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Home My WebLink AboutForm 460 - Firefighters' Association PAC (2013-09-21)a 0 ReclFaftlentCommiffee Campaign Statement Cover Page (Government Code Sections 84200-84216.5\i Statement covers period 7/1/2013 from W"T SEE INSTRUCTIONS ON REVERSE I 1. Type of Reciplient Committee". All Committees — Complete Parts 1,, 2� 3. and 4. Ej Officeholder, Candidate Controlled Committee E) Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (AISO Complete Part 5) 0 Sponsored (Ato Compk4te Pat 6) General Purpose Committee 0 Sponsored E] Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Nso Complete Part 7) 3. Commiffee Informafion COMMITTE (OR CANDIDATE'S NAME IF NO COMMITTEE) San Rafael Firefighters Political Awareness Committee STREET ADDRESS (NO R0. BOX) 999 5th Street Suite 350 CITY STATE ZIP CODE AREA CODE7 H O"N JE .c: Rafael CA 94901 707.975.4764 ..... - - - - - - - - - - OPTIONAL- FAX/ E -MAI L � _DD R -E S Date of election if applicable: (Month, Day, Year) November 5th, 2013 T T zt X Ak q -4 �W' f•TLI For Official Use Only R1 Preelection Statement E] Quarterly Statement E] Semi-annual Statement [:] Special Odd -Year Report E] Termination Statement E] Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 491, Ej Amendment (Explain below) I Treasurer(s) NAME OF TREASURER Jason Hatfield MAILING ADDRESS PO Box 2519 A AS ISTANT TREASURER, IF ANY NM OPTIONAL- FAX / E-MAIL ADDRESS STATE ZIP CODE AREA CODEIPHONE 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of pequry under the laws of the State of California that the foregoing is true and correct. Executed on Date By Siarefixe of Treaswer or Assista-d Treastmer Campaign Disclosure Statement Type or print in ink. SUMMARY PAGE Summairy Page Amounts may be rounded to whole dollars. Statement covers period A 7/1/2013 0 from 9/26/2013 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 Contributions Received ColumnA Column B Calendar Year Summary for Candlidates TOTALTHIS PERIOD (FKW ATTACHED SCHEDULES) CALENDARYEAR TOTALTODATE Running iin Both the State Primary and 0 0 1/1 through 6/30 7/1 to Date ® Loans Received ...................................................... Schedule 8, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 4 2 $ 4163 $ 12,650 20. Contributions 0 0 ived Rece$ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 21. Expenditures ® TOTAL CONTRIBUTIONS RECEIVEDp......................... Add Lines 3 + 4 $ 4163 $ 12�650 Made $ $ Expenditures Made MMONNUMMEM Expendliture LImi"t Summary for State 6. 1 Payments Made ....................................................... Schedule E, Line 4 $ 81092.69 $ 81362.69 Candl"dates 0 0 7. Loans Made ............................................................. Schedule H, Line 3 81092-69 81362.69 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS .................................... Add Line's 6 + 7 $ $ (if Subject to Voluntmy Expenditure Urnft) 0 0 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... Schedule Q, Line 3 0 0 (mm/dd/yy) 81092.69 81362.69 11. TOTAL EXPENDITURES MADE................................ Add Lines 8 + 9 + 10 $ $ $ Current Cash Statement I $ I *Amounts in this section may be different from amounts I reported in Column B, FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Aft b%chedule D Summary of Expenditures Support"Ing/Opposing Candidates, Measures NAME OF FILER San Rafael Firefighters Political NAME AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, ORCOMMITTEE Friends of Kate Colin for San Rafael City 21 Support [] Oppose Maribeth Bushey -Lang for San Rafael City 9/16/2013 Council F; ,4 Support 0 Oppose 0 Support 0 Oppose Type or print in Ink. Amounts may e rounded to whole dollars. CUMULATIVE TO DATE PER ELECTIO Ar AMOUNTTHIS CALENDAR YEAR TO DATE 'I FPPC Fonn 460 (January/05) Schedule D (Continuation Sheet) Summary of Expenditures Supporting/Opposing Other Candidates, NAME