
312
STATE
ZIP CODE
AREA CODE/PHONE
Oakland
CA
94607
(415)
OF ASSISTANT TREASURER, IF ANY
Stacy Owens
STREET ADDRESS (NO P.O. BOX)
312
STATE
ZIP CODE
AREA CODE/PHONE
Oakland
CA
94607
(415)
OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY
Attach additional information on appropriately labeled continuation sheets.
STATE ZIP CODE AREA CODE/PHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the foregoing is true and correct. D0
15/2023
Executed on By
DATE
Executed on By
DATE
co"
OF CONTROLLING OFFICEHOLDER, CANDIDAI E, OR SIAIE MEASURE PKOPUNEN I
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
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DocuSign Envelope ID: 2E9D437C-9053-40DE-B5FB-3EOABF3E9765
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Kate Colin for San Rafael Mayor 2024
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Bank of San Francisco
ADDRESS
AREA CODE/PHONE
(415)744-6700
CITY
BANK ACCOUNT NUMBER
STATE ZIP CODE
345 California Street #1600 San Francisco CA 94104
4. TyOe df OCr>iCT�M06- CQmplete the applicable sections.
I.D. NUMBER
Page 2 of 3
1457593
• 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.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Kate Colin
Mayor San Rafael
2024
Nonpartisan
g
Partisan
(list political party below)
Nonpartisan
Partisan
(list political party below)
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
T OPPOSE
OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
DocuSign Envelope ID: 2E9D437C-9053-400E-B5FB-3EOABF3E9765
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Kate Colin for San Rafael Mayor 2024
Page 3 of 3
NUMBER
PurposeGeneral Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
SponsoredList additional sponsors on an attachment.
NAME OFSPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
J
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
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Date qualified
5. Termination, , Reouirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions leave 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