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Home My WebLink AboutForm 460 - Firefighters' Association PAC (2013-01-01)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from Date of election if applicable: 6130/2012 1 (Month, Day, Year) through 1/1/2013 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. El Officeholder, Candidate Controlled Committee El Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored 54 General Purpose Committee (Al- Comphete Part 6) * Sponsored E] Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D.NUMBER 1 891308 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) San Rafael Firefighter's Political Awareness Committee STREET ADDRESS (NO P.O. BOX) San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX San Rafael. CA 94912 CITY STATE ZIP CODE AREA CODE/PHONE 2. Type of Statement: 0 Preelection Statement Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) F-1 Amendment (Explain below) Treasurer(s) NAME OF TREASURER Jason Hatfield MAILING ADDRESS COVER PAGE Page / of For Official Use Only n Quarterly Statement [:1 Special Odd -Year Report E] Supplemental Preelection Statement -Attach Form 495 U177— STATE ZIP CODE AREA CO15ff/TH_5_NY_ San Rafael CA 94912 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX I E-MAIL ADDRESS STATE ZIP CODE AREA CODE/PHONE 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 perjury under the laws of the State of California that the foregoing is true andS4mactl. Executed on By -7 �5-=atLireofTre5iYei6'rii-sFan7Tre—asLTef Executed on ;-#y Executed on By S4"ureofControlfrV(noehokler, CiF3daW Statemeasure Proponert Executed on By SqiahzeoFGvTUhNOMoeWder. Carddate, FPPC Form 460 (January/05) =DDP TMt-r— W.Wi aawaQv-ropr Mrr.M79-17711 Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. SUMMARY PAGE Statement covers period from 6/30/12 1 1/1/13 1 Pane Z of k NAME OF FILER I.D.NUMBER San Rafael Firefighters' Political Awareness Committee � 891308 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD (FROM CALENDAR YEAR Running in Both the State Primary and ATTACHED SCHEDULES) TOTALTO DATE General Elections 1 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 8694 $ 17192 111 through 6/30 7/1 to Date 2. Loans Received ................... .............. ................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ... ......... Add Lines I + 2 $ 8694 $ 17192 20. Contributions ....... Received $ $ 4. Nonmonetary Contributions ............... .......... ........ Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED .......................... Add Lines 3 + 4 $ 8694 $ 17192 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 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 0 $ 0 tir Subject to voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ..................... ........ . Schedule F Line 3 0 Date of Election Total to Date 10. Nonmonetary Adjustment ..... ..... _ .......................... .. Schedule C, Line 3 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + to $ 0 $ 0 1 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 86448 13. Cash Receipts ........... ......................... ............ . Column A, Line 3 above 8694 14. Miscellaneous Increases to Cash...... ........... ......... Schedule 1, Line 4 15 15. Cash Payments ................................... __ ... ....... Column A, Line 8 above 0 16. ENDING CASH BALANCE .......... Add Lines 12 4. 