OF FILER .Committee Type or print in ink. DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAY MENT MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE Committee r a safer San Rafael -Yes on Monetary 8/28/2013 Measure E Contribution Nonmonetary Contribution Independent R1 Support Oppose Expenditure » Friends r San Rafael City Monetary 9/12/2013 Council 2013 Contribution Nonmonetary Contribution Independent support Oppose Expenditure Monetary Contribution Nonmonetary Contribution Independent Support 0 Oppose Expenditure Monetary Contribution T0 0 Nonmonetary Contribution Independent 0 Support 0 Oppose Expenditure } 11500 1 11770 SUBTOTAL $ 6 500 FPPC Form 460 (January/06) FPPC Toll -Free s NAME OF FILER San Rafael Firefighters Political Awareness Committet Type or pnint in ink. Amounts may be rounded to whole dollars,, Statement covers period 7/1/2013 f rom 9/:M/2013 through I.D. NUMBER 891308 NAME AND ADDRESS OF PAYEE (IF COWTTEE, AM ENTER 1. D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID 1000 4th Street, Suite 600 CTB 5t000 San Rafael, CA 94901 FPPC 1359556 PO Box 150817 CTB 11500 San Rafael CA 94915 FPPC 1357514 PO Box 150352 CTB 11500 San Rafael, CA 94915-0532 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 81000 FPPC Form 460 (January/05) FPPC Toll -Free Helpfine: 866/ASK-FPPC (866/276-3772) Schedule A Type or print in ink. SCHEDULE A Amounts may ne rounaen Monetary Contributions Received to whole dollars. Statement covers period 7/1/2013 N from • 9/2" 6/201 6 / SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (ETITE,ALSENTERI.D.NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) aIND Firefighter 9/23!20 3� CO San Rafael Fire 69 207 � ❑ 171 PTY Department ❑ SCC ✓Mr/` k /c �� •� OIND Firefighter 9/28/2013 ik ncom San Rafael Fire 69 207 ❑OTH El PTY Department �//U ❑SCC Li t/�L1 c/s�;n !3a/YacsJ 01ND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH ❑ PTY Department sy 76 ❑ SCC zl / e' �/ i�a gIND Firefighter 9/23/2013 ❑coM San Rafael Fire 69 207 ❑OTH Department ❑ PTY ❑SCC OIND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department ❑ PTY ❑ SCC SUBTOTAL $ 3 L{ 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.) ....................... TOTAL $ 8Z. 4// 6 3 *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers per 0. AN to whole dollars. 7/1/2013 from 9/2612013i - l% through Page of NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR OFCOMMITTEE,ALSND I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Jf %J/v wr7 OIND Firefighter 9/23/2013 G ,� ❑conn San Rafael Fire 69 207 ❑OTH Department oSCC -zi c� f t° G� FI ND Ire Ig er 9/?48/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department Sa.,..i•- 9s'S/oS� ❑PTY ds.� ❑ scc ar OIND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department // Saw• /CG XI/ El PTY []SCC OIND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department M PTY ❑ scc v S A e. OIND Firefighter 9/98/2013 [-]COM San Rafael Fire 69 207 ❑OTH Department / � y�yBZ Ule 4 El PTY . ❑ scc SUBTOTAL $ 'p D Z e) '70 '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. 7/1/2013 0 1 from 2 9/26/2013 through Page 8 of l NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ✓' �c Givs Xi C11ND Firefighter 9/2T/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department ❑ PTY ❑scc 9/26/2013 %� G��dw�''' gIND ❑conn Firetighter San Rafael Fire 69 207 ❑ OTH Department ❑ PTY ❑scc dei �ro�� RJIND Firefighter Rafael 9/23/2013 ❑conn San Fire 69 207 ❑OTH Department ❑ PTY p scc �cl� c�a/ ., OIND Firefighter 9/29/2013 ,G1�,r ❑COM San Rafael Fire 69 207 ❑ OTH Department �1Sc/ZS_ El PTY ❑scC Zi ✓ s"` °` /�`' �/� OIND Firefighter 9/2t/2013 nCOM San Rafael Fire 69 207 ❑OTH Department ❑PTY ❑ scc SUBTOTAL $ l O s 1 `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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 7/1/2013 46 from FORM 9/26/2013 9 17 through Page of NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE,ALSO ENTER I.D.NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) y/ X/iy// �� [JJ IND Firefighter 9/28/2013 ❑conn San Rafael Fire 69 207 ❑OTH Department ❑PTY ❑ SCC .SV�t �, '� d��` OINDFirefighter 9/23'/2013 "`',`� ❑conn San Rafael Fire 69 207 ❑OTH Department ,Se'h C'ir►Se/r�o 1Sfg6 d El PTY [-]SCC / vxw �� A* Ile XON OIND Firefighter 9/23/2013 ❑conn San Rafael Fire 69 207 ❑OTH Department •S�s�H c.sy �. 