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Home My WebLink AboutForm 460 - Police Association PAC (2011-10-22)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 — 09/25/2011 through 10/22/2011 1. Type of Recipient Committee: All Committees – Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee E] Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Pail 5) 0 Sponsored (Also Complete Part 6) General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political PartylCentral Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMM F-1 Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D.NUMBER San Rafael Police Association Political Action Committee STREET ADDRESS (NO P.O. BOX) 1520 Fifth Avenue CITY STATE ZIP CODE AREA CODE/PHONE San Rafael, CA 94901 (415) 485-3000 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX P.O. Box 151557 CITY STATE ZIP CODE AREA CODE/PHONE San Rafael, CA 94915-1557 OPTIONAL: FAX / E-MAIL ADDRESS Date Stamp Date of election if applicable: (Month, Day, Year) 11/08/2011 COVER PAGE Page 1 of 33 For Official Use Only 2. Type of Statement: F&] Preelection Statement Quarterly Statement E] Semi-annual Statement E] Special Odd -Year Report E] Termination Statement Ej Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Mr. Scott Ingels MAILING ADDRESS 1520 Fifth Avenue CITY STATE ZIP CODE AREA CODE/PHONE San Rafael, CA 94901 (415) 485-3000 NAME OF ASSISTANT TREASURER, IF ANY Mq Stacy R_ (lens MAILING ADDRESS 5940 College Avenue CITY STATE ZIP CODE AREA CODE/PHONE Oakland. CA 94618 OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 10/27/2011 Date Executed on 10127120// Date Executed on Date Executed on Date www.netfile.com By herein and in the attached schedules is true and complete. I certify Assistant By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor By Signature at Cont-d1fing Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officehoider, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of Califomia Type or print in ink. COVERPAGE-PART2 Recipient Committee Campaign Statement CALIF. ORNIA 460 0 Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: Listany 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. COMMITTEENAME I.D.NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMM ITTEEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) Page 2 of 33 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTERI JURISDICTION I ❑ 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 CITY STATE ZIP CODE AREA CODEtPHONE Attach continuation sheets if necessary FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California www.netfile.com Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. Statement covers period from 09/25/2011 SUMMARYPAGE SEE INSTRUCTIONS ON REVERSE through - 10/22/2011 _ Page 3 of 33 NAME OF FILER I.D.NUMBER San Rafael Police Association Political Action Committee 831553 Contributions Received 1. Monetary Contributions .. .................... _ ....... Z Loans Received ............................ ....... _ ... 3. SUBTOTAL CASH CONTRIBUTIONS.....,... 4. Nonmonetary Contributions ........................ 5. TOTAL CONTRIBUTIONS RECEIVED ........ Expenditures Made 6. Payments Made .................................. 7. Loans Made....__...._ .. ... __ ........ ....... & SUBTOTAL CASH PAYMENTS ........... 9. Accrued Expenses (Unpaid Bills) ...... 10. Nonmonetary Adjustment ..... _ .......... 11. TOTAL EXPENDITURES MADE .......... Column A TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) Schedule A, Line 3 $ 4,886.00 Schedule 8, Line 3 0.00 _____9_.00 .... Add Lines I + 2 $ 4,886.00 Schedule C, Line 3 0.00 ... I—— ............ Schedule C, Line 3 . ......... Add Lines 3 + 4 $ 4,886.00 .......... _ ... Add Lines 8 + 9 + 10 ... ........ Schedule E, Line 4 $ 27,099.71 ........... 1. 1. Schedule H, Line 3 0.00 ............ I I ....... Add Lines 6+7 $ 27,099.71 ..................... Schedule F Line 3 -90.25 ... I—— ............ Schedule C, Line 3 0.00 .......... _ ... Add Lines 8 + 9 + 10 $ 27, 009.46 Current Cash Statement 12. Beginning Cash Balance.., ................ Previous Summary Page, Line 16 $ 31,662,39 13. Cash Receipts ..................... __ ........... ......... . Column A, Line 3 above 4, 886_00 14. Miscellaneous Increases to Cash ..... ....... .... Schedule 1, Line 4 0.20 15, Cash Payments ........ .............. ____ ........... .... . . Column A, Line 8 above 27,099.71 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 9,448.88 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. GO 19. Outstanding Debts .. ... ........ __ ...... . Add Line 2 +Line 9 in Column B above $ 27,561,28 www.netfi*le.com Column B CALENDAR YEAR TOTALTO DATE $ 36,530.00 $ 36,530.00 1,127.73 $ 37,657,73 $ 29,351.71 0.00 $ 29,351.71 27,561.28 1,127.73 $ S8,040,72 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). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ 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) I ___J_-/ $ `Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Qt-h,mrli illa A Type or print in ink. SCHEDULE A Amounts may be rounded Monetary Contributions Received dollars. Statement covers period CALIFORNIA to whole 46 from 09/25/2011 FORM Page 4 of 33 through 10/22/2011 SEE INSTRUCTIONS ON REVERSE KA -ME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER Ic. NUMBER) CODE IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN, 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Elisha Adams ®IND Police Officer 58.17 433,71 El COM C/o: San Rafael Police Association ❑ OTH City of San Rafael 1520 Fifth Avenue ❑PTY San Rafael, CA 94901 cc Union member's dues received through intermedia iv:E;San Rafael Police Association, 152C Fifth Avenue, San Rafaei, CA 94901 10/20/2011 Raul Aguilar BIND Police officer 58,17 433,71 [:] Com C/o: San Rafael Police Association [_1 OTH City of San Rafael 1521 Fifth Avenue EI PTY San Rafael, CA 94902 Union member's dues received through intermedia iv:[4SnCR�qfaEl Police Association, 152C Fifth Avenue, S n Rafael, CA 94901 10/20/2011 Anthony Augustyn ®IND Police Officer 58.17 433.71 ❑Com C/o: San Rafael Police Association E] OTH City of San Rafael 1522 Fifth Avenue CI PTY San Rafael, CA 94903 Union member's dues received through intermedia :Iy:1Z9C1Raf.Sl Police Association, 152C Fifth Avenue, S Rafael, CA 94901,1 10/20/2011 Blair Auld QIND Police officer 58.17 433.71 ncom C/o: San Rafael Police Association El OTH City of San Rafael 1523 Fifth Avenue PTY San Rafael, CA 94904 Union member's dues received through intermedia iy:E:1WCRafaEl Police Association, 1521 Fifth Avenue, San Rafael, CA 9490'1 10/20/2011 James Bellamy Ex] IND Police Officer 5817 1 , 433 � 711 I OCOM C/o: San Rafael Police Association OOTH City of San Rafael 1524 Fifth Avenue El PTY San Rafael, CA 94905 Union member's dues received _throe qh intermediaify:[APCRafa l Police Association, 15201., Fifth Avenue, Sin Rafael, CA 94901 SUBTOTAL$ 290.85 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ........ ............. .......... __ ................ ....... .................... ............. $ 4,769,68 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.).. www.netfile.com .1.1... $ TOTAL $ 116.32 *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 4,886.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE A (CONT) Statement covers period from 09/25/2011 through 10/22/2011 1 Page S of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 *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 www.netfile.com SUBTOTAL$ 290.85 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/201-- Todd Berringer RIND Police Officer 58.17 433.71 [:] COM C/o: San Rafael Police Association El OTH 1525 Fifth Avenue ❑ PTY City of San Rafael San Rafael, CA 94906 Union member's dues received through intermedia iv:E;aSnCCRafael Police Association, 1520 Fifth Avenue. San Rafael. CA 9490 10/20/2011 Geoffrey Bowker RX IND Police Officer 58.17 433.71 [_1COM C/o: San Rafael Police Association EIOTH 1526 Fifth Avenue R PTY City of San Rafael San Rafael, CA 94907 E;SCC Union member' intermedia an Rafael Police Association. 1520 Fifth Avenue. San Rafael. CA 94901 10/20/2011 Michael Byers RIND Police Officer 58,17 433.71 EICOM C/o: San Rafael Police Association E] OTH 1527 Fifth Avenue [-I PTY City of San Rafael San Rafael, CA 94908 nn Union member's dues received through intermedia rv:[;anNafael Police Association, 1520 Fifth Avenue, S n Rafael, CA 94901 10/20/2011 Shelly Cade RIND Police Officer 58.17 433.71 RCOM C/o: San Rafael Police Association ❑ OTH City of San Rafael 1528 Fifth Avenue ❑PTY San Rafael, CA 94909 Union member's dues received through intermedia iy:qaSnPRaf.el Police Association, 1520 Fifth Avenue, S n Rafael, CA 94901 10/20/2011 Joseph Camins RIND Police Officer 58.17 433.71 EICOM C/o: San Rafael Police Association DOTH City of San Rafael Fifth Avenue ❑ PTY l1529 CA 9491-0 San Rafael, Union member's dues received through int fael, CA 949011 *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 www.netfile.com SUBTOTAL$ 290.85 FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statementcovers period CALIFORNIA to whole dollars. 460 from 09/25/2011 FO M through 10/22/2011 Page 6 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE, ALSO ENTER I D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -OEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 David Casalnuovo BIND Police Officer 58.17 433.71 ❑COM C/o: San Rafael Police Association F-1 OTH 1530 Fifth Avenue [-] PTY City of San Rafael San Rafael, CA 94911 SCC Union member's dues received through intermediarv: q an Rafael Police Association 1520 Fifth Avenue S n Rafael, CA 9490 10/20/2011 Allan Castaneda RIND Police Officer 58.17 433.71 RCOM C/o: San Rafael Police Association El OTH 1531 Fifth Avenue PTY City of San Rafael San Rafael, CA 94912 Union member, rmediarv:qaS:CCRafael Police Association. 1520 Fifth Avenue, San Rafael. CA 94901 10/20/2011 Edward Chin ©IND Police Officer 58.17 433.71 EICOM C/o: San Rafael Police Association OOTH 1532 Fifth Avenue El PTY City of San Rafael San Rafael, CA 94913 Union member's dues received through intermedia qaSnC :`-fan 12afael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Robert Cleland FXIIND Police Officer 58.17 433.71 RCOM C/o: San Rafael Police Association DOTH 1533 Fifth Avenue R PTY City of San Rafael San Rafael, CA 94914 Union member's dues received through intermediary: qanC�Zafael Police Association, 1520 Fifth Avenue, S�, Rafael, CA 94901 10/20/2011 Christopher Coale [�flIND Police Officer 58.17 433.71 F] COM C/o: San Rafael Police Association DOTH City of San Rafael i 1534 Fifth Avenuer_1 PTY San Rafael, CA 94915 Union member's dues received through intermediany:Q§P�Zafaeil Police Association, 15201 Fifth Avenue, San Rafael, CA 949011- *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 www.netfile.com F_ SUBTOTAL$ 290.85 1 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) 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. 460 from 09/25/2011 FORM through 10/22/2011 Page 7 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE In OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE. ALSO ENTER NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JW 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 john Coen BIND Police Officer 58.17 433.71 [:]COM C/o: San Rafael Police Association ❑ OTH 1535 Fifth Avenue ❑ PTY City of San Rafael San Rafael, CA 94916 Union member's dues received through intermediaiv:E]8anCCRafael Police Association, 1520 Fifth Avenue. San Rafael. CA 94901 10/20/2 011 Lori Coen Rx IND Police officer 58.17 433.71 RCOM C/o: San Rafael Police Association EIOTH 1536 Fifth Avenue ❑PTY City of San Rafael San Rafael, CA 94917 iv:E;aSnC E�intermediaafael Union member's dues received � Police Association 1520 Fifth Avenue, S Rafael. CA 94901 10/20/2011 Er ic Cogbill nx IND Police Officer 58.17 433.71 [:]COM C/o; San Rafael Police Association DOTH 1537 Fifth Avenue ❑City PTY of San Rafael San Rafael, CA 94918 Union member's dues received through intermedia :`-San Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2 011 Ryan Coghill [ZIND Police officer 58.17 433.71 R COM C/o: San Rafael Police Association [] OTH City of San Rafael 1538 Fifth Avenue El PTY San Rafael, CA -. 4-19 Union member's dues received throw ediaxy:E;aPRafael Police Association, 1520 Fifth Avenue, S n Rafaei, CA 9490L 0/20/2 oil Thomas Collins RIND Police Officer 58.17 433.71 PCOM C,/o: San Rafael Police Association El OTH City of San Rafael X539 Fifth Avenue PTY San Rafael, CA 94920 .ion member's dues received throe intermedia Jun :'—Sit; Police Association, 1520IFi'. n Rafael, CA 9490R *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 www.netrtle.com I I SUBTOTAL$ 290.85 1 1 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-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 CALIFORNIA to whole dollars. 460 from 09/25/2011 FORM through 10/22/2011 Page 8 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER Ic. NUMBER) CODE ((IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Antonette Cook Fx� I IN D Police Officer 58.17 433.71 ❑ COM C/o: San Rafael Police Association E]OTH 1540 Fifth Avenue El PTY City of San Rafael San Rafael, CA 94921 SCC member's dues received through intermediaiv: qUnion an Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Jaime Correa Rx IND Police officer 58,17 433.71 [:] COM C/o; San Rafael Police Association � OTH 1.541 Fifth Avenue Fj PTY City of San Rafael San Rafael, CA 94922 Union member' rmediaiy:E;aSnCCzafael Police Association. 1520 Fifth Avenue, S Rafael, CA 94901 10/20/2011 David Cron RIND Police officer 58.17 433.71 EICOM C/o: San Rafael Police Association El OTH 1542 Fifth Avenue F� PTY City of San Rafael San Rafael, CA 94923 Union member's dues received through intermedia nv:qaSPi afael Police Association, 1520 Fifth Avenue, Sz n Rafael, CA 94901 10/20/2011 Katherine Cronin RIND Police officer 58.17 433.71 ❑ COM C/o: San Rafael Police Association OTH City of San Rafael 1543 Fifth Avenue PTY San Rafael, CA 94924 Union member's dues received through intermedia iy:qaSnCCRafael Police Association, 1520 Fifth Avenue, San Rafael, CA 9490L 10/20/2011 Ryan De Marta BIND Police officer 58.17 433.71 ncom C/o: San Rafael Police Association [I OTH City of San Rafael 1544 Fifth Avenue F� PTY S" Rafael CA 94925 Union member's Dues received through intermedia ny:QW;afaell Police Association, 1520, Fifth Azenue, SIn Rafael, CA 949011 *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 www.neffile.com SUBTOTAL$ 290.85 1 1 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. 