13 + 14, then subtract Line 15 $ 95157 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED .... __ ...... .... _ . ... Schedule B, Part 2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ..... ...... .............. .... See instructions on reverse $ 19. Outstanding Debts Add Line 2 + Line 9 in Column B above $ 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). *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) Schedule A Type or print in ink. Aunts may be rounded Statement covers period Amounts Monetary Contributions Received to whole dollars. from 6/30/12 1/1/12 SEE INSTRUCTIONS ON REVERSE through 1/1/13 NAME OF FILER - San Rafael Firefighters' Political Awareness Committee SCHEDULE A -5 Page of I.D.NUMBER 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE (IF COMMITTEE, ALSO ENTER I D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME I PERIOD (JAN. I - DEC. 31) OF BUSINESS) 12/1/2012 BIND Firefighter 145 !286.5 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (include all Schedule A subtotals.) ....... ................... 2. Amount received this period — uniternized 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.) ... ...... $ 8694 $ 0 PER ELECTION TO DATE (IF REQUIRED) `Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) 0TH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee TOTAL $ 8694 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) carnes, Daniel ncom OTH nPTY City of San Rafael Mill Valley, CA 94941 nSc;C 12/1/2012 ®IND Firefighter �145 1286.5 Barrow, Justin ncom E]OTH F-1 PTY City of San Rafael Sonoma, CA 95476 EISCC 12/1/2012 ZIND IFirefighter 145 1286.5 Bernard,Paul j EICOM E]OTH nPTY City of San Rafael Elk Grove, CA 95624 EISCC 12/1/2012 1 Bowermaster, Paul ®IND Firefighter 1145 1286.5 ncom [JOTH 1 nPTY Fity of San Rafael Dr. Concord, E -]SCC 12/1/2012 FIND Firefighter ----------------- 14FS 1286.5 Brown, Richard FJCOM EJOTH �ity of San Rafael Claklev, CA 94561[:]SCC EIP TY SUBTOTAL$ 11432.5 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (include all Schedule A subtotals.) ....... ................... 2. Amount received this period — uniternized 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.) ... ...... $ 8694 $ 0 PER ELECTION TO DATE (IF REQUIRED) `Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) 0TH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee TOTAL $ 8694 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink. SGHEDULEA (CONT.) Monetary Contributions Received Amounts may be rounded I Statement covers period to whole dollars. CALIFORNIAe from 6/30/12 i ✓ I through 1/1/13 j Page of 5 NAME OF FILER San Rafael Firefighters' Political Awareness Committee DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IF COMMITTEE, ALSO ENTER I D NUMBER) CODE 12/1/12 Clark, Nathan MIND ❑cOM Santa Rosa, CA OTH ❑PTY -- — 5404 – - ---- - -- ------------------ nsCC 12/1/12 iConover,Jeffery [71IND E]COM Petaluma, CA 94954 OTH EjPTY ❑scc 12/1/12 !Cooper,Chris BIND ❑ COM (Rd. San Rafael, n OTHPTY Fj A 94903 1 ❑scc 12/1/12 rCornell, David 2IND ❑COM (Roseville, CA 95678 � Pn ❑SCC 12/1/12 Crimmins,Paul BIND ❑COM Ave. Cotati, PTH E] PTY ICA 94931 ❑scc *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCG — Small Contributor Committee IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) irefighter itv of San Rafael I 891308 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEG. 31)� (IF REQUIRED) i 1286.5 refighter 145 ty of San Rafael i refighter 145 ty of San Rafael refighter 1145 ty of San Rafael ty of San Rafael 145 i i SUBTOTAL: 5 U .5 FPPC Form 460 (January/OS) FPPG Toll -Free Helpline: 8661ASK-FPPG (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions N - AMF6FP1I-FRI.D. San Rafael Firefighters' Association Political Awareness Committee Statement covers period CALIFORNIA A All 10ft from 1/1/12 FORM I through 6/30112 1 Page Of NUMBER R9130R DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER i AMOUNT CONTRIBUTOR CUMULATtVETO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER i RECEIVED THIS (IF SELF-EMPLOYED, ENTER NAME i PERIOD CALENDAR