95�f"d'Si EISCC zr�yiFi �� •� OIND Firefighter 9/28/2013 a,�► R �c ❑conn San Rafael Fire 69 207 ❑OTH Department `i cesco Jul Z El PTY ❑SCC a l/, OIND Firefighter 9/23/2013 ❑conn San Rafael Fire 69 207 MOTH Department ,// � � 06 v/ . f�s 1 % ❑ SCC SUBTOTAL $ 4 O '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Tvoe or orint in ink. SCHEDULE (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period ICALIFORNIA to whole dollars. 7/1/2013 ' from _ •R 9/26/201 through Page of / 7 NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 �� (EET A IT RE, ALSO ENTER ZIP FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) < < Ls S D Firefighter 9/23/20 3f '' San Rafael Fire 69 207 DOTH Department b Ga.. ct S (ov 3 D PTY DSCC zj ✓f/ 9/26/2013 �� Lo�es VIIND ❑COM Firefighter San Rafael Fire 69 207 DOTH Department 5 ow. ►Qw-�a e ( Ca . �'-�a o 3 ❑ PTY ❑Scc U ✓ Je �� Ig IND Firefighter 9/23/2013 _ _ ❑COM San Rafael Fire 69 207 DOTH Department -/'' KocciS677 ❑PTY D Scc zj ✓orf% �VC" �� 1 OIND Firefighter 9/A/2013 ❑COM San Rafael Fire 69 207 DOTH Department SOQL ra µnG A,'(�. S gZ 7 ❑ PTY ❑ SCC 9/23/2013 OIND ❑COM Firefighter San Rafael Fire 69 207 DOTH Department D PTY ❑SCC SUBTOTAL$ '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period �. to whole dollars. 7/1/2013 from vJ.R-IFI 9/26/2013 -7through Page of NAME OF FILER I. D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF (IFCOMMITiEE,ALSO ENTER I.D.NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Firefighter 9/23/2013 ❑conn San Rafael Fire 69 207 ❑OTH Department to m U'- Llej rte . � S v s n SC is clw G h FJIND Ire Ig er 9/23/2013 N u. o roto pcOM San Rafael Fire 69 207 ❑OTH Department []scc 2r Jif ` S $� BIND Firefighter 9/28/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department F r&&_eASe o 6d. Ck A ❑ PTY ❑ SCC V� A v�e�l(e �..� sa 1 I �C�a OIND Firefighter 9/28/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department ��eSKo Ga• �j 7 Z6 E] PTY []SCC Z4 %1H fj\, � t t Ped ll,� gIND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department El PTY ❑scc SUBTOTAL$ Z-0-70 &, Z t v *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period _ to whole dollars. /1 /2013 7/1/201' a from � 9/26/2013 / Z through Page of NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Firefighter 9//2013 [3Com San Rafael Fire 69 207 ❑OTH Department ate.. fow.[ sco 9'Al3`5 ❑PTY ❑SCC Zi /H 9/2$/2013 G�1nnr 5 l < < r P' INDFirefighter ❑COM San Rafael Fire 69 207 ❑ OTH Department �ce-v. ) 04 ❑ PTY ❑SCC jiose0L, More-( MIND Firefighter 9/x/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department Ilk ❑PTY ❑ SCC / ✓"�� Au• el La,.,.de,rcrde WlIND Firefighter 9/2.x/2013 ❑Com San Rafael Fire 69 207 ❑OTH Department ",e d0d G��kj GF. G'tKob3 TY ❑❑s Zr c/N� P1�c�•rct Lccs MIND Firefighter 9/2j/2013 ❑com San Rafael Fire 69 207 ❑OTH Department ❑ PTY ❑SCC SUBTOTAL$ %LAS *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period ICALIFORNIA to whole dollars. 7/1/2013 • from FORM 9/21512013 through Page 13 of 17 NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER IDNUMBER) NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 MOTH Department o Co r o U4 5' Sr% 70 [] PTY M SCC zr ✓.> 9/?Z/2013 A Wes dY i1G MIND MCOM F IreIg h te San Rafael Fire 69 207 MOTH Department M PTY \ -Dr,-,o(. lj f.115 9 S-76 z []SCC lnl BIND Firefighter 9/28/2013 MCOM San Rafael Fire 69 207 MOTH Department �(�(�� sor G`• �1 STkgZ El PTY ❑SCC z( i/�/%! 