460 from 09/25/2011 FORM through 10/22/2011 Page 9 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE. ALSO ENTER Io NUMBER) OCCUPATION AND EMPLOYER RECEIVEDTHIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Christian Diaz Fxj I IN D Police Officer 58.17 433.71 ncom C/o: San Rafael Police Association nOTH 1545 Fifth Avenue n PTY City of San Rafael San Rafael, CA 94926 Union member's dues received through intermedia rv:qaSnCCRafael Police Association, 1520 Fifth Avenue, San Rafael. CA 9490L 10/20/2011 William Drolla nx IND Police Officer 58.17 433.71 F] COM C/o: San Rafael Police Association FIOTH 1546 Fifth Avenue ❑PTY City of San Rafael San Rafael, CA 94927 Union member's dues received throe intermedia xv:qaSnCCRafael Police Association, 1520 Fifth Avenue. San Rafael, CA 94901 10/20/2011 Christopher Duncan N IND Police officer 58.17 433.71 El Com C/o: San Rafael Police Association DOTH 1547 Fifth Avenue El PTY City of San Rafael San Rafael, CA 94928 Union member's dues received through intermedia xv:qanNafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Scott Eberle nX IND Police officer 58.17 433.71 El COM C/o: San Rafael Police Association ❑ OTH City of San Rafael 1548 Fifth Avenue ❑PTY San Rafael, CA 94929 Union member's dues received through intermedia xy:qSP �afael Police Association, 1520 Fifth Avenue, S n Rafael, CA 94901 10/20/2611 Daniel Fink nX IND Police Officer 58.17 433.71 [j Com C/o: San Rafael Police ASSOC4atJonH [:1 OTH City of San Rafael 1549 Fifth Avenue ❑ PTY San Rafael, CA 94930 jUnion member's dues received through intermedia ny:Q§iY�Zafae..[L.P.o-,-ice Assoc-lation, 1520 Fifth Avenue, SAn Rafael, CA 9490IL *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 www.netrile.com SUBTOTAL$ 296.85 1 1 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) Schedule A (Continuation Sheet) Tvpe or print in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 from 09/25/2011 FORM through 10/22/2011 Page 10 Of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF 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) OF BUSINESS) 10/20/2011 Jeffrey Franzini HIND Police Officer 58,17 433.71 [-] COM C/o: San Rafael Police Association [] OTH 1550 Fifth Avenue El PTY City of San Rafael San Rafael, CA 94931 Union member's dues received through inteLmediaxv: qSCC an Rafael Police Association. 1520 Fifth Avenug, San Rafael, CA 94901 10/20/2011 Millard Garrett nX IND Police officer 58,17 433.71 F] COM C/o: San Rafael Police Association EIOTH 1551 Fifth Avenue F1 PTY City of San Rafael San Rafael, CA 94932 E;SCC Union member's dues received throe intermedia an R fael Police —Association 1520 Fifth Avenue an Rafael CA 9490L 10/20/2011 Justin Graham nx IND Police officer 58,17 433.71 EICOM C/o: San Rafael Police Association OTH 1552 Fifth Avenue PTY City of San Rafael San Rafael, CA 94933 Union member's dues received through intermedia iv:qaSnC(�afael Po -lice Association. 1520 Fifth Avenue, San Rafael 9490L — 10/20/2011 Julie Griffith nX IND Police officer 58'��CA 433.71 ncom C/o; San Rafael Police Association OTH City of San Rafael 1553 Fifth Avenue PTY San Rafael, CA 94934 Union member's dues received through intermedia xy:qaSnP�.fael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Lori Hendricks nX IND Police officer 58.17 433.71 ncom C/o: San Rafael Police Association El OTH City of San Rafael 1554 Fifth Avenue [_1 PTY San Rafael, CA 94935 ermediarly:Q§P�Zafae� 'Uintermedia Police Association, 1520 Fifth Avenue, S]. Rafael, CA 9490L *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 www.netfile.com SUBTOTAL$ 290.85 1 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. 460 from 09/25/2011 FORM through 10/22/2011 Page 11 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER Lb NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Robert Henkle RIND Police Officer 58.17 433.71 EICOM C/oc San Rafael Police Association [-] OTH 1555 Fifth Avenue F-1 PTY City of San Rafael San Rafael, CA 94936 Union member's dues received through intermedia iv: qSCC an Rafael Police Association, 1520 Fifth Avenue, San Rafael. CA 94901 10/20/2011 J. Alexander Holm BIND Police officer 58.17 433.71 ncom C/o: San Rafael Police Association nOTH 1556 Fifth Avenue PTY City of San Rafael San Rafael, CA 94937 cc nion member's dues received �y: q��l Rafael -L _8anafee Police Association, _L520 Fifth Avenue, San Rafael. CA 9490• 1 10/20/2011 Lisa Holton nx IND Police officer 58.17 433.71 [:]COM C/o: San Rafael Police Association OTH 1557 Fifth AvenueCity PTY of San Rafael San Rafael-, CA 94938 ion member's dues received through intermedia ny:qanC(Tafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Kyle Hornstein [XIND Police Officer 58.17 433.71 nCOM C/o: San Rafael Police Association ❑ OTH City of San Rafael 1558 Fifth Avenue PTY San Rafael, CA 94939 Union member's dues received through intermedia qsp� an afae Police Association, 1520 Fifth Avenue, S n Rafael, CA 9490R 10/20/2011 rmothy Horvath FRIIND Police Officer I 56.17 433.71 ROOM C/o: San Rafael Police Association [:] OTH City of San Rafael 1559 Fifth Avenue PTY San Rafael, CA 94940 Union member's dues received through intermediadv:Q§Pf^ Zafael Police Association, 1520, Fifth Avenue, Sal. Rafael CA 9490[ SUBTOTAL$ 191-17S *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 www.netfile.com 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 Statementcove ALIFORNIA to whole dollars. 460 from 09/25/2011 FORM through 10/22/2011 Page 12 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF 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) OF BUSINESS) 10/20/2011 Carl Huber Fxj I N D Police Officer 58*17 433.71 QCOM C/o: San Rafael Police Association [__j OTH 1560 Fifth Avenue PTY City of San Rafael San Rafael, CA 94941 Union member's dues received through intf�_rmediarv:qa':CRafael Police Association, 1520 Fifth Avenue. San Rafael, CA 94901 10/20/2011 Eric Huot LINO Police officer 58.17 433.71 EICOM C/o: San Rafael Police Association � OTH 1561 Fifth Avenue n PTY City of San Rafael San Rafael, CA 94942 Union member's dueqre intermedia qSCC an Rafael Police Association, 1520 Fifth Avenue S 4n Ra-ael. CA 94901 — 10/20/2011 Scott Ingels BIND Police officer 58.17 I 433.71 [:]COM C/o: San Rafael Police Association El OTH 1562 Fifth Avenue PTY City of San Rafael San Rafael, CA 94943 Union member's dues received through intermedia ny:qaS]CR.f.el Police Association, 1520 Fifth Avenue, S n Rafael, CA 94901 10/20/2 011 Gina johnson RIND Police officer 58.17 433.71 ❑Com C/o: San Rafael Police Association El OTH City of San Rafael 1563 Fifth Avenue PTY San R.fa.! CA 94944 , Union member's dues received