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Home My WebLink AboutForm 460 - Maika Llorens Gulati for City Council 2020 (12-31-23)COVER PAGE Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 01/06/2023 through 12/31/2023 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. m Officeholder, Candidate Controlled Committee O State Candidate Election Committee O Recall (Also Complete Pert 5) ❑ General Purpose Committee 8 Sponsored Q Small Contributor Committee O Political Party/Central Committee 3. Committee Information ❑ Primarily Formed Ballot Measure Committee 8Controlled Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER Maika Llorens Gulati for San Rafael City Council District 12020 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 CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX / E-MAILADDRESS I at a • . .- Date of election f LLLbl&T 5 2024 Page 1 of 5 (Month, Day ear For Official Use Or 11/03/2020 1 CITY 9LERK'S OFFICE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement m Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) El Amendment (Explain below) Treasurer(s) NAME OF TREASURER Maika Llorens Gulati MAILINGADDRESS CITY STATE ZIP CODE AREACODEIPHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILINGADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best Offic:ai ['I By Signature of Controlling Officeholder, Candidate, Stale Measure Proponent By Signature of Controlling Officeholder, Candidate, Stale 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 IFAPPLICABLE) City Council Member City of San Rafael District 1 RESIDENTIALJBUSINESSADDRESS (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 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER 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 List names 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 07/01/2023 SUMMARY PAGE 12/31/2023 Page 3 of 5 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Maika Llorens Gulati for San Rafael City Council District 12020 1425910 Column 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 0.00 0.00 2. Loans Received................................................................ Schedule B, Line 3 0.00 0 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ $ Received $ $ 0.00 0.00 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 0.00 0 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED...............................Add Lines 3+4 $ $ 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 6+9+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 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 gin Column B above $ 0_00 $ 50 0.00 $ 50 0 0.00 $ 50 To calculate Column B, add amounts in Column A to 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) IJ $ *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 wnoie aouars. Statement covers period CALIFORNIA 460 from 07/01/2023 - through 12/31/2023 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, STREETADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR 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. 0.00 (Include all Schedule A subtotals.).........................................................................................................$ — 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 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 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 0.00 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Maika Llorens Gulati for San Rafael City Council District 12020 Amounts may be rounded to whole dollars. CODES: If one of the following codes accurately describes the payment, you may enter the code CMP campaign paraphernalia/misc. MBR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)* OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads Statement covers period from 07/01/2023 through 12/31/2023 Otherwise, describe the payment. SCHEDULE Page 5 of 5 I.D. NUMBER 1425910 RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration 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.......................................................................................................................................... $ 0.00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 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