1, f �cwr. W L r. �C.e�w� OIND Firefighter 9/2.372013 MCOM San Rafael Fire 69 207 leo G� C( p PTY Department [-]SCC zl 011FLi4.L&cr- ° BIND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 MOTH Department w� tja Cc.. F-1 PTY I M SCC SUBTOTAL$ Z?b 49 *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 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 7/1/2013 from FORM 7 ✓lrf/ 9/P6/2013 % 17 through Page// of NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , (IF COMMITTEE, ALSO ENTER I. D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) OIND Firefighter 9/26/2013 ❑coM San Rafael Fire 69 207 ❑OTH Department ❑PTY � a. ❑SCC M� S Q` FJINDFirefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department Mor a,nn l Gn 03 7 5 ❑ PTY ❑ SCC fW ,IH,41 -Dd^! c s W �� OIND Firefighter 9/26/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department 7 El PTY El SCC LO ✓;r`�1 °Li' s�,c�Ii� OIND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department 0f W.' -. ciS? d Z Os c Jo UaSc OIND Firefighter 9/26/2013 c ` ❑COM San Rafael Fire 69 207 ❑OTH Department 9e 'j %0% e_ C a "1 S ❑PTY -4S-- ❑SCC SUBTOTAL$ -3 %O S'_ q I -z) *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 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 7/1/2013 ' from FORM 91�/2013�M� / -c-i7 through Page of NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR QFCOMMITTEE,ALSO ENTER I.D.NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOVED,ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 21 ,/"W Misr. ®IND Firefighter 9/29/2013 Q""�e r O ❑COM San Rafael Fire 69 207 ❑OTH Department Qodd Gc. gllo6l y ❑PTY ❑scc zi ✓��t �� r r -FE ha e� PJIND Firefighter 9/28/2013 o ❑COM San Rafael Fire 69 207 ❑OTH Department F0r�b-1 �r�l�� G�.iS�t340 ❑ PTY pscc 7-1 VA -fl -1 �� S WJIND Firefighter 9/26/2013 P ❑COM San Rafael Fire 69 207 F❑OTH Department 5-14 -7 b PTY ❑Scc 2i ✓r�,�1 n e r OIND Firefighter 9/26/2013y MC jtjLjA ❑COM San Rafael Fire 69 207 ❑OTH Department iVs. �e-. Ga. q4 41 psc . 2I ✓H// RIIND Firefighter 9/26/2013o us P ❑COM San Rafael Fire 69 207 ❑OTH Department o%�ner-4 Ga. ��kg2S 0 PTY ❑SCC SUBTOTAL$ *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period ICALIFORNIA to whole dollars. 7/1/2013 4601, from FORM .2f vl"_ f 9126/2013 through Page 16 of. L� NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR QF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 7 rL-oJtcc 4o MIND Firefighter 9/2/2013 ❑conn San Rafael Fire 69 207 ❑OTH Department Mv✓�� er�Y, Ca. 9 59��i F1 PTY ❑ SCC 2f ✓`'%� E r� c Maw QuS�Q-�.cQ 16INDFirefighter 9/?A/2013 ❑conn San Rafael Fire 69 207 ❑OTH Department 5 a ,,. l� �.s e lw•a G d �� l�{le d r-1 sc :7 1H�kc `f BIND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑ OTH Department t p, Q ,` k L1 ✓r �Ja-u• t,\ 01ND Firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department El PTY ❑ SCc �c. e-,Je t MIND firefighter 9/23/2013 ❑COM San Rafael Fire 69 207 ❑OTH Department Q�1 G.. �'1 `4e ► L) ❑ PTY W 0. ❑SCC SUBTOTAL$ *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period �. to whole dollars. 7/1/2013 3h from 9/26/2013 throug through Page �7 �7 of NAME OF FILER I.D. NUMBER San Rafael Firefighters Political Awareness Committee 891308 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , (IFCOMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) V j1H'I X%^Al^6 Art%)sa BIND Firefighter 9/ /2013 N Y ❑COM San Rafael Fire 69 207 ❑OTH Department �url ,.cl4w.t Ge.. q�Ol(� ❑ PTY ❑SCC 2l '1W 9/23/2013 �� ass.. MIS Pcw�� RJIND ❑Com Firefighter San Rafael Fire 69 207 ❑OTH Department ❑ PTY ❑SCC ZI V-///sco RnIND Firefighter 9/22/2013 ❑COM San Rafael Fire 69 207 ❑ OTH Department r— r U%o&4,-- y c't Z ❑ PTY ❑SCC OIND Firefighter 9/ag/2013 ❑Com San Rafael Fire 69 207 ❑OTH Department �rvL^CA cv C6. qiQ l3Z F1 PTY ❑scC OIND Firefighter 9/23/2013 ❑Com San Rafael Fire 69 207 ❑OTH Department ❑ PTY ❑ SCC SUBTOTAL $ 4081 *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)