through intermedia ry:qaSnP� alae l Police Association, 1520 Fifth Avenue, Sin Rafael, CA 9490 10/20/2011 Lynette 1,11,r OX IND Police officer 58.17 433.71 [-ICOM C/o: San Rafael Police Association DOTH City of San Rafael 1564 Fifth Avenue PTY San Rafael,CA 9494S Union member's dues received through internnediany:Q§P�Zafaeli Police Association, 15201 Fifth Avenue, Sdn Rafael CA 9490 *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 www.neffile.com SUBTOTAL$ 290.85 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 I CALIFORNIA to whole dollars. / 60 from 09/2st2011 • RM through 10/22/2011 Page 13 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR ADDRESS CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSNTERLD NUMBER) CODE * (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20t2o11 Rebecca Kuga HIND Police Officer 58.17 433.71 ❑ COM C/o: San Rafael Police Association E] OTH 1565 Fifth Avenue ❑ PTY City of San Rafael San Rafael, CA 94946 nn Union member's dues received through in ermedia :`fan RafaeI Police Association 1520 Fifth Avenue San Rafael CA 94901 10/20/2011 arc Laplante BIND Police Officer 58.17 433.71 COM C/o: San Rafael Police Association [I OTH 1566 Fifth Avenue ElPTY City of San Rafael San Rafael, CA 94947 nn Union member's dues received throu h intermedia :`"fan Rafae Police Association 1520 Fifth Avenue San Rafael CA 9490 10/20/2011 Kimberly Larkey BIND Police Officer 58.17 433.71 ❑ COM C/o: San Rafael Police Association ❑ OTH 1567 Fifth Avenue PTY City of San Rafael San Rafael, CA 94948 Dion member's dues received through intermedia ((�� ; :`-fan (12afae Police Association 1520 Fifth Avenue San Rafael CA 9490 10/20/2011 ndora Lee BIND Police Officer 58.17 433.71 ❑ COM C/o: San Rafael Police Association E] OTH City of San Rafael 1568 Fifth Avenue ❑ PTY San Rafael, CA 94949 Union member's dues received through intermediary:`3an nn (; T�afae Police Association, 1520 Fifth Avenue, S n Rafael, CA 9490 10/20/2011 Rogelio Leon RIND Police Officer 58.17 433.71 ❑ COM C/o: San Rafael Police Association ❑ OTH City of San Rafael 1569 Fifth Avenue PTY San Rafael, CA 94950 nion member's dues received through intermedia (—j Q T {�C Kafae Police Association 15201 Fifth Avenue San Rafael CA 9490r '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 SUBTOTAL$ 290.85 I; 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 to whole dollars. / 0 ' from 09/25/2011 through 10/22/2011 page 14 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE, ALSO ENTER ID NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE {IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Eugene Lew X IND Police Officer 58.17 433.71 O COM C/o: San Rafael Police Association O OTH 1570 Fifth Avenue O PTY City of San Rafael San Rafael, CA 94951 Union member's dues received through intermediaiv:qanCRafael Police Association 1520 Fifth Avenue S n Rafael CA 9490 10/20/2011 Kevin Macdougall BIND Police Officer 58.17 433.71 [:]COM C/o: San Rafael Police Association O OTH 1.571 Fifth Avenue ❑ PTY City of San Rafael San Rafael, CA 94952 (� (; Union, member's dues received throe h intermedia :`'San 4Rafae Police Association 1520 Fifth Avenue S n Rafael CA 9490 10/20/2011 Robin Mark -White OgIND Police Officer 58.17 433.71 O COM C/o: San Rafael Police Association O OTH 1572 Fifth AvenueOP Y 1.Y City of Sari Rafael San Rafael, CA 94953 II�� Union member's dues received through intermedia :`-San 72afae Police Association 1520 Fifth Avenue Stn Rafael CA 9490 10/20/2011 ichael Mathis RIND Police Officer 58.17 I 433.71 O COM C/o: San Rafael Police Association OTH City of Sari Rafael � 1573 Fifth Avenue El PTY San Rafael, CA 94954 Union member's dues received through intermediary:[;anCCRafael Police Association, 1520 Fifth Avenue, S n Rafael, CA 9490 1G120f20ll Kelly Maisel DIND Police Officer 58.17 433.71 O COM C/o: San Rafael Police Association O OTH City of San Rafael 1574 Fifth Avenue O PTY Sar. Rafael, CA 94955 n1�I {C��{{'�� Union member's dues received throu h intermedia :'--3§PtZafae Police Association 1520 Fifth Avenue S�n Rafael CA 9490 *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 www.netrile.com SUBTOTAL$ 290.85 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULEA (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. 460 from 09/25/2011 FORM through 10/22/2011 Page 15 Of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION (IF COMMITTEE, ALSO ENTER Io NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JW 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Glenn Mcelderry NIND Police Officer 58.17 433.71 EICOM C/O: San Rafael Police Association r_1 OTH 1575 Fifth Avenue [:] PTY City of San Rafael San Rafael, CA 94956 Union member's dues received through intermediaxv: qSCC an Rafael Police Association, 1520 Fifth Avenue, S Rafael. CA 94901 10/20/2 IT, Lisa Mcelroy Rx IND Police Officer 58.16 433.66 [:] COM C/o: San Rafael Police Association MOTH 1576 Fifth Avenue F] PTY City of San Rafael San Rafael, CA 94957 E;SCC Union member's dues received through intermediaiv: an Rafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Phillip Melodia BIND Police Officer 58.16 433.66 OCOM C/o: San Rafael Police Association ❑ OTH 1577 Fifth Avenue El PTY City of San Rafael San Rafael, CA 94958 C union member's dues received through intermedia :`-San Rafael Police Association, 1520 Fifth Avenue, S n Rafael, CA 94901 10/20/2011 Beth Minka RIND Police Officer 58.16 433.66 ❑Com C/o: San Rafael Police Association [1 OTH 1578 Fifth Avenue El PTY City of San Rafael San Rafael, CA 94959 Union member's dues received through intermediary: q J'P�.fael Police Association, 1520 Fifth Avenue, San Rafael, CA 9490L 10/20/2011 Alexis Nielsen [ZIND Police Officer 58.16 433.65 [-I COM C/o: San Rafael Police Association DOTH 1158 0 Fifth Avenue 0 PTY City of San Rafael Can Rafael, CA 94961 Tan member's dues received through intermedia il ly :Zafae[L Police Association, 1520 Fifth Avenue, San Rafael, CA 9490L *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 www.neffile.com SUBTOTAL$ 1 290.81 [ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Tvne or orint in ink. SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statementcovers period CALIFORNIA to whole dollars. 460 from 09/25/2011 FORM through 10/22/2011 Page 16 of 33 I.D. NUMBER NAME OF FILER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF 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 (JW 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Leslie O'Toole [XIND Police officer 58.16 433.65 OCOM C/o: San Rafael Police Association E] OTH 1581 Fifth Avenue R PTY City of San Rafael San Rafael, CA 94962 Cron member's dues received through int rmediarv:qaS nCiizafael Police Association. 