YEAR TO DATE (JAN.I -DEC. 31) I (IF REQUIRED) OF BUSINESS) 12/1/12 !Goodwin, Ryan IND Firefighter S 1286.5 com !Petaluma, CA 94954 TH P, OTY City of San Rafael SCC 12/1/12 Gordan, Shawn William IND Firefighter 1145 j286.5 com 'Dublin, Ca, 94568 OTH PTY City of San Rafael SCC 12/1/12 Ground, Robert IND ---------- Firefighter —1145 11286.5 com ,Santa Rosa, CA 95404 OTH ity of San Rafael PTY SCC 12/1/12 ;Harnilton, Kyle IND Firefighter 145 x,286,5 Folsom, CA 95630 COM OTH City of San Rafael PTY SCC 12/1/12 lHamilton, Richard IND y of San Rafael 145 ;286.5 i Com (Ripon, CA 95366 OTH PTY SCC ------------ SUBTOTAL$ -7 Schedule A (Continuation Sheet) Monetary Contributions NAME OF FILER San Rafael Firefighters' Political Awareness Committee DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED (IFCOMMITTEE,ALSO ENTERLD. NUMBER) CODE 12/1/12 oseph IND I.D. NUMBER — coM 891308 (Mill Valley CA 94941 OTH CUMULATIVE TO DATE PER ELECTION PTY CALENDAR YEAR TO DATE SCC 12/1/12 ;David Lopes - IND COM ISan Rafael CA 94903 OTH PTY � SCC 12/1/12 �eff Endaya - - - ----- ; - IND coM 'Rocklin CA 95677 PTY � scC 12/1/12 Randall Ainsworth - IND COM Auburn CA 95603 i OTH PTY SCC 12/1/12 --_ - ---- ------ - — — ---- Ilvan Zhuk .-IND COM ,Sacramento CA 95827 OTH PTY i SCC IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) refighter tv of San Rafael refighter tv of San Rafael Statement covers period CALIFORNIA from 111/12 FORM through 6130112 Page (0of I.D. NUMBER — 891308 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD I (JAN. 1 - DEC. 31) (IF REQUIRED) t5 286.5 86.5 irefighter X145 1286.5 ity of San Rafael refighter 145 286.5 ty of San Rafael refighter tv of San Rafael SUBTOTAL $ ! "7 Schedule A (Continuation Sheet) Monetary Contributions NAME OF FILER San Rafael Firefighters' Political Awareness Committee DATE RECEIVED 12/1/12 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IFCOMMITTEE, ALSO ENTER I.D. NUMBER) CODE Davis, Steven —IND IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Firefighter -7 Page of lPenngrove, CA 94951 COM PTY OTH SCC City of San Rafael 12/1/12 IdeLambert, Robert i IND Firefighter i CALENDAR YEAR TO DATE PERIOD COM --------------- 45 286.5 Windsor, CA 95492 W OTH PTY City of San Rafael 12/1/12 iDonohue, Chris SCC mIND firefighter 11286.5 COM !Ukiah, CA 95482 OTH PTY ity of San Rafael 12/1/12 lGeide, Gregory SCC ND (Firefighter (Sebastopol, CA 95472 COM OTH PTY ity of San Rafael sec 12/1/12 IGiusti, Nick IND City of San Rafael I COM !Novato, CA 94947 OTH PTY SCC Statement covers period from 6/30/2012 CALIFORNIA A FORM through 1/1/13 -7 Page of f 891308 308 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS i CALENDAR YEAR TO DATE PERIOD (JAN. I -DEC. 31)(, IF REQUIRED) --------------- 45 286.5 45 286.5 45 1286.5 45 !286.5 45 11286.5 SUBTOTAL$ z- -7, 16 Schedule A (Continuation Sheet) Statement covers period CALIFORNIA A -m Monetary Contributions from 6130/12 FORM through 11/11/13 Page of NAME nF FII FIR I.Q. NUMBER San Rafael Firefighters' Political Awareness Committee Rq1 qnR FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IFCOMMITTEE, ALSOENTERI.D. NUMBER) CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS 1 CALENDAR YEAR TO DATE RECEIVED CODE * (JAN. I -DEC. 31) (IF SELF-EMPLOYED, ENTER NAME PERIOD (IF REQUIRED) OF BUSINESS) 12/1/12 !Hatfield, Jason IND Firefighter 145 11286.5 com Santa KOSa, t yDnu7 OTH ity of San Rafael PTY scc 4- 12/1/12 Hax, Gary IND Firefighter 1145 1286.5 com Novato, CA 94947 PTY PTY ity of San Rafael SCC 12/1/12 Xadzielawa, Steve D Firefighter i286.5 com San Anselmo, CA 94960 0TH PTY City of San Rafael � SCC i 12/1/12 i Kelleher, Kevin IND !Firefighter 1286.5 com Fairfield, CA 94534 PTY VIH City of San Rafael SCC - — - — -------------- ---------- 12/1/12 Kelly, Conan I —IND City of San Rafael 145 1286.5 com Mill Valley, CA 94941 0TH PTY SCC SUBTOTAL$ Schedule A (Continuation Sheet) Monetary Contributions NAME OF FILER San Rafael Firefighters' Ac,.