1520 Fifth Avenue, San Rafael. CA 94901 10/20/2011 Nicola Pata EZ IND Police officer 58.16 433.65 ncom C/o: San Rafael Police Association F OTH 1582 Fifth Avenue F] PTY City of San Rafael San Rafael, CA 94963 member's dues received throe intermedia qaSnNafael Police Association 1520 Fifth Avenue San Rafael CA 9490 -Union 10/20/2 011 Raff-ello Pata BIND Police Officer 58.16 433.65 [:] COM C/o: San Rafael Police Association [j OTH 1583 Fifth Avenue PTY City of San Rafael San Rafael, CA 94964 member's dues received through interinedlaiv:E42�afael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 -Union 10/20/2011 Brian Patterson [N IND Police officer 58.16 433.65 ❑ COM C/o: San Rafael Police Association ❑ OTH City of San Rafael 1584 Fifth Avenue PTY San Rafael, CA 94965 member's dues received throe throe intermedia ry: qJSnC(;afe1 _Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 -Union 10/20/2011 Buffy Paxson RIND Police officer 58.16 433.65 R COM C/o: San Rafael Police Association OTH City of San Rafael 1585 Fifth Avenue ❑ PTY San Rafael, CA _94966 d through intermediar1v:Q§Fqzafae11 Police Association, 1520 Fifth Avenue Son Rafael, CA 94901l Union member's dues receive *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 www.netfile.com SUBTOTAL$ 290-80 1 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Tvpe or print in ink. SCHEDULEA (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period I CALIFORNIA to whole dollars. 460, from 09/25/2011 FORM through 10122/2011 Page 17 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 IF AN INDIVIDUAL. ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF 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) OF BUSINESS) 10/20/2011 Aaron Piombo RIND Police Officer 58.16 433,65 EICOM C/o: San Rafael Police Association � OTH 1586 Fifth Avenue Ej PTY City of San Rafael San Rafael, CA 94967 Union member's dues received through int�ermediary:qaSnCCRafael Police Association. 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Alan Piombo RIND Police officer 58.16 433.65 ocom C/o: San Rafael Police Association El OTH 1587 Fifth Avenue El PTY City of San Rafael San Rafael, CA 94968 nion member's dues received throe intermedia :qaSnCCRaf.el Police —Association 1520 Fifth Avenue San RafaelCA94901 10/20/2 oil Kenneth Poehlman RIND Police officer 58.16 433.65 El COM C/o: San Rafael Police Association OTH 1.588 Fifth Avenue PTY City of San Rafael San Rafael, CA 94969 S Union member's dues received through intermedia rv:E;anCCRafael Police Association, 1520 Fifth Avenue, S n Rafael, CA 9490 10/20/2 011 Dennis Prince FXj IND Police Officer 58.16 433.65 ❑ COM C/o: San Rafael Police Association ❑ OTH City of San Rafael 1189 Fifth Avenue El PTY San Rafael, CA 94970 Union member's dues received through intermedia xy:qaSnC RzafaeR Police Association, 1520 Fifth Avenue, S Rafael, CA 94901 — 10/20/2011 Ronda Reese FX -1 I N D IPolice Officer 58.16 433.65 ncom C/o: San Rafael Police Association [_1 OTH City of San Rafael 1590 Fifth Avenue PTY San Rafael, CA 94971 Rafael, CA 9490L ,or member's dues received through irtermediarly:LAF _�Zafaei Police Association, 1520 Fifth Avenue_S�c *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 www.netfile.com SUBTOTAL$ 290.80 1 1 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 CALIFORNIA to whole dollars. 11 460 from 09/25/2011 FORM through 10/22/2011 Page 16 Of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE OF COMMITTEE. ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Peggy Ruge BIND Police Officer 58.16 433.65 OCOM C/o: San Rafael Police Association E] OTH 1592 Fifth Avenue ❑PTY City of San Rafael San Rafael, CA 94973 nion member's dues received through intermedia xv:qanCCRafae1 Police Association, 1520 Fifth Avenue. San Rafael, CA 94901 10/20/2011 Travis Ruggles RIND Police Officer 58.16 433.65 EICOM 7 : I C/o: San Rafael Police Association ❑ OTH 1593 Fifth Avenue ❑ PTY City of San Rafael San Rafael, CA 94974 nion member's dues re mediary:aSnCCRafae1 q Police Association. 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Thomas Sabido rx� IND Police Officer 58.16 433.65 OCOM C/o: San Rafael Police Association DOTH 1594 Fifth Avenue ❑City PTY of San Rafael San Rafael, CA 94975 C Union member's dues received through intermedia rv:qaSnC?afae1 Police Association, 1520 Fifth Avenue, S,n Rafael, CA 94901 10/20/2011 George Schikore NIND Police Officer 58.16 433.65 [:]COM C/o: San Rafael Police Association [:1 OTH I695 Fifth Avenue PTY City of San Rafael San Rafael, CA 94976 Union member's dues received through intermediary: qE] a:CR.fael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Justin Schraeder RIND Police Officer 58.16 433.65 DCOM C/o: San Rafael Police Association DOTH City of San Rafael 1596 Fifth Avenue ❑ PTY San Rafael, CA 94977 IUnion member's dues received through intermediany:QW;afaell Police Association, 15201 Fifth Avenue, Sain Rafael, CA 9490l *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 17777 =0 Wra =0 SUBTOTAL$ 290.80 1 1 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-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 CALIFORNIA to whole dollars. 460 from 09/25/2011 FORM through 10/22/2011 Page 19 Of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE (IF COMMITTEE, ALSO ENTER 1.0, NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN- 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Wanda Spaletta RIND Police Officer 58,16 433.65 El COM C/o: San Rafael Police Association r-1 OTH 1597 Fifth Avenue F] PTY City of San Rafael San Rafael, CA 94978 Union member's dues received through intermediaxv: qSCC an Rafael Police -Association, 1520 Fifth Avenue, San Rafael. CA 9490L 10/20/2011 David Starnes BIND Police Officer 58.16 433.65 [:]COM C/o: San Rafael Police Association F-1 OTH 1598 Fifth Avenue F] PTY City of San Rafael San Rafael, CA 94979 Union member's dues received throucih intermedia rv:E;aS nCCRafael Police Association 1520 Fifth Avenue. S Rafael, CA 94901 — 10/20/2011 Christopher Sweeney [ZIND Police Officer 58.16 433.65 [:] COM C/o: San Rafael Police Association El OTH 1599 Fifth Avenue E] PTY City of San Rafael San Rafael, CA 94980 Union member's dues received through intermedia rv:qanCCRafael Police Association, 1520 Fifth Avenue, San Rafael, CA 94901 10/20/2011 Charly Taylor FXJ IND Police Officer 58.16 433.65 ❑ COM C/o: San Rafael Police Association ❑ OTH 1600 Fifth Avenue ❑PTY City of San Rafael San Ra�..l , CA 94981 Union member's dues received through intermedia xy:qa":C(�afael Police Association, 1520 Fifth Avenue, San Rafael, CA 9490 10/20/2011 Chuck Tirre [E IND Police Officer 58.16 433.65 F-1 COM C/o: San Rafael Police Association El OTH City of San Rafael Fifth Avenue El PTY L" -'1601 San Rafael, CA 94982 ,'on member's dues received throw intermedia :QW; Police Association, 15201 Fifth AVE n Rafael, CA 949013- 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 www.netfile.com I SUBTOTAL$ 290.80 1 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_ to whole dollars. / � ' from 09/25/2011 • RM through 10/22/2011 Page 20 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO ENTER LD.NUMB CODE* (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 10/20/2011 Michael vergara RIND Police Officer 58.16 433.65 ❑ COM C/o: San Rafael Police Association [:] OTH 1602 Fifth Avenue E] PTY City of San Rafael San Rafael, CA 94983 nl�i Union member's dues received through interm dia :''San Rafae Police Association, 1520 Fifth Avenue San Rafael CA 9490L 10/20/2011 Kathleen Wata FDND Police Officer 58.16 433.65 ❑ COM C/o: San Rafael Police Association OTH 1603 Fifth Avenue PTY City of San Rafael San Rafael, CA 94984 �j Union member's dues received throu h intermedia :`'San Rafae Police Association 1520 Fifth Avenue San Rafael CA 9490 ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH PTY ' ❑SCC '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 www.netfile.com SUBTOTAL$ 116.32 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Schedule D WWWFallmillffill Summary of Expenditures Type or print in ink. Statement covers period Amounts may roundedCALIFORNIA � 1f Supporting/Opposing{ether of t0 whole dollars. � •' from 09/25/2011 Candidates, Measures and Committees through 10/22/2011 page 21 of 33 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 CUMULATIVE TO DATE PER ELECTION DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CALENDAR YEAR TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IE REQUIRED) PERIOD (JAN 1 -DEC, 31) (IF REQUIRED) OR COMMITTEE 10/17/2011 rew Mccu oug Mailer including 4,648.67 13,542.76 G 11 13,542. ❑ Monetary production and postage in Contribution support of Andrew McCulloughfor San Rafael City Council Member Council City of San Rafael, CA ❑ NonmonetaryCity Contribution 171 Independent x❑ Support ❑ Oppose Expenditure 10/17/2011 Damon Connolly ❑ Monetary Mailer including production and postage in 4,648.67 14,642.76 Gil 14,642. Contribution support of Damon Connolly City Council Member for San Rafael City Council City of San Rafael, CA ❑ Nonmonetary Contribution n Independent © Support ❑ Oppose Expenditure :.0/17/2011 Cary PhillipsMailer including 4,648.66 20,115.73 G-11 20,115. Monetary E] production and postage in support of Gary PhilYips Contribution for San Rafael Mayor. Mayor City of Sar, Rafael, CA ❑ Nonmonetary Contribution Q Independent x❑ Support ❑ Oppose Expenditure SUBTOTAL $ 13,946.0 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) . 2. Unitemized contributions and independent expenditures made this period of under $100..................................................................... 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ......... www.netfile.com $ 26,892.00 ............ $ 0.00 TOTAL $ 26,892.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) 76 76 73 Schedule D (Continuation Sheet) Type or print in ink. SCHEDULE D (CONT.) Amounts may be rounded Summary of Expenditures Statement covers period CALIFORNIA to whole dollars. 460 Supporting/Opposing Other 09/25/2011 FORM from Candidates, Measures and Committees through 10/22/2011 Page 22 - of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REQUIRED) PERIOD (JAN 1 -DEC 31) (IF REQUIRED) OR COMMITTEE 10/19/2011 Gary Phillips Mailer including 6,473 .00 20,115.73 G 11 20,115. ❑ Monetary Production and postage Mayor Contribution phi llipsposuprtfor of Gary San Rafael City of San Rafael, CA ❑ Nonmonetary Mayor. Contribution Independent nx Support F1 Oppose Expenditure 1_0/19/20,1 Greg Brockbank Mailer including 6,473 .06 6,473.00 Gil 6,473, ❑ Monetary production and postage Mayor Contribution in opposition to Greg Brockbank for San Rafael City of San Rafael, CA ❑ Nonmonetary Mayor Contribution Independent E] Support Q Oppose Expenditure ❑ Monetary Contribution E] Nonmonetary Contribution E] Independent ❑ Support E] oppose Expenditure ❑ Monetary Contribution Nonmonetary Contribution ❑ Independent E] Support ❑Oppose Expi nditure SUBTOTAL $ 112,946.0 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) FIFT7TWITI—WIM Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER San Rafael Police Association Political Action committee Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 09/25/2011 through 10/22/2011 Page 23 of 33 I.D.NUMBER 831553 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/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 (intemet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3 , 000.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).. ... .......... ....... ................ ........ . ....... ..................................... .......... $ 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)............................................................................... $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ www.netfile.com 27,097.72 2.00 0.00 2?,099.71 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE. ALSO ENTER I.D. NUMBER) Freeman Public Affairs, Inc. IND Phone calls in support of Andrew McCullough for San Rafael 1,000.00 City Council 1405 Marcelina Avenue, Suite 111 Torrance, CA 90501 Freeman Public Affairs, Inc. IND Phone calls in support of Damon Connolly for San Rafael 1,000.00 City Council 1405 Marcelina Avenue, Suite 111 Torrance, CA 90501 Freeman Public Affairs, Inc. IND Phone calls in support of Gary Phillips for San Rafael Mayor 1,000.00 1405 Marcelina Avenue, Suite 111 Torrance, CA 90501 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3 , 000.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).. ... .......... ....... ................ ........ . ....... ..................................... .......... $ 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)............................................................................... $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ www.netfile.com 27,097.72 2.00 0.00 2?,099.71 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E SCHEDULE E (CONT.) Type or print in ink. Statement covers period (Continuation Sheet) Amounts may be roundedCALIFORNIA Payments Made to whole dollars. 1 460 09/25/2011 FORM M from through 10/22/2011 Pae 24 of 33 SEE INSTRUCTIONS ON REVERSE g NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/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 IAD 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) * Payments that are contributions or independent expenditures mustalso be summarized on Schedule D. SUBTOTAL $ 19, 833.58 FPPC Form 464 (January/45) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.neffile.com NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER LD. NUMBER) Freeman Public Affairs, Inc. Mailer including production and postage in support ol Gary Phillips for San Rafael Mayor 1405 Marcelina Avenue, Suite 111 IND 3,845.41 Torrance, CA 90501 Freeman Public Affairs, Inc. Mailer including production and postage in support o Andrew McCullough for San Rafael City Council 3,845.42 1405 Marcelina Avenue, Suite til IND Torrance, CA 90501 Freeman Public Affairs, Inc. Mailer including production and postage in support ol Damon 1405 Marcelina Avenue, Suite 111 IND Connolly for San Rafael City Council 3,845.42 Torrance, CA 90501 Freeman Public Affairs, Ino. Mailer including production and postage in support ol Gary Phillips for San Rafael Mayor n _,148.66 1405 Marcelina Avenue, Suite 111 SND Torrance, CA 90501 Freeman Public Affairs, Inc. Mailer including production and postage in support ol Damon IND (Connolly for San Rafael City Council 4,148.67 1405 Marcelina Avenue, Suite 1... Torrance, CA 90501 I I * Payments that are contributions or independent expenditures mustalso be summarized on Schedule D. SUBTOTAL $ 19, 833.58 FPPC Form 464 (January/45) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.neffile.com Schedule E Type or print in ink. (Continuation Sheet) Amounts may be rounded Payments Made to whole dollars. ON REVERSE NAME OF FILER San Rafael Police Association Political Action Committee Statement covers period from — 09/25/2011 through 10/22/2011 SCHEDULE E(CONT) Page 25 of 33 I.D. NUMBER 831553 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphernalia/mise. 