-;oriation political Awareness CommittP.P Statement covers period CALIFORNIA A from 6/30/12 FORM through 111/13 Page t of DATE I FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONT 'RIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT RECEIVED (IF COMMITTEE, ALSO ENTER I.D NUM CODE OCCUPATION AND EMPLOYER RECEIVED THIS (IF SELF-EMPLOYED, ENTER NAME PERIOD - ------ *__ ieffer,3_irn___________ IND OF BUSINESS) Firefighter !145 COM LA 94904 PTY OTH City of San Rafael ,�reenbrae, !Kirkpatrick. Rvan SCC12/1/12 IND com Firefighter 1145 I can Francisco, CA 96123 PTY PTY 'City of San Rafael SCC --- 12/1/12 ------- Landavercle, Anael IND Firefighter 145 com Redwood City, CA 94063 PTY City of San Rafael PTY SCC 12/1/12 Lewis, Michael Sylvain ND Firefighter 1145 I COM ivermore, CA 94550 'Livermore,PTY �City of San Rafael PTY SCC 12/1/12 !Locatelli, Matthew IND lCity of San Rafael 1145 com Scotts Valley, CA 95066 PTY PTY SCC Rq130R I CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE (JAN. 1 - DEC. 31) (IF REQUIRED) 86.5 5 �.* M. SUBTOTAL$ 0 2-7. Schedule A (Continuation Sheet) Monetary Contributions NAME cIFFiLEA--I.D. San Rafael Firefighters' Political Awareness Committee Statement covers period CALIFORNIA A from 6130/12 FORM 96t through 11/11/13 Page of NUWB—ER--- 891 308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CONTRI I BUTI CUMULATIVE TO DATE PER ELECTION RECEIVED OF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE -OR OCCUPATION AND EMPLOYER 1 RECEIVED THIS I CALENDAR YEAR TO DATE - -- --- - - - - (IF SELF-EMPLOYED, ENTER NAME i PERIOD OF BUSINESS) I (JAN. 1 - DEC, 31) (IF REQUIRED) 12/1/12 Minard, Evan Firefighter 1286.5 COM Dublin, CA 94568 PTYCity of San Rafael PTY SCC 12/1/12 1! Northern, Garrett ------------------ -------- -- IND Firefighter �,145 2 86.5 CA 95436 COM PTYI POTY City of San Rafael SCC ------ - --- 12/1/12 Phillips, Artie IND Firefighter 1145 i286.5 COM Sonoma, CA 95476 OTH City of San Rafael ; PTY SCC --- --�1-45 12/1/12 Imorgeniaender, Mike INa firefighter 1286.5 COM IPetaluma, CA 94954 PTY City of San Rafael PTY SCC 12/1/12 Mrsny, Cameron INDity of San Rafael --+145 286.5 com� ;East Palo Alto, CA 94303 OTH PTY SCC SUBTOTAL$ Schedule A (Continuation Sheet) Monetary Contributions NAME OF FILER San Rafael Firefighters' Political Awareness Committee DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR i IF AN INDIVIDUAL, ENTER CONTRIBUTOR i RECEIVED (IF COMMITTEE, ALSO ENTER 1. D. NUMBER) CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME 12/1/12 Nettelman, Rich OF BUSINESS) IND Firefighter Novato, CA 94947 Conn OTH PITY City of San Rafael SCC 12/1/12 Reuter, Kyle IND Firefighter com El Sobrante, CA 94803 OTH PTY City of San Rafael scc 12/1/12 j Rogerson, Andrew IND Firefighter COM kohnert Park, CA 94928 City of San Rafael PTY PTY 1 SCC 12/ 1/ 12 S -ay sette, Grant IND Firefighter Sf, CA 94133 com OTH PITY �ity of San Rafael SCC 12/11/12- ISedlack, Mark IND City of San Rafael COM !Morgan Hill, CA 95037 OTH PTY SCC Statement covers period CALIFORNIA A A11h. from 6/30112 FORM through I/1/13 Page of 891308 AMOUNT CUMULATIVE TO DATE i PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) I (IF REQUIRED) 1286.5 ;286.5 5 9 SUBTOTAL$ I Z 7- - Schedule A (Continuation Sheet) Monetary Contributions NAME OF FILER San Rafael Firefighters' Political Awareness Committee DATE IF AN INDIVIDUAL, ENTER FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER ((F COMMITTEE, ALSO ENTER I.D. NUMBER) RECEIVED RECEIVED THIS CODE (IF SELF-EMPLOYED, ENTER