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 Gable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FIND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals M 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 I IT rAmnaion literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER 10 NUMBER) Freeman Public Affairs, Inc. Mailer including production and postage in support ol Andrew McCullough for San Rafael City Council 1405 Marcelina Avenue, Suite ill Torrance, CA 90501 IND 4,148,67 Michael Math's Reimbursed expense under the $SOO Schedule G thresho.d 115.46 C/o: San Rafael Police Association, 1573 Fifth Avenue OFC San Rafael, CA 94954 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4,264 .13 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.netfile.com Type or print in ink. Schedule F Amounts may be rounded Statement covers period Accrued Expenses (Unpaid Bills) to whole dollars. from 09/25/2011 through 10/22/2011 SEE INSTRUCTIONS ON REVERSE SCHEDULEF Page 26 of 33 NAME OF FILERI I.D. NUMBER San Rafael Police Association Political Action Committee 831553 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/mise. 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 camaaian literature and mailings PRT print ads WEB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 4,514.70 $ 0 .00 $ 3,845.42$ 669.28 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ................................ 2. Total accrued expenses paid this period. (include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) .......... 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) .._ .. ........ .... .............. ........... .................... ............. _......... .................. www.netfile.com ............ INCURRED TOTALS $ 26 892.00 PAID TOTALS $ 26, 982.25 NET 90.25 May be a negative number FPPG Form 460 (January/05) FPPG Toll -Free Helpline: 866/ASK-FPPG (866/275-3772) (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE: ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Henry C. Levy & Company PRO 6.73 0.00 0.00 6.73 5940 College Avenue Oakland, CA 94618 Henry C. Levy & Company PRO 662.55 0.00 0.00 662.55 5940 College Avenue Oakland, CA 94618 Freeman Public Affairs, Inc_ IND Mailer including 3,845.42 0.00 3,845.42 0.00 production and postage in support of Andrew 1405 Marcelina Avenue, Suite ill McCullough for San Torrance, CA 90501 Rafael City Council * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 4,514.70 $ 0 .00 $ 3,845.42$ 669.28 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ................................ 2. Total accrued expenses paid this period. (include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) .......... 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) .._ .. ........ .... .............. ........... .................... ............. _......... .................. www.netfile.com ............ INCURRED TOTALS $ 26 892.00 PAID TOTALS $ 26, 982.25 NET 90.25 May be a negative number FPPG Form 460 (January/05) FPPG Toll -Free Helpline: 866/ASK-FPPG (866/275-3772) Schedule F Type or print in ink. SCHEDULE F (CONT.) Amounts may be rounded Statement covers period CALIFORNIA (Continuation Sheet) to whole dollars. i • 1 FORM Accrued Expenses (Unpaid Bills) from 09125{2011 through 10/22/2011 Page 27 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/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 GVC civic donations PEr 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 FIND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals W 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. 0.00 3,845.41 SUBTOTALS $ -5,988.--6 $ 0.00 $ 15,988.16$ 0.00 FPPC Form 460 (January/05) FPPC Tall -Free Helpline: 8661ASK-FPPC (8661275-3772) www.netfile.com (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I . NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Freeman Public Affairs, Inc. IND Mailer including 3,845.42 0.00 3,845.42 0.00 production and E}ostaae in support of for 1405 Marcelina Avenue, Suite 111 Damon Connoii San Rafael City Torrance CA 90501 Council Freeman Public Affairs, Inc. IND Mailer including 3,845.41 0.00 3,845.41 0.00 production and Avenue, Suite 111 arta_h in Sup ort of Phillips por San 1405 Marcelina Torrance CA 90501 y Rafael Mayor Freeman Public Affairs, Inc. IND Mailer including 4,148.66 0.00 4,148.66 0.00 production and 1405 Marcelina Avenue, Suite 111 postaoe in support of Gary Phillips or Sari Torrance CA 90501 Rafael Mayor Freeman Public Affairs, Inc. I2v'D Mailer including 4,148.67 0.00 4,148.67 0.00 production and 1405 Marcelina Avenue, Suite 111 postage in support of 'Torrance CA 90501 Damon. Connoiifor I San Rafael Ci4 I Council SUBTOTALS $ -5,988.--6 $ 0.00 $ 15,988.16$ 0.00 FPPC Form 460 (January/05) FPPC Tall -Free Helpline: 8661ASK-FPPC (8661275-3772) www.netfile.com Schedule F Type or print in ink. SCHEDULE F (CONT.) Amounts may be rounded Statement covers period CALIFORNIAA (Continuation Sheet) to whole dollars. i Accrued Expenses (Unpaid Bills) from 09125/toll FORM through 10/22/2011 Page 28 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/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 PEr 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS $ 7, 148.67 $ 0.00 $ 7, 148.67$ 0.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) www.netfile.com (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE. ALSO ENTER I O NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Freeman Public Affairs, Inc. IND Mailer including 4,148.67 0.00 4,148.67 0.00 production and postage ir_ support of 1405 Marcelina Avenue, Suite ill Andrew MCCullough for Torrance CA 90501 San Rafael City Council Freeman Public Affairs, Inc. IND Phone calls in 1,000.00 0.00 1,000.00 0.00 support of Andrew 1405 Marcelina Avenue, Suite 111 McCullough for San Rafael City Council Torrance CA 9G501 Freeman Public Affairs, Inc. IND Phone calls in I 1,000.00 0.00 1,000.00 0.00 support of Damon 1405 Marcelina Avenue, Suite III r Connol_ faSan Torrance CA 90501 City Council Rafael Ci Freeman Public Affairs, Inc. IND Phone calls in ; 1,000.00 O.GO 1,000.00 0.00 14055 Marce?ina Avenue, Suite 111 support of Gary Phillips for San Torrance CA 90501 Rafael Mayor ! I I SUBTOTALS $ 7, 148.67 $ 0.00 $ 7, 148.67$ 0.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) www.netfile.com Schedule F Type or print in ink. SCHEDULE F (CONT.) Amounts may be rounded Statement covers period CALIFORNIA (Continuation Sheet) to whole dollars. FORM 460 Accrued Expenses (Unpaid Bills) from 49/25/2011 through 10122/2011 Page 29 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/mise. 