NAME 12/1/12 !:Shubin, David OF BUSINESS) IND —IFirefighter 1286.5 com t5 'Napa, CA 94558 i OTH PTY City of San Rafael 286.5 t5 SCC 12/1/12 iSutherlin, Daniel IND Firefighter com El Dorado Hills, CA 95762 OTH City of San Rafael PTY SCC 12/1/12 :Schifando, Andrew IND Firefighter com iFresno, Ca, 93720 OTH !City of San Rafael PTY SCC 12/1/12 ;Schmitt, Jason IND Firefighter COM ;Livermore,TH ivermore, CA 94550 City of San Rafael PTY SCC 12/1/12 Vasco, Joe y IND ity of San Rafael Petaluma, CA 94954 COM OTH PTY SCC SUBTOTAL Statement covers period CALIFORNIA A 10 11 from 6/30/12 FORM through 11/1/13 1 Page 12- of I I.D. NUMBER 891308 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 15 1286.5 286.5 t5 ,286.5 ts 286.5 t5 1286.5 t '-A 1 -? z s- I Statement covers period A AM Alft CALIFORNIA Schedule A (Continuation Sheet) I from 6/30/12 FORM Monetary Contributions through 1/1113 Page of NAME OF I.D. NUMBER San Rafael Firefighters' Political Awareness Committee 891308 IF AN INDIVIDUAL, ENTER AMOUNT 1 CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME I PERIOD (JAN. 1 -DEG. 31) (IF REQUIRED) OF BUSINESS) 12/1/12 !Wasdyke, Bill IND F—ire—fig—hter 145 1286.5 com TH El Dorado Hills, CA 95762 OCity of San Rafael PTY SCC 12/1/12 Wasclyke, Michael IND Firefighter 1145 1286.5 com --POTH Rancho CordovaCA 95670 1 ,Ra , PTY City of San Rafael SCC i 12/1/12 !Winkelman, Graham 1[ aIND Firefighter 145 --286.5 com Santa Rosa, CA 95403 CITH City of San Rafael PTY scc 12/1/12 Winner, Rob IND Firefighter 1145 286.5 com VCITH ;Vallejo, CA 94590 City of San Rafael PTY scc 12/1/12 ,Miguel Padilla - IND !Firefighter 145 11286.5 com Dublin CA 94568 OTH PTY City of San Rafael SCC ------ - ---------- SUBTOTAL$ -7 -7 Schedule A (Continuation Sheet) Monetary Contributions NAME OF FILER � San Rafael FirefightersAssociation Political Awareness Committee Statement covers period CALIFORNIA - from 6/30/12 FORM 4+ Wj through I/1/13 Page Of --------------in NIJMRFR 891308 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER ID NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) 12/1/12 Lovecchio, Darren v J INDcom Firefighter 145 1286.5 Monterey, CA 93940 OTH PTY City of San Rafael scc 12/1/12 ';MacAusland, Eric IND !Firefighter 1145 i286.5 COM San Anselmo, CA 94960 OTH PTY ity of San Rafael 12/1/12 'Martin, Kenneth SCC D 46 Firefighter R r 145 !286.5 om c 'M Santa Rosa, CA 95409 OTH City of San Rafael PTY SCC 12/1/12 — ---------- !Mathis, Marcus -IND com Firefighter 145 i286.5 ,Santa Rosa, CA 95405 OTH City of San Rafael PTY SCC 12/1/12 -IMcCarthy, Michael I IND �itV of San Rafael 1145 1286.5 com 'Mill Valley, CA 94941 OTH PTY SCC SUBTOTAL Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Firefighters Political Awareness Committee DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.Q. NUMBER) 12/1/12 iBank of America San Rafael CA 94901 Attach additional information on appropriately labeled continuation Sheets. Type or print in ink. Amounts may be rounded Statement covers period to whole dollars. from 6/30/12 through 111/13 nterest DESCRIPTION OF RECEIPT Schedule I Summary 1. Itemized increases to cash this period.......-- ............ ......... ............... ........................ ...... ........... $ 15 2. Uniternized increases to cash of under $100 this period. ....... ..... $ 0 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ... ......... ........ —$ 0 SUBTOTAL $ Page of I.D. NUMBER AMOUNT OF INCREASE TO CASH 5.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2. and 3. Enter here and on the Summary Page, Line 14.) ---- .................. - ................ .......... -- ....... .......... --- ............ ................... TOTAL $ 15 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)