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 supportinglopposing 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 (intemet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS$ 0.00 $ 20,419.00$ 0.00$ 20,419.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) wrww.netfile.com ( t NAME AND ADDRESS OF CREDITOR CODE OR OUTS AMOUNTINCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE. ALSO ENTER I . NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Freeman Public Affairs, Inc. IND Mailer including 0.00 4,648.67 0.00 4,648.67 production and postage in support of 1405 Marcelina Avenue, Suite 111 Andrew McCullough for Torrance CA 90501 San Rafael City Council Freeman Public Affairs, Inc. IND Mailer including 0.00 4,648.67 0.00 4,648.67 production and Suite 111. peatage in support of for 1405 Marcelina Avenue, Torrance CA 90501 Damon Conr_oll San Rafael City Council Freeman Public Affairs, Inc. IND Mailer including 0.00 4,648.66 0.00 4,648.66 production and 1405 Marcelina Avenue, Suite 111 postage in support of Terrance CA 90501 Gary Phillips or San Rafae- Mayor. Freeman Public Affairs, Inc. IND Mailer ircludina_ 0.00 6,473.00 0.00. 6,473.00 j production and 1405 Marcelina Avenue, Suite ill{ poStag in support Of Torrance CA 90503 jf Cary I,hi_iips or San Rafa. Mayor. e I SUBTOTALS$ 0.00 $ 20,419.00$ 0.00$ 20,419.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) wrww.netfile.com scxsouLsp(Czrwr) Schedule F Type or print in ink. Amounts may be rounded Statement covers period (Continuation Sheet) to whole dollars. CALIFORNIA A60 FORM Accrued Expenses (Unpaid Bills) from 09/25/2011 through 10/22/2011 Page 30 of 33 NAME OF FILER I.D. NUMBER San Rafael Police Association Political Act-= Committee 831553 CODES: If one of the following codes accurately describes the payment, you may enter the code. Othenwoe, describe the paymenL CMP campaignpam;hemnlia/misc MBR member communications RAD radio airtime and production costs mNS campaign consultants MTG meetings and appearances mo returned contributions CTB contribution (explain nnnmunatary)^ OFC ommo expenses SAL campaign workers' salaries cvo civic donations ns petition circulating TEL tx o,cable airtime and vumucuun oomv nL candidate filing/ballot fees pmr phone banks TRC candidate travel, lodging, and meals pwo mrmmiomo events pnL polling and survey research Tma stamspouseuavo/. |vxuinn, and meals IND independent expenditure xuppvmnompvvnmo others (explain)* pon postage, delivery and messenger nnrv/000 TSF transfer oemmon committees of the same candidate/sponsor uss legal defense pmOpmmov|vna|oewico, (|noa|, accounting) voT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (/mamet.e-mao) * Payments thatare contributions or independent expenditures mustalso be summarized on Schedule D. NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT INCURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCEATCLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Freeman Public Affairs, Inc. IND Mailer Inc luding 0.00 6,473.00 0.00 6,473.00 production and Torrance CA 90501 San Ra el Mayor. � SUBTOTALS $ 0.0c $ 6,473.00 $ 0.00$ 6'473,00 FPPC Form 460(Januarym5) pppcToll-Free Helpline: uomAan-Fppc(8uamr5-xrru) Schedule G Type or print in ink. SCHEDULE Payments Made by an Agent or Independent Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 460 Contractor (on Behalf of This Committee) from 09/25/2011 FORM through 10/22/2011 Page 31 Of 33 SEE INSTRUCTIONS ON REVERSE NAME OFFILERI.D. NUMBER San Rafael Police Association Political Action Committee 831553 NAME OF AGENT OR INDEPENDENT CONTRACTOR Freeman Public Affairs, Inc. CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphernalia/mise. MBR member communications RAD radio airtime and production costs CNS campaign consultants MITG 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 M independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads V\EB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER LD NUMBER) U.S, Postmaster IND Postage for mailer in support of 2,100.00 Gary Phillips for San Rafael Mayor 1433 Marcelina Avenue Torrance CA 90501 U -S. Postmaster IND Postage for mailer in support of 2,100.00 Damon Connolly for San Rafael City 1433 Marcelina Avenue Council Torrance CA 90501 U.S. Postmaster IND Postage for mailer in support of 2,100.00 Andrew McCullough for San Rafael 1433 Marcelina Avenue City Council Torrance CA 90501 U.S. Postmaster IND Postage for mailer in support of 3,150,00 Gary Phillips for San Rafael Mayor 1433 Marcelina Avenue Torrance CA 90501 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 9,450.00 * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. www.netfile.com FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule G Type or print in ink. --------T SCHEDULE Payments Made by an Agent or Independent Amounts may be rounded Statement covers periodCALIFORNIA A Contractor (on Behalf of This Committee) to whole dollars. from 09125/2011 — FORM -r60 through 10/22/2011 - _ Page — 32 of 33 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER San Rafael Police Association Political Action Committee 831553 NAME OF AGENT OR INDEPENDENT CONTRACTOR Freeman Public Affairs, Inc. CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW Campaign paraphernalia/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 FIND 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D.NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID U.S. Postmaster 1433 Marcelina. Avenue Torrance CA 90501 IND Postaae for mailer in opposition to Greg Brockbank for San Rafael Mayor 3,150.00 Attach additional information on appropriately labeled continuation sheets, TOTAL* $ 3,150.00 * Do not transfer to any other schedule or to the Summary Page, This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. www.netfile.com FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) Qt-hchrixoUgmU ocnFoo/p/ -----_'- .,,--,-_''- Miscellaneous Increases to Cash Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 09/25/2011 through 10/22/201-1 CALIFORNIAA FORM -v60 Page 33 of 33 NAME OF FILER San Rafael Police Association Political Action Committee I.D. NUMBER 831553 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER It NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additional information nnappropriately labeled continuation sheets. Schedule ASummary 1.Itemized increases to cash this period. .... .............. -............................................ --................. -' 2.Unitemizedincreases to cash of under $1OOthis period ............... ___ .............. ___ ...... ....... ... ...... 3. Total of all interest received this period on kmno made to others, (Schedule H. Column (e)j --- 4. Total miscellaneous increases tocash this period. (Add Lines 1. 2. and 3. Enter here and onthe wwxnetfilocom SUBTOTAL $ 0.00 -----$ 0.00 -----G ozo -----$ » .00 TOTAL $ uzo